6 ms·

Donors of bone marrow can now be paid

55 points by jphackworth 15y ago

jphackworth 15y ago
This is interesting timing because of the Amit Gupta social media attempt to get a donor. Now, Amit is allowed to offer money for the bone marrow.
- avree 15y ago
  It's too late now, unfortunately. http://amitguptaneedsyou.com/ http://amitguptaneedsyou.com/
  - tapp 15y ago
    I'm not sure it is. To the best of my knowledge, Amit hasn't found a donor yet - they've just found several possible matches. If so, then the next challenge will be getting one of those matches to donate. Per article on HN yesterday, "more than 50 percent of South Asians in the registry refuse to go through with the donation process if selected" (Source: http://www.good.is/post/amit-gupta-and-the-south-asian-bone-marrow-deficit/ http://www.good.is/post/amit-gupta-and-the-south-asian-bone-... ) If payment improves that ratio, then I would think this could still potentially help Amit.
  - MichaelApproved 15y ago
    What was the clock counting down to?
    - gujk 15y ago
      Artificial deadline to instill a sense of urgency leveraged by the call to action.
skylan_q 15y ago
Oh no! Now there will be bone marrow thieves! </sarcasm>
deleted 15y ago
[deleted]
jlcx 15y ago
If people own their organs, then why can't they sell them? In any case, this seems to be a step in the right direction.
- abstractbill 15y ago
  You own yourself, but cannot sell yourself into slavery, for very good reasons.
  - extension 15y ago
    No, but you can sell your posessions, your labor, your ideas, your likeness, and numerous other rights and privileges. Why the arbitrary comparison between organs and slavery?
    - TheSOB88 15y ago
      Because of the pressures it would put on the people most likely to 'take advantage' of it. Do I sell my kidney or tell my kid he can't go to college? Do I sell my liver or live in credit card debt for the rest of my life? Plus, the illegal gaining and trading of organs would spike.
      - daenz 15y ago
        No idea why you're being downvoted. This is some interesting context on paying for organs: In Pakistan, 40 percent to 50 percent of the residents of some villages have only one kidney because they have sold the other for a transplant into a wealthy person, probably from another country, said Dr. Farhat Moazam of Pakistan, at a World Health Organization conference. Pakistani donors are offered $2,500 for a kidney but receive only about half of that because middlemen take so much.[33] In Chennai, southern India, poor fishermen and their families sold kidneys after their livelihoods were destroyed by the Indian Ocean tsunami on December 26, 2004. About 100 people, mostly women, sold their kidneys for 40,000–60,000 rupees ($900–$1,350).[34] Thilakavathy Agatheesh, 30, who sold a kidney in May 2005 for 40,000 rupees said, "I used to earn some money selling fish but now the post-surgery stomach cramps prevent me from going to work." Most kidney sellers say that selling their kidney was a mistake.[35] http://en.wikipedia.org/wiki/Organ_transplant#Compensated_donation http://en.wikipedia.org/wiki/Organ_transplant#Compensated_do...
ck2 15y ago
There is a massive profit made along the chain from selling donated blood in the USA to hospitals and patients - we're talking billion of dollars (the Red Cross is very guilty, so is Baxter and other corporations). The plasma payment model works just fine, I say try it for other things that are renewable.
