[avar]

    “If I don’t sell my kidney,
    I will be forced to sell
    my one-year-old daughter.”

It's an odd sort of cognitive bias to conclude from this article that the selling of kidneys is the problem. You don't think they should be given the option of selling their kid or their kidney?

My takeaway from this article is that the market just isn't developed enough. If they were able to sell their kidneys to richer westerners then they could easily get 10x or 100x as much money.

In that part of the world that's easily enough to make the best way to extend your statistical lifetime be to sell your kidney. You'd get access to better healthcare for life, your children could get an education etc.

[ceejayoz]

> You don't think they should be given the option of selling their kid or their kidney?

I think we can aspire to give our citizens better choices than "sell child or sell kidney", yes.

[avar]

"Our citizens"? I didn't know the Taliban could be found on HN. You should do an AMA.

What I'm pointing out is that you seemingly only care because the proposed scheme might cause you or other affluent people to interact somehow with the desperately poor. So the knee-jerk reaction is that we should ban the scheme entirely.

But those people will still be desperately poor without it, even more so. It's really arrogant to say that they shouldn't be given the option.

Would I sell my own kidney if there was a market for it? No, almost certainly not. But I don't live in those circumstances.

But we're talking about a country where the life expectancy is around 60 years, and where people are making something in the very low 4-digit USD/yr.

It's not hard to imagine how that could be turned into a win-win if the more affluent were able to buy kidneys.

[ceejayoz]

> "Our citizens"? I didn't know the Taliban could be found on HN. You should do an AMA.

The proposal is expanding this practice, correct? Permitting Americans to sell their kidneys?

> What I'm pointing out is that you seemingly only care because the proposed scheme might cause you or other affluent people to interact somehow with the desperately poor.

Ooof, a body blow to that strawman. Bravo! Well fought!

> But those people will still be desperately poor without it, even more so. It's really arrogant to say that they shouldn't be given the option.

They'll be even more desperately poor when the remaining kidney fails, they lose their job (and thus health insurance), and donor kidneys aren't available because they've all been bought up for $100k.

[avar]

How is that a strawman? You're arguing against any market mechanism on the basis of a human interest story discussing Afghanis who sold their kidneys for what you'd expect to pay for a new laptop.

I'm assuming you aren't actually in Afghanistan, so I thought the out-of-sight-out-of-mind comment was fair.

   > They'll be even more
   > desperately poor when
   > the remaining kidney fails.

Make that case statistically, how many statistical years do you lose from kidney donation with access to modern medicine?

    > and donor kidneys aren't
    > available because[...]

Everyone's born with two, you generally only need one, and failure is rare.

That's why it's such a perfect example for why a market-based approach could be a win-win for everyone. Nobody would die from kidney failure.

[ceejayoz]

Afghanistan offers an example of the market-based approach to kidney donation and its downsides. There are certainly Americans desperate enough for a few grand in a similar fashion.

> Everyone's born with two, you generally only need one, and failure is rare.

https://www.kidney.org/transplantation/livingdonors/long-ter... lists a number of potential downsides to donating a kidney while alive.

[avar]

    > Afghanistan offers an example
    > of the market-based approach
    > to kidney donation and its
    > downsides.

And upsides, e.g. the person who avoided selling their child by selling their own kidney.

Is that an overall terrible situation? Yes, but I'd like to think any parent would make the same choice.

Anyway, to respond to this and your up-thread (which I believe you added in an edit after I replied to that comment):

    > The proposal is expanding
    > this practice, correct?
    > Permitting Americans to
    > sell their kidneys?

No, let's narrowly stick to Afghanistan, since that's the example you brought up. It avoids getting into the muddy waters of introducing multiple variables.

Afghans are selling their kidneys right now, for the equivalent of around 1/2 to 1 year of local median salary. They're selling them to other Afghanis, or Pakistanis etc. willing to travel there.

Now, let's say an American dying of kidney failure was allowed to fly over that same Afghani to the US as a paid kidney donor for hire.

They'd still be out of a kidney, but now they might have gotten 20-40 years worth of the median salary in Afghanistan as a reward.

Don't you think that would be better for everyone involved?

    > [<URL>] lists a number of
    > potential downsides to
    > donating a kidney while alive.

I'll take that as a "no" to the question about whether you're able to support your up-thread "when the remaining kidney fails" claim with any numbers.