[Music]
hi everyone I’m going to speak on
solving the organ shortage the United
States has a very severe organ shortage
approximately one American dies every
hour because I can’t get a life-saving
transplant historically the United
States has emphasized deceased organ
donation as a way to solve the organ
shortage
unfortunately that strategy has failed
as you can see by this graph back in
1990 it looked like we might be able to
solve the organ shortage with organs
from the recently deceased but today
even if every American agreed to be an
organ donor when they died we wouldn’t
have anywhere enough organs to solve the
organ shortage so in recent years US
policymakers have started to think about
living organ donors as a way to fill the
gap in principle that is a good idea but
we need to go about it the right way
encouraging people to donate by
promising them money or promising them
perks or by creating educational
campaigns that imply that people will
feel better about themselves if they
become living organ donors is the wrong
way that’s because it borders on
unethical to tempt people to participate
in a broken system the problem is we
have something like a conspiracy of
silence going on the medical community
the media and even living organ donors
themselves tend to describe the ideal
donor experience because they don’t want
to discourage people from donating but
by doing that they create an atmosphere
where policies are geared towards the
ideal scenario and living organ donors
aren’t prepared
when things don’t go as expected I’m
going to focus on kidney donation
because most living organ donors are
giving up one of their two kidneys to
save the life of another person so what
might be a bad scenario bad policy
well telling potential kidney donors
that they can be back at work within 30
days would be a bad idea because it’s
really only true about the ideal donor
someone who is young and healthy who has
a desk job who doesn’t have to do any
heavy lifting at work or at home who
doesn’t Drive large distances and who is
not one of the kidney donors who has a 5
to 10 percent chance of having a
complication that doesn’t resolve within
30 days so if you’re not that ideal
donor you might be out of work for 60 or
90 days or longer this wouldn’t be so
bad except most kidney donors have to
take unpaid leave and are using up their
savings and going into debt expecting to
be back at work in a month so when one
month becomes two months or three months
or longer and my goodness if there are
medical bills on top of it all it can
mean financial disaster the way it is
supposed to work with medical bills is
that the insurance company for the
person who is getting the life-saving
organ is supposed to pay all donation
related medical bills but sometimes they
deny coverage and sometimes the donors
own insurance also denies coverage
claiming that living organ donation is
elective surgery so while the insurance
companies Duke it out the donor is
with the bills I volunteer for the
American living organ donor fund and I
have seen a kidney donor end up homeless
on the street because of medical bills
we do everything we can to help donors
find financial assistance including the
federal program that helps with travel
and lodging and other charities that
help with post donation expenses but
still we only have enough funding to
help maybe one in ten of the donors who
come to us for assistance an important
measure of success for any transplant
policy is a number of organs made
available for transplant but when you’re
talking about living organ donors you
must also consider the donors and their
well-being three years ago I did a TED
med talk on paid kidney donation in Iran
I went to Iran because Iran was the only
country in the world claiming to have
solved its kidney shortage remember how
in the u.s. almost one person is dying
every hour
well Iran claimed that it had no waiting
list and no one dying so I went to Iran
but unfortunately I found a lot of
unhappy kidney donors but in one city
Isfahan the donors seemed to be happier
than elsewhere in Isfahan
donors received extra health insurance
job services non interest loans and
other donation related benefits so I
ended my TEDMED by saying we need to
take a closer look at places like
Isfahan where the Iranian system seems
to be working for donors and try to
parse the good from the bad after my
TEDMED Mike Mittleman and I started the
American living organ donor fund and as
I got to know us organ donors
better I started to argue that we need
to do right by these good people whether
it increases the number of organs for
transplants or not it’s simply wrong to
abandon living organ donors when things
go wrong because of their organ donation
now imagine my excitement when I learned
that the Netherlands is now
outperforming Iran in its living organ
donor program by doing exactly what US
organ donors have been telling me they
need if the organ recipients insurance
doesn’t pay the donors has to donors are
guaranteed their jobs back now remember
these are all things that don’t exist in
the United States okay so donors are
guaranteed their jobs back donors get
paid leave as much as they need and
there is a government program that helps
with donation related expenses like
travel babysitting and even extra
psychological counseling so now I say
forget Iran how can we be more like the
Netherlands well we can start by passing
a law that prohibits insurance companies
from treating living organ donation as
elective surgery that way if an organ
recipients insurance doesn’t pay the
donors will have to another option would
be to find a private insurance product
that protects living organ donors when
things don’t go as expected there are a
few policies out there intended for
living organ donors but unfortunately
they are all woefully inadequate that
doesn’t mean some enterprising company
couldn’t come up with a worthwhile
product it just means one doesn’t exist
yet third we could put all living organ
donors on Medicare this isn’t as
far-fetched as it may seem
Medicare is already pay
mean for most donation surgeries and
donor complications because the people
getting the organs are on Medicare so if
Medicare covered all of the donors
healthcare instead of just the donation
related medical expenses that would be
one way to avoid the is this covered
problem if we put donors on Medicare for
one or two years that would be like Iran
if we put them on Medicare for life that
would be like the Netherlands since
living organ donation has both potential
short-term and potential long-term
complications it would provide more
security for living organ donors if they
received healthcare for life
finally we could create a federal fund
that helps with medical expenses we have
such a fund for people who suffer from
vaccine complications we could do the
same kind of thing for living organ
donors but whatever we do whether the
solution is a combination of these ideas
or something different we need to
acknowledge that the current system is
broken we need to stop denying that
things aren’t going well for living
organ donors and start focusing on
fixing the situation as the Netherlands
has shown we don’t need to entice
Americans to donate to solve our organ
shortage we just need to treat them
fairly
[Applause]
hi everyone I’m going to speak on
