[diolpah]

Here's an unpopular thought, but one that may not be on the list of "things too taboo to think about" for HN readers.

What if marrow donation was a for-profit industry, or at the very least a nonprofit or government-run industry that allowed people to sell their marrow at market prices? Would Amit and thousands of others in his position be resorting to begging for access to life-saving treatments, or being put on waiting lists that are far too long relative to their prognosis?

My guess is no, with the exception of people too poor to afford access to such materials - which are already so cost prohibitive that this is already a problem. I've never understood why the notion of making a market in organs and other medical materials is such taboo.

[RealGeek]

Organ transplant is a for-profit industry in India. Blood, bone marrow, kidneys; everything is bought and sold. There are no waiting lists, doctors sell it to the highest bidder.

Indian doctors engage in organs trading, nice doctors would hook you up with a poor and offer to buy his organs. Evil ones will abduct poor laborers, take out both of their kidneys & other organs, and dump their dead body.

There have been thousands of criminal instances of such horrific incidents and millions of organs traded illegally.

You can read some stories at following links:

http://www.washingtonpost.com/wp-dyn/content/article/2008/01...

http://www.time.com/time/world/article/0,8599,1709006,00.htm...

http://articles.timesofindia.indiatimes.com/2003-02-02/india...

http://www.indianexpress.com/oldStory/16890/

[0x12]

> There are no waiting lists, doctors sell it to the highest bidder.

I think that translates into: the waiting list is invisible, it contains everybody that is poor.

This is reminiscent of the quote by Douglas Adams: "no one was really poor, at least no one worth speaking of.".

[jgilliam]

One thing to know that is somewhat unique to bone marrow transplants, is that you need a lot of people registered in order to find anyone who will match. It's not like you can go pay someone for their bone marrow and be done with it, you need to find that one person amongst millions.

That changes the incentives a lot. When you register, some day you may get a call that you are the one person in the world that can save someone's life.

[I had a bone marrow transplant from a stranger 15 years ago]

[sliverstorm]

On the other hand, the incentive to sign up would probably improve.

[ck2]

It's a slippery slope.

If it was for-profit, countries like China would be pulping political prisoners for it.

Actually maybe not just China, I am sure some states in the US would make it mandatory for prisoners to donate to pay for their own prison sentences and maybe judges would take a cut too, increasing their willingness to find people guilty (judges are already allowed to own stock in privately run prisons).

[sliverstorm]

At least in the US, look on the bright side- the odds of anyone needing your marrow are low, so there would be no sense in a systematic harvesting of marrow prison-wide every month. Inmates already work in labor gangs. So, if you are a prisoner and you get selected, strike a deal and get out of labor gangs for a month (because you just earned as much as if you had been in a labor gang). It'd be a good thing to get picked!

[angelbob]

Maybe. Bone marrow donation is debilitating and really painful. I suspect not everybody would want to duck out on labor gang for it.

[gst]

Painful? At least in Europe this is done under general anesthetic and after the procedure you shouldn't feel more than light pains.

[Symmetry]

This won't make those scenarios any more likely. Its perfectly legal to sell organs already, as long as they aren't _your_ organs, but rather organs someone else donated.

[cjy]

If that was the case, wouldn't prisons already force inmates to sell their plasma/sperm? I'm pretty sure that would get struck down in a court.

[m_eiman]

I'm, pretty sure that inmate sperm would be in pretty low demand :P

[extension]

How about people can sell it and the gov't has to pay for it when someone needs it? Seems a lot less distopian that way.

[Symmetry]

I don't see people holding out for that much more money than the surgery costs, and given the alternatives available to insurance companies I don't see why they wouldn't pay for the organ. Keeping someone alive on dialasis, say, is really very expensive.

[diolpah]

Well, I think the question of "who pays for it", while important, is orthogonal to this particular issue, which is about increasing the available supply.

If a poor but healthy south asian immigrant wants startup capital to open a restaurant, and Amit wants a long and fruitful life, a legal market that allowed such a transaction would dramatically increase the supply of available materials. And it may even be possible that this increased supply would drive the end cost of living tissue down.

Now to be clear, I don't want to detract from Amit's immediate issue - this thread should be about helping him, not lead off a discussion that has nothing do to with his immediate problem( nobody here is going to change the legal framework within a month ). But I would like to at least understand the downsides to allowing markets in living tissue.

[extension]

Well, I think the question of "who pays for it", while important, is orthogonal to this particular issue

I would say it's at the heart of the issue. Presumably, the rationale for disallowing a body parts market is that, while there might be more supply overall, there would be less available to the poor, because they would be competing with the rich. If the cost is socialized then that issue goes away.

[sneak]

This may be the very first legitimate use of tax dollars I've ever heard of.

[kens]

The economics of bone marrow are different, because finding the match is the hard part. The strange thing is that they often charge the person _registering_ their bone marrow: http://marrow.org/Join/FAQs_about_Joining.aspx#cost This is just insane - how many people would donate blood if they were expected to pay or were hit up for cash donations? (And why does it cost $100 when 23 and Me's DNA analysis is $99? (Is bone marrow typing a DNA test, or something else?))

To be clear, I recommend registering your marrow. I've registered mine (and am disappointed that nobody has needed it yet). You can do it without being required to pay: http://marrow.org/Join/Join_Now/Join_Now.aspx