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Kidney black markets and legal transplants: Are they opposite sides of the same coin?

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  • Mendoza, Roger Lee

Abstract

Objectives This study investigates why the illegal traffic of kidneys exists and remains resilient in the Philippines. It also evaluates the efficacy of the legal and regulatory framework for kidney (and organ) transplantation, and the corresponding implications for health policy. The experiences of comparable countries are noted.Methods Three surveys were employed in this study: 1) a review of related literature on kidney black markets; 2) questionnaire-based interviews of a multi-stage probability sample of 131 kidney vendors from the two largest supplier regions in the Philippines; and 3) a comparative content analysis of pertinent legal and regulatory measures to address the underground kidney trade.Results Survey results, based on a 4.0 percent statistical margin of error, indicate that kidney vendors are typically males (98.4 percent) who belong to the lower income classes/groups D and E (88.5 percent). The vast majority of vendors (89.2 percent) were unrelated to kidney recipients, many of whom were of foreign descent (60.3 percent). The study finds that certain key elements underpin the kidney black market in the Philippines: an open, brokered and compensation-based contractual system between unrelated donors and sellers. These elements are sustained and reinforced by a robust supply-and-demand interface anchored on brokerage pricing, government incapacity, policy contradictions and public tolerance or indifference.Conclusion The study suggests that the relative ambiguity of, and continuity between, the legal and underground kidney transplant systems be carefully addressed prior to enacting more specific reforms. The study also calls attention to the unintended consequences of various reform efforts, which are often neglected in formulating health policy and evaluating its costs and benefits.

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  • Mendoza, Roger Lee, 2010. "Kidney black markets and legal transplants: Are they opposite sides of the same coin?," Health Policy, Elsevier, vol. 94(3), pages 255-265, March.
  • Handle: RePEc:eee:hepoli:v:94:y:2010:i:3:p:255-265
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    References listed on IDEAS

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    1. Gary S. Becker & Julio Jorge Elías, 2007. "Introducing Incentives in the Market for Live and Cadaveric Organ Donations," Journal of Economic Perspectives, American Economic Association, vol. 21(3), pages 3-24, Summer.
    2. Alvin E. Roth, 2007. "Repugnance as a Constraint on Markets," Journal of Economic Perspectives, American Economic Association, vol. 21(3), pages 37-58, Summer.
    3. Alvin E. Roth & Tayfun Sönmez & M. Utku Ünver, 2005. "Efficient Kidney Exchange: Coincidence of Wants in a Structured Market," Boston College Working Papers in Economics 621, Boston College Department of Economics.
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    Cited by:

    1. Beckert, Jens & Wehinger, Frank, 2011. "In the shadow illegal markets and economic sociology," MPIfG Discussion Paper 11/9, Max Planck Institute for the Study of Societies.

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