Legalization and Standardization of Organ Donation

[SafeDonor]

I've had this idea in my head since 2019, what if it was legal in the US for people to get paid to become a donor.
2 years later, I think I've worked out a framework, but unfortunately it looks like I missed the cutoff date for state ballot initiative requests for the 2022 election cycle.

So here's my framework
Adopting a VC style of investment.
-people are paid a set price for the exclusive right per organ.
-they are given the money upfront, no exams needed
-there are no lifestyle restrictions
-the transplant only occurs after you die
-your estate is given equal or more money than you were given upfront
-if the organ is no longer viable, no big deal, just the cost of doing business. Your off the hook.
-if you change your mind, no big deal, pay back the money at 10% interest to remove your name off the list.
-you must be 18 years or older to apply
-you can enroll your children into the program. Same rules apply, money upfront, transplant only happens after death. On their 18th birthday, they are removed from the program, and have the option to re-enroll. If accepted, same rules apply.

The idea here is that there are over 100,000 people in US in need of transplants and not enough donors. Over 8,000 people die annually, with most waiting over 3 years. The longer they wait, the less productive they become, not including all the stress due to uncertainty.
My proposal is would provide cash upfront, work like the typical VC/Crypto model where you diversify and only need a small handful to breakeven.
The exclusive right would be sold to insurance companies or governments, who would pay 3-5x multiples.

Example 1
Jim, 20 years old, male, lives in Denver Colorado.
He sells us the exclusive right to both his kidney's for $500 each upfront.
We then sell the right to XYZ insurance company for $50,000 per kidney.
I'm assuming insurance companies would then sell term life organ policies to cover expenses.

This transaction is beneficial because insurance companies generally have to spend about $25,000 per year for some dialysis treatments which take up 10+ hours per week for the person in need of a transplant. We are filling the demand. And the cost of the transplant surgery wise is often $100-200,000 anyway. But because their policy holder becomes more productive and increased years to live, the insurance company can justify the expense. Plus based on public data, there are 33,244 fatal motor vehicle crashes in the United States in 2019 in which 36,096 deaths occurred. This resulted in 11.0 deaths per 100,000 people and 1.11 deaths per 100 million miles traveled. The fatality rate per 100,000 people ranged from 3.3 in the District of Columbia to 25.4 in Wyoming. Also based on the numbers, it seems that men in the US begin to start dying in their 40's/50's, 10 years earlier than women. I want to avoid culture war issues and really focus on college kids and not the poor, I don't want this being seen as a payday lending scheme.

I'm working on the website now. Will start on the blockchain next month. The goal is to raise money to get this on the ballots of state elections for the 2024 Presidential election cycle. I want to amend the first line of the current law prohibiting the sale of organ donations after death. This is a felony currently. The average signature needed is about 100-300k per state and seems to be a huge undertaking. Do you guy's see the crypto community getting behind this effort either as early investors or joining the waitlist? What do you guys think of the concept overall.


Blockchain
-----------------------
Each transaction will be available in a blockchain. Those in need will know where in line they are, but the public won't know the names of said people, only the public ID's, and transaction codes.
-shows transaction data
--new donor registration, payout, removal, death
--donor recipient moving up in line, currently in surgery, successful transplant
--insurance company, policy sales




  

[paxmao]

One of the countries where donating organs is a source of income is Iran. You can sell your kidneys, parts of the liver or anything else that you can do without for money. As you may imagine this is a resource for the most deprived citizens and it has been shown to have negative psychological effect in the long term as the money goes away and the organ is lost forever.

A person in need of a kidney is referred to the Dialysis and Transplant Patients Association which matches them with a potential donor. These un-related donors are guaranteed monetary compensation of approximately $1,200 from the government and an additional amount from the recipient which varies anywhere from $2,300 to $4,500.

In China, it was legal to harvest the organs of the executed. This obviously creates a perverse incentive of the system to sentence to death more people - not that they really need much incentive.

Till 2014, Chinese authorities permitted the harvesting of organs from executed prisoners without prior consent from them or their families. In fact, in December 2005, the country’s deputy health minister estimated that as many as 95 per cent of the organs used in China’s transplants came from such sources.

https://sites.ndtv.com/moretogive/organ-donation-what-other-countries-are-doing-1297/

[hatshepsut93]

America already has lots of problems with poverty, inequality and absurdly expensive health care, legalizing organ selling is like adding oil to the fire, poor people will have no choice but to give away their health for money. A better solution is to just make every deceased person an organ donor, with an option to opt out of this program for the paranoid people, making them ineligible to receive organs in exchange.

And what does the blockchain solve in this situation? If someone wants to cheat in this system and has a power to do so, they would still do it. They can create fake identities and put them into the queue, for example.

[Darker45]

If I am not mistaken, it is not illegal to donate organs. What is illegal is selling them.

