December 12, 2023 • 30 mins
Imagine a world where living kidney donors are compensated for their life-saving gift. A world where a severe shortage of kidneys doesn't result in the preventable deaths of over a million Americans. In this riveting dialogue, we're joined by four non-directed kidney donors - Ned Brooks, Elaine Perlman, Dr. Matt Harmody, and Cody Maynard who are the founding members of the Coalition to Modify NOTA. This team will help us uncover the implications of the National Organ Transplant Act (NOTA) of 1984. Together, they propose a life-altering solution that could end the kidney transplant wait list by offering tax credits to donors.
Living kidney donation is the gold standard of kidney care. Living kidneys last on average twice as long as deceased donor kidneys. Only living organ donors can solve the kidney shortage.
One percent of all Federal taxes that are collected is spent on patients in end stage renal disease. Every time someone gets a kidney transplant, an American can not only survive but begin to thrive again while taxpayers save money. In twenty years, the number of living kidney donors declined seven percent while the number of Americans on the kidney wait list doubled. The need for kidneys rises by seven percent per year. One million Americans will have kidney failure by the year 2030.
In today’s podcast episode we will discuss how modifying NOTA could end the transplant wait list.
Show Links
Coalition to Modify NOTA website
Bios for the 4 Founders of the Coalition
Most Americans Support Compensating Donors
The Ethics of Transplant by Janet Radcliffe Richards
The Ethics of Rewarding Living Donors symposium video 1, video 2, and video 3
A Cost-Benefit Analysis of Government Compensation of Kidney Donors
Would Government Compensation of Living Kidney Donors Exploit the Poor? An Empirical Analysis
The Terrible Toll of the Kidney Shortage
Removing Disincentives to Kidney Donation: A Quantitative Analysis
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Right now, the number of Americans with end-stage
renal disease would barely fitin the five largest NFL stadiums
.
Picture that Now.
Picture a world after the HEROAct has been passed.
Picture the line outside of thetransplant centers of people
who are willing to donatelife-saving kidneys.
(00:20):
Now that they will becompensated, let's turn back to
those stadiums full of peoplewho can attend their children's
weddings, finish college, belong-living parents and enjoy
this gift of life.
With so much life in them, itis unethical to let them die.
Speaker 4 (01:03):
Welcome back to Donor Diaries.
This is your host, Lori Lee.
I have four very special gueststoday who are part of my kidney
donor tribe.
All four are non-directedkidney donors who have gone on
to do incredible work in thetransplant space.
We have Ned Brooks, who foundedthe National Kidney Donation
Organization, also known as NKDO.
Ned's a returning guest toDonor Diaries.
(01:25):
You can check out season one,episode four, to hear his first
interview called Leverage, wherewe talked about the impact of a
kidney chain and kidneyvouchers.
We have my friend, ElainePerlman, director of Weightless
Zero, which is an organizationthat is taking the lead in
changing and creating policiesto support and protect living
donors, with the goal ofdoubling the number of living
(01:48):
donors in the US in the nextfive years.
She's also an incredible veganchef who is welcome to feed me
any day, even though I'm notvegan.
We have Dr Matt Harmady, arecently retired physician and a
non-directed kidney donor.
That's an unusual status that Ialways love to see, so thanks
(02:08):
for that, Matt.
Matt took care of dialysispatients nearly every day for
his 20-year career.
He's also an athlete who runsultra marathons and he was part
of the group who did the onekidney climb of Mount
Kilimanjaro summoning on WorldKidney Day in 2022.
Lastly, we have Cody Maynardfrom Evergreen Nephrology.
(02:29):
Cody is the winner of the Men'sDivision of the Donor Games,
which is a sort of Olympics forliving donors.
Cody is also a returning guest.
You can hear his donation storyin season one, episode five,
where we enjoyed margaritas on aporch swing with a choir of
crickets.
Today, we are talking about atopic that is kind of a part two
(02:50):
to season one, episode nine,where we interviewed Dr Frank
McCormick about compensatingliving kidney donors.
If this is a topic thatinterests you, I encourage you
to check out that episode for afirst time, or even a second
time.
It's actually one of my veryfavorite episodes and it's
packed with supporting contentthat complements this episode.
(03:12):
So, turning this over to myguest today, you four are all
founding members of theCoalition to Modify Noda and are
engaged in a game-changingeffort to pass the SHIELD Act
and, finally, in the shortage ofkidneys that kills more and
more Americans every year, yourplan is to compensate living
kidney donors for theirwillingness to give a body part
(03:35):
to save a life, and today Ican't wait for you to tell our
audience all about this amazingeffort, which is one that is
near and dear to my heart.
Speaker 2 (03:43):
Welcome guys.
Oh, we're so happy to be here.
Lori, thank you for thisopportunity.
Speaker 4 (03:49):
So, Elaine, let's start with you.
Can you give us some backgroundinformation on your Coalition
to Modify Noda?
Speaker 2 (03:54):
Sure?
Well, first let me quicklyexplain what Noda is.
So Noda stands for the NationalOrgan Transplant Act that was
signed in 1984, and that date isreally significant because it's
the year that George Orwellwrote about in his excellent
book 1984.
And you know the phrase theRoad to Hell is Paved with Good
Intentions.
That pretty much describes Nodavery well.
(04:16):
Noda forbids any organ donorfrom receiving anything of value
for their organ, and perhapsour government had good
intentions when they wrote thelaw.
That states quote it isunlawful for any person to
knowingly acquire, receive orotherwise transfer any human
organ for valuable considerationfor use in human
transplantation.
Unquote the punishment forbeing paid for a live organ is
(04:38):
$50,000 and five years in prison.
So why do I think this isOrwellian?
Because Noda created the kidneyshortage.
Over 85% of our demand forkidneys is unmet in the United
States, and over a millionAmericans who could have gained
good health and longevity from aliving kidney transplant
instead died from the kidneyshortage since the year 1984
(05:01):
when Noda was passed.
If, at that time, thegovernment had provided a
financial incentive like arefundable tax credit and not
what is instead the reality ofhuge financial loss for donors,
far more Americans would havestepped forward to donate their
kidneys and those one millionpeople would not have died the
miserable death from kidneyfailure.
