Letters to the Editor

Viewpoint: A revolutionary plan to save lives, money

As Congress gets ready to duke it out over Obamacare, here’s a means to help many Americans live longer and better — and it isn’t going to cost a dime. In fact, it will save money.

One of the easiest ways to lengthen a life is to have more human organs available for transplant. If you need a kidney replacement today, you’re likely to wait three to five years before you get one (or more likely, die), according to the United Network for Organ Sharing.

Why is the wait so long? Why aren’t there more organs available? It’s not that there is a shortage of people who die in America; more than 2.4 million did last year. The problem is a scarcity of donors. Too few of us take the time to sign up to offer up our organs.

According to our national organ clearing house, the U.S. Organ Procurement and Transplantation Network, there were 100,597 people on the wait list for organs in 2008. And (sadly) the number of organ donors in 2008, including both living and dead, was only 14,203.

Current law will not allow anyone to offer (or receive) a financial inducement for organs, but to date, we haven’t yet come up with a program to get Americans to sign up in sufficient numbers. We give generously from our wallets while alive, but evidently, we won’t give that which we cannot use and no longer need when dead. Odd, isn’t it?

What to do? How do we get more folks to sign up? Here’s two suggestions.

Many countries in Europe run an opt-out program for organ donations. After you’re dead, doctors will harvest your organs unless you have specifically stated that you do not wish to give. We’re skeptical whether this could work in America given the obvious inducements for lawsuits.

Here’s our favorite alternative. Create two lists. List A is made up of those who have agreed to give their organs upon death. They’ve made their intentions clear, unambiguous and have done so well prior to any evident need of their own.

List B is everyone else.

Here’s how it would work. When someone dies, regardless of the list they are on, doctors will look to offer their organs for transplant to someone in need on List A first. Only after the U.S. Organ Procurement and Transplantation Network and the other organizations who work in concert cannot find someone suitable and in need on List A, then the organs would be offered to someone in need on List B. In short, everyone on List A is in front of everyone on List B.

Now imagine what most people would do when this is announced. They’d sign up. They would soon figure out that as more people sign up, the numbers on List A get bigger and the line in front of them, if their need arose and if they are on list B, gets longer. List B people become less likely to get an organ if they need it, so they sign up to get on to List A. Thus the number of organ donors grows, which is, after all, the whole point of the exercise.

We know that some people would feel this would be unfair to those on List B. They’d be discriminated against, we’ll hear. What if someone in need hasn’t heard of the program and didn’t sign up? We suspect that the list of qualifications and exceptions inserted by legislators would be long, but the idea is still sound.

We know what list we would want to be on. In fact, we sort of are today. It’s called LifeSharers, and you can find further details at LifeSharers.org. LifeSharers members have promised their organs to fellow members first. Only after determining if any members need an organ would they become available to others. The difference between what we proposed and LifeSharers is that all available organs would be offered first to those who elect to give (List A).

And how would this save money in our health care system? For example, it costs Medicare $72,000 per person per year to keep someone on kidney dialysis while they await an organ transplant. Creating incentives such as this for more people to give the gift of life is a costless inducement that should be implemented as soon as possible.

Gordon and Nancy Mullin live in San Luis Obispo and can be reached at dgmullin@yahoo.com.