This House would let people sell one of their kidneys.

ethics

Iran is the only country with a regulated kidney market. The waitlist for transplants there is near zero. Critics argue the policy commodifies the poor; defenders argue prohibition leaves people to die.

Background

About 100,000 Americans are on the kidney transplant waitlist; 13 die each day. Iran's regulated market, established in 1988, eliminated the country's waitlist within 11 years. Donors are compensated roughly $4,500 plus a year of insurance, with the government as broker. Studies by Sigrid Fry-Revere have found donor regret rates and health outcomes comparable to altruistic donors in the US.

The coercion critique has real teeth: 78% of Iranian donors in a 2014 survey reported financial distress as the primary motivation, and donor demographics skew heavily toward the bottom income quintile. The middle path, Singapore-style "rewarded gifting" with non-cash benefits like priority in future organ allocation, paid leave, and lifetime health insurance, has been proposed by Sally Satel and others. The motion as stated puts this on a binary, but most policy proposals sit on a spectrum between current prohibition and full markets.

Government opens with

A regulated market with price floors saves more lives than prohibition.

Opposition responds with

Voluntary in the abstract is coerced in practice; the poor will be the donor class.