Now this does not includeothers from buying and selling
(05:24):
organs, only the original ownerof the organ.
I was in a meeting with atransplant surgeon who said that
the organ procurementorganization in his area charges
this hospital over $50,000 fora kidney.
So plenty of money is beingmade, but at this moment the
donor cannot receive any money.
Now here's a little historyabout the coalition to modify
Noda.
It was created by four peopleNed Brooks, dr Matt Harmony,
(05:48):
cody Maynard and me.
We all gave our kidneys tostrangers.
The coalition is proposinglegislation that will launch a
trial of removing disincentivesfor kidney donors who give their
kidneys to strangers, so thatwe can eventually expand both
the benefit of longer lives forrecipients and greater cost
savings for taxpayers byextending the program to all
(06:10):
living kidney donors.
We believe this is ethical,safe and regulated alternative a
refundable tax credit of$50,000 over five years to
living kidney donors who givetheir kidneys to strangers.
Right now, about 93,000Americans are on the kidney
waitlist and 13 of them dieevery day.
We estimate a million Americanswill have failed kidneys by
(06:30):
2030.
And the US government spends$50 billion a year for 550,000
Americans to have dialysis.
It costs about $100,000 perpatient per year and that
treatment is far more expensivein the long run than
transplantation.
Each kidney transplant savestaxpayer money and living kidney
transplants are the goldstandard for treating kidney
(06:51):
failure.
Under our bill, we estimate thetaxpayers will cumulatively
save over $10 billion by year 10under our proposal.
You know, lori, we know that weonly need one kidney to
maintain vitality and longevity,and 95% of donors say that we
would do it again if we could.
So providing a tax credit fordonors is both logical and it's
(07:13):
favored by over half ofAmericans surveyed.
So is this gonna apply to?
Speaker 4 (07:18):
all donors or just non-directed donors?
Speaker 2 (07:21):
So you know, since I've been working on trying to
pass legislation, I've learnedthat the government really likes
trials.
We will have a trial first withnon-directed donors.
Once we prove that this is bothlife saving and tax saving,
then we are going to advocate topass a bill so that all living
donors will receive therefundable tax credit.
Speaker 4 (07:42):
So I know 2% of our federal budget is spent on care
for those in end stage renaldisease.
I'm gonna dip back into thearchives here for a second and
share a clip from episode ninewith economist Frank McCormick,
who has dedicated years to thiswork.
I think this adds some extracontext to the cost savings
aspect of a bill like this.
Speaker 5 (08:02):
Yeah, we estimate that the lifetime cost of
someone on dialysis is about$1.2 million, and if you could
transplant those people, thenthat cost would end.
However, it costs something totransplant folks and it turns
(08:23):
out that the taxpayer is payingabout 80% of both the cost of
dialysis and of transplantationand once you subtract the cost
of transplantation from the costof dialysis, you wind up with
about $200,000 a year.
So the taxpayer, for everyperson who receives a kidney
(08:48):
transplant, is saving about$200,000 a year.
We estimate that the value of atransplant kidney to the
recipient and the caregiverwhich is very important is about
$1.5 million.
So you're saving their life.
Okay, that's the importantthing, but if you put an
(09:10):
economic value on that, it comesout to be about $1.5 million.
So it's a win-win situation,shall we say.
If we offer $80,000 per kidney,if the government does that,
then that will end the kidneyshortage.
We don't think that will beexploiting the donor.
(09:35):
We've written a paper analyzingthis in great detail and what
we find is that if we pay people$80,000, that would not be
exploiting them.
That's a sufficient amount ofmoney that they would not be
exploited and the benefit thatthey will give to someone else
(09:55):
is vastly greater than that Ifyou were in an operating room
waiting for an organ and it'sdelivered to you.
It's not provided free.
It has a stiff price tag on itthat reflects all of the work
that various people have done toproduce that organ, and that is
(10:16):
rightly so.
Only the donor is notcompensated.
Everybody else involved inproducing the organ is
compensated, and if we couldjust have the government offer
kidney donors something like$80,000, then all that would end
and we would be saving over40,000 people a year, and of
(10:39):
course that's an enormous thing.
Speaker 4 (10:42):
I know that Frank talked about paying a lump sum
of $80,000 to all donors, butyour coalition understands that
we have to take baby steps, andstarting with a $50,000 tax
credit for non-directed donorsonly and not directed donors is
the start to something that oneday might look more like what
Frank describes.
(11:03):
So are you guys saying thatNoda is responsible for the
shortage and all of these deaths, or is it more complicated than
that?
Speaker 6 (11:12):
I think it's also a multifaceted issue.
There's a cause and effect, anda lot of the cause of people
needing kidneys in the firstplace is due to very difficult
social challenges that aredifficult to overcome, such as
just general nutrition andhealth literacy, various
(11:37):
socioeconomic statuses acrossdifferent communities in this
very heterogeneous country, andso it's not as easy for the
United States to have as healthyof a population as a very
homogeneous population in someother, say, European countries
or Asian countries, and so thechallenges of just keeping our
(12:00):
country healthy is first andforemost the issue that's
causing a lot of people to havekidney disease.
But then the preventativemeasure that the government has
done to prevent individuals fromdonating their organs and
receiving compensation isfurther exacerbating the
disparity between the supply andthe demand of organs.
(12:22):
I often think about a quote byDr Daniel Solomon, the medical
doctor, the kidney, pancreas andtransplant program at Scripps.
He said every person in thechain of organ donation except
one profits.
The supplier of the kidney isunpaid.
It's illogical that we have ashortage.
The hospitals, the nurses, thedoctors, the pharmaceutical
(12:44):
companies all get paid.
We have no shortage of peoplein those fields who benefit the
most from that transplant.
So it is the recipient who getsto enjoy a better life and a
longer life, but the donor isthe only one who doesn't receive
the actual compensation.
Speaker 1 (13:02):
Yeah, and what Cody's describing in simple terms is
that a commodity passes througha chain of transactions and
everyone in that chain benefitsexcept the supplier of the
commodity.
Speaker 3 (13:14):
So we've mentioned exploitation in the past, but
it's really the lack ofcompensation that is exploitive
in this situation.
