Give Donors a Tax Credit.

• Author: Satel, Sally

Under Section 301(a) of the National Organ Transplant Act (NOTA) of 1984, it is a federal crime for "any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce."

Congress adopted NOTA with noble intentions, seeking to prevent a situation in which only wealthier patients could afford to buy organs that would mainly come from low-income "suppliers." Unfortunately, the ban on donor compensation has made it difficult to address the nation's transplant organ shortage.

For decades, the transplant community has mounted educational efforts, improved its procurement efforts at the time of death of potential donors, and tried a variety of other approaches to increase the supply of transplant organs. Yet, the number of living and deceased donors has not risen significantly. More potent enticement for donors is needed.

We believe the prohibition on financial compensation for organ donation is responsible for tens of thousands of needless deaths. Fiscal imperatives also compel reform. Dialysis costs Medicare about $ 100,000 per patient per year. With nearly 600,000 dialysis patients in the country, the total expenditure represents approximately 7% of the entire Medicare budget.

Tax credit / It is time to try another approach. Then-congressman Al Gore (D-TN), who spearheaded the adoption of NOTA, spoke at the time of using "a voucher system or a tax credit to a donor's estate" if "efforts to improve voluntary donation are unsuccessful." Unfortunately, this sensible idea has long been forgotten by lawmakers, at least at the federal level.

Several states have adopted tax incentives for organ donors, but those incentives appear to be too small and too poorly publicized to significantly increase donations. It is likely that larger and better publicized incentives would have significant effects. A 2016 cost-benefit analysis published in the American Journal of Transplantation concluded that a payment of $45,000 to donors would eliminate the waiting list for kidneys.

We propose a $50,000 federal tax credit for living donors willing to save the life of a stranger by donating a kidney, and a $5,000 federal tax credit for deceased donors of kidneys, intestines, pancreases, livers, and lungs. The credit would be refundable in cash for people who do not owe income tax, and it would not be phased out at high income levels. There would be no...