For every 1,000 Americans who pledge to donate their kidneys after death, only three die in a way that permits a transplant. That frees up about 14,000 kidneys a year — about one for every seven people on the 90,000-strong transplant waiting list. The longer they wait — five years, on average — the sicker they get. Every day, some 13 people die waiting.

That’s why living donors are so important — and why donations should be encouraged rather than penalized.

Roughly 6,000 Americans donate one of their kidneys each year, typically to a family member or friend. It’s hardly an easy decision. Complications are rare, and healthy donors generally don’t experience long-term problems.

But all surgeries carry risks, and donors have to plan for a two- to six-week recovery period. This puts them at risk of being laid off. They might also find themselves denied health or life insurance. Donors should be protected from these costs not just to reward their generosity, but because their selflessness provides clear public benefits.

The gain to the recipient, of course, is obvious. With a kidney transplant, a patient can live a relatively normal life. Without it, he or she must spend an average of five to 10 years on dialysis — a costly, grueling process that often interferes with work and family — followed by an early death.

But transplants are a better deal for taxpayers too. A year of dialysis costs nearly three times as much as a transplant, and Medicare covers about 80% of dialysis costs for most patients. Researchers estimate that if every American who needed a kidney could get one, it would save taxpayers $12 billion a year.


If everyone benefits from living donations, then the state should take action to encourage them. Colorado, Idaho, Maine, Maryland and New York have all passed bills to encourage living organ donations and prevent donors from being discriminated against. And at the federal level, a bipartisan group of representatives in February introduced the Living Donor Protection Act, which would ensure donors can take up to three months off work to recover and would prohibit insurers from limiting coverage or charging higher premiums to live organ donors. These are good first steps.

Even bolder thinking may also be in order — for example, revisiting the 1984 law that bans payment for organs. If the government gave $45,000 to each living donor as “an expression of appreciation by society,” as some nephrologists have proposed, it would save up to 10,000 lives a year and taxpayers would still come out more than $10 billion ahead.

Still, one step at a time. Before debating new incentives for organ donation, at least take down the disincentives already in place. Nobody should lose a job or be denied health insurance for saving a life.


Editorial by Bloomberg Opinion

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