Addressing the Organ Donor Crisis
Summary
The organ-donation crisis is one of the most persistent, expensive, and yet solvable public-health challenges of our time. As of January 2020, nearly 115,000 Americans were waitlisted for an organ transplant. The vast majority have kidney failure, which, as one of the rare conditions qualifying patients for Medicare, imposes billions of dollars of costs on taxpayers. In 2016 alone, taxpayers spent an alarming $113 billion on kidney disease — more than the entire budgets of the National Institutes of Health ($39 billion), the Department of Homeland Security ($44 billion), and the National Aeronautics and Space Administration (NASA, $21.5 billion) combined. The clear solution is to shorten the organ waiting list. For every Medicare patient who receives a kidney transplant, taxpayers save $250,000 in avoided dialysis costs. This proposal presents a discrete set of actions for the federal government to take to quickly and decisively to address the organ-donation crisis.
Western states functionally manage trillions in global climate risk (permafrost, forest carbon, etc.) and can do so in ways that drive state economic development.
Implementation will not be easy. Several of the plan’s critical strategies challenge established utility business models.
We won’t solve the cost-of-living crisis without improving the capacity of state public utility commissions to protect customers, find and implement new solutions to meet rising demand, and realign broken utility incentives.
Public service commissions should require utilities to quantify avoided healthcare costs, reduction in pollution exposure, and improvements in population health alongside traditional metrics.