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Will Paying for Kidneys Reduce the Transplant Wait List?

In a Washington Post column Megan McArdle suggests that we pay people to donate their kidneys as a way on increasing the number of donors and reducing the number of people who must rely on dialysis. Needless to say, to many folks it is attractive to get market relationships into ever more aspects of our lives. However, if we are interested in getting more kidneys, rather than just getting more money for the health care industry, this is likely a bad way to go.

There was a great study done a few years back with child care centers in Israel. As it was, the vast majority of parents picked up their children on time because they knew that being late meant a teacher had to stay late. The study examined what happened if centers charged a small fee to parents for being late to pick up their kids. It turned out that the fee significantly increased the frequency with which parents picked up their kids late.

The explanation offered is that when there was no fee parents felt an obligation not to make teachers stay late. When they paid a fee, they felt that they were compensating with the fee, therefore they didn’t feel guilty about being late.

Would it be the same story with kidneys? It’s hard to say, but people donate now with the idea of providing help to someone in need, often a family member or friend. These donations may well fall off if they know kidneys are readily available for the right price.

For my part, I no longer check off the spot on my drivers’ license to be an organ donor. While I would be very happy if one of my organs could extend the life of a person in need, I remember how Mickey Mantle was pushed to the front of the line to get a liver transplant. The great baseball player had destroyed his liver with a life of hard drinking. Nonetheless, he was pushed to the front of line to get a transplant at the age of 64. He died shortly after the transplant.

I have spent my life trying to combat this sort of sleaze. If some doctors want to get rich providing transplants for the rich and famous, I don’t intend to help them with my death.

This article originally appeared on Dean Baker’s blog.