Read More

Friday, December 16, 2011

Kidney Market

We like to watch White Collar on Netflix. Tonight we saw the episode Vital Signs, from season 1. Frankly, I sympathize with the bad guy. I went in expecting people waking up in a bathtub with their organs harvested. Nope. It turns out the bad guys are evil because they buy kidneys from willing donors and sell them to willing buyers. Wait a minute, isn't that a good thing? Apparently not, because bypassing the donor registry and a wait list makes you a white collar criminal.

The bad guys contact June when her granddaughter is bumped from her position on the wait list. They basically offer to get her a kidney for $100,000.00. When June tells Neil about this, the FBI comes in to save the day.

Let's look at the kidney market. There are about a hundred thousand people on the kidney transplant wait list. According to, 4,573 kidney patients died in 2008 waiting for a kidney. You know why nobody is out there donating kidneys? It's because NO ONE IS PAYING THEM TO DO IT. Why is no one paying them to do it? BECAUSE THAT MAKES YOU A WHITE COLLAR CRIMINAL. We should let people sell their kidneys. Lots of people out there are willing to pay good money for a working kidney, and the donor has one to spare. The donor needs cash, so he would willingly sign the dotted line to feed his family--or his vices (IE. gambling, drinking, investing etc).

Currently, if you have money, and you need a kidney, your only option is the black market. Unfortunately, the black market is full of cutthroats, snakes and charlatans, not to mention extortionists. An open market with reputable channels would improve the quality of the product and allow more people to get what they want and need. Having willing donors also alleviates demand for unwilling donors.

You would think someone who could bring compatible buyers and sellers together would get a reward, maybe even a Nobel Prize. Instead, the guy saving lives and feeding families by lining up kidney transplants goes to prison. Here's the kicker, the show magically glosses over this problem. Everyone feels good about the happy ending in which the FBI pulls some strings to get the grandchild back to her original spot on the wait list. The ending doesn't satisfy. First, it means the FBI unjustly bumped a more urgent recipient off the list. Second, there is no guarantee the grandchild will EVER get a kidney. Even if she does, she will suffer through years of bad health waiting for it. If the FBI had just allowed the bad guy to facilitate a kidney transaction, the grandchild would have a new kidney within weeks.

Oh, and I want to be his lawyer. The FBI obtained their evidence against the bad guy illegally. They also committed some pretty serious crimes and torts against him. Kidnapping, assault, extortion, intentional infliction of emotional distress, interference with chattel, etc. He's got a pretty good pay day coming. I would represent him for a contingency fee.


Sheri said...

This was a fun read. Loved it.

*rOcKiN rIcHiNs* said...

I have know given this a couple of days thought and .... I totally agree. Very interesting to think about! :)

*rOcKiN rIcHiNs* said...

now...not know...

Danny said...

Nate, this definitely sounds like the economist lawyer's perspective on the kidney market. I actually haven't thought this issue through enough to have a strong opinion, but here are some concerns: first, you assume that all transactions in the market for kidneys will be free and uncoerced. But, it's certainly plausible to think that some people will sell their kidneys 1) under duress, 2) for very bad reasons (to get drugs or alcohol), or 3) against their long term interests. $100,000 sounds great, but then many people don't comprehend the health risks and problems they will face when they sell a kidney (I know, the market assumes perfect information - an assumption that seems ill-suited to this kind of market transaction). And it seems reasonable to believe that some people will be bullied, blackmailed, or otherwise coerced into selling their kidneys by their "friends", family, or the mafia. No amount of red tape will catch all of these cases; people can usually find a plausible story about why they need to sell. Mandatory education will probably also have a limited effect. Further, the incentives for middle-men to drum up business will also be high, and seem to run counter to the interests of the potential donors. In any event, it seems like a problematic market. Wikipedia says that Iran currently allows such transaction.