Speaker 1 (13:24):
That is the very definition of exploitation.
Speaker 4 (13:27):
So, dr Matt, I know this affects you both
professionally and personally.
Can you tell us a little bitabout what connected you to this
effort?
Speaker 3 (13:37):
My experience, laurie , is multifaceted.
I've had a career in emergencymedicine over 20 years and, as
you had mentioned earlier, Ihave had the opportunity and
privilege to take care of manydialysis patients over that time
, probably nearly every shiftthat I worked.
In addition, my father sufferedfrom kidney disease and was on
(14:02):
dialysis for several years andactually benefited when the law
was put in place for Medicare tocover all chronic kidney
disease patients, who are thoseon dialysis despite their age.
My father was only 50 when hiskidneys failed.
So that perspective of having apersonal story as well as a
(14:26):
professional experience reallyjust gives me a lot of
background in being able tounderstand this problem.
In addition, I think we allknow here but for the audience
it's wonderful and I think manyof you have had personal stories
to see a dialysis patient whogenerally makes no urine to be
(14:50):
transplanted and immediately beproducing urine as early as in
the operating room.
It's just a magical experience,especially for the recipients,
and it just goes to show youthat living donation is the way
to go.
Speaker 4 (15:05):
Yeah, I actually remember that, post donation,
when I was told that myrecipient was producing urine,
it was a pretty great feeling.
Speaker 2 (15:13):
Yeah, I remember that moment too, when the nurse came
into my room a few hours aftermy surgery and gave me that
great news.
And I think it's important foreveryone to understand that a
living kidney lasts about 15 to20 years on average, but with
good fortune and good care, akidney lasts way longer than
that, and I heard about theperson whose living kidney
transplant has been lasting for56 years and it's still going.
(15:35):
So people on the younger sidemay need two or three
transplants during theirlifetime and I just found out
from a doctor in California thatOPO's the organ procurement
organizations.
They charge hospitals upwardsof $54,000 for a deceased donor
kidney.
So that sort of shows.
What Ned was saying is there'smoney being made by many people
(15:56):
in the kidney world, just not bythe donor.
Speaker 1 (15:59):
The big problems of people are not lining up to
donate their kidneys.
In the past two decades, whilethe number of people who need a
kidney transplant has greatlyincreased, the number of living
donors is declined by 7%, whilethere are 90,000 people on the
wait list for a kidney.
That doesn't take into accountthe people who have become too
(16:21):
sick to get a kidney transplant,so upward to 500,000 people,
and most of them are too sick toget a transplant because they
had to wait too long for it.
So you've got such a gap insupply and demand and it's
totally preventable and we'requite confident that the
solution we propose is one thatwill solve the problem.
Speaker 2 (16:45):
Yeah, the power of a transplant is so tremendous.
Both my son and I gave ourkidneys to strangers and when
AB's recipient met him, he saidto my son you gave me a new life
.
And, like Ned said, that is thepower of a transplant is really
to save a person's life andextend it.
And those who are at peace withthe status quo, where thousands
of people are dying from thispreventable kidney shortage it's
(17:07):
just like being okay withintentionally depriving someone
of life-saving medicine andthose who are opposed need to
understand that our country'sunwillingness to pay donors have
directly resulted in thesethousands of Americans dying and
we could use our resources tomake sure we have an adequate
supply of kidneys.
And that's what the HERO Act isall about.
Speaker 6 (17:27):
We have people in the US who don't wanna donate under
any circumstances.
I think, as far as the deceaseddonation aspect is concerned,
it's very important and we don'twanna minimize that, but right
now we've sort of maxed out thenumber of kidneys that we can
receive from the deceaseddonation pool.
(17:49):
So, even if you aren'tregistered as a deceased donor,
the OPO representative willlikely still ask your family if
it's okay if you donate, and,very fortunately, the majority
of families still say yes, thatthey would like to, which is
great.
That being said, it's importantto note that there's only a
(18:11):
small percentage that chancethat you die in a way in which
your organs can be procured soaround one out of every 3,000
deaths in the United Statesbecause it has to be in a very
controlled way, where the organsare healthy enough to be
transplanted, and so, becausewe've tapped that out, we really
(18:32):
need to tap into the livingdonor population, and people are
getting less and less healthy.
It's especially challenging forindividuals who live in
communities where their friendsand family are also suffering
from chronic illnesses likediabetes or hypertension, and so
their pool of potential donorsis smaller, and so I think
(18:57):
that's an important thing torecognize as well, as we on this
call may be thinking well, Ihave plenty of healthy friends
and family that would donate,but other individuals who don't
have a lot more difficult timefinding a donor, and so, simply
put, we just don't have enoughdonors.
Speaker 4 (19:15):
Wow, so you guys just unpacked a lot there.
So I want to repeat what Nedsaid, that the demand for
kidneys is going up while thesupply is going down, and I
don't think most people realizethat.
I'm guessing when this law waspassed, lawmakers weren't
thinking about this problem asone that would get so big so
fast.
Do you think they would haveconsidered incentivizing donors
(19:37):
if they understood thetrajectory of the organ shortage
and where it was going?
Speaker 2 (19:43):
Senator Gore said that if we cannot have an
adequate supply of kidneys, weshould consider incentivizing
kidney donation.
Yeah, but unfortunately untilnow it has not been revisited
right, so I'm really proud ofthis team for bringing it to the
forefront.
We are all super motivated toend the shortage of kidneys.
We've read plenty of articlesby advocates who are in favor of
compensating donors for theirkidney gift.
(20:05):
These include Frank McCormick,janet Radcliffe, richard Sallie
Sattel, ike Brannon and PhillipHeld, and even Nobel Prize
winner Al Roth.
They're all in favor.
You can check out oursupporters page.
It's a beautiful thing to seehow many people have come out in
favor of the HERO Act, and someof these people have been donor
Diaries guests.
Speaker 1 (20:25):
I think if you go to the website and you look at some
of those folks, you'll be veryimpressed at those who are true
leaders in the transplant fieldthe surgeons, the nephrologists,
the donor coordinators.
These are some of the mosthighly respected people in
transplant, and what this tellsme is that this group has come
(20:47):
to the recognition that thesystem is failing.
The system has failed.
