Markets for Kidney Transplants

Michael Giberson

Last week, a Dutch “reality” show was announced in which three patients in need of a kidney transplant would compete to acquire a kidney to be given by a living donor. The proposal generated a storm of commentary, for and against, only to be revealed as a hoax of sorts, a publicity stunt intended to generate attention to the issue of organ donations.

Tim Worstall had some of the best comments. News reports indicated that many in the Dutch government saw the proposed program as unethical. Worstall responded:

What is unethical are the current arrangements for organizing (sorry) the whole process of garnering kidneys for transplant. You see, under the guise of “ethics”, many thousands of people are condemned to lengthy and painful dialysis treatment, many of whom die before they receive a new kidney. And yet we know how to solve this….

He then cited an Economist story about Iran, which permits a payment of $2,000 to $4,000 to kidney donors and no longer has a waiting list. Worstall again:

What’s worse is that this is not news to those who decide our policies on such matters. But they condemn those thousands to death rather than allowing icky things like markets to solve the problem.

But of course there is a market in kidney transplants. As I read Worstall’s blog post, I couldn’t help but notice the contextually-cued “Ads by Google.” One said “Kidney Transplant at Penn: Among the Top 10 Programs in the US, High Volumes, Experienced Surgeons.” Another: “Learn about our active programs at New York-Presbyterian Hospital.”

In the kidney transplant business in the United States, the hospital can get paid. Apparently the business is profitable because otherwise it wouldn’t pay to advertise.

And, by the way, the doctors can get paid and the nurses can get paid and the orderlies can get paid and the medical supply companies that supply the bandages can get paid and the food service personnel that work in the hospital kitchen can get paid … everyone involved can be paid for their time and trouble except the person giving up a kidney.

NOTES: The publicity stunt worked: In addition to Tim Worstall’s posting there was an Associated Press story in the Washington Post. Blogging at: Dynamist (and again), Marginal Revolution, Division of Labour, among others.