How much does a kidney cost? An organ market to end waiting lists

How much does a kidney cost? Gary Becker, Nobel laureate in Economics in 1992 and professor at the University of Chicago, argues that an organ market should be created to solve the problems facing thousands of people waiting for a transplant.

In an article published in The Wall Street Journal together with Julio J. Elías, a professor at the CEMA University in Argentina, the authors believe that a way must be found to increase the supply of organs, which would reduce both waiting times and deaths and would also reduce the suffering of patients. The most effective way to do this would be to give compensation to people who donate organs, which means establishing a market.

Becker and Elías point out that the technology and the number of transplants have grown very fast, but not as fast as the number of patients who need a transplant. These patients face, in addition to a possible death, enormous economic costs. According to his estimates, the total cost of the average 4.5 years to wait for a kidney in the US is $350,000, to which must be added the $150,000 cost of the transplant itself.

In the US, efforts to increase the number of donors, as well as agreements between compatible people to ‘exchange’ their organs in case of problems have not been successful enough to reduce the problem of waiting for patients. The implied consent used in some countries (organs from cadavers are available unless otherwise stated) has also failed to sufficiently increase the supply of organs.

This shortage is not only a problem in the US, but occurs in the vast majority of countries, regardless of the methods used. For this reason, Becker and Elías defend that paying for organs would finally eliminate this imbalance between supply and demand, and also would not imply a very high increase in the total cost of a transplant.

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How much would a kidney cost in a market?

Economics professors have gone a step further and have dared to calculate what the price of a kidney would be, taking into account the risk for the donors, the sick leave that it entails and the possible loss of quality of life. According to their estimates, kidneys should be found at a price of $15,000, although they place the price in a range between $5,000 and $25,000.

Some countries have already allowed the sale of organs. Although the data is not very clear, in Iran the price of a kidney is currently about 4,000 dollars and waiting lists have been practically eliminated. Considering that the median income there is about a quarter of Americans, a simple extrapolation would give a figure similar to the $15,000 that Becker and Elías calculate.

The idea of ​​paying for organs has also reached other countries such as Singapore and Australia, although in these cases only compensation for lost work time is allowed.

Within this supply-demand system for organs, the proposal also includes donors who accept the use of their organs after their death. This section is important, since there are transplants such as heart or lung transplants that obviously can only be done after the death of the donor. The payment would go to the donor’s heirs.

Immoral, ineffective, disgusting…

This idea of ​​paying to donate organs has been highly criticized, both from the world of medicine and from the political and academic world. The main ones are that it would be ineffective, immoral and would also cause the vast majority of donors to be desperately poor people.

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To defend themselves, Becker and Elías believe that the evidence shows that it would be effective. For this they give the example of surrogate mothers, who receive around 20,000 dollars. Regarding immorality, the authors defend that it is a subjective issue, and that it should be pondered that thousands of lives could be saved with the measure and the quality of life of those waiting for a transplant would be improved.

On the fact that the poor will be the main donors, both believe that although this is likely to happen, it is also the poor who currently suffer most from this system. The rich often avoid waiting lists by traveling to other countries such as India or having residence in several states, which allows them to shorten the time for a transplant.

In addition, as the supply would increase, the organs would be more available to people with fewer resources, and it could even be considered to subsidize them with government programs.

I would end up being accepted and applauded

However, Becker and Elías believe that limits must be placed on this system to avoid exploitation and irresponsible behavior. For example, they believe that a period of at least three months should be established before someone can actually donate an organ, giving them time to assess the consequences and be able to back out.

With this new system, altruistic donations would decrease for sure, however, monetary donations for those who need a transplant could be increased.

In its early stages, a market for the trading of organs would seem strange, and many people would even find it repugnant. However, Becker and Elías believe that in time it would be accepted, as the benefits became apparent and eventually people would come to wonder why it has taken so long to do this to end the problem of organ shortages.

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