[HN Gopher] How to stop losing 17,500 kidneys
___________________________________________________________________
How to stop losing 17,500 kidneys
Author : Michelangelo11
Score : 100 points
Date : 2024-04-16 16:42 UTC (6 hours ago)
(HTM) web link (www.statecraft.pub)
(TXT) w3m dump (www.statecraft.pub)
| hinkley wrote:
| Oh good, we're going to Let the Free Market Fix the Problem.
| throwup238 wrote:
| Our Market, which art invisible, hallowed be thy hand;
| thy equilibrium come; thy allocation be done on
| earth as it is in theory. Give us this day our daily
| goods, and forgive us our regulations, as we
| forgive those who regulate against us. And lead us not
| into market failure, but deliver us from inefficiency.
| For thine is the kingdom, and the power, and the glory
| of wealth creation, forever and ever. Amen.
| justrealist wrote:
| How many decades of central planning organ-management failure
| would you like before concluding the experiment has failed?
| hinkley wrote:
| Have you heard of the One Percent?
|
| We have the shittiest healthcare system in the first world.
| The Market has not provided. It uses people as fuel, this
| should not be surprising to anyone.
| PaulHoule wrote:
| Worst in some ways, best in others.
| Ma8ee wrote:
| Best in which ways?
| itishappy wrote:
| Medicine. We're really freakin' good at it. We make a lot
| of drugs, and our quality is high. We invent new drugs.
| Our doctors rank among the best in the world. We develop
| new treatments, techniques, and devices.
|
| It's access to care that we suck at, and our lifestyles
| aren't doing us any favors. People generally leave the
| country due to cost, not an expectation of better care.
| snakeyjake wrote:
| It seems to me, based on the article, that the main issue is
| the profit-seeking ghouls (err.. I mean... "Job Creators")
| exploiting the government, its limited resources, and faulty
| regulations-- which are slowly being fixed.
|
| There is ample evidence (e.g. the entire rest of the
| industrialized world vs. the US healthcare system) that
| decentralized capitalist control of the donor organ system
| would lead to an exploitative nightmare that would make the
| current system look like unassailable perfection.
| hinkley wrote:
| Real time trading. Oh a more lucrative recipient just
| popped onto the board, sorry!
| candiddevmike wrote:
| Playing devils advocate, that exploitative nightmare
| already exists elsewhere in the world. If a consenting
| adult wants to sell a kidney or lung, why shouldn't they be
| allowed to?
| ceejayoz wrote:
| > that exploitative nightmare already exists elsewhere
|
| Expanding it seems like the wrong approach?
|
| > If a consenting adult wants to sell a kidney or lung,
| why shouldn't they be allowed to?
|
| Because it leads to horrific results. Desperate poor
| people get peanuts and life-long health problems.
| https://www.aljazeera.com/news/2022/2/28/desperate-
| afghans-r...
| avar wrote:
| "If I don't sell my kidney, I will be forced to
| sell my one-year-old daughter."
|
| It's an odd sort of cognitive bias to conclude from this
| article that the selling of kidneys is the problem. You
| don't think they should be given the option of selling
| their kid or their kidney?
|
| My takeaway from this article is that the market just
| isn't developed enough. If they were able to sell their
| kidneys to richer westerners then they could easily get
| 10x or 100x as much money.
|
| In that part of the world that's easily enough to make
| the best way to _extend_ your statistical lifetime be to
| sell your kidney. You 'd get access to better healthcare
| for life, your children could get an education etc.
| ceejayoz wrote:
| > You don't think they should be given the option of
| selling their kid or their kidney?
|
| I think we can aspire to give our citizens better choices
| than "sell child or sell kidney", yes.
| avar wrote:
| "Our citizens"? I didn't know the Taliban could be found
| on HN. You should do an AMA.
|
| What I'm pointing out is that you seemingly only care
| because the proposed scheme might cause you or other
| affluent people to interact somehow with the desperately
| poor. So the knee-jerk reaction is that we should ban the
| scheme entirely.
|
| But those people will still be desperately poor without
| it, even more so. It's really arrogant to say that they
| shouldn't be given the option.
|
| Would I sell my own kidney if there was a market for it?