It's not doing what it wasintended to do, and when they're
willing to sign on to somethinglike our mission statement, I
think that really says a lotabout how badly this system is
in need of renovation.
Speaker 4 (21:07):
Thanks, ned, and to our listeners.
If you're interested inchecking out who Ned and Elaine
are referring to, there will bea link in my show notes for you
to check out.
Their supporters, frankMcCormick and Al Roth, have both
been guests, and many of theother names you guys mentioned
are actually aspirational donorDiaries guests, I mean.
Several of these experts havededicated years to solving this
(21:29):
problem, so congratulations toyou guys for getting the support
from these thought leaders.
It's no small feat, but tell uswhat is the opposition saying.
Speaker 6 (21:39):
This is Cody, so I've taken point on running
opposition for our team,basically to stress test a lot
of our ideas.
We all have differentcontributions and there are a
lot of valid concerns when itcomes to a proposal like this.
So I don't want to minimizethose concerns and we want to
recognize that, in order to dothis, the most important
(22:02):
imperative is to do thisethically and safely, and so
there are a variety of differentconcerns socially, morally,
politically and philosophically,and just the logistics of
getting Congress to put theirweight behind this has deterred
some people by saying that's toolarge of a mountain for us to
(22:26):
surmount.
Speaker 4 (22:27):
So I imagine the biggest huge ethical concern
here is that this is gonnaexploit people, like people
would feel extreme pressure todonate a kidney to resolve a
serious financial problemquickly.
How will modifying Noda ensurepeople won't be exploited?
Speaker 3 (22:43):
I'm worried that the proposal is progressive, which
was another concern raised bymany.
In other words, there'sprobably as many as 50% of
Americans that do not payfederal income tax, so the
benefit to lower middle incomefolks in this country will be
much greater because it'srefundable.
(23:05):
So if they do not pay federalincome taxes, they would
actually receive a check fromthe federal government.
So it makes it extremelyprogressive and would have much
less of an impact on, say, awealthy person stepping up to
donate.
Speaker 4 (23:20):
So a wealthy person is just gonna get a tax credit,
but someone who makes maybe$30,000 a year would actually
get a check.
Do I understand that correctly?
Speaker 3 (23:30):
Just to use rough numbers.
Someone that may earn $30,000 ayear would not pay federal
income taxes and they wouldreceive a $10,000 check, whereas
, say, someone else that earns$150,000 a year would get a tax
credit and their federal incometaxes do so roughly.
The $10,000, $30,000 a yearearner would be much more
(23:54):
significant than, say, $150,000a year earner.
Speaker 4 (23:59):
Do you guys know or have you talked to people who've
said they would change theirmind about becoming a donor if
they were financiallyincentivized to?
Speaker 2 (24:08):
I definitely know.
Speaker 1 (24:09):
Yeah, intuitively it certainly does.
We did a survey of kidneydonors and asked them if you
were to be compensated in thisfashion and able to donate again
, would this compensation makeyou more inclined to donate,
less inclined to donate or notmake any difference at all?
Those who about half of themsaid it would make them more
(24:32):
inclined to donate, roughly halfsaid it would make no
difference at all and one or twosaid that it would make them
less inclined to donate.
So just on the basis of peoplewho've already gone through this
, you've got half of them whosay it would make them more
inclined to donate.
I think you can extrapolatethat to the rest of the
(24:52):
population in some fashion.
Speaker 4 (24:55):
So, guys, what else do you want people to know that
we haven't covered today?
Tell us some more.
Speaker 2 (25:00):
Since we already donated, we all have nothing to
materially gain from the passageof the HERO Act.
We just want those who aredying these preventable deaths
to live longer and healthierlives.
We are also very eager for theAmerican taxpayer to save
billions of dollars each year.
Speaker 1 (25:16):
Well, you know the old phrase insanity is doing the
same thing over and over whileexpecting a different result.
This transplant process in thiscountry is basically fits that
description of insanity.
While we've been doing the samething over and over, the wait
list has done nothing but grow.
As Cody pointed out earlier,it's about twice what it was 20
(25:38):
years ago, and we believe thatthe time is as good as it's ever
been to end the kidney shortageby compensating all kidney
donors.
We are leading the charge.
We need people who will supportthis vision.
So, anyone who's listening tothis, we urge you to go to the
website modifynotaorg and readour mission statement and, if
(26:00):
you agree with it, to join thecoalition by completing the form
in there.
What we have seen and heardfrom talking with professionals
in organizations which have anorganizational statement in
opposition to compensation isthat most of them privately
agree with us, but they have tokeep their voices low in order
(26:24):
not to be in conflict with theirorganizations.
That is something we need tochange, and we are taking on
these organizations one by one.
Speaker 4 (26:35):
Alright.
So now is the time.
Now is the time to speak up.
If you want to support thisinitiative, the best thing you
can do is go to ModifyNotaorgand this link will be in our
show notes and there's a link toclick on to back the cause.
And these guys don't just needyou to say you support the cause
.
They want your name on theirwebsite and mugshot, maybe, to
(26:57):
illustrate all of the people insupport of this initiative.
That's what's going to give ussome momentum here.
Speaker 2 (27:03):
Love the mugshot image.
Fortunately, support for kidneypatients and donors is
bipartisan.
I worked last year on passing awaitlist zero law in New York,
a state called the Living DonorSupport Act, and once that's
implemented, this bill will makeNew York the most generous
state in the country forreimbursing living donors for
their lost wages and out ofpocket costs.
(27:25):
And the really encouragingthing is that that bill was
passed with you in.
That bill was passed withunanimous bipartisan support
because kidney disease impactseveryone, republicans and
Democrats alike.
So we're fortunate that kidneysare bipartisan.
Speaker 1 (27:41):
Yeah, the poorer we are, the less healthy we are as
a country.
That's why so many middle andlow income Americans have no one
in their social circle who ishealthy enough to donate when we
have a surplus of kidneys.
All Americans will benefit,regardless of their economic
background.
Speaker 6 (27:57):
This proposal is both financially responsible and the
humanitarian thing to do, andso it's really a win-win for the
American people.
Speaker 2 (28:07):
I was recently speaking with a New York City
firefighter who gave his kidneyto save a stranger, and this
person had not told anyone abouthis gift, not even his family.
