The Biden-Harris administration has indicated that it intends to increase scrutiny of racial gaps in health care. We have a suggestion of how to fill the gaps in one important area: The treatment of kidney disease.
A study released earlier this year found that there has been virtually no change in the amount of time people have spent on wait lists for the last two decades. Today, more than 500,000 Americans are on kidney dialysis. They depend on machines to do what kidneys normally do: prevent toxins from building up in the blood. Dialysis can prolong life for years, but dialysis machines aren’t as efficient as kidneys and the thrice-weekly process leaves many people weak and unable to live a normal life. What’s more, people on dialysis also don’t live as long as they would if they could get a kidney transplant.
Nearly 100,000 Americans are on the national kidney transplant list, but these numbers don’t reflect the fact that many people never get placed on a transplant list because their chances of receiving a transplant under the current system are so low. Last year, there were only about 21,000 kidney transplants in the United States. As many as 43,000 Americans die prematurely each year for lack of a kidney transplant, more than die in car crashes.
The current system doesn’t serve any racial, age, or group really well: people from all groups die prematurely waiting for kidney transplants. However, African Americans, Hispanics, and American Indians are at higher risk than whites for developing kidney failure: scientists aren’t quite sure why that is, but there appears to be a genetic component.
What’s more, a wealthy person with kidney disease will have the wherewithal to navigate the system to maximize his chances of receiving a donated kidney, such as by going on multiple transplant waiting lists across the country. Most minorities afflicted with end-stage renal failure do not have the resources to do such a thing.
Fortunately, there is a way out of these problems. The shortage of kidneys and other organs arises from the National Organ Transplant Act of 1984, which prohibits compensating organ donors. Unlike other organs, kidneys and livers can be donated by living persons, who can then continue to lead normal lives. Most people have two functioning kidneys but can get by fine with one. People only have one liver, but part of it can be transplanted and both parts then grow back in the donor and the recipient.
The federal government doesn’t need to ration bread because at an adequate price, there is plenty of supply. The same principle applies to blood and organ donations. Canada only collects about one-sixth of the blood plasma it needs domestically because it forbids compensating donors. Fortunately for Canadians, the United States allows compensation, so it produces enough plasma for its own needs and for Canada’s. The same would occur if we compensated living organ donors as well. One study estimates that a payment of $50,000 would eliminate any organ shortages in the U.S.
As a bonus, compensating donors would save taxpayers money. Kidney dialysis costs about $80,000 a year per recipient, most of which is borne by Medicare. Transplantation has a payback period of two years. The federal government could save as much as $100 billion over a ten-year budget window if it were to compensate living kidney donors.
The Trump administration made some progress toward compensating donors with an executive order that, among other things, provides more money to cover the expenses and lost wages of people who donate an organ, an effort that received bipartisan support. The Biden-Harris administration should work with Congress to reform the National Organ Transplant Act to remove fully the barriers that prevent the government from compensating donors so that every American who needs a kidney transplant can get one.
Keith Melancon, chief of the transplant institute at George Washington University, co-authored this piece.
Transplant News Sharing // “Kidney Transplants” – Google News from Source www.forbes.com