| No, almost certainly not. But I don't live in those
| circumstances.
|
| But we're talking about a country where the life
| expectancy is around 60 years, and where people are
| making something in the very low 4-digit USD/yr.
|
| It's not hard to imagine how that could be turned into a
| win-win if the more affluent were able to buy kidneys.
| ceejayoz wrote:
| > "Our citizens"? I didn't know the Taliban could be
| found on HN. You should do an AMA.
|
| The proposal is _expanding_ this practice, correct?
| Permitting Americans to sell their kidneys?
|
| > What I'm pointing out is that you seemingly only care
| because the proposed scheme might cause you or other
| affluent people to interact somehow with the desperately
| poor.
|
| Ooof, a _body_ blow to that strawman. Bravo! Well fought!
|
| > But those people will still be desperately poor without
| it, even more so. It's really arrogant to say that they
| shouldn't be given the option.
|
| They'll be even more desperately poor when the remaining
| kidney fails, they lose their job (and thus health
| insurance), and donor kidneys aren't available because
| they've all been bought up for $100k.
| avar wrote:
| How is that a strawman? You're arguing against any market
| mechanism on the basis of a human interest story
| discussing Afghanis who sold their kidneys for what you'd
| expect to pay for a new laptop.
|
| I'm assuming you aren't actually in Afghanistan, so I
| thought the out-of-sight-out-of-mind comment was fair.
| > They'll be even more > desperately poor when
| > the remaining kidney fails.
|
| Make that case statistically, how many statistical years
| do you lose from kidney donation with access to modern
| medicine? > and donor kidneys aren't
| > available because[...]
|
| Everyone's born with two, you generally only need one,
| and failure is rare.
|
| That's why it's such a perfect example for why a market-
| based approach could be a win-win for everyone. Nobody
| would die from kidney failure.
| ceejayoz wrote:
| Afghanistan offers an example of the market-based
| approach to kidney donation and its downsides. There are
| certainly Americans desperate enough for a few grand in a
| similar fashion.
|
| > Everyone's born with two, you generally only need one,
| and failure is rare.
|
| https://www.kidney.org/transplantation/livingdonors/long-
| ter... lists a number of potential downsides to donating
| a kidney while alive.
| avar wrote:
| > Afghanistan offers an example > of the market-
| based approach > to kidney donation and its
| > downsides.
|
| And upsides, e.g. the person who avoided selling their
| child by selling their own kidney.
|
| Is that an overall terrible situation? Yes, but I'd like
| to think any parent would make the same choice.
|
| Anyway, to respond to this and your up-thread (which I
| believe you added in an edit after I replied to that
| comment): > The proposal is expanding
| > this practice, correct? > Permitting Americans
| to > sell their kidneys?
|
| No, let's narrowly stick to Afghanistan, since that's the
| example you brought up. It avoids getting into the muddy
| waters of introducing multiple variables.
|
| Afghans are selling their kidneys right now, for the
| equivalent of around 1/2 to 1 year of local median
| salary. They're selling them to other Afghanis, or
| Pakistanis etc. willing to travel there.
|
| Now, let's say an American dying of kidney failure was
| allowed to fly over that same Afghani to the US as a paid
| kidney donor for hire.
|
| They'd still be out of a kidney, but now they might have
| gotten 20-40 years worth of the median salary in
| Afghanistan as a reward.
|
| Don't you think that would be better for everyone
| involved? > [<URL>] lists a number of
| > potential downsides to > donating a kidney
| while alive.
|
| I'll take that as a "no" to the question about whether
| you're able to support your up-thread "when the remaining
| kidney fails" claim with any numbers.
| candiddevmike wrote:
| If you read the article, there isn't really any central
| planning. It's one of those "regulated monopolies" with only
| one (private) contractor. These kind of things always end
| poorly for the customers in my experience... Either go full
| free market or have it ran by the government.
| bedobi wrote:
| this isn't some libertarian nonsense, there's plenty serious
| people in medicine and economics who advocate organ markets
| (but not in the dystopian way you probably imagine)
|
| if you read up about it you might even learn something
| soperj wrote:
| > but not in the dystopian way you probably imagine
|
| How do you end up with any other way? (serious question)
| bedobi wrote:
| https://impact.stanford.edu/article/how-does-applied-
| economi...