When he heard about the HeroAct, he said that among the
firefighters, the mantra iswhatever it takes to save a life
, and that's what the Hero Actis all about.
We only need to compensatedonors until we come up with the
(28:27):
high tech or Zeno replacementfor disease kidneys.
But we know that this is yearsaway and in the meantime, we
cannot stand oddly by as peopledie from a preventable death.
We had a shortage of sperm,eggs and plasma, and so we pay
the donors.
In all but three states,surrogate pregnancy can earn a
person up to $100,000.
And that is exactly what weneed to do to end the deadly
(28:51):
kidney shortage.
Speaker 1 (28:53):
Right now, the number of Americans with end stage
renal disease would barely fitin the five largest NFL stadiums
.
Picture that Now.
Picture a world after the HeroAct has been passed.
Picture the line outside of thetransplant centers of people
who are willing to donate life,saving kidneys.
(29:13):
Now that they will becompensated, let's turn back to
those stadiums full of peoplewho can attend their children's
weddings, finish college, belong living parents and enjoy
this gift of life.
With so much life in them, itis unethical to let them die.
Speaker 4 (29:32):
Wow.
Well, that's a powerful imageto leave everyone with.
Ned.
You nailed our closing today.
Thank you Well.
I can't thank you guys enoughfor joining me today.
I'm genuinely proud to havedonor friends who are up to such
incredible things.
The work you are doing is soimportant to future donors and I
can't wait to do a follow uppodcast in the future where
(29:56):
maybe we're going to talk aboutthe olden days when donors
weren't compensated.
Thank you so much.
Keep up the great work.
Speaker 3 (30:03):
Thanks for having me, Laurie.
Yeah, thank you so much, Laurie.
Speaker 4 (30:07):
Thank you, guys.
We referenced lots of resourcesin this episode today and I
hope you check them all out inthe show notes, making sure to
click on the link the coalitionto modify, not a home page where
it says join the coalition.
Here you can endorse themission statement and it will
also sign you up to be invitedto the coalition's monthly
(30:27):
meetings.
And to the listeners out there,I just want to say thank you so
much for listening to donordiaries.
As long as you keep listening,the podcast will keep coming.
If you're enjoying this podcast, don't forget to hit your
subscribe button so you getalerts as we drop new episodes.
You can also find us onFacebook and join the
conversation there.
This is your host, laurie Lee,signing out for 2023.
(30:47):
See you next year.
Right now, the number of Americans with end-stage
renal disease would barely fitin the five largest NFL stadiums
.
Picture that Now.
Picture a world after the HEROAct has been passed.
Picture the line outside of thetransplant centers of people
who are willing to donatelife-saving kidneys.
(00:20):
Now that they will becompensated, let's turn back to
those stadiums full of peoplewho can attend their children's
weddings, finish college, belong-living parents and enjoy
this gift of life.
With so much life in them, itis unethical to let them die.
Speaker 4 (01:03):
Welcome back to Donor Diaries.
This is your host, Lori Lee.
I have four very special gueststoday who are part of my kidney
donor tribe.
All four are non-directedkidney donors who have gone on
to do incredible work in thetransplant space.
We have Ned Brooks, who foundedthe National Kidney Donation
Organization, also known as NKDO.
Ned's a returning guest toDonor Diaries.
(01:25):
You can check out season one,episode four, to hear his first
interview called Leverage, wherewe talked about the impact of a
kidney chain and kidneyvouchers.
We have my friend, ElainePerlman, director of Weightless
Zero, which is an organizationthat is taking the lead in
changing and creating policiesto support and protect living
donors, with the goal ofdoubling the number of living
(01:48):
donors in the US in the nextfive years.
She's also an incredible veganchef who is welcome to feed me
any day, even though I'm notvegan.
We have Dr Matt Harmady, arecently retired physician and a
non-directed kidney donor.
That's an unusual status that Ialways love to see, so thanks
(02:08):
for that, Matt.
Matt took care of dialysispatients nearly every day for
his 20-year career.
He's also an athlete who runsultra marathons and he was part
of the group who did the onekidney climb of Mount
Kilimanjaro summoning on WorldKidney Day in 2022.
Lastly, we have Cody Maynardfrom Evergreen Nephrology.
(02:29):
Cody is the winner of the Men'sDivision of the Donor Games,
which is a sort of Olympics forliving donors.
Cody is also a returning guest.
You can hear his donation storyin season one, episode five,
where we enjoyed margaritas on aporch swing with a choir of
crickets.
Today, we are talking about atopic that is kind of a part two
(02:50):
to season one, episode nine,where we interviewed Dr Frank
McCormick about compensatingliving kidney donors.
If this is a topic thatinterests you, I encourage you
to check out that episode for afirst time, or even a second
time.
It's actually one of my veryfavorite episodes and it's
packed with supporting contentthat complements this episode.
(03:12):
So, turning this over to myguest today, you four are all
founding members of theCoalition to Modify Noda and are
engaged in a game-changingeffort to pass the SHIELD Act
and, finally, in the shortage ofkidneys that kills more and
more Americans every year, yourplan is to compensate living
kidney donors for theirwillingness to give a body part
(03:35):
to save a life, and today Ican't wait for you to tell our
audience all about this amazingeffort, which is one that is
near and dear to my heart.
Speaker 2 (03:43):
Welcome guys.
Oh, we're so happy to be here.
Lori, thank you for thisopportunity.
Speaker 4 (03:49):
So, Elaine, let's start with you.
Can you give us some backgroundinformation on your Coalition
to Modify Noda?
Speaker 2 (03:54):
Sure?
Well, first let me quicklyexplain what Noda is.
So Noda stands for the NationalOrgan Transplant Act that was
signed in 1984, and that date isreally significant because it's
the year that George Orwellwrote about in his excellent
book 1984.
And you know the phrase theRoad to Hell is Paved with Good
Intentions.
That pretty much describes Nodavery well.
(04:16):
Noda forbids any organ donorfrom receiving anything of value
for their organ, and perhapsour government had good
intentions when they wrote thelaw.
