The American Society of Transplantation prepares to consider a pilot study of financial incentives for living organ donation

 As I prepare to speak later this month at the American Transplant Congress in Boston, I note that  the American Society of Transplantation (AST) has, among its Key Position Statements  one from late last year called A Roadmap for Removing Disincentives for Living Organ Donors 

As the title suggests, the statement focuses on removing financial disincentives for organ donation. 

But I'm struck by the last item on the list:

"Additional Steps
"In advocating for the elimination of disincentives to living donation, AST will examine, in parallel, the legal,ethical, and practical considerations involved in a pilot study of financial incentives for living organ donation."

  

"In the long run, the public interest depends on private virtue." JQ Wilson

 

 Here's a photo from the lobby of the American Enterprise Institute, which I visited as part of my recent book tour.  It seems particularly apt right now.

 

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Earlier: 

Saturday, May 16, 2026  Moral Economics: video of the AEI book event (you can listen to me read from the book) 

 

 

Mary Childs, formerly of Planet Money, has a new podcast, called Mary in America (on which we talk about Moral Economics)

 Mary Childs, formerly of Planet Money, has a new podcast, called Mary in America.

I was the guest on her first interview: 

Organs, Sex Work, and Drugs: A Nobel Economist on Why Banning Things Can Backfire, Mary in America
 

"A Nobel Prize-winning economist makes the case that our moral objections to controversial markets are getting people killed. Alvin Roth won the Nobel Prize in Economics for figuring out how to build markets that work. Now he's turned his attention to the markets we refuse to build, and why that refusal has consequences nobody wants to talk about. In this episode, Mary and Al dig into what he calls "repugnant transactions" — the deals that some people want to make and others think shouldn't be allowed. They get into why banning organ sales creates black markets where donors get operated on in apartments, why the same logic that ended Prohibition applies to the war on drugs, how surrogacy bans in Europe are turning babies into stateless people, and why it's easy to buy heroin but nearly impossible to hire a hit man. Al's argument isn't that everything should be for sale. It's that if you care about outcomes more than intentions, you have to confront what your bans are actually doing. Subscribe for new episodes every week. Chapters: 00:00 Friendship Isn't A Market 00:32 Meet Nobel Economist Al Roth 01:02 What Makes a Market "Repugnant"? 02:58 Should We Pay People for Kidneys? 08:31 Why Drugs Thrive But Hit Men Don't 15:58 Surrogacy, Politics, and Unintended Consequences 21:45 Why Prohibition Keeps Failing 25:19 Markets, Morality, and Reality 28:19 The Rise of Prediction Markets 34:30 What Money Can't Buy"

China is smoking

 The NYT has the story:

Xi Jinping Quit Smoking. China Still Cannot.
China’s tobacco monopoly has become so financially vital to the government that even its powerful leader has failed to curb the country’s smoking habit. By Joy Dong

"While cigarette sales have fallen across much of the world, China has moved in the opposite direction.

"Cigarette consumption in China rose 39 percent from 2003 to 2023, even as it fell 26 percent in the rest of the world. The 2.4 trillion cigarettes sold in China each year account for nearly half the global total, according to a report by a nongovernmental organization founded by former officials from the Chinese Center for Disease Control and Prevention.
...

"The failure to slow cigarette sales is a measure of the clout wielded by China’s State Tobacco Monopoly Administration, which both regulates the industry and operates the country’s dominant cigarette maker, the China National Tobacco Corporation.

"The company generated roughly $244 billion in profit and tax revenue in 2025, about 7 percent of national government revenue and nearly what China says it spends on defense."
 

"How Moral Panic Creates Black Markets," interview by Nick Gillespie about Moral Economics

Nick Gillespie, from Reason Magazine,  interviews me about "How Moral Panic Creates Black Markets"

"Nobel Prize-winning economist Alvin E. Roth discusses the moral limits of markets, how bans create black markets, and why harm reduction often works better than prohibition."

"Today's guest is Nobel Prize-winning economist Alvin E. Roth, the author of Moral Economics: From Prostitution to Organ Sales, What Controversial Transactions Reveal About How Markets Work.

He talks with Nick Gillespie about why some voluntary transactions provoke moral outrage even when no one is being directly harmed. Roth explains why black markets often emerge when governments try to ban activities with persistent demand, why both markets and prohibitions require social support to function, and how unintended consequences can make moralistic policies backfire. They discuss the war on drugs, prostitution, surrogacy, same-sex marriage, price gouging, and why Iran remains the only country in the world with a legal market for kidney donors.

They also explore Roth's work designing kidney exchange networks and school choice systems, how digital technology and private transactions make certain bans harder to enforce, and why harm reduction may work better than prohibition in areas ranging from drug policy to sex work."

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Survey of economists, concerning Living-Donor Kidney Transplants

Romesh Vaitilingam writes to draw my attention to the recent survey of economists, concerning Living-Donor Kidney Transplants, conducted by the Clark Center for Global Markets at Chicago Booth.

He says 

" I’m writing now as I thought you might be interested in the results of this survey, which was inspired by reading your recent Wash Post column."*

Below are the three questions they asked, and the results to each one. At the survey link above you can find the responses of the individual economists surveyed.

 

 

 Only one economist appeared to be skeptical about kidney exchange, and I was surprised at who it was (respondents may answer these questions very quickly...).

 

The next question concerns the End Kidney Deaths Act, which was introduced to the respondents at these links:

"There is draft legislation in Congress to increase the supply of human kidneys by encouraging donations to strangers: https://www.congress.gov/bill/119th-congress/house-bill/2687

"It is summarized here: https://www.hawaiibusiness.com/bipartisan-bill-aims-to-prevent-kidney-deaths-by-compensating-donors/ "

 

 

 The End Kidney Deaths Act gets a good deal of support (above) while an unspecified decentralized market gets considerably less support, below.

 

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*Earlier posts

Friday, May 8, 2026 It’s time to carefully but urgently rethink payments to kidney donors. My op-ed in the Washington Post