Should The Government Compensate Kidney Donation? by Alex Tabarrok, Foundation For Economic Education

It’s not a market, but is it better than prohibition?

The latest issue of the American Journal of Transplantation has an excellent and comprehensive cost-benefit analysis of paying kidney donors, by Held, McCormick, Ojo, and Roberts.

Earlier, Becker and Elias estimated that a payment of $15,000 per living donor would be sufficient to eliminate the US waiting list. The authors adopt a larger figure of $45,000 for living donors and $10,000 for deceased donors and find that even at these rates paying donors generates benefits far in excess of costs.

In particular, a program of government compensation of kidney donors would provide the following bene?ts (quoting from the article):

  • Transplant kidneys would be readily available to all patients who had a medical need for them, which would prevent 5,000 to 10,000 premature deaths each year and signi?cantly reduce the suffering of 100,000 more receiving dialysis.
  • This would be particularly bene?cial to patients who are poor and African American because they are considerably over-represented on the transplant waiting list. Indeed, it would be a boon to poor kidney recipients because it would enable them to reap the great bene?ts of transplantation at very little expense to themselves.
  • Because transplant candidates would no longer have to spend almost 5 years receiving dialysis while waiting for a transplant kidney, they would be younger and healthier when they receive their transplant, increasing the chances of a successful transplantation.
  • With a large number of transplant kidneys available, it would be much easier to ensure the medical compatibility of donors and recipients, which would increase the success rate of transplantation.
  • Taxpayers would save about $12 billion each year. Dialysis is not only an inferior therapy for end-stage renal disease (ESRD), it is also almost 4 times as expensive per quality-adjusted life-year (QALY) gained as a transplant.

About Alex Tabarrok

Alex Tabarrok is a professor of economics at George Mason University. He blogs at Marginal Revolution with Tyler Cowen.

Should The Government Compensate Kidney Donation?