[[{“value”:”Iran is one of the few countries in the world to have eliminated the shortage of kidneys. A useful new paper looks at what donors are like, First some background: The adoption of a regulated market mechanism for kidney procurement in Iran started in 1988 in the absence of sufficient posthumous donations (Ghods and Savaj,
The post Iranian Kidney Donors appeared first on Marginal REVOLUTION.”}]]
Iran is one of the few countries in the world to have eliminated the shortage of kidneys. A useful new paper looks at what donors are like,
First some background:
The adoption of a regulated market mechanism for kidney procurement in Iran started in 1988 in the absence of sufficient posthumous donations (Ghods and Savaj, 2006). The mechanism allows living unrelated Iranian individuals to donate kidneys to Iranian patients with end stage renal disease (ESRD) for financial gains. The program was successful in eliminating the renal transplant waiting list within a decade of its implementation (Mahdavi-Mazdeh, 2012). In addition, the Organ Transplant Act legalized brain-stem death donations in 2000. Both ESRD patients and potential kidney donors are referred to and registered with The Association for Supporting Renal Patients, a non-profit organization (NGO) which conducts a primary medical evaluation and facilitates the market exchange. Upon successful completion of the test, a formal consent is acquired and the potential donor and the recipient are introduced to each other. At this stage both the patient and the donor are referred to a nephrologist for further evaluation, cross-match, and angiography. If the patient-donor pair is compatible, in the next step the pair negotiate the terms and conditions of the exchange. All terms within the price-cap are guaranteed and enforceable by the NGO. The price-cap is frequently adjusted for inflation and during the course of our study was set at 180 million Iranian Rial (US$4700 in August 2017). However, the negotiation is private and the pair can agree any terms they wish. The donor also receives a “gift of altruism” and 1 year of insurance from the government through the Charity Foundation for Special Diseases. Transplant surgery is carried out free of charge in public university hospitals. The Iranian Ministry of Health and Medical Education introduced further procedural changes in July 2019. In particular, they established a center for organ transplant and procurement at the ministry which acts as the matching centre and provides oversight and overall control of the process.
Are the donors irrational, risk-loving, impatient? No, they are normal people making the best of sometimes limited opportunities:
The overall picture is of individuals who were in financial need, often unemployed but with a family to support and where alternatives sources of financial support were grim. However, despite their financial position, these individuals were typically patient and not especially prone to risk-taking. They were no less rational than the average, but those who ended up completing the process might be characterized as more altruistic than those who did not….More broadly our findings indicate that even in situations of extreme poverty we should not assume lower levels of rationality will be pervasive.
Given that donation saves lives and that kidney donation is not especially risky (much less risky than driving a motorcycle, for example) the tradeoff seems positive and well within ordinary bounds.
Turning to the US, here is Sally Satel on a proposed tax credit for kidney donation:
What if we could solve the organ donor shortage with a simple tax credit? That is the idea behind the End Kidney Deaths Act (EKDA) (HR 9275).
The bill, advanced by the Coalition to Modify NOTA (NOTA stands for the National Organ Transplant Act passed in 1984) would provide a $50,000 refundable tax credit—$10,000 per year for five years—to any living donor who gave a kidney to the next person on the waiting list. The tax credit would be a 10-year pilot program.
The credit would save 10,000 to perhaps as many as 100,000 lives over ten years.
FYI, I am a supporter of Modify NOTA (along with Al Roth, Steve Levitt, and Mario Macis, to name just a few of the economists, joined by surgeons, nephrologists and others).
Hat tip: Kevin Lewis.
The post Iranian Kidney Donors appeared first on Marginal REVOLUTION.
Economics, Law, Medicine
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