New Zealand to Compensate Organ Donors for Lost Earnings

NZ Ministry of Health: People who donate a kidney or part of their liver can now do so knowing they can be fully compensated for lost earnings as a result of their donation surgery.

The Ministry of Health will be implementing compensation for live organ donors from 5 December. People who donate a live organ will be fully recompensed for lost earnings for up to 12 weeks while they recover. This will be paid weekly following the donation surgery. In the past donors received some assistance in the form of a benefit for this.

Former GMU student, Eric Crampton, now Senior Fellow at University of Canterbury had a role in the design.

Hat tip: Frank McCormick.


Does this mean that the value of an organ contributed by someone with high earnings is more valuable than an organ contributed by someone with low earnings? Of course, simply compensating someone for the value of the donated organ is considered unethical, so some method of compensation had to be developed that isn't considered unethical. Does the method developed in New Zealand pass the test? Is there a cap (other than 12 weeks of compensation)? What if the donor is a banker earning millions of dollars a year, 12 weeks of compensation would be a tidy sum. If there's a cap, isn't that simply putting a value on the donated organ?

The system in Australia (which I assume that this is modelled on as health systems in the two countries are aligned in a number of ways) has payments set at the equivalent of minimum wage in Australia, which is just less than AUD20/hour, or close to $700/week. My understanding is that rather than placing a value on the organ, this is an incentive for people to put themselves on the organ donation register; a number of conditions have to be satisfied in order to receive the compensation, e.g. you have to already be employed and you have to take time off work to recover. So the payment isn't for the organ per se; a person who isn't employed can't effectively 'sell their kidney'.

The *cost* of the time they give up is higher. Using the emotion-laden word "value" leads to lots of angst -- but at a *minimum* the cost to the donor is equal to their lost wages.

This article, by a kidney expert, explains why live donor transplants are a very bad idea.

Another factor is lack of deep knowledge and specific education. If someone proposes to me that they are going to remove one of my kidneys, what I hear them say is that they want to cut my renal reserve in half. Now because I understand what happens in normal, healthy aging I know that my renal reserve will be down to ~60% of baseline by the time I'm 75:

Thus, it strikes me as a terrible idea to cut my renal reserve by 50% when I am young (or at any age). Knowing that it will also likely result in hypertension much earlier makes it a complete non-starter. And that leaves out the surgical and medical risks. Unless you were donating to a loved one, you'd have to have a screw loose to give a kidney to a stranger, "just to be nice."

However, explaining this to people, at least in my experience, has no deterrent effect whatsoever. They simply refuse to believe me, minimize the risks, or completely ignore me. It's much the same when I'm asked my opinion about chronic vaping. I know that inhaling the pyrolysis products of propylene glycol, flavoring agents, nicotine and the like are going to be toxic to lung cells. This will cause increased lung cell turnover which can be thought of in the same way as breast and ovarian cell turnover during menstruation: the more cell division the more cell mutation and the more division of stem cells (telomere exhaustion). This results in increased mutations and greater risk of cancer and COPD. COPD is basically a stem cell telomere disease.

Your idea is good but there are more compelling ways of telling it: what's the point of giving a kidney at 35 if you will ask it back (another one) at 65?

Where is the effect on the life expectancy of donors? Show me the data, the rest is nonsense.

Further articles from the same author:

I think this has the links and data requested. I am no expert, but the writer of that is, having worked on transplants for a lot of his career.

He has made a further comment here:

Donor renal reserve from the remaining kidney is expected to grow by at least 50% in the ~year post-production.

Also renal function is not evenly distributed -- my function was close to 200% of normal pre-donation which made me an excellent candidate to donate from the perspective of both my health and the recipient's. With a sufficiently large living donor base, only ideal donors could be used.

Post-production should be post-donation.

This is great news! Now there is room to start making arguments that the unemployed and those with low incomes deserve more.

Hopefully those persuaded by (bad) arguments that "rich people's kidney's aren't worth more" will work to raise the amount paid for poor people's time and risk, rather than capping the benefit to those with higher incomes.

Yes, this will mean that the poor will be more likely to donate (because they see it as relatively valuable), but the value of saving a life is much higher than the cost of the time of almost anyone who donates, as are the true costs to the donor.

It's important to note that this is the New Zealand government acting as a provider of health insurance, not as a regulator. It is perfectly legal in the U.S. for living donors to receive compensation for expenses, including lost wages. But insurers, including government programs, do not provide the money.

It's also worth noting that the failure to provide for lost wages hits hourly workers harder than salaried employees, who can often arrange for paid leave of some sort.

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