On why the US should have a market for kidney transplants
The second installment of my finding my extant prejudices supported by Gary Becker. This time it's his excellent article about the reasons why the US should have a paid market for kidney transplants. This is something I've written about here (and elsewhere) in our own UK experience so it's nice to see the work being done all over again for the US.
My very much back of the envelope numbers for the UK were that offering perhaps £20,000 as compensation to a live donor would reduce deaths from kidney disease and at the same time save the NHS a fortune. Beckers's (obviously, more accurate, for he is an economist and I am not) estimate is that the same results could be achieved in the US with a fee of perhaps $15,000:
We have estimated how much individuals would need to be paid for kidneys to be willing to sell them for transplants. These estimates take account of the slight risk to donors from transplant surgery, the number of weeks of work lost during the surgery and recovery periods, and the small risk of reduction in the quality of life. Our conclusion is that a very large number of both live and cadaveric kidney donations would be available by paying about $15,000 for each kidney. That estimate isn't exact, and the true cost could be as high as $25,000 or as low as $5,000—but even the high estimate wouldn't increase the total cost of kidney transplants by a large percentage.
They've also started exactly where I did: with the observation that Iran is the only place in the world without a queue for such trasnplants and Iran is the only place in the world with a paid donation program. It is possible to think that there might be a connection between these two things.
Paying for organs would lead to more transplants—and thereby, perhaps, to a large increase in the overall medical costs of transplantation. But it would save the cost of dialysis for people waiting for kidney transplants and other costs to individuals waiting for other organs.
More important, it would prevent thousands of deaths and improve the quality of life among those who now must wait years before getting the organs they need. Initially, a market in the purchase and sale of organs would seem strange, and many might continue to consider that market "repugnant." Over time, however, the sale of organs would grow to be accepted, just as the voluntary military now has widespread support.
Eventually, the advantages of allowing payment for organs would become obvious. At that point, people will wonder why it took so long to adopt such an obvious and sensible solution to the shortage of organs for transplant.
Or as I have been putting it for some years now, there are some problems that are simply too important not to use markets to solve them.