The Market Value of Your Kidney
What would you charge for one of your kidneys?
If it was a stranger that needed it? If it was a distant cousin? Your son or daughter?
Somewhere along that spectrum the decision is a balance of altruism and coercion. Free will to help family on one end and persuasion of the mighty dollar on the other. Most people would gladly give a kidney to their child in exchange for the feeling of helping someone they love. We have a robust system of carrying this out, a patient is in need and a family member is found to be a suitable donor, so we take out their kidney and give it to the patient. Many times it’s a life changing event for both parties involved. We typically think of it as saving one person’s life, but in many cases it saves two. Donors often describe it as their greatest accomplishment life.
Many people seek out experiences that bring fulfillment to their lives - climbing a mountain, adopting a pet or publishing a book. What would a perfect system look like that could allow the experience of donating an organ like a kidney for those who seek it? The obvious issue is to shield people from being forced into organ donation out of necessity for money. It’s easy to see how someone living in poverty would be drawn to selling a kidney as an extra source of income. One suggestion to avoid this is a deferred payment system where money exchanged for one organ transaction is funneled to a separate organ transaction. The next in line funds the one that came before, similar to the way social security in the U.S. functions. Though this doesn’t seem to satisfy a perfect system’s needs, the donor doesn’t seem to be sufficiently removed from the pull of financial incentive. An organ donated is a promise of future financial gain.
Another system has been proposed that offers donors lifelong health insurance for their kidney donation, a particularly intriguing approach in a country like the U.S. where adequate health insurance remains elusive for many. This compensation seems to avoid the coerciveness of a large payment of cash while being sufficiently life changing to be an adequate repayment. Given the risks associated with kidney donation have been dramatically reduced with improved surgical techniques, health insurance would not just be covering issues created by the donation itself. Instead it would be protecting the donor from the costs of health care they would likely already have to face.
In countries which have regulated living-donor systems for kidney donation have seen organ waitlists disappear. For an individual currently on the waitlist with end-stage renal disease, they can certain see the value in that. Medicine often teeters on the brink of taboo in many things it deals with. It’s important we aren’t afraid to discuss certain topics and instead should search for ways to improve our current thinking and help push ourselves forward.
