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Kidneys for Sale?

There’s an interesting article about organ transplantation in today’s Wall Street Journal, by Laura Meckler. It’s primarily about a transplant surgeon named Arthur Matas who has been advocating for the legalization of kidney sales in the U.S. Despite much opposition in the transplant community, Matas has been making headway:

Appearing at a January meeting of the American Society of Transplant Surgeons, Drs. Matas and Delmonico each presented their thoughts on the issue. Afterwards, the audience was asked to take sides with a show of hands. The surprising result: A majority indicated they would support a trial to determine the viability of a U.S. organ market.

Dr. Delmonico, it should be noted, is Francis Delmonico, a friend of Matas, fellow transplant surgeon, and former president of the United Network for Organ Sharing.

Anyone who is at all interested in organ transplantation should read this article, if only to take the temperature of the issue. Among other things, you will learn that the legislation that banned organ sales in the U.S. was introduced in Congress by a representative from Tennessee named Al Gore.

I have to admit, the headline of the article was a little surprising: “Kidney Shortage Inspires a Radical Idea: Organ Sales.” While the idea may indeed be radical to many, this argument is hardly new. In a column about the economics of organ transplantation from more than a year ago, we wrote about a paper by Gary Becker and Julio Jorge Elias arguing that “monetary incentives would increase the supply of organs for transplant sufficiently to eliminate the very large queues in organ markets, and the suffering and deaths of many of those waiting, without increasing the total cost of transplant surgery by more than 12 percent.” (Here are more links about organ transplantation.)

Another problem with the Journal article: while it raises the common objection that poor people might be unduly pressured into selling a kidney, it ignores the logical flipside of the argument: what about all the poor people who need a kidney but can’t get one because there is no supply? In fact, you could argue that rich people have a larger advantage now than if a regulated market existed, since they have more options available — e.g., traveling to a foreign country to get a kidney — than disadvantaged people. So on average, a kidney market may well help the poor more than anyone.