solving the organ shortage the United
States has a very severe organ shortage
approximately one American dies every
hour because I can’t get a life-saving
transplant historically the United
States has emphasized deceased organ
donation as a way to solve the organ
shortage
unfortunately that strategy has failed
as you can see by this graph back in
1990 it looked like we might be able to
solve the organ shortage with organs
from the recently deceased but today
even if every American agreed to be an
organ donor when they died we wouldn’t
have anywhere enough organs to solve the
organ shortage so in recent years US
policymakers have started to think about
living organ donors as a way to fill the
gap in principle that is a good idea but
we need to go about it the right way
encouraging people to donate by
promising them money or promising them
perks or by creating educational
campaigns that imply that people will
feel better about themselves if they
become living organ donors is the wrong
way that’s because it borders on
unethical to tempt people to participate
in a broken system the problem is we
have something like a conspiracy of
silence going on the medical community
the media and even living organ donors
themselves tend to describe the ideal
donor experience because they don’t want
to discourage people from donating but
by doing that they create an atmosphere
where policies are geared towards the
ideal scenario and living organ donors
aren’t prepared
when things don’t go as expected I’m
going to focus on kidney donation
because most living organ donors are
giving up one of their two kidneys to
save the life of another person so what
might be a bad scenario bad policy
well telling potential kidney donors
that they can be back at work within 30
days would be a bad idea because it’s
really only true about the ideal donor
someone who is young and healthy who has
a desk job who doesn’t have to do any
heavy lifting at work or at home who
doesn’t Drive large distances and who is
not one of the kidney donors who has a 5
to 10 percent chance of having a
complication that doesn’t resolve within
30 days so if you’re not that ideal
donor you might be out of work for 60 or
90 days or longer this wouldn’t be so
bad except most kidney donors have to
take unpaid leave and are using up their
savings and going into debt expecting to
be back at work in a month so when one
month becomes two months or three months
or longer and my goodness if there are
medical bills on top of it all it can
mean financial disaster the way it is
supposed to work with medical bills is
that the insurance company for the
person who is getting the life-saving
organ is supposed to pay all donation
related medical bills but sometimes they
deny coverage and sometimes the donors
own insurance also denies coverage
claiming that living organ donation is
elective surgery so while the insurance
companies Duke it out the donor is
with the bills I volunteer for the
American living organ donor fund and I
have seen a kidney donor end up homeless
on the street because of medical bills
we do everything we can to help donors
find financial assistance including the
federal program that helps with travel
and lodging and other charities that
help with post donation expenses but
still we only have enough funding to
help maybe one in ten of the donors who
come to us for assistance an important
measure of success for any transplant
policy is a number of organs made
available for transplant but when you’re
talking about living organ donors you
must also consider the donors and their
well-being three years ago I did a TED
med talk on paid kidney donation in Iran
I went to Iran because Iran was the only
country in the world claiming to have
solved its kidney shortage remember how
in the u.s. almost one person is dying
every hour
well Iran claimed that it had no waiting
list and no one dying so I went to Iran
but unfortunately I found a lot of
unhappy kidney donors but in one city
Isfahan the donors seemed to be happier
than elsewhere in Isfahan
donors received extra health insurance
job services non interest loans and
other donation related benefits so I
ended my TEDMED by saying we need to
take a closer look at places like
Isfahan where the Iranian system seems
to be working for donors and try to
parse the good from the bad after my
TEDMED Mike Mittleman and I started the
American living organ donor fund and as
I got to know us organ donors
better I started to argue that we need
to do right by these good people whether
it increases the number of organs for
transplants or not it’s simply wrong to
abandon living organ donors when things
go wrong because of their organ donation
now imagine my excitement when I learned
that the Netherlands is now
outperforming Iran in its living organ
donor program by doing exactly what US
organ donors have been telling me they
need if the organ recipients insurance
doesn’t pay the donors has to donors are
guaranteed their jobs back now remember
these are all things that don’t exist in
the United States okay so donors are
guaranteed their jobs back donors get
paid leave as much as they need and
there is a government program that helps
with donation related expenses like
travel babysitting and even extra
psychological counseling so now I say
forget Iran how can we be more like the
Netherlands well we can start by passing
a law that prohibits insurance companies
from treating living organ donation as
elective surgery that way if an organ
recipients insurance doesn’t pay the
donors will have to another option would
be to find a private insurance product
that protects living organ donors when
things don’t go as expected there are a
few policies out there intended for
living organ donors but unfortunately
they are all woefully inadequate that
doesn’t mean some enterprising company
couldn’t come up with a worthwhile
product it just means one doesn’t exist
yet third we could put all living organ
donors on Medicare this isn’t as
far-fetched as it may seem
Medicare is already pay
mean for most donation surgeries and
donor complications because the people
getting the organs are on Medicare so if
Medicare covered all of the donors
healthcare instead of just the donation
related medical expenses that would be
one way to avoid the is this covered
problem if we put donors on Medicare for
one or two years that would be like Iran
if we put them on Medicare for life that
would be like the Netherlands since
living organ donation has both potential
short-term and potential long-term
complications it would provide more
security for living organ donors if they
received healthcare for life
finally we could create a federal fund
that helps with medical expenses we have
such a fund for people who suffer from
vaccine complications we could do the
same kind of thing for living organ
donors but whatever we do whether the
solution is a combination of these ideas
or something different we need to
acknowledge that the current system is
broken we need to stop denying that
things aren’t going well for living
organ donors and start focusing on
fixing the situation as the Netherlands
has shown we don’t need to entice
Americans to donate to solve our organ
shortage we just need to treat them
fairly
[Applause]
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