That states quote it isunlawful for any person to
knowingly acquire, receive orotherwise transfer any human
organ for valuable considerationfor use in human
transplantation.
Unquote the punishment forbeing paid for a live organ is
(04:38):
$50,000 and five years in prison.
So why do I think this isOrwellian?
Because Noda created the kidneyshortage.
Over 85% of our demand forkidneys is unmet in the United
States, and over a millionAmericans who could have gained
good health and longevity from aliving kidney transplant
instead died from the kidneyshortage since the year 1984
(05:01):
when Noda was passed.
If, at that time, thegovernment had provided a
financial incentive like arefundable tax credit and not
what is instead the reality ofhuge financial loss for donors,
far more Americans would havestepped forward to donate their
kidneys and those one millionpeople would not have died the
miserable death from kidneyfailure.
Now this does not includeothers from buying and selling
(05:24):
organs, only the original ownerof the organ.
I was in a meeting with atransplant surgeon who said that
the organ procurementorganization in his area charges
this hospital over $50,000 fora kidney.
So plenty of money is beingmade, but at this moment the
donor cannot receive any money.
Now here's a little historyabout the coalition to modify
Noda.
It was created by four peopleNed Brooks, dr Matt Harmony,
(05:48):
cody Maynard and me.
We all gave our kidneys tostrangers.
The coalition is proposinglegislation that will launch a
trial of removing disincentivesfor kidney donors who give their
kidneys to strangers, so thatwe can eventually expand both
the benefit of longer lives forrecipients and greater cost
savings for taxpayers byextending the program to all
(06:10):
living kidney donors.
We believe this is ethical,safe and regulated alternative a
refundable tax credit of$50,000 over five years to
living kidney donors who givetheir kidneys to strangers.
Right now, about 93,000Americans are on the kidney
waitlist and 13 of them dieevery day.
We estimate a million Americanswill have failed kidneys by
(06:30):
2030.
And the US government spends$50 billion a year for 550,000
Americans to have dialysis.
It costs about $100,000 perpatient per year and that
treatment is far more expensivein the long run than
transplantation.
Each kidney transplant savestaxpayer money and living kidney
transplants are the goldstandard for treating kidney
(06:51):
failure.
Under our bill, we estimate thetaxpayers will cumulatively
save over $10 billion by year 10under our proposal.
You know, lori, we know that weonly need one kidney to
maintain vitality and longevity,and 95% of donors say that we
would do it again if we could.
So providing a tax credit fordonors is both logical and it's
(07:13):
favored by over half ofAmericans surveyed.
So is this gonna apply to?
Speaker 4 (07:18):
all donors or just non-directed donors?
Speaker 2 (07:21):
So you know, since I've been working on trying to
pass legislation, I've learnedthat the government really likes
trials.
We will have a trial first withnon-directed donors.
Once we prove that this is bothlife saving and tax saving,
then we are going to advocate topass a bill so that all living
donors will receive therefundable tax credit.
Speaker 4 (07:42):
So I know 2% of our federal budget is spent on care
for those in end stage renaldisease.
I'm gonna dip back into thearchives here for a second and
share a clip from episode ninewith economist Frank McCormick,
who has dedicated years to thiswork.
I think this adds some extracontext to the cost savings
aspect of a bill like this.
Speaker 5 (08:02):
Yeah, we estimate that the lifetime cost of
someone on dialysis is about$1.2 million, and if you could
transplant those people, thenthat cost would end.
However, it costs something totransplant folks and it turns
(08:23):
out that the taxpayer is payingabout 80% of both the cost of
dialysis and of transplantationand once you subtract the cost
of transplantation from the costof dialysis, you wind up with
about $200,000 a year.
So the taxpayer, for everyperson who receives a kidney
(08:48):
transplant, is saving about$200,000 a year.
We estimate that the value of atransplant kidney to the
recipient and the caregiverwhich is very important is about
$1.5 million.
So you're saving their life.
Okay, that's the importantthing, but if you put an
(09:10):
economic value on that, it comesout to be about $1.5 million.
So it's a win-win situation,shall we say.
If we offer $80,000 per kidney,if the government does that,
then that will end the kidneyshortage.
We don't think that will beexploiting the donor.
(09:35):
We've written a paper analyzingthis in great detail and what
we find is that if we pay people$80,000, that would not be
exploiting them.
That's a sufficient amount ofmoney that they would not be
exploited and the benefit thatthey will give to someone else
(09:55):
is vastly greater than that Ifyou were in an operating room
waiting for an organ and it'sdelivered to you.
It's not provided free.
It has a stiff price tag on itthat reflects all of the work
that various people have done toproduce that organ, and that is
(10:16):
rightly so.
Only the donor is notcompensated.
Everybody else involved inproducing the organ is
compensated, and if we couldjust have the government offer
kidney donors something like$80,000, then all that would end
and we would be saving over40,000 people a year, and of
(10:39):
course that's an enormous thing.
Speaker 4 (10:42):
I know that Frank talked about paying a lump sum
of $80,000 to all donors, butyour coalition understands that
we have to take baby steps, andstarting with a $50,000 tax
credit for non-directed donorsonly and not directed donors is
the start to something that oneday might look more like what
Frank describes.
(11:03):
So are you guys saying thatNoda is responsible for the
shortage and all of these deaths, or is it more complicated than
that?
Speaker 6 (11:12):
I think it's also a multifaceted issue.
There's a cause and effect, anda lot of the cause of people
needing kidneys in the firstplace is due to very difficult
social challenges that aredifficult to overcome, such as
just general nutrition andhealth literacy, various
(11:37):
socioeconomic statuses acrossdifferent communities in this
very heterogeneous country, andso it's not as easy for the
United States to have as healthyof a population as a very
homogeneous population in someother, say, European countries
or Asian countries, and so thechallenges of just keeping our
(12:00):
country healthy is first andforemost the issue that's
causing a lot of people to havekidney disease.
But then the preventativemeasure that the government has
done to prevent individuals fromdonating their organs and
receiving compensation isfurther exacerbating the
disparity between the supply andthe demand of organs.
(12:22):
I often think about a quote byDr Daniel Solomon, the medical
doctor, the kidney, pancreas andtransplant program at Scripps.
He said every person in thechain of organ donation except
one profits.
