Some Good News on Organ Donation

Representative Matt Cartwright (D-PA 17th District) has introduced the Organ Donor Clarification Act. The act would:

  • Clarify that certain reimbursements are not valuable consideration but are reimbursements for expenses a donor incurs
  • Allow government-run pilot programs to test the effect of providing non cash incentives to promote organ donation.  These pilot programs would have to pass ethical board scrutiny, be approved by HHS, distribute organs through the current merit based system, and last no longer than five years.

Importantly the legislation has been endorsed by the American Medical Association and a number of other groups including Fair Allocations in Research Foundation, Transplant Recipients International Organization and WaitList Zero.

See my piece on the organ shortage in Entrepreneurial Economics and previous MR posts for more.

Comments

"Allow government-run pilot programs to test the effect of providing non cash incentives to promote organ donation."

It's gonna take a whole lotta cookies, juice, and stickers to add up to a kidney.

What if we threw in a back massage from Joe Biden?

Angela says W's are better.

Man, I get that stuff from donating blood, much easier.

What would be a good non-monetary incentive to give organ donors? How about giving them special bumper stickers that allow them to drive in HOV lanes? Or exempting them from various safety rules like helmet laws or seatbelt laws?

Parts of South-East Asia give a reduction of sentences for donors.

You can see the Left and the Right coming together to mitigate the prison crisis this way. After all, who could be against it?

How about free health insurance for life?

'to test the effect of providing non cash incentives to promote organ donation'

Well, I can certainly imagine a number of people with time on their hands who would be willing to donate a kidney - a sentence reduction of 5 years, for example. See? - no cash involved. As a matter of fact, suitable donors who turn down such an offer could be denied parole, since they clearly do not share the proper community values for pre-release.

Still better than the comparable non-cash Chinese model, it would seem - 'China has promised to stop harvesting organs from executed prisoners by 1 January, state media report.

It has said for many years that it will end the controversial practice. It previously promised to do so by November last year.

Death row inmates have long served as a key source for transplants.

China has been criticised for taking their organs without consent, but has struggled to encourage voluntary donations due to cultural concerns.

Prisoners used to account for two-thirds of transplant organs, based on previous estimates from state media.

For years, China denied that it used organs from executed prisoners and only admitted to the practice a few years ago.' http://www.bbc.com/news/world-asia-china-30324440

I really don't understand why anyone is allowed to sell any of their possessions. Giving your possessions away I get, but selling them inevitably results in coercion. What if I sell my house and then have problems with my new house? Better to take the money that would have been spent on purchases and assign it all to government-favored groups like doctors and public sector employees, and when someone dies their house may be assigned to you for a minor fee paid to the government housing transfer authority and a private housing transfer expert.

It's almost like humans are not "econs."

(I have no problem with "certain reimbursements are not valuable consideration but are reimbursements for expenses a donor incur." It seems a nice middle ground between the economic ideal and the human aversion.)

There seems to be an easy fix to your perceived problem. Don't include reduced sentences as part of the non-cash incentives allowed.

non cash? So a check, money order or Bitcoin is OK?

Given the frequent use of guns to commit suicide,

We should have an automatic opt in organ donation feature for obtaining gun licenses instead.

This public service announcement and nudge brought to you by the NRA.

Asia has much higher suicide rates and no guns. Its probably the fact that suicide by gun is in everyone's evoke set of ways to die, just as jumping in front of a subway, or going off a tall building or bridge is in Asia. Sure you could affect the rate with changes in access to these things, but that is a short run equilibrium, long run equilibrium makes these efforts futule.

See. You need to change Asian gun laws.

@Justin Kelly, see: https://en.wikipedia.org/wiki/List_of_countries_by_suicide_rate only South Korea supports your 'much higher' thesis. China has less suicides than the USA (possibly under-reporting), Japan is less than India (reincarnation plays a role?), and Greece is way low. Lithuania is always high (well known) possibly more sunlight is needed up there.

@Ray, Japan is quite high too, as for China, check CDC figures which puts them in line with SK and JP, China fudges their numbers.

https://en.wikipedia.org/wiki/Suicide_in_China

Success rate for gun suicides is incredibly high compared to most other modes. How anyone can argue that doesn't lead to more suicides is beyond me. If Asian cultures have higher suicide rates (Asia is not a monolith, many Asian countries don't, but let's ignore that for now), then it's probably safe to assume that making what is arguably the easiest and most effective means of suicide more widely available there would increase the rate of suicide.

