Kinda. I think it would fail utterly in practice. The per-person incentives are all wrong. You're less likely to get picked if you ruin one of your kidneys, fo

Kinda. I think it would fail utterly in practice. The per-person incentives are all wrong. You're less likely to get picked if you ruin one of your kidneys, for example. "Donors" are going to be unwilling in general, and that will cause a lot of trouble and turmoil. Lots of protesting. Not to mention any abuse of the system would be kind of horrifying. But the general idea of substituting "bad luck you got a disease" with "bad luck you lose the lottery", when there's only half as many lottery losers as there were disease losers... maybe that's not so bad. When it comes to trolley problems, you also have to imagine yourself on the track. Do nothing and there's a 5/6 chance you die. Throw the switch, and there's a 1/6 chance you die.