Many of us are aware that there’s a desperate shortage of organ donation in Australia.
It shouldn’t come as a surprise that thousands have died on waiting lists.
And yet we still have one of the lowest donation rates in the developed world.
Fortunately, economists Steven D Levitt and Sephen J Dubner have hit on a solution that doesn’t depend on altruism — which is apparently one of the least effective motivating principles going around.
Their new book, Superfreakonomics, champions a more realistic solution: paying for donation.
In the States, there are 80,000 people waiting for a kidney, but only 16,000 will get a transplant this year. In Australia, 1300 patients are on the kidney waiting list; many will die waiting.
So if people aren’t generous enough to give up a kidney – even when they’re dead – let the market fix the price for a kidney, say Levitt and Dubner.
With demand being high, and desperate, the donors will come to the party.
Yes, they’ll be poor, or imported, but tens of thousands of lives will be saved — not least those of donors who might otherwise starve to death in the developing world. It’s a win-win; and if you don’t like it, don’t buy in.
This solution was, of course, scuttled in the US — by none other than Al Gore. Most of us, it transpires, are uncomfortable with the idea of people in need selling an un-needed kidney.
And yet we’re entirely comfortable with the fact these very people are dying by the million of starvation. Perhaps they find consolation in dying with all the human dignity attached to two unpeddled and healthy kidneys.
But in less irrational societies, this organ economy is already at work. Take Iran – not often the market leader in social sanity – where a kidney is worth about $1200 plus a donation from the recipient.
The waiting list there is… non-existent.
And hey, it worked for Kerry Packer, who bought his chopper pilot’s kidney for $3.3 million. Sorry, gave him a property worth $3.3 million in a gesture utterly unrelated to the pilot’s generous altruism. (Imagine the spike that would’ve created on an open kidney market.)
Even so, this won’t solve the shortage of less commodity-oriented organs like hearts and lungs.
And we have a critical shortfall there, too, thanks our lawmakers’ decision to have organ donation by consent only, as well as, perversely, by subsequent consent of the departed donor’s family. (Various European countries passed laws of ‘presumed consent’, and waiting lists are relatively shorter.)
But perhaps, instead of looking for economic incentives, we might try out a little disincentive? If we’re not comfortable with the carrot, bring on the stick.
Why not simply prioritise organ transplants for those who are themselves registered donors? So a patient who registered for donation prior to their diagnosis will skip up the waiting list ahead of those who were too lazy or organ-stingy to register their consent.
1625 Australians are currently on organ transplant waiting lists, and many of them will die there.
The registered donors dying on those lists must be horror-struck by our laws and laziness, thwarting their recovery.
Even more so, by the organ-withholders ahead of them, who refused to be donors themselves but will happily snap up that last heart.
So why are we still consigning patients to the altruistic waiting list? In their place, you’d bet your ass on the carrot and the stick.
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