A New York Times editorial yesterday brought attention to the severe shortage in the number of kidneys available for transplant. There are over 100,000 Americans on the waiting list for a kidney transplant, and the average wait time is almost five years. Last year there were only 4,715 transplants from living donors. The vast majority of these donations were from relatives, only 463 kidney donations were from unrelated individuals. Relative to the pool of people waiting, this is little more than a drop in the bucket. Clearly, demand for kidneys is far outpacing the supply and our system for supplying viable organs to those who need them is failing, and these failures have serious consequences. The National Kidney Foundation estimates that almost 3,381 patients died while waiting for a kidney transplant last year. Absent change, this problem will only get worse in the future.
It is commendable that the editorial board raises this issue, but they then devote the rest of the post to trying to find ways to remedy the problem without having to “resor[t] to paying for kidneys.” The primary reasons for dismissing any kind of market for organs are that such a market is prohibited by law and is not supported by the World Health Organization. There are ethical concerns and fears of exploitation, and these should not be summarily dismissed. However, given how badly our current system is failing, could it be time to rethink our policy? Could a free‐market better address the needs of thousands of organ transplant patients? Because organ sales are currently illegal in most industrialized countries, there is almost no empirical data and no sense of what to expect if we were to make this shift. However, at a Cato event in March, Sigrid Fry‐Revere shared what she learned from observing one of the only countries with a free‐market for organ donations.