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this post was submitted on 02 Apr 2024
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chapotraphouse
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a government purchase program for kidneys isn't really that innovative. Many governments procure food grains, wool etc at a floor price.
the issue is with getting money involved. under capitalism, you have a class of unemployed, underemployed and underpaid workers who are desperate for money. it doesn't matter if Government is buying kidneys and distributing it through a fair lottery system, the coercive element is still there.
But the system is designed to avoid the scenario of poor and desperate people selling their kidneys.
the compensation is still there. i meant that any compensation, whether in form of tax credits, installments or even a house is coercive under the capitalist system.
who do you think will be giving kidneys for $50,000? a person who earns $10k a year or a person earning $1m a year?
I'll admit I don't know much about American taxation, but in Canada someone who earns $10k a year pays $0 in taxes, and therefore would gain $0 from selling their kidneys under this scheme.
I reckon this option would mostly be considered by people who earn $80k a year or more. We should encourage more people in this bracket to be donating their kidneys.
It doesn't really matter how its designed. The reality is that only desperate people are going to sell their organs.
How could it "not matter how it's designed"? Do you realize how limiting that statement is? You're saying there's literally no way to ethically encourage people to donate their kidneys no matter how hard you try.
If money is changing hands, yes that is my opinion.
That's absurd. You're merely applying the general principle that capitalism is bad in all circumstances. Sure, let's tear down capitalism -- but if we live in a capitalist society, you can't just draw a circle around what look to me like comparatively ethical capitalist practices and say "that's ghoulish."
What if kidney donors were awarded with a doctor's note for paid time off work? Would that then be unethical? How about if the award is being bumped up to the top of the kidney donor's list? (That's real and already happening! Isn't that ghoulish?)
Neither of those examples include monetary compensation for the kidney. The paid time off work should be a given for someone who is donating a kidney, but they are being compensated by their employer at the same rate they would have been had they just gone to work. Someone who makes $15/hr would actually "make" less off the kidney donation than someone making $50/hr, but either way they could have just not donated the kidney and ended up with the same amount of money...and their kidney.
So in the US there are tax credits (work the way you said) and also refundable tax credits. Refundable tax credits will end up paying you money if you don't owe anything.
I didn't realize this distinction. I am not sure the article specifies. I think the charitable interpretation then is that it's the non-refundable kind, otherwise it would be a stupid system.
I stand corrected.
In that case, I may simply not understand exactly the mechanism in which the ghoulish harvesting of kidneys from the lower class would be prevented by this system, but that doesn't mean there isn't one. Their website claims that this amount merely offsets the "cost" accompanied with donating a kidney, but I don't really understand where that cost comes from (paper). They also claim that their proposal is designed to uphold the declaration of Istanbul, which among other things states "Organ donation should be a financially neutral act." Also, their proposal requires screening to ensure that the donor is not being coerced. So there do seem to be a number of safeguards here.
Still, I wouldn't advocate for the system they're suggesting without a better understanding of how exactly kidney donation would be financially neutral, and how they would prevent desperate people from using this to boost their income. But I do think we should at least consider a system like this as it would help save a lot of lives and prevent a lot of suffering.
I think it will be a lot easier to take some of these ideas into consideration when everyone has their basic needs met and universal healthcare. I think up until then, we will still have a non zero amount of people having their kidneys harvested to get a leg up in this economy.
There are a lot of things that go through my mind and I wistfully think, "ah, that will be great to try implementing once everyone has their basic needs met!"
But here's a proposal that will actually help people get their basic needs met. If we can give a healthy kidney to every (poor, starving) person in need of a kidney transplant, we'll save a lot of lives and help keep a lot of people afloat.
I would hope the proposal would keep the number of people who donate a kidney just to pay rent to a minimum. But honestly, even if there's a small number of people who do donate a kidney out of desperation, on balance isn't it still a good thing? Think of all the recipients and how much this will help them. And those few people who donated out of desperation -- how much worse off will they be? Maybe it would be ghoulish in a sense, but surely there's a system which (unlike blood donations) minimizes the harm caused and maximizes the benefits.
$50,000 is a life changing amount of money for everyone I've ever met. Hell $10,000 is.
If the regulations are so stringent as to prevent people doing this for monetary reasons, then why are we even discussing money?
This is just smoke and mirrors to get around the fact that only people who need the money will sell their kidneys. Do you think Jeff Bezos will be jumping at the opportunity to sell his kidney?
And if there's not enough monetary incentive, then we're right back where we started anyway.
I don't think it's a reach to say that we should prioritize universal healthcare, universal housing, or universal food access before opening the market up for kidneys.
Way more people die a year due to not having proper medical insurance (in the US) than due to kidney failure. More difficult to get estimates for the lethality caused by food or housing insecurity, but it doesn't take much imagination to see how these factors contribute to negative health outcomes. And these solutions not only save lives without exploiting anyone, but also raise the quality of life for everyone.
https://www.kron4.com/news/bay-area/100k-a-year-is-low-income-in-the-bay-area-according-to-new-report/
Besides, I don't see how a $10k a year tax credit for next five years would be an appealing incentive considering the 'cost' of doing the same is being cut open and having your kidney taken (much more invasive than a blood donation), if your other kidney fails you are screwed.
And yet there are already people who donate their kidneys even without any incentive at all. Are you suggesting that with this incentive, fewer people will donate?
Maybe, it certainly reduces the altruism motive. People would see kidney donations as a transactional thing.
I said it before, I'm not against it in a more just world. In the USSR, there were medals given for various good deeds and these medals carried benefits such as better housing, allowance etc.
I could see something like this for kidneys happening in a more equal world where people were awarded a medal for kidney donations (good for social standing, seperates it from purely being transactional) with the medal benefits like more vacation days, better housing or a bonus on your existing salary.
Keep in mind in this world, everyone has a home for free and all the basic needs are met by the state already.
I suspect it will still feel altruistic; I think there's not much difference between tax credits and a medal. I find it improbable that the altruistic motivation would fall off in some specific non-linear way such that the overall motivation would be lower. At least, you must admit that this bears trying. Even if there's a 50% chance you're right, there's still a 50% chance this solution will significantly help.
Counterpoint: no it's not