| ceejayoz wrote:
| It seems weird to describe this technique as a market.
| bedobi wrote:
| and yet without economists and economics, whose entire
| purpose for existing is studying all the ways in which
| markets DON'T work and how to fix their resulting
| problems (the opposite of "shilling for neoliberal free
| market trickle down policies" which is what most people
| seem to think they do), this kidney market (because it is
| a market) wouldn't exist
| GartzenDeHaes wrote:
| Soylent Red, the for profit recycling of corpses.
| rrr_oh_man wrote:
| Valued at $4.2T and currently losing less than $2B per year.
| dang wrote:
| " _Eschew flamebait. Avoid generic tangents._ "
|
| " _Don 't be snarky._"
|
| https://news.ycombinator.com/newsguidelines.html
| dynm wrote:
| For a contrary view, this comment on Marginal Revolution is worth
| considering
| (https://marginalrevolution.com/marginalrevolution/2024/04/un...)
|
| > My spouse works for a doctor who specializes in kidney
| transplants. This post has numerous errors and misleading
| statements; so many that it probably should be taken down.
|
| > Firstly, there is a very good reason why some recovered organs
| are not transplanted. It's because they arent healthy kidneys.
| Either due to the health of the donor or a long cold ischemic
| time, these kidneys would not function properly in a recipient.
| The center my spouse works for is nationally recognized as being
| aggressive; making use of kidneys that other doctors reject, but
| there are plenty of kidneys that they will mot use and no center
| will.
|
| > Secondly, organs are GPS tracked.
|
| > Next, UNOS requires each center to remove someone from the wait
| list within 24 hours of finding out about the death. My spouses
| center checks in with patients once every 3 months, so, at most,
| there can be a 3 month delay between death and list maintenance.
| In practice, the family or dialysis center will notify the
| doctors office much earlier than that. I highly doubt the 17
| percent of matches are against deceased patients stat because it
| has never happened in all the years my spouse has been working
| there
|
| > Also prior living donors are given priority
| jessriedel wrote:
| > Also prior living donors are given priority
|
| This does not conflict with the Marginal Revolution post.
| Tabarrok is suggesting a policy where registered potential
| organ donors (i.e., people who sign up to be organ donors _in
| the event of their own death_ ) should receive priority if they
| later need an organ. There are vastly more such people than
| living donors.
|
| > Secondly, organs are GPS tracked.
|
| This seems wrong. If they all were tracked, it would be a very
| silly mistake to make to claim otherwise. The most likely
| resolution is that the organ transport firm who works with this
| particular doctor (the commenter's spouse) does do tracking,
| but that tracking is not universal and perhaps not common. In
| which case Tabarrok's criticism would stand.
|
| Here's the source of the claim that GPS tracking is not
| required, which indeed notes that some transport firms track
| and some do not:
|
| > Jones noted that his firm ships organs only on direct flights
| and uses GPS tracking to monitor them.
|
| > However, GPS tracking isn't universal -- or required by UNOS
| or HRSA. Some couriers and airlines use it; many don't. Many
| OPOs monitor organs through a combination of verbal handoffs,
| automation and label scans, Brown said.
|
| https://kffhealthnews.org/news/how-lifesaving-organs-for-tra...
| eviks wrote:
| Seems that 17% is from 2008-2015 data (this is the link from
| the original article linked in the post)
| https://www.amjtransplant.org/article/S1600-6135(22)09789-1/...
|
| Also it mentions a policy of relying on SSA data, which makes
| more sense than checking on each patient manually every 3
| months (though the data access got worse due to a policy
| change). Curious why this doesn't match ther personal
| experience of the commenter's spouse, should be a high enough
| number to be noticeable?
| Levitating wrote:
| This is just a comment from someone whos "spouse works for a
| doctor who specializes in kidney transplants" on a semi-related
| internet post by a professor of economics.
|
| The actual article here is an interview with the people who
| accumulated all this data and have spent years researching
| UNOS.
|
| Besides:
|
| > There have been some tremendous surgeons who have spoken up,
| and three have testified before three different congressional
| hearings in recent years, saying that too many of their
| patients are dying, and the system has to be fixed.
