Transplant tourism and black market organsYou carry a fortune around with you every day, but one that you're likely never realize. Why? Because unlocking the value of your kidneys or liver or other valuable organs would most likely kill you. For the poor in some impoverished countries, however, selling an organ on the black market is an increasingly popular choice, which has created the field of transplant tourism.

How much money is on the [operating] table? A World Health Organization report suggested that in India, where an estimated 2,000 people sell one of their kidneys each year, such a sale could bring an end-market price of $20,000. The same could bring $40,000 in China. A grade-A kidney from Israel could bring as much as $160,000. According to one study, by 2006, two out of every three kidney transplants done in Pakistan put those good kidneys into the body of foreigners.
Much of this bounty does not percolate down to the donor, however. A study of organ donors in Pakistan found that they earned an average of $15.40 a month. Most of them took this step to repay debt of, on average, $1,311. They received, on average, $1,377 for their kidney, out of which they had to pay the hospital costs. After all this, 88% found that their lives were not improved, and 98% suffered deteriorated health.

Some countries have taken steps to address this problem. Singapore has been considering a change to its laws to allow live donors to receive compensation for donations; a kidney may be worth as much as $35,000. However, recipients will be limited to citizens or permanent residents of the country.

In Iran, organ selling has long been legal. According to the Wall Street Journal (subscription required) a donor is paid $1,200 for a kidney, while the recipient pays as much as $4,500. Recipients, however, must live in Iran.

Why is the black market trade in organs such a problem? Supply and demand. An American between the ages of 35-49 who went on the wait list for a kidney in 2003-2004 has a median wait time of 1,805 days, almost five years, according to the Organ Transplant and Procurement Network. Nobel Laureate Gary Beck and Julio Elias recently estimated that the shortage of kidneys in the U.S. could be eliminated by paying living donors $15,000 per kidney.

As our population ages, we'll have more people in need of new organs and fewer in good enough health to donate useful ones, U.S. Sen Arlen Specter, D-Pa., recently circulated a draft of a bill, The Organ Trafficking Prohibition Act of 2009, that would permit donors to receive some benefits such as health and life insurance and help with the cost of burial. That's a start to creating a system that would balance need and supply.

Our country has embraced, for better or worse, the private market concept for everything from telephone services to health care. Perhaps its time to consider making a market for organs, too.

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