Anyway, between somebody who is already unproductive and dying in need of an organ transplant and somebody who is active, productive, and healthy who is a possible organ donor and would face risks by doing so, I'd rather leave the dying to face his/her own death than possibly cause another man a difficult life.

Donation is donation. The moment you monetize it, all hell breaks loose. If a donation is made in exchange for money, it is not anymore a donation. That is selling. Legalized organ selling will cause more harm.

I'd rather forget about the 8,000 people who die annually if what it takes to try to heal them is the risky process of taking some organs from healthy persons which could make them ill as a result. A healthy person in exchange for a dying person is never cost-beneficial.  

[Rruchi man]

https://sites.ndtv.com/moretogive/organ-donation-what-other-countries-are-doing-1297/

for the case of organ donation, in countries where there is a "presumed consent law" for organ donation after death like in Spain, France, Norway etc, it is my opinion that more awareness be raised about it, so everyone knows about it and they at least know that they have the choice of opting out if they don't like it. It makes sense that your working organs could be the reason another person is alive after your death, but people should be made to know the concept and reason behind it.

[Obito]

This is actually a good proposition, with blockchain on the way, Jim wouldn't worry that the insurance company is going to fuck things up just to gain much more profit from him when he dies. But it may sound good but I don't like the idea of organ donation in the first olace especially if it enables human traffickers, look up China's illegal organ harvest industry, this is their way of persecuting minorities in their country. Plus, there's already a revolution in 3D printing that can easily print you an organ.

[Lucius]

If it's legal to sell blood and sperm in the US (and it's legal in some states), then I don't see it disputable to regulate and pay people to donate organs - although moral dilemmas arise as to how to protect such data and reduce manipulation to the least possible measure. The fact is that the demand for human organs is very high, and that people may need to be encouraged to become voluntary donors in the event of death, and the question is how people and the community in general would react to the fact that there is a monetary initiative behind organ donation?

~snip~

I was familiar with the data for China because a lot has been written about it in recent years, especially when the Uighur issue is mentioned. It is unbelievable that people are killed just because of their religion or political views, and then their organs are taken away and given to those who are loyal to the regime. However, this is the first time I have heard about Iran and their law on this issue, because since it is a predominantly Muslim country, isn't the literal sale of organs in conflict with their religion?

[molsewid]

If I am not mistaken, it is not illegal to donate organs. What is illegal is selling them.

Anyway, between somebody who is already unproductive and dying in need of an organ transplant and somebody who is active, productive, and healthy who is a possible organ donor and would face risks by doing so, I'd rather leave the dying to face his/her own death than possibly cause another man a difficult life.

Donation is donation. The moment you monetize it, all hell breaks loose. If a donation is made in exchange for money, it is not anymore a donation. That is selling. Legalized organ selling will cause more harm.

I'd rather forget about the 8,000 people who die annually if what it takes to try to heal them is the risky process of taking some organs from healthy persons which could make them ill as a result. A healthy person in exchange for a dying person is never cost-beneficial.  

I do understand the point of view of OP and I think that he just wanted to try to provide another way to save lives of those people who were in need for a donor of organs but also thinking that if it would be monetize I'm afraid that it will only lead to a many crimes like kidnapping and human trafficking. Is it only me who is thinking that maybe the mafia for human trafficking may regroup for a big group sharing common goal and that is to get money in exchange of organs? I may be exaggerated it but this is what have come to my mind after reading the thread.

[vapourminer]

I do understand the point of view of OP and I think that he just wanted to try to provide another way to save lives of those people who were in need for a donor of organs but also thinking that if it would be monetize I'm afraid that it will only lead to a many crimes like kidnapping and human trafficking. Is it only me who is thinking that maybe the mafia for human trafficking may regroup for a big group sharing common goal and that is to get money in exchange of organs? I may be exaggerated it but this is what have come to my mind after reading the thread.

larry niven (a "hard" science fiction writer) wrote several stories about harvesting organs for profit or "the greater good" in the 1960's/70s. basically, the whole concept goes south real fast. i tend to agree with him.

brief overview:
http://www.technovelgy.com/ct/content.asp?Bnum=337

[bosede1]

I know that for some organ donor you are being paid for it, both if I see it from your point of view it will become a normal business and can create avenue for things not so good in the community and so on.

[Gozie51]

Organ transplant has gone commercial now, and not only that there other medical surgeries, artificial surgery, replacement and adjustments made on human bodies now. This is having effect on the economy and may not be excluded for the high rate of kidnapping and terrorism attacks which may have the connection of organ replacement for money. People risk the life of others for money and some give birth and sell them for money. Encoding these into the blockchain will lead to increase in the rate of organ transplant because identities will be concealed. I'm just looking at the negative effect anyway.

