Why We Need a Market for Organs

06/22/2015 03:57 pm ET | Updated Jun 22, 2016

Over 123,000 people in the U.S. need organ transplants. But in 2014, only 28,953 transplants were performed. Every day, 21 people die because they cannot secure an organ for transplant-- and this number is on the rise. Even with countless celebrity-backed public service announcements urging the public to become organ donors, the supply of organs is nowhere close to matching the demand. If we continue to rely on donations alone, there is little we can do to help patients in need of organ transplants.

A burgeoning black market for organs fills this gap between supply and demand. Patients from more affluent countries like the US, Canada and the UK travel to countries like China and India to buy organs illegally. In 2011, the FBI discovered the first US based organ ring in Brooklyn, New York. Levy Izhak Rosenbaum, an Israeli citizen, confessed to arranging illegal kidney transplants and pocketing approximately $410,000 in brokerage fees. He was sentenced to two and a half years in prison. None of the organ recipients were prosecuted.

Transplant surgeons and economists alike advocate for a legal organ sales market to remedy the problem. The sale of eggs, sperm and blood is legal, so why should organs be any different? Yet this idea has not been widely accepted by the public. Resisters argue that legalizing organ sales will exploit the poor, as they are more likely to risk organ removal surgery for monetary gain. Poor people are not only more likely to participate, but also less likely to have the resources to take care of themselves after the invasive surgery.

Opponents often fail to acknowledge that the poor are already exploited in the black market. Like most illegal activities, the sale of organs is fraught with criminality and violence. Organs are stolen or purchased at a great disadvantage to the seller with very high brokerage fees. Worst of all, the surgeries may be performed in unsafe conditions, by unqualified individuals. This puts both the organ donor's and the patient's lives at risk.

The current U.S. system for legally procuring organs depends on the good will of donors who want to save the life of someone they know, or a stranger they may never meet. But no other necessary medical procedure depends on such a capricious system. If the supply of morphine depended on the good will of pharmaceutical companies no hospital would be able to address the pain of its ailing patients. A regulated market would not only increase the supply of organs by setting a fair price for them, but also protect the rights and safety of the people who are willing to sell their organs.

Regulation of organs for sale has been successfully implemented in one country: Iran. In a state-regulated market, the government buys organs and sells them to patients at a fair price. This has greatly reduced the waiting time for an organ. Organ sellers enter a contract knowing that they will also be provided with free health insurance for a year. The government mandates that organ recipients pay for as much of the cost of the organ purchase and transplant surgery as they possibly can, with the government covering the rest.

Iran's success should prompt us to recognize the value of a well-regulated market when it comes to organs. We should also respect an individual's right to assess the risk of selling their organs. Why are we still preventing individuals from willingly selling their organs for a fair price in a safe environment? Especially when it means we can save 21 lives every day.