| DoreenMichele wrote:
| As a woman on HN (and former homemaker) who gets all kinds of
| shit for daring to participate as openly female, I'm both
| amused and appalled that the top comment is a dismissal of the
| article based on an internet comment from someone claiming to
| be "the spouse of..." etc.
|
| I was so tempted to say "I'm a former military wife. Maybe the
| Pentagon should run all of its policies past me." but it's a
| violation of HN guidelines.
|
| Don't get me wrong, I routinely cite "I'm a former military
| wife..." as an explanation of why I know some things about, for
| example, military culture.
|
| I also worked for a major insurance company for over 5 years
| and had annual HIPAA training. And I feel like either this
| person is blowing smoke or their spouse is possibly in
| violation of HIPAA.
|
| If only "I'm supposedly married to...and I'm not giving my name
| either!" served as a legitimate citation, maybe I would be
| taken more seriously and making more money.
|
| Edit: Their supposed name is apparently at the top of the
| comment. My bad.
| hanniabu wrote:
| > Secondly, organs are GPS tracked.
|
| While they're transported or while they're in you?
| clcaev wrote:
| paired kidney exchange is a Market Design, see "Who Gets What and
| Why" by Alvin Roth
| renewiltord wrote:
| The reason I'm not an organ donor is simple. Everyone in the
| chain makes money: the OPO, the hospital, the doctor, and the
| insurance company. The only one who doesn't is my family, but
| they're the ones offering the scarce resource. If there were a
| pre-registered organ market then I would gladly opt-in if the
| price were sufficiently high.
|
| If no one else will work for free, I will not either.
| ceejayoz wrote:
| Fine, but you should be ineligible to _receive_ , in that case.
| renewiltord wrote:
| Fine by me. I'm in a minority ethnic group here in the US.
| I'm not going to match that easily anyway.
|
| EDIT: Sorry to you ceejayjoz, I was trying to reply to others
| by adding info to this because the rate limit doesn't let me
| but that's going to get discussions confused. I edited it out
| once I thought about that. So I'm fine with this so-called
| donation being a de-facto self-insurance pool. If the terms
| are like that, then I opt out.
| ceejayoz wrote:
| > It's called "donation" not a "risk pool".
|
| Unsympathetic people get fewer donations throughout
| society, and I'm inclined to see someone who'd rather let
| their organs rot in the ground or be cremated when they
| could save _lives_ as... quite unsympathetic.
| Jemaclus wrote:
| As an organ transplant recipient who would have died 20 years
| ago without one, I hope you reconsider.
| wara23arish wrote:
| I feel the same way.. Why can't my family benefit from making
| money from my organs?
| delecti wrote:
| Because then poor people are incentivized to kill themselves
| or their relatives to sell their organs.
| renewiltord wrote:
| A living kidney donor faces lower mortality risk than a
| logger but we allow people to be loggers. Explain that.
|
| We allow people to risk their lives to provide for their
| families, except in this way. Unless your position is that
| whenever mortality risk exceeds living kidney donor
| mortality risk we should immediately ban the job. If so,
| let's ban logging. We can take this to its absurd
| conclusion.
|
| On the other hand, Matt Yglesias points out why it's so
| much better to have a market here
| https://www.slowboring.com/p/solving-problems-by-letting-
| peo... including for kidneys
|
| And specifically points out the plasma-donation situation
| as a contrast.
| soneil wrote:
| If you donate your family don't benefit. If you don't donate,
| your family don't benefit. The only logic I can find here is
| spite.
| Calavar wrote:
| > If no one else will work for free, I will not either.
|
| If you're deceased, what sort of labor are you doing exactly?
|
| To me, your argument seems to fall more along the lines of your
| body and organs being property that can be inherited by your
| family in the same was as cash, real estate, etc. Which is an
| interesting idea.
|
| But ultimately it's called "donation" for a reason. If you
| donate to, say UNICEF or Red Cross, you're also the only one in
| the chain who doesn't get paid.
| dotnet00 wrote:
| >If you're deceased, what sort of labor are you doing
| exactly?
|
| Keeping the kidney healthy so that it is usable upon death?