[Hydrogen]

I don't think the united states is a suitable climate for a future hub of organ donations. Cost of living is too high. Taxes, regulation and expenses too much overhead. Health and dietary regimen of americans can be a negative trend in contrast to healthcare and standard of living of countries who enjoy healthier average diet and lifestyle.

The natural progression would likely be for nations outside the USA to be offered monetary incentive for organ donation. With organs being imported into the US.

With the format being shifted to include monetary payout only upon the event of death via natural causes.

[romero121]

How this going to work effectively is still a myth. Because the donar is paid upfront, and the donar agree for the organ transfer after his death. This could increase the chance of crime.

For example person A is rich and he has got good sum of money. Person B is poor and he agrees for the organ donation and gets upfront payment. Now person B is in the urge of transplantation for survival. By this time some people will intend to kill and take the organ. So, this isn't going to be more effective plan. If something offensive or controversial I'm sorry for that, nothing intentional. Human minds are built in such a way.

[Oceat]

This might lead to a dangerous idea since we all know that people are greedy. I have no problem with the donation of organ thing but when there's money involved that's a different story. It would make a bad reputation to the blockchain or to the crypto community if things goes sideways. I know some government will try to make it look like the source of the problem is the crypto currency. And worse is like what happened in China as @paxmao mentioned.

It may still be under in a debate but I don't agree to monetize donating organ. Donation is different from monetizing.

[Darker45]

If I am not mistaken, it is not illegal to donate organs. What is illegal is selling them.

Anyway, between somebody who is already unproductive and dying in need of an organ transplant and somebody who is active, productive, and healthy who is a possible organ donor and would face risks by doing so, I'd rather leave the dying to face his/her own death than possibly cause another man a difficult life.

Donation is donation. The moment you monetize it, all hell breaks loose. If a donation is made in exchange for money, it is not anymore a donation. That is selling. Legalized organ selling will cause more harm.

I'd rather forget about the 8,000 people who die annually if what it takes to try to heal them is the risky process of taking some organs from healthy persons which could make them ill as a result. A healthy person in exchange for a dying person is never cost-beneficial.  

I do understand the point of view of OP and I think that he just wanted to try to provide another way to save lives of those people who were in need for a donor of organs but also thinking that if it would be monetize I'm afraid that it will only lead to a many crimes like kidnapping and human trafficking. Is it only me who is thinking that maybe the mafia for human trafficking may regroup for a big group sharing common goal and that is to get money in exchange of organs? I may be exaggerated it but this is what have come to my mind after reading the thread.

There must still be some untapped ways to improve or maximize organ donation. But never the monetization of it. I'm afraid the negative consequences of which would be much bigger than the problem it intends to address. As you mentioned, one of which is the possible emergence of syndicates focusing on human trafficking or kidnapping for the sake of organ gathering.

How many people die everyday? Accidents, deaths, happen every hour of the day. How many of the dead have healthy organs which could still be used by people who need transplant? Many, I suppose. I guess we could develop or strengthen programs, if there are already existing ones, to encourage families to donate the organs of their dead loved ones.

[yhiaali3]

It is necessary before every project to know the negative aspects. Does this project encourage criminals who trade in human organs to kill more victims??!! If such a project is approved and the sale of organs becomes legal even if it is after death, perhaps this will be tantamount to obtaining an official certificate for gangs selling human organs to practice their work freely. There are many such gangs, especially in third world countries, who kill their victims and then sell their organs to Wealthy sick people who need these organs to continue their luxurious lives!!! What is the deterrent anymore for these criminal gangs to increase their brutal activities against innocent victims?!!
I know you have a good intention, but such a project may have very serious consequences for the safety of society.

[fiulpro]

I think you are not aware of the dark web that secretly takes the organs out of poor people sometimes then sells it in either black market and for some of them they end up getting sold in countries with legal organ donation. It's not as simple as it sounds since at the end of the day, organ donation becoming legal might mean these activities will increase in some corrupted Nations. It is legal in some countries but it still comes with a lot of negative effects. Also at the same time it's not really a 100% safe procedure, I myself would not recommend anyone to do it as a means of earning money since your body might have infection, sepsis, internal bleeding, long term damage and death as well. If done for emergencies it's completely understandable, if done for selling and earning some money, a lot of things can go wrong.

[SafeDonor]

How this going to work effectively is still a myth. Because the donar is paid upfront, and the donar agree for the organ transfer after his death. This could increase the chance of crime.

For example person A is rich and he has got good sum of money. Person B is poor and he agrees for the organ donation and gets upfront payment. Now person B is in the urge of transplantation for survival. By this time some people will intend to kill and take the organ. So, this isn't going to be more effective plan. If something offensive or controversial I'm sorry for that, nothing intentional. Human minds are built in such a way.