The supplier of the kidney isunpaid.
It's illogical that we have ashortage.
The hospitals, the nurses, thedoctors, the pharmaceutical
(12:44):
companies all get paid.
We have no shortage of peoplein those fields who benefit the
most from that transplant.
So it is the recipient who getsto enjoy a better life and a
longer life, but the donor isthe only one who doesn't receive
the actual compensation.
Speaker 1 (13:02):
Yeah, and what Cody's describing in simple terms is
that a commodity passes througha chain of transactions and
everyone in that chain benefitsexcept the supplier of the
commodity.
Speaker 3 (13:14):
So we've mentioned exploitation in the past, but
it's really the lack ofcompensation that is exploitive
in this situation.
Speaker 1 (13:24):
That is the very definition of exploitation.
Speaker 4 (13:27):
So, dr Matt, I know this affects you both
professionally and personally.
Can you tell us a little bitabout what connected you to this
effort?
Speaker 3 (13:37):
My experience, laurie , is multifaceted.
I've had a career in emergencymedicine over 20 years and, as
you had mentioned earlier, Ihave had the opportunity and
privilege to take care of manydialysis patients over that time
, probably nearly every shiftthat I worked.
In addition, my father sufferedfrom kidney disease and was on
(14:02):
dialysis for several years andactually benefited when the law
was put in place for Medicare tocover all chronic kidney
disease patients, who are thoseon dialysis despite their age.
My father was only 50 when hiskidneys failed.
So that perspective of having apersonal story as well as a
(14:26):
professional experience reallyjust gives me a lot of
background in being able tounderstand this problem.
In addition, I think we allknow here but for the audience
it's wonderful and I think manyof you have had personal stories
to see a dialysis patient whogenerally makes no urine to be
(14:50):
transplanted and immediately beproducing urine as early as in
the operating room.
It's just a magical experience,especially for the recipients,
and it just goes to show youthat living donation is the way
to go.
Speaker 4 (15:05):
Yeah, I actually remember that, post donation,
when I was told that myrecipient was producing urine,
it was a pretty great feeling.
Speaker 2 (15:13):
Yeah, I remember that moment too, when the nurse came
into my room a few hours aftermy surgery and gave me that
great news.
And I think it's important foreveryone to understand that a
living kidney lasts about 15 to20 years on average, but with
good fortune and good care, akidney lasts way longer than
that, and I heard about theperson whose living kidney
transplant has been lasting for56 years and it's still going.
(15:35):
So people on the younger sidemay need two or three
transplants during theirlifetime and I just found out
from a doctor in California thatOPO's the organ procurement
organizations.
They charge hospitals upwardsof $54,000 for a deceased donor
kidney.
So that sort of shows.
What Ned was saying is there'smoney being made by many people
(15:56):
in the kidney world, just not bythe donor.
Speaker 1 (15:59):
The big problems of people are not lining up to
donate their kidneys.
In the past two decades, whilethe number of people who need a
kidney transplant has greatlyincreased, the number of living
donors is declined by 7%, whilethere are 90,000 people on the
wait list for a kidney.
That doesn't take into accountthe people who have become too
(16:21):
sick to get a kidney transplant,so upward to 500,000 people,
and most of them are too sick toget a transplant because they
had to wait too long for it.
So you've got such a gap insupply and demand and it's
totally preventable and we'requite confident that the
solution we propose is one thatwill solve the problem.
Speaker 2 (16:45):
Yeah, the power of a transplant is so tremendous.
Both my son and I gave ourkidneys to strangers and when
AB's recipient met him, he saidto my son you gave me a new life
.
And, like Ned said, that is thepower of a transplant is really
to save a person's life andextend it.
And those who are at peace withthe status quo, where thousands
of people are dying from thispreventable kidney shortage it's
(17:07):
just like being okay withintentionally depriving someone
of life-saving medicine andthose who are opposed need to
understand that our country'sunwillingness to pay donors have
directly resulted in thesethousands of Americans dying and
we could use our resources tomake sure we have an adequate
supply of kidneys.
And that's what the HERO Act isall about.
Speaker 6 (17:27):
We have people in the US who don't wanna donate under
any circumstances.
I think, as far as the deceaseddonation aspect is concerned,
it's very important and we don'twanna minimize that, but right
now we've sort of maxed out thenumber of kidneys that we can
receive from the deceaseddonation pool.
(17:49):
So, even if you aren'tregistered as a deceased donor,
the OPO representative willlikely still ask your family if
it's okay if you donate, and,very fortunately, the majority
of families still say yes, thatthey would like to, which is
great.
That being said, it's importantto note that there's only a
(18:11):
small percentage that chancethat you die in a way in which
your organs can be procured soaround one out of every 3,000
deaths in the United Statesbecause it has to be in a very
controlled way, where the organsare healthy enough to be
transplanted, and so, becausewe've tapped that out, we really
(18:32):
need to tap into the livingdonor population, and people are
getting less and less healthy.
It's especially challenging forindividuals who live in
communities where their friendsand family are also suffering
from chronic illnesses likediabetes or hypertension, and so
their pool of potential donorsis smaller, and so I think
(18:57):
that's an important thing torecognize as well, as we on this
call may be thinking well, Ihave plenty of healthy friends
and family that would donate,but other individuals who don't
have a lot more difficult timefinding a donor, and so, simply
put, we just don't have enoughdonors.
Speaker 4 (19:15):
Wow, so you guys just unpacked a lot there.
So I want to repeat what Nedsaid, that the demand for
kidneys is going up while thesupply is going down, and I
don't think most people realizethat.
I'm guessing when this law waspassed, lawmakers weren't
thinking about this problem asone that would get so big so
fast.
Do you think they would haveconsidered incentivizing donors
(19:37):
if they understood thetrajectory of the organ shortage
and where it was going?
Speaker 2 (19:43):
Senator Gore said that if we cannot have an
adequate supply of kidneys, weshould consider incentivizing
kidney donation.
Yeah, but unfortunately untilnow it has not been revisited
right, so I'm really proud ofthis team for bringing it to the
forefront.
We are all super motivated toend the shortage of kidneys.
We've read plenty of articlesby advocates who are in favor of
compensating donors for theirkidney gift.
