Should Medicare Pay Kidney Donors?

As President Obama focuses on rising costs in his efforts to overhaul the U.S. health care system, Virginia Postrel points to a particularly costly area of health care--dialysis treatment for patients awaiting kidney transpants--and suggests some solutions.

One of those solutions, donor chains, has already arisen with the National Kidney Registry, a small nonprofit that matches willing donors with recipients in need. When someone needs a kidney and his/her friends and relatives don't match (a common occurrance due to blood types and the development of antibodies in "sensitized" recipients), strangers with willing donors can get matched. The registry creates a matrix of people to achieve just that.

But another, more controversial suggestion, is offering financial incentives--paying people to donate kidneys. If Medicare paid for it, Postrel suggests, it could save taxpayers billions.


Providing long-term dialysis--which is covered by law under Medicare to Americans of any age who've made minimum Social Security payments--is costly, to the tune of $100,000 on average per patient, Postrel says. Eliminating the 80,000-patient waiting list for transplants would save taxpayers $8 billion.

If donors got something in return for their altruism--$25,000 or $50,000, for instance--the list would go down faster, saving and vastly improving lives, and saving the government money. Many are vehemently opposed to the idea,: it would corrupt the system, they say, and possibly induce poor people to make bad medical choices in return for the cash.

But if Medicare paid $50,000 to nondirected donors (those who aren't giving to save a particular person, rather to a stranger at the hospital's discretion)--instead of the $100,000 on average for dialysis--it would save taxpayers $4 billion.

It's tough to get organ-donation policy passed in Congress, Postrel notes: often, a lawmaker has to die for a bill to get through, named in the lawmaker's honor. And it's also a controversial argument--but, according to Postrel, it makes both moral and financial sense.