> Success rate for gun suicides is incredibly high compared to most other modes.

As opposed to jumping off of buildings bridges and in front of trains? I see this rationalization carted out a lot, also to support the 4x disparity of suicide rates between male and females (men use guns while women use pills!) and yet this disparity is global, extending to places where men don't have guns and women don't have pills (really poor places).

The problem with analyzing a situation at that particular resolution (as in detail) is that there are so many other contributing factors that are unknown and left out you end up cherry picking and/or post hoc analyzing. Its best to just step back and do a more simple analysis.

That would definitely shift the numbers a bit.

3D printed kidneys are coming.

I know, more low hanging fruit.

Reciprocity. If I agree to donate my organs, I go to the front of the line if I need an organ. How close to the front might depend on whether my agreement includes, for example, living kidney donations. Wouldn't that (help) avoid the free rider problem that plagues organ donations?

You need to control for quality, at least in your case.

Maybe you could expand on how your comment would promote organ donations.

2 for one if yours are poor quality, as you have talked about your habits on the site in the past.

Premium for mine. Nothing but the best.

However, there is a moral hazard question here: are we encouraging bad behavior by those who have the moolah to buy other folks body parts. Maybe we ought to nix this idea of parts for sale so as to discourage your bad behavior. In fact, given your previous disclosure, maybe you go to the back of the line.

Or, perhaps, you meet with the Death Panel set up under Obamacare to have them sort this out.

I think you're confusing him with another Ray.

Maybe so. He seems more serious.

Ray,

The first reciprocity program was endorsed in the Bible:

"An eye for an eye, a tooth for a tooth."

You would think that after Australia instituted a two year trial organ payment program two years ago there would be some stories about their effectiveness. How many additional body parts, how much extra cost, were there displacement effects, etc. Found nothing in my search but there must be some evidence.

Did some searching. Australian organ donation rates continue to decline, despite money.

Okay, only loosely related to the post but this is an incredible story

http://www.timesofisrael.com/israeli-doctors-spies-rally-to-save-5-year-old-syrian-girl/

Israel is quietly treating hundreds of Syrian kids who have been hurt in the war. Quietly because releasing their names would mean they and their parents could be killed at home for receiving Israeli care.

So a 5-year-old girl arrives at the hospital and after attending to her wounds, the doctors discover she has cancer. And the only way to save her is to find a relative who can donate bone marrow. A relative is willing but they live in an enemy state that prevents them to Israel. So the doctors call the military and they mount an operation into said country and bring the donor back to Israel.

I fished around for more after reading this and came across an NYT story from 2014 that hundreds of Syrian kids were at the time being treated in Israeli hospitals, all anonymously, because we live in a very messed up world.

Good to hear the good side from there from time to time.

The Minister of Defense resigned out of concern of the rise of "extremist and dangerous elements" taking over the country. I guess the Israelis who travel to non-Western countries aren't commonly among that group, 'cause the ones I've met mostly seemed like pretty reasonable people, if Jewish in all the stereotypical ways.

"Jewish in all the stereotypical ways"

Interesting...
Feel like saying a bit more?

Haggling with poor peasants for 15 minutes to get 2c savings and then bragging to everyone how they got a better deal. Complaining about any lack in service at the same time as demanding the lowest possible price,. Getting angry at the audacity of anyone trying to obtain a premium for a service offered, and spreading negative commentary about anyone who tries to do so (unless it is a Jew who is looking for the premium, in which there can be nothing but praise to be offered).

Coming into peaceful places and being loud and obnoxious, spreading negative attitudes and generally reducing the quality of the atmosphere.

A good source of information on good deals though, especially if meet ones who are more concerned about value than price. I like them, one at a time. Maybe two.

On topic though, I think Israel has a great model for organ donations.

I know very little about this topic. However, why not allow dead people to get paid for organ donation? Basically it is a life insurance policy that costs nothing and you can bequeath the money to your kin.

To be clear, the entities that support this don't matter a bit in the political world. The National Kidney Foundation and other groups that ostensibly represent people with kidney disease are fierce opponents of this, and they are powerful enough that this bill has no chance of being made into law.

Why they oppose this is worth asking

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