THE Dutch health minister, Ab Klink, is considering a recommendation to offer
free health insurance for life to anyone who donates a kidney for transplant.
The award would be quite valuable, worth about $1500 a year or $24,000 in present discounted value (30 yrs, 5% discount rate, no increase in health care costs). Becker and Elias predict a large increase in organ supply at $15,000 so the Dutch are in the ballpark for a good test. More here.
Thanks to Dave Undis of LifeSharers for the pointer.
I bet Austin Powers’ father will have to revise his opinion of the Dutch.
Random reactions:
-I didn’t know Ab Klink was a terrorist! [/organ sale opponent reaction]
-Yeah, but isn’t someone’s expected health care cost going to shoot up when they have to hedge
against a more severe kidney failure event?
-Ab Klink is a pretty weird name, even in Dutch.
It used to be (something) like that. Nowadays everyone practically has the same kind of basic insurance á €100,- per month. You can add some extra insurances for your own special needs, but on average it’s about $1500 for everyone.
What I find interesting is the psychological issue here. In The Netherlands as much as in the rest of the Western world, paying somebody for a body part in an outright commercial transaction is considered unseemly. The present plan is obviously intended to re-frame the reward as a generous gesture of recognition for a citizen who sacrifices a kidney for the common good. The reward is free health insurance, not an annual sum of cash, even though the two are nearly equivalent in a country where health insurance is mandatory and priced within pretty tight regulatory limits. If you replace “free health insurance” by “an annuity,” the proposal immediately sounds a lot weirder, even though it would be pretty much equivalent.
I’m not sure the re-framing has succeeded entirely (the Christian-Democrats are busily criticizing the plan), but the basic insight is probably correct: quid pro quo works, but obscuring the quid pro quo brings political acceptability.
@Robert: There is much to criticize about the present Dutch health insurance system, but coverage of the poor is, as far as I know, actually very good.
Many peoples objection to paying for organ donations stems from the worry that the poor would be desperate enough to sell body parts for short term gain but suffer a long term loss. Offering a reward that has less monetary value to the poor, and that guarantees care for any long term negative effects reduces the worry.
It doesn’t make sense to me, because the one isn’t related to the other (it actually makes the system _more_ expensive). Next year I’ll pay EUR 400 (after taxes) for my health insurance, assuming I don’t use health services. Otherwise I only get anything back if I spend more than EUR 650 on health. And there’s no opt-out because everybody is insured by definition.
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