- carbocation 15y ago
  In a recent thread I argued that renewable is not a sufficient criterion (and perhaps not necessary, either). Risk to the donor is much more important. Money in medicine is coercive, but if you are coercing someone into doing something nearly never harmful (blood or sperm donation), it's not a problem. If you're coercing them into doing something with high risk, even if the tissue is renewable, then I believe we have a problem (liver donation). Modern marrow collection techniques generally put the donor at low risk, and marrow is renewable, so it appears to be a clear win.
  - daeken 15y ago
    Risk matters, but the only impact is has on anything is on price. If something has a 0.1% chance of killing me, I'll expect far, far less money for it than something with a 5% chance of killing me. I might still do it, but the payoff has to be proportional to the risk I'm taking. I ride in cars knowing that I'm taking a risk, but I do it because I want the value that riding in a car gives me.
    - carbocation 15y ago
      In the abstract, I agree. One could create a utility function expressing the necessary compensation (for them) in exchange for taking on a certain amount of risk. In the concrete, I'm not so comfortable with this on a population scale. People in general are not good at understanding risk, and they are not good at understanding medicine. Procedure X has a 10% chance of killing you, a 1% chance of leading to necrotizing fasciitis that will not kill you but will require an amputation, a 3% chance of disfiguring scarring, a 4% chance of in-procedure myocardial infarction that will leave you alive but in heart failure ... etc. If we even had an exhaustive list of the actual risks of the actual procedures in the hands of the actual surgeon doing the procedure (we don't), it would still be impractical to get any particular person to understand the whole array of risks that they face, not just mortal risk. We would need a much better way of measuring 'understanding' than I believe we have right now for me to get onboard with compensation for extremely high risk procedures for donation. And that's assuming a coldly rational populace.
mhb 15y ago
Decision: http://www.ij.org/images/pdf_folder/economic_liberty/NOTA/no. http://www.ij.org/images/pdf_folder/economic_liberty/NOTA/no....
gkoberger 15y ago
I probably just don't fully understand the situation, however this seems bad. I'm usually for capitalism and the concept of supply and demand, but not in this case. What's my marrow worth to me? Probably not much; a bit of time and discomfort but overall not a huge deal. However, for the buyer, it's the matter of life or death. Seems like it would be easy to extort someone who needs it. This is one of the rare cases where I hope the market is very heavily regulated -- say, "Bone marrow is worth $1k. It's illegal to ask for more."
- pg_bot 15y ago
  Having price ceilings would cause shortages in supply which would possibly lead to more deaths than cost increases. By meddling in the marketplace you are bound to create a lot of unintended consequences that will be detrimental to patients.
  - gujk 15y ago
    Death is not the only measure of quality of life. ER docs are not empowered to negotiate fees with their patients in the moments before service either.
- eli 15y ago
  Right now the problem is supply. The problem is not people being unable to pay $x more for the treatment.

