A call for reimbursing the costs of kidney donation

The New Republic carries a passionate appeal by Sigrid Fry-Revere and David Donadio under the headline America's Organ Transplant Law Is Criminally Unfair to Donors

They write

"As a result of the National Organ Transplant Act, more Americans have lost their lives waiting for an organ than died in world wars I and II, Korea, Vietnam, Afghanistan, and Iraq combined. The law bans almost any non-medical payment to living organ donors, whether by the government, health insurance companies, or charities. Recipients themselves can reimburse donors’ travel, lodging, and lost wages, which helps—but only when the recipients have the means and will to do so.

"The solution is not to create a market in organs, but to help living donors meet the considerable expenses they incur in saving others’ lives. Giving an organ costs an average of $5,000, but as the Journal of the American Society of Nephrology notes, can be as much as $20,000. According to the U.S. Census Bureau, 20 percent of American households have no discretionary funds at all, and only 8 percent can afford to spend $5,000 donating organs without dipping into their savings or going into debt.

"In the coming weeks, the American Society of Transplant Surgeons, the American Renal Society, and the American Society for Transplantation will all release white papers arguing for studies on compensated organ donation. While there is no harm in studying the creation of incentives, the first step should be to get rid of the financial disincentives that currently keep thousands of living donors from being able to donate. One sensible proposal would be creating a debit card-based system not unlike the one the government employs for the victims of natural disasters, enabling government programs, private medical charities, and other people to cover donors’ expenses as they occur."

Writing about the history of the NOTA, they write

"The law resulted 30 years ago from righteous revulsion at a proposal by Dr. Barry Jacobs that the government pay people to come to the U.S. to donate their kidneys. Jacobs wanted to start his own business marketing organs, and figured that the government could spend relatively little compensating these donors—maybe only $1,000 each—and then send them on their way.

"Initially, Congress had simply been considering a low-profile law implementing a nationwide network to distribute cadaver organs, but when Jacobs suggested his idea in official testimony, it immediately got representatives’ attention. The prospect that the U.S. would ship thousands of impoverished people here from developing nations so that rich Americans could harvest their kidneys read like the plot of a science fiction novel.

"Dr. Paul Terasaki, president of one of the three main American transplant societies, testified before Congress in 1983 that physicians “strongly condemn the recent scheme for commercial purchase of organs from living donors,” and that it is a “completely morally and ethically irresponsible proposal.” Congress reacted by adding a provision that banned all but very specific types of payment in relation to organ donation, and the rest is history."