I’m Not Kidding, Sell Your Kidney

Kidneys toil away on a daily basis regulating everything from blood pressure to pH and excreting one’s bodily wastes and toxins. In spite of all the work that kidneys do, a majority of the population can survive perfectly fine with just one. This should be great news for the over 100,000 people in the United States who are waiting for a kidney transplant.

However, the National Kidney Foundation states that 13 people die everyday waiting for a kidney transplant. A majority of this deficit in kidneys comes from the 1984 National Organ Transplant Act, a well-meaning piece of legislation that established a national organ-matching registry and prohibited the sale of organs. The penalty for any parties caught doing so is a fine that can cost up to $50,000, up to five years of imprisonment, or both.

As a society, we have deemed it perfectly legal for a person to sell their eggs or sperm. Yet when it comes to kidneys, people are expected to donate their vital organs solely out of pure altruism. In fact, in America, donors are expected to shoulder all their travel and caretaker costs and the four to six weeks taken off of work to recover: an unfeasible financial obligation for most. Instead, a regulated market for kidneys needs to be legalized so kidneys can be freely bought and sold.

A year of dialysis costs approximately $88,000, which is about the same cost as a kidney transplant. If Medicare, which covers the costs of dialysis for a patient of any age for an unspecified number of years, simply reallocated its funds from paying for years of dialysis to paying for individual transplants, thousands of lives and large amounts of money would be saved. A government-run system would also prevent the rich from monopolizing the kidney market by simply bidding up prices.

Many people worry that opening kidneys up to the capitalistic system of supply and demand would disproportionately lead the poor to sell their organs. Frankly, it probably would. However, a piece in the New York Times argues that “people, especially poor people, take risks for money all the time” that are statistically far more dangerous than donating a kidney, like “accepting money for being a policeman or miner or soldier.” Of course, the interests of potential living organ donors should be protected through processes such as interviews to make sure that individuals are making completely independent, informed decisions, payment for all medical and nonmedical related expenses, and follow-up health care. Countries, including Saudi Arabia, Israel, Singapore, and the United Kingdom with similar programs have seen a direct correlation between such compensation and a rise in donations.

It’s easy for people to become sentimental over major societal shifts when their own lives are not at stake. For those in the United States who do not have the fortune of getting a living donor, a long and uncertain future of dialysis and deteriorating health often lies ahead. The organ shortage we have is self-inflicted, and thus solvable. Controversial or not, the legalization of kidney sales is a step that needs to be taken in order to save real lives.