The idea is that for people becoming donors, there's close to zero risk. We are paying you to become a member and forget your on the list. Many fintech companies like Paypal/Coinbase have done the same. You then go and live your life. After death, your estate (family) would get paid out 2-3x whatever you were paid initially so in this case ($1500) which they can use for anything (funeral costs, cover daily expenses, etc) if the organ is viable and the transplant occurs. After death, hospitals would run your name to see if your in the system. Each hospital would have their own credentials and everyone can see logs of hospitals accessing the blockchain, but the donor and recipient names remain encrypted.

This is what makes what I am doing so expensive and why I will need the crypto/VC community to fund this. So if I pay 100 people $500 just to sign up and sell me the exclusive right to one kidney for example, and I sell that right to xyz insurance company or government healthcare system (europe) for $50k, 1 death covers 100 bets. The cypto/VC investors see their investment grow since margins are so big. And we fill a pressing need. Even if we account for the additional $1500 payout to the family after death, this expense is easily accounted for since I'm expecting the average member's lifespan to reach 30-50 years. Inflation will reduce their payout amount, and conservatively investing small sums in an index fund or AAA bond (gov or corporate bond) over 10 years would yield the amount needed and the rest would be profit.

Math
$50k Crypto/VC investment per 100 people, excluding additional expenses to keep the math simple
$500 per person
$1500 estate payout upon death and transplant
$50,000 average payout from insurance company payout to us
10% average return on the S&P500 from 1926 to 2018
18-25 years old average donor age up registration
30 year conservative projection of average life expectancy of each donor after registration

$50,000 - $50,000 (100 people) = $0
100 * $50,000 (insurance pays us) = $5,000,000

$49,500 invested in the S&P500 at a conservative 4% expected return over 10 years with zero additional contributions = $23,770 profit
$49,500 invested in the S&P500 at 10% expected return over 10 years with zero additional contributions = $78,890 profit
$49,500 invested in the S&P500 at a conservative 4% expected return over 30 years with zero additional contributions = $111,048 profit
$49,500 invested in the S&P500 at 10% expected return over 30 years with zero additional contributions = $814,245 profit


Insurance company's projected profits per term policy, assuming $1000 initial investment and $200 monthly contribution over 30 years at 10% return = $398,935
Starting amount - $1,000
Total contribution (monthly fee paid by policy holder) - $72,000
Total investment - $471,935

[SafeDonor]

It is necessary before every project to know the negative aspects. Does this project encourage criminals who trade in human organs to kill more victims??!! If such a project is approved and the sale of organs becomes legal even if it is after death, perhaps this will be tantamount to obtaining an official certificate for gangs selling human organs to practice their work freely. There are many such gangs, especially in third world countries, who kill their victims and then sell their organs to Wealthy sick people who need these organs to continue their luxurious lives!!! What is the deterrent anymore for these criminal gangs to increase their brutal activities against innocent victims?!!
I know you have a good intention, but such a project may have very serious consequences for the safety of society.

I think the increase of crime is somewhat overstated. Sure crypto and bitcoin are used for crime but it pales in comparison to the amount of transactions that are normal. It would be hard for criminals to disrupt this process, a lot would have to go right for them.
-They would have to be colluding with a rich person in need of an organ. This person would tell them where they are in line. The blockchain would tell them this, but it wouldn't tell them who is infront or below them in line.
-If the rich person is not #1 in line, nothing can be done since the blockchain won't revel the identity of people on the waiting list.
-If the rich person is #1 in line or close to it, there's little incentive for him to pay for an illegal service and risk felony charges. At scale, people wouldn't have to wait long anyway, maybe days or weeks as oppose to the current 3-5+ years.
-They would have to know who's a donor and which organ have they sold rights to. People won't tell you this, just like most won't tell you their social security number. And the transplant only occurs after death. It would look suspicious for a new member to die within a week, or month, or year. I'm certain investigators/reporters/data scientists and AI would notice this anomaly and piece it all together which would result in the rich guys finances being scrutinized until they find the link to the criminal organization.

[Ucy]

I don't really think it's a good idea to sell your organ for money to save lives. That could translate to: "I will only save your life if you give me money".

I haven't really sat down to deeply consider the use of organs from strangers and the implications. Assuming it's moral, I would rather encourage donations and look for ways to get more people to donate. Maybe by offering their children/relatives some sort of beautiful certificates/cards that prove that their dead parents or relatives helped save the lives of those in need of organs. Donors could be treated with respect... That all the certificate can do
I don't like the idea of people selling part of their body for money, it could encourage all sort of abominable behaviors.
I think you could just publicly list those who need organs, with urgent cases at the top of the list. If someone on the list dies, it should be public too so that more people will be willing to apply to save others. Those on the list can be anonymous, but there should be ways to verify they are real humans in need of organs.