There are currently 101,000 people in America on a waiting list for a life-saving kidney transplant operation. The wait list has people scheduled up to 7 years to get an organ; only 15 percent of those waitlisted will get the organ they need; 17,000 people from that list die every year; 12 die every day.
One would think that when someone donates a kidney they would be rewarded by the government for their altruism. Unfortunately, the opposite is true. When one wants to donate an organ they undergo extensive questioning about their income, family, and, workplace by government officials. Many potential donors are then turned away, for reasons they don't fully comprehend, resulting great consternation as they see their loved ones continue to suffer and face death. The reason behind this fatal vetting process is the well-intentioned National Organ Transplant Act(NOTA) of 1984. NOTA bans almost any non-medical payment to living organ donors, whether by the government, health insurance companies, or charities. Recipients can only reimburse the donor's travel to the hospital, lodging related to the procedure, but not lost wages. Kidney donation is a complicated surgical procedure with long recovery time, and many donors can not afford to be without their earnings, while others may need home nursing care to recover. Donation of a kidney can therefore cost the donor anywhere between $5,000 and $20,000 and six weeks out of work. The law does not make any exceptions, and infringement of this policy is considered kidney trafficking which carries a jail sentence of 5 years and a $50,000 fine.
A side effect resulting from the strictness of NOTA is the rise of an organ black market. Essentially what happens is that rich people, desperate for a donation, will spend large sums to entice a someone into an illegal donation, where the transfer may be done in some back room, under unsafe conditions , that are drought with danger for both recipient and donor. NOTA therefore, causes exactly what it set out to prevent. It creates to a market where shady business dealers prey the the poor to sell their organs and milk rich people, desperate to live, of their savings. NOTA has created a conundrum that needs to be solved.
A possible solution comes from a country where it is least expected-- Iran. Iran is the only country that has eliminated the kidney donor wait list completely. This was accomplished is by implementation of a government policy that oversees the selling and buying of organs from willing donors. Now this notion might seem a bit crazy, but having the whole process be heavily regulated and adding incentives such as health insurance extended to the entire family, exemption from military service, and monetary compensation. In Iran anybody can qualify for an organ donation, regardless of status. If they do not have the means to pay up front, the government helps arrange payment plans and is a partner in the bargaining process to arrange for a price that is acceptable to both donor and recipient. Iran is not alone in exploring these options. Westernized countries, such as Israel, Australia, and Singapore are looking into emulating some of these practices.
The essential question is whether the Iranian model could also work in the US. The success of Iran’s policy was brought up in congress, but it didn't get very far. Almost all sides of the political spectrum agreed that allowing people to sell their organs would encourage poor who are most risk people to sell their organs for quick cash. Hence poor people would be placed at risk on regular basis, since donating a kidney could lead to long term health defects.
Whether you believe that someone should be encouraged by the government to donate organs or not, there is no doubt that donors should be properly compensated , Not as an incentive so that people would want to do it but proper care so that they won’t have suffer monetarily for their altruism. Countless lives are being lost as you read this. Not all good deeds must be punished, and the American government should reward altruism rather than punish it.
