Let people sell their organs

Richard Lorenc Cofounder, Liberty Markets LLC
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People will do anything for a buck. But should that include selling their internal organs?

According to a new poll by Reason-Rupe, a majority of Americans believe people should be allowed to receive some form of compensation for donating an organ such as a kidney. And why not? Healthy people can live full lives with a single kidney, and thousands of needy patients die each year with their names on transplant waiting lists.

Given this reality, you would think concerned citizens would be jamming the Capitol switchboard with demands that legislators repeal the federal ban on organ reimbursement immediately.

Sadly, the phone lines are clear. Although 55 percent of Americans approve of compensation for organ donation, another 34 percent oppose it (the rest are undecided). Something about exchanging a human body part for cold, hard cash just doesn’t feel right for many people.

Federal legislation continues to reflect this now-minority view. The National Organ Donation Act of 1984 made it a federal crime “for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation.” This covers not only kidneys and other non-renewable organs such as lungs and hearts, but also bone marrow, which our bodies generate continually inside our bones. (The Institute for Justice is now challenging in court another federal act that prohibits compensation for marrow donation.)

Today, if a patient with renal failure wants to acquire a kidney transplant legally, he must put his name onto a national waiting list. The system will then attempt to match the patient with a compatible donor.

According to the Organ Procurement and Transplantation Network, there are 113,842 patients on waiting lists for organ transplantation today. 91,753 of those people are in need of a kidney immediately. In 2011, there were 17,907 total kidney transplants, of which only 600 came from people who donated a kidney altruistically.

The difference between kidneys demanded and kidneys supplied is massive and growing. The sad truth is, the current system requires us to accept that thousands of patients will die waiting for an organ or wait so long that transplantation is no longer viable.

The current system provides no incentives for healthy people to assist needy patients they do not know, and every incentive for them to become criminals.

“This is a solvable problem,” says Ira Brody, the former chief development and communications officer for the National Kidney Registry. “If a reimbursement program were initiated, we would solve the kidney shortage in two years.”

Brody blames forces on both the political left and the political right for turning a blind eye to the idea of compensating kidney donors to increase the supply. Retired, he speaks today on his own behalf.

“I think there’s an unsaid agenda on the right that believes if the sale of organs were allowed, that means your body is your property,” Brody says. “The Evangelical right and the Catholic Church believe you have a lease on your body from God. The big fear is that, if you can sell an organ, prostitution becomes legal, you can use drugs, and women can have abortions.”

The Reason-Rupe poll found no significant correlation between religious affiliation and support for compensating organ donors, but it did find the more highly educated a respondent was, the less likely he will support a compensation regime.

Brody has a theory about those with advanced degrees. “The far left believes this will coerce the poor to sell an organ,” he explains. “Their problem is they don’t like the way the poor are going to spend their money. They think, ‘In a year, this poor person will be in the same place financially, but with one kidney.’”

But where one person sees coercion, others see motivation. Permitting healthy people to receive compensation for donating an organ in a legal, medically sound environment would be a massive improvement over how they must do it underground today.

“If it becomes legal, the mafia can’t deal in organs,” Brody says.

Brody has created a plan that sets a price for living people’s kidneys, which Medicare and private insurance companies will pay upon donation. That price is $40,000.

Though far from being ideal to those who believe supply and demand should dictate the price of an organ donation, this would be an improvement over the current waiting list system. And it would be a knockout punch to the thriving black market in organ sales, which the federal ban actually promoted.

Not only is allowing people to receive compensation for their generosity a good way to allow the supply of organs to meet the demand, but it is also a way to save a whole lot of money.

“If you add up the cost savings of kidney transplants over keeping patients on dialysis, Medicare could save over $100 billion in 10 years,” Brody explains.

As the federal debt continues to grow and sick people die every day lacking the organs they need to live, perhaps it’s time legislation changes to address the unintended consequences of prohibiting mutually beneficial exchange in human body parts.

Richard Lorenc is co-founder of the Liberty Markets Fund for Freedom, a community foundation recruiting small donors to the pro-liberty think tank movement.