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Taboo Trades
Frank McCormick is an economist and the author of numerous articles focused on the shortage of kidneys for transplantation. He is retired from the Bank of America where he was Vice-president and Director of U.S. Economic and Financial Research. Today, we’re discussing his recent article, Projecting the Economic Impact of Compensating Living Kidney Donors in the United States: Cost-Benefit Analysis Demonstrates Substantial Patient and Societal Gains, co-authored with Philip J. Held, Glenn Chertow, Thomas G. Peters, and John P. Roberts. It is published in the journal, Value in Health and is available here: https://www.sciencedirect.com/science/article/pii/S109830152201957X/
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In an email to his extensive mailing list, McCormick writes:
If you don’t have 45 minutes to spare, the key points I have to make are:
1. The death toll due to the shortage of transplant kidneys is much greater than is generally realized. The Health Resources and Services Administration (HRSA) misleads everyone by saying only 19 people a day die waiting for a transplant organ -- because it counts only patients who die while on the waiting lists (for kidneys alone that number is about 13 deaths per day).
But HRSA does not count:
A. Patients who are removed from the wait list because their health has become so poor they may not survive a transplant operation (or for other reasons) who soon die;
B. Patients who are never placed on the waiting list to begin with, but who could be saved from a premature death by transplantation if there were no kidney shortage.
Adding the latter two groups raises the death toll due to the kidney shortage to more than 110 deaths per day (40,000 per year).
2. This appalling death toll due to the kidney shortage could be completely ended if the government compensates kidney donors about $77,000 per donor (with a wide range of uncertainty surrounding that estimate). But even if the required compensation is two or three times this amount, it would be trivial compared to:
A. The value of a longer and healthier life to a kidney recipient (and their caregiver), which my co-authors and I estimate at about $1.5 million.
B. The savings (mainly to taxpayers) from the kidney recipient not needing expensive dialysis therapy, which we estimate at about $1.2 million per recipient.
In the long run, this program of government compensation of kidney donors would not cost taxpayers anything; rather it would save them about $7 billion per year.
References:
1. McCormick F, Held PJ, Chertow GM. The Terrible Toll of the Kidney Shortage. J Am Soc Nephrol 2018;29:2775-2776. https://jasn.asnjournals.org/content/jnephrol/29/12/2775.full.pdf.
2. McCormick F, Held PJ, Chertow GM, Peters TG, Roberts JP. Perspectives: Projecting the Economic Impact of Compensating Living Kidney Donors in the United States: Cost-Benefit Analysis Demonstrates Substantial Patient and Societal Gains. Value in Health, online 9 June 2022. https://doi.org/10.1016/j.jval.2022.04.1732.
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