| kelnos wrote:
| So you've chosen to potentially sentence a patient to death
| because you don't like the infra around the donation process?
| Basically the definition of throwing the baby out with the
| bathwater.
| stonogo wrote:
| There's a whole chain of novels by Larry Niven about what might
| happen when human organs enter a market economy. It assumes it
| works like any other closely-regulated market, producing a
| robust black market quickly dominated by organized crime.
|
| Also, none of the people in the chain you list are profiting
| from your 'scarce resource,' but from providing skills and
| facilities to enable transplantation. (Insurance companies are
| just parasites, no argument there.)
|
| Further, you left out the primary motivating factor behind the
| program: the recipient.
| astrange wrote:
| > There's a whole chain of novels by Larry Niven about what
| might happen when human organs enter a market economy. It
| assumes it works like any other closely-regulated market,
| producing a robust black market quickly dominated by
| organized crime.
|
| This is like when people quote Pournelle's Law like it's a
| fact. The only thing this paragraph means, just like the only
| thing Pournelle's Law means, is that the person who wrote it
| is a Republican. It doesn't actually demonstrate anything
| factual or even related to reality.
|
| (You can get paid for plasma and sperm donations but there
| isn't a black market for those.)
|
| > Insurance companies are just parasites, no argument there.
|
| They provide insurance, and they're probably more aligned
| with your interests than the rest of the supply chain is.
| tzs wrote:
| > (You can get paid for plasma and sperm donations but
| there isn't a black market for those.)
|
| There were plasma black markets during and after the COVID
| pandemic [1][2][3][4][5]. There are black markets in sperm
| [6][7][8][9][10].
|
| [1] https://www.indiatoday.in/india/story/exclusive-
| coronavirus-...
|
| [2] https://www.al-monitor.com/originals/2020/07/iraq-
| coronaviru...
|
| [3] https://www.al-monitor.com/originals/2020/06/egypt-
| coronavir...
|
| [4] https://www.occrp.org/en/daily/12644-blood-plasma-
| black-mark...
|
| [5] https://www.deccanchronicle.com/nation/medical-experts-
| warn-...
|
| [6] https://www.dailymail.co.uk/health/article-12370461/Fac
| ebook...
|
| [7]
| https://www.dailymail.co.uk/news/article-13298869/sperm-
| dono...
|
| [8] https://www.dailystar.co.uk/news/world-news/wild-west-
| sperm-...
|
| [9] https://worldcrunch.com/culture-society/undercover-
| hunt-in-i...
|
| [10] https://www.thehelper.net/threads/seedy-world-of-the-
| super-s...
| prmoustache wrote:
| Congratulation, I think you successfully managed to find a cozy
| place around the pedophiles, the terrorists, the nazis and
| feyenoord hooligans in the humanity scale.
| bee_rider wrote:
| 17,500 doesn't really hit that hard, at least for me--I don't
| have a good intuition for how many kidney transplants happen
| per... whatever, day, year. The number in the article is more
| intuitive, I wonder why they didn't put it in the headline.
|
| > If you're an organ donor in the U.S., there's a 25% chance your
| kidney ends up in the trash.
|
| That's a _wild_ number of wasted kidneys compared to the supply.
| ceejayoz wrote:
| > That's a wild number of wasted kidneys compared to the
| supply.
|
| It's not that wild if you dig in a little; not every kidney you
| take out is going to wind up suitable for transplantation.
| There's some research into expanding the "suitable" criteria:
|
| https://www.kidney.org/news/kidneys-initially-deemed-unfit-t...
|
| > The study tracked 291 kidneys that became available from 172
| deceased donors but were at first rejected for transplant
| between January 2014 and December of 2016. The kidneys were
| initially refused using code 830, which indicates that the
| organ was of low quality or the donor's age was too advanced.
| The organs were subsequently procured by Southwest Transplant
| Alliance in Dallas and transplanted into patients on the kidney
| waitlist.
|
| https://www.nhsbt.nhs.uk/organ-transplantation/kidney/receiv...
|
| > There may be problems with the donor or organ that mean the
| kidney has a higher risk of failure than you or your transplant
| team are willing to accept. You may have problems, such as a
| recent infection, that makes you unsuitable to undergo
| transplantation at that time.
