[njarboe]

Funnier social engineering fact: If it's legal for people sell their kidneys, wait lists for kidneys goes to zero[1]. Too bad only one country in the world does that.

Another fun fact. The US government spends more on dialysis than the budget for NASA.

[1]https://en.wikipedia.org/wiki/Kidney_trade_in_Iran

[ricardobeat]

From news sources I found, it looks like the system in Iran works exactly as one would expect: the poor and desperate end up with one less kidney while not significantly benefitting from the trade.

Which is precisely the reason such sales are outlawed worldwide.

[JamesBarney]

Kidney donors in Iran get ~6 month salary, kidney donors in the U.S. get 0 months salary.

Are Iranian kidney donors the ones getting scammed?

[echelon]

Kidneys in the US are largely sourced from cadavers.

If we enticed poor people to sell their kidneys, some percentage of them would wind up needing kidneys again without an ability to pay for them.

This turns into a kidney marketplace where the rich win out over the poor.

FCFS with triage based on need, immunocompatibility, and health outcome is the most equitable model.

[JamesBarney]

Poor people need kidneys far more often than rich people.

Diabetes and uncontrolled high blood pressure are the top cause of kidney failure. These two conditions are far more common in the poor, and far more likely to be poorly managed.

Also if the price of a kidney relative to median income in the U.S. was similar to Iran, then a kidney would cost $15,000. This is expensive but still far cheaper than dialysis. And there is no reason an ACA plan or Medicaid wouldn't pay for it.

[ro_bit]

If the ACA or Medicaid will pay for kidneys for those who can't afford, what stops the price of kidneys from becoming equivalent to the price of dialysis should the kidney not be bought?

[avereveard]

> FCFS with triage based on need, immunocompatibility, and health outcome is the most equitable model.

In theory. In practice rich people can jump ahead the line no matter what system. I.e. Steve Jobs and the liver that went to waste.

[DennisP]

According to CNN, "it is unlikely that someone like Steve Jobs can 'cut the line' of the transplant waiting list. The reason that some people might be able to get transplants more quickly is that they're standing in more lines. Nothing prevents someone from being evaluated and listed at multiple transplant centers. As long as a patient has the wherewithal to fly around the country -- and be available at the drop of a hat if a liver becomes available (this is where the private jet comes in handy) -- a patient can, in theory, be evaluated by all the transplant centers in the country."

https://www.cnn.com/2009/HEALTH/06/24/liver.transplant.prior...

[pnutjam]

Yeah, that's why parent poster said "in practice". It's stupid that this is allowed.

[catlikesshrimp]

If you legalize selling organs, less rich people will be able to afford them. I don't like the idea of merchandizing humans. It is worse than prostitution. Maybe worse than slavery, as humans become disposable.

[xwdv]

The difference is we are talking about saving lives, not prurient interests.

[aksss]

> This turns into a [marketplace] where the rich win out over the poor.

Same could be said for gambling and sales tax.

[BurningFrog]

I agree that if you ignore the saved life on the other end of the transaction, it does seem rather pointless.

[manquer]

It is problematic yes, however so is most of medical care, poor don't get access to it as much as the rich do , whether it is countries or people.

Sadly, economics dictate a lot of people's health is going to be like. Living/Work conditions lifestyle, diet are all influenced by wealth.

Poor people work most of the dirty and unhealthy jobs that significantly cut short life spans. Wealth and lifespans are known to be strongly correlated.

As countries we are perfectly comfortable reserving vaccines blocking poor countries with patents, polluting a lot more or exploiting their labor in terrible conditions we wouldn't tolerate. Compared to what we are willing to accept already this doesn't seem worse.

If a commercial system could save more lives(probably more likely rich) it is not that much worse for poor than it already is.

[ricardobeat]

Uhum. Maybe the next step is to encourage the poor to have more kids so we have a little extra supply?

[xwdv]

Before we get to that we should probably harvest organs from prisoners. A person who will spend life in prison has no need for two kidneys.

[taneq]

Surely for the budget of NASA, the U.S. government could just buy or build their own dialysis machines instead of paying for hospitals to do it.

[whimsicalism]

Presumed consent would effectively end waiting lists for most organs.