55 points by jphackworth 15y ago

This is interesting timing because of the Amit Gupta social media attempt to get a donor. Now, Amit is allowed to offer money for the bone marrow.

avree 15y ago
It's too late now, unfortunately. http://amitguptaneedsyou.com/ http://amitguptaneedsyou.com/
- tapp 15y ago
  I'm not sure it is. To the best of my knowledge, Amit hasn't found a donor yet - they've just found several possible matches. If so, then the next challenge will be getting one of those matches to donate. Per article on HN yesterday, "more than 50 percent of South Asians in the registry refuse to go through with the donation process if selected" (Source: http://www.good.is/post/amit-gupta-and-the-south-asian-bone-marrow-deficit/ http://www.good.is/post/amit-gupta-and-the-south-asian-bone-... ) If payment improves that ratio, then I would think this could still potentially help Amit.
- MichaelApproved 15y ago
  What was the clock counting down to?
  - gujk 15y ago
    Artificial deadline to instill a sense of urgency leveraged by the call to action.

skylan_q 15y ago

Oh no! Now there will be bone marrow thieves! </sarcasm>

deleted 15y ago

[deleted]

jlcx 15y ago

If people own their organs, then why can't they sell them? In any case, this seems to be a step in the right direction.

abstractbill 15y ago
You own yourself, but cannot sell yourself into slavery, for very good reasons.
- extension 15y ago
  No, but you can sell your posessions, your labor, your ideas, your likeness, and numerous other rights and privileges. Why the arbitrary comparison between organs and slavery?
  - TheSOB88 15y ago
    Because of the pressures it would put on the people most likely to 'take advantage' of it. Do I sell my kidney or tell my kid he can't go to college? Do I sell my liver or live in credit card debt for the rest of my life? Plus, the illegal gaining and trading of organs would spike.
    - daenz 15y ago
      No idea why you're being downvoted. This is some interesting context on paying for organs: In Pakistan, 40 percent to 50 percent of the residents of some villages have only one kidney because they have sold the other for a transplant into a wealthy person, probably from another country, said Dr. Farhat Moazam of Pakistan, at a World Health Organization conference. Pakistani donors are offered $2,500 for a kidney but receive only about half of that because middlemen take so much.[33] In Chennai, southern India, poor fishermen and their families sold kidneys after their livelihoods were destroyed by the Indian Ocean tsunami on December 26, 2004. About 100 people, mostly women, sold their kidneys for 40,000–60,000 rupees ($900–$1,350).[34] Thilakavathy Agatheesh, 30, who sold a kidney in May 2005 for 40,000 rupees said, "I used to earn some money selling fish but now the post-surgery stomach cramps prevent me from going to work." Most kidney sellers say that selling their kidney was a mistake.[35] http://en.wikipedia.org/wiki/Organ_transplant#Compensated_donation http://en.wikipedia.org/wiki/Organ_transplant#Compensated_do...

ck2 15y ago

There is a massive profit made along the chain from selling donated blood in the USA to hospitals and patients - we're talking billion of dollars (the Red Cross is very guilty, so is Baxter and other corporations). The plasma payment model works just fine, I say try it for other things that are renewable.

carbocation 15y ago
In a recent thread I argued that renewable is not a sufficient criterion (and perhaps not necessary, either). Risk to the donor is much more important. Money in medicine is coercive, but if you are coercing someone into doing something nearly never harmful (blood or sperm donation), it's not a problem. If you're coercing them into doing something with high risk, even if the tissue is renewable, then I believe we have a problem (liver donation). Modern marrow collection techniques generally put the donor at low risk, and marrow is renewable, so it appears to be a clear win.
- daeken 15y ago
  Risk matters, but the only impact is has on anything is on price. If something has a 0.1% chance of killing me, I'll expect far, far less money for it than something with a 5% chance of killing me. I might still do it, but the payoff has to be proportional to the risk I'm taking. I ride in cars knowing that I'm taking a risk, but I do it because I want the value that riding in a car gives me.
  - carbocation 15y ago
    In the abstract, I agree. One could create a utility function expressing the necessary compensation (for them) in exchange for taking on a certain amount of risk. In the concrete, I'm not so comfortable with this on a population scale. People in general are not good at understanding risk, and they are not good at understanding medicine. Procedure X has a 10% chance of killing you, a 1% chance of leading to necrotizing fasciitis that will not kill you but will require an amputation, a 3% chance of disfiguring scarring, a 4% chance of in-procedure myocardial infarction that will leave you alive but in heart failure ... etc. If we even had an exhaustive list of the actual risks of the actual procedures in the hands of the actual surgeon doing the procedure (we don't), it would still be impractical to get any particular person to understand the whole array of risks that they face, not just mortal risk. We would need a much better way of measuring 'understanding' than I believe we have right now for me to get onboard with compensation for extremely high risk procedures for donation. And that's assuming a coldly rational populace.

mhb 15y ago

Decision: http://www.ij.org/images/pdf_folder/economic_liberty/NOTA/no. http://www.ij.org/images/pdf_folder/economic_liberty/NOTA/no....

gkoberger 15y ago

I probably just don't fully understand the situation, however this seems bad. I'm usually for capitalism and the concept of supply and demand, but not in this case. What's my marrow worth to me? Probably not much; a bit of time and discomfort but overall not a huge deal. However, for the buyer, it's the matter of life or death. Seems like it would be easy to extort someone who needs it. This is one of the rare cases where I hope the market is very heavily regulated -- say, "Bone marrow is worth $1k. It's illegal to ask for more."

pg_bot 15y ago
Having price ceilings would cause shortages in supply which would possibly lead to more deaths than cost increases. By meddling in the marketplace you are bound to create a lot of unintended consequences that will be detrimental to patients.
- gujk 15y ago
  Death is not the only measure of quality of life. ER docs are not empowered to negotiate fees with their patients in the moments before service either.
eli 15y ago
Right now the problem is supply. The problem is not people being unable to pay $x more for the treatment.