| hinkley wrote:
| When I was late teens early twenties, someone would have been
| lucky to get my organs. Especially my heart. Today not so
| much.
|
| You can list yourself as an organ donor and have health
| issues. You kidneys might be good and your liver shot. Or
| your lungs and corneas good and everything else a disaster.
| soneil wrote:
| That's pretty much my take on it too. Mid-40s, and to be
| honest if you got my corneas you've hit the jackpot. If
| you're after anything else .. I've got bad news for you.
|
| The idea that 25% of us have goods that aren't worth
| selling, does not blow my mind.
| anon291 wrote:
| Non profit is such a silly term. All it means is that
| shareholders don't profit (because there are no shares). It says
| nothing about employees or executives.
|
| IMO, we should be honest. Only volunteers or those sworn to
| poverty should be allowed employment in these things. This is why
| they were originally implemented, so things like your local
| Masons or Knights of Columbus or convent can have some legal
| structure.
|
| They were not intended for something like this. Let's be honest.
| We have new corporate structures like public benefit corporations
| that make more sense.
| daedrdev wrote:
| I saw an interesting article arguing that we should legalize
| paying for kidney donations. [1]
|
| I'm not sure how I feel about it, but the article was well
| argued. The main argument is that even if it is immoral, we are
| still short hundreds of thousands of kidneys unless we can
| somehow make them, and so this would save lives.
|
| [1] https://www.nytimes.com/2024/04/02/opinion/kidney-
| donations-...
| tiagod wrote:
| I find the idea repulsive. Saving lives by paying poor people
| to part with organs that they would keep if it wasn't for the
| cash.
| pyuser583 wrote:
| I'm fine with a nominal payment. Like how they charge you 1
| cent for paper bags. Enough to make it "not nothing", but not
| enough to sway your conscience.
| bombcar wrote:
| I could see an argument that paying for donations _from the
| dead_ via a bidding system could promote actually caring if
| the organ gets where it is going.
| astrange wrote:
| This is a common opinion in bioethics and it doesn't really
| make sense. It's not moral to reward people for doing
| something because it might cause them to do it?
|
| It's like the idea that people shouldn't be paid for growing
| food or building houses because they'll profit for it. Which
| leaves people only being able to profit from making useless
| things because then nobody needs them.
| ygjb wrote:
| I think that any country that wants to consider legalizing
| the sale of body parts from living people should probably
| illustrate how they have effectively eliminated human
| trafficking for other forms of exploitation first.
|
| Generally speaking, it is not a moral act to reward people
| for harming themselves, or allowing themselves to be
| harmed. Most society overlook this in the name of sport, or
| in the name of freedom (e.g. drugs, alcohol, driving, and
| other massively harmful, but shockingly profitable
| ventures), but the balance of respecting freedom while
| preventing exploitation is generally a complete shit show
| as evidenced by the rampant human trafficking, and the
| ongoing exploitation of addiction that the illicit drug
| trade represents.
|
| The moral arguments also set aside the fact that the
| overall quality of "ethically sold" organs are likely to be
| lower due to the overall impact that a life of poverty on
| individual health has, and that selling an organ is most
| likely going to be an option of last resort for most
| people.
|
| Personally profiting from an act of self harm doesn't stop
| it being an act of predation or exploitation.
| astrange wrote:
| If donating an organ is self-harm why are you allowed to
| do it for free?
| kobalsky wrote:
| > and so this would save lives
|
| lives of people who can buy a kidney.
|
| this is a transfer of longevity from poor people to rich
| people.
|
| and since because everything balances, in the future it will
| take selling a kidney to get to the average, and poor people
| will end in the same place but with only one kidney
| intuitionist wrote:
| The linked article suggests that the federal government would
| be a monopsony buyer in the US kidney market. My
| understanding is that most serious policy proposals along
| these lines would have the same feature. Medicare already
| covers care for nearly all US citizens with severe chronic
| kidney disease; paying for kidney donations would move some
| number of patients from dialysis to transplant but they
| wouldn't be out of pocket.
| keybored wrote:
| I don't see how that solves the potential problem. You
| could still end up in the same place of "balancing out"
| where the extra money from your kidney becomes something
| you need i.e. a transfer from poor to rich people.
| intuitionist wrote:
| Well, the people receiving the kidneys won't be rich on
| average, although it's possible they'll be richer on
| average than the compensated donors.
|
| There's a big shortfall of available kidneys but the
| number is pretty tiny compared to the number of people
| living paycheck-to-paycheck in America. So it seems
| unlikely to me that in the future everyone needs to
| donate a kidney just to stay in the same place--that'd be
| a couple orders of magnitude more kidneys than we need.
| nerdponx wrote:
| Great example of how simply allowing a market to exist can
| result in inequality, compared to if the market were illegal.
| RheingoldRiver wrote:
| I don't agree with paying for kidney donations, but I think we
| should pay people to be organ donors via some tax deduction if
| you've been registered as a donor for the past 2 years (so you
| can't like, register then file taxes then unregister)
| DoreenMichele wrote:
| If you are rich enough to think buying kidneys makes sense, I
| implore you to advocate for better health care which improves
| the odds of keeping your own original equipment from the
| manufacturer functioning adequately.
|
| Transplant is not all upside. You remain on drugs for life. You
| may die anyway if your body rejects the transplant.
|
| I see a lot of pro-transplant headlines on HN. People don't
| seem to want to hear any criticism of organ transplants.
|
| But I think organ transplants are "ooh, shiny tech" that makes
| for good headlines not actually _good medicine_. I think _good
| medicine_ would fix you, not turn you into Frankenstein so
| doctors can feel powerful.
|
| Keeping people healthy is boring, doesn't really get tracked,
| no one cares. Letting their lives go to hell and then "saving"
| them makes for good headlines.
|
| I have a condition that accounts for a lot of organ
| transplants. I would rather keep my own organs functioning.
|
| All of HN loathes me for having that opinion. But if you think
| you are at risk of "needing" a transplant and have resources, I
| encourage you to actively look for other solutions to advocate
| for.
|
| We mostly don't hear the horror stories about transplant. If
| that got more publicity, maybe people wouldn't be so quick to
| act like I'm some kind of nutter for having opinions about the
| topic.
| TheCowboy wrote:
| Some things jumped out from the article as feeling sloppy.
|
| > The tech is so bad. The United States Digital Service found 17
| days of downtime in recent years.
|
| If anyone is curious, a total of 17 days since 1999 according to
| a report obtained by the Washington Post from 2021.
|
| > Until recently, the algorithm that was protecting all organ
| donor patient information in the country, so STI status, mental
| health, every physical history, was from 1996.
|
| The algorithm? Huh? But it actually does seem serious that they
| have "denied nearly 100 federal requests to audit source code,
| reported The Washington Post." UNOS said they would have
| pentesting done in the WaPo article, but I couldn't find any
| reporting on if they actually followed through.
|
| Additional sources:
|
| https://fedscoop.com/usds-organ-transplant-system-shakeup/
|
| https://www.washingtonpost.com/health/2022/07/31/unos-transp...
| firejake308 wrote:
| > Until recently, the algorithm that was protecting all organ
| donor patient information in the country, so STI status, mental
| health, every physical history, was from 1996.
|
| I take issue with the way this point is presented. I'm willing
| to believe that healthcare data wasn't encrypted with the SOTA
| methods and one that was regarded as "good enough" instead, but
| the age of the algorithm has nothing to do with it's security.
| After all, RSA encryption is from 1977.
| TheCowboy wrote:
| Right. I also didn't find anything to corroborate this
| sentence with anything, so it could also be a case of a
| layperson referring to everything as "the algorithm".
| rdl wrote:
| I was amazed we spend $38B/yr on kidney failure.
| DoreenMichele wrote:
| The airlines are less likely to lose your suitcase than this
| organization is to lose your kidney and one percent of the
| federal budget goes to dialysis.
|
| I hope they fix this and I'm a longstanding critic of organ
| donation who routinely gets mountains of hatred and downvotes for
| it.
| ifdefdebug wrote:
| Also make donation opt-out instead of opt-in because most people
| don't care either way and with opt-out those who actually care
| have to take measures and not the other way around. That's how it
| works here in my and in many other European countries.
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