(20:05):
These include Frank McCormick,janet Radcliffe, richard Sallie
Sattel, ike Brannon and PhillipHeld, and even Nobel Prize
winner Al Roth.
They're all in favor.
You can check out oursupporters page.
It's a beautiful thing to seehow many people have come out in
favor of the HERO Act, and someof these people have been donor
Diaries guests.
Speaker 1 (20:25):
I think if you go to the website and you look at some
of those folks, you'll be veryimpressed at those who are true
leaders in the transplant fieldthe surgeons, the nephrologists,
the donor coordinators.
These are some of the mosthighly respected people in
transplant, and what this tellsme is that this group has come
(20:47):
to the recognition that thesystem is failing.
The system has failed.
It's not doing what it wasintended to do, and when they're
willing to sign on to somethinglike our mission statement, I
think that really says a lotabout how badly this system is
in need of renovation.
Speaker 4 (21:07):
Thanks, ned, and to our listeners.
If you're interested inchecking out who Ned and Elaine
are referring to, there will bea link in my show notes for you
to check out.
Their supporters, frankMcCormick and Al Roth, have both
been guests, and many of theother names you guys mentioned
are actually aspirational donorDiaries guests, I mean.
Several of these experts havededicated years to solving this
(21:29):
problem, so congratulations toyou guys for getting the support
from these thought leaders.
It's no small feat, but tell uswhat is the opposition saying.
Speaker 6 (21:39):
This is Cody, so I've taken point on running
opposition for our team,basically to stress test a lot
of our ideas.
We all have differentcontributions and there are a
lot of valid concerns when itcomes to a proposal like this.
So I don't want to minimizethose concerns and we want to
recognize that, in order to dothis, the most important
(22:02):
imperative is to do thisethically and safely, and so
there are a variety of differentconcerns socially, morally,
politically and philosophically,and just the logistics of
getting Congress to put theirweight behind this has deterred
some people by saying that's toolarge of a mountain for us to
(22:26):
surmount.
Speaker 4 (22:27):
So I imagine the biggest huge ethical concern
here is that this is gonnaexploit people, like people
would feel extreme pressure todonate a kidney to resolve a
serious financial problemquickly.
How will modifying Noda ensurepeople won't be exploited?
Speaker 3 (22:43):
I'm worried that the proposal is progressive, which
was another concern raised bymany.
In other words, there'sprobably as many as 50% of
Americans that do not payfederal income tax, so the
benefit to lower middle incomefolks in this country will be
much greater because it'srefundable.
(23:05):
So if they do not pay federalincome taxes, they would
actually receive a check fromthe federal government.
So it makes it extremelyprogressive and would have much
less of an impact on, say, awealthy person stepping up to
donate.
Speaker 4 (23:20):
So a wealthy person is just gonna get a tax credit,
but someone who makes maybe$30,000 a year would actually
get a check.
Do I understand that correctly?
Speaker 3 (23:30):
Just to use rough numbers.
Someone that may earn $30,000 ayear would not pay federal
income taxes and they wouldreceive a $10,000 check, whereas
, say, someone else that earns$150,000 a year would get a tax
credit and their federal incometaxes do so roughly.
The $10,000, $30,000 a yearearner would be much more
(23:54):
significant than, say, $150,000a year earner.
Speaker 4 (23:59):
Do you guys know or have you talked to people who've
said they would change theirmind about becoming a donor if
they were financiallyincentivized to?
Speaker 2 (24:08):
I definitely know.
Speaker 1 (24:09):
Yeah, intuitively it certainly does.
We did a survey of kidneydonors and asked them if you
were to be compensated in thisfashion and able to donate again
, would this compensation makeyou more inclined to donate,
less inclined to donate or notmake any difference at all?
Those who about half of themsaid it would make them more
(24:32):
inclined to donate, roughly halfsaid it would make no
difference at all and one or twosaid that it would make them
less inclined to donate.
So just on the basis of peoplewho've already gone through this
, you've got half of them whosay it would make them more
inclined to donate.
I think you can extrapolatethat to the rest of the
(24:52):
population in some fashion.
Speaker 4 (24:55):
So, guys, what else do you want people to know that
we haven't covered today?
Tell us some more.
Speaker 2 (25:00):
Since we already donated, we all have nothing to
materially gain from the passageof the HERO Act.
We just want those who aredying these preventable deaths
to live longer and healthierlives.
We are also very eager for theAmerican taxpayer to save
billions of dollars each year.
Speaker 1 (25:16):
Well, you know the old phrase insanity is doing the
same thing over and over whileexpecting a different result.
This transplant process in thiscountry is basically fits that
description of insanity.
While we've been doing the samething over and over, the wait
list has done nothing but grow.
As Cody pointed out earlier,it's about twice what it was 20
(25:38):
years ago, and we believe thatthe time is as good as it's ever
been to end the kidney shortageby compensating all kidney
donors.
We are leading the charge.
We need people who will supportthis vision.
So, anyone who's listening tothis, we urge you to go to the
website modifynotaorg and readour mission statement and, if
(26:00):
you agree with it, to join thecoalition by completing the form
in there.
What we have seen and heardfrom talking with professionals
in organizations which have anorganizational statement in
opposition to compensation isthat most of them privately
agree with us, but they have tokeep their voices low in order
(26:24):
not to be in conflict with theirorganizations.
That is something we need tochange, and we are taking on
these organizations one by one.
Speaker 4 (26:35):
Alright.
So now is the time.
Now is the time to speak up.
If you want to support thisinitiative, the best thing you
can do is go to ModifyNotaorgand this link will be in our
show notes and there's a link toclick on to back the cause.
And these guys don't just needyou to say you support the cause
.
They want your name on theirwebsite and mugshot, maybe, to
(26:57):
illustrate all of the people insupport of this initiative.
That's what's going to give ussome momentum here.
Speaker 2 (27:03):
Love the mugshot image.
Fortunately, support for kidneypatients and donors is
bipartisan.
I worked last year on passing awaitlist zero law in New York,
a state called the Living DonorSupport Act, and once that's
implemented, this bill will makeNew York the most generous
state in the country forreimbursing living donors for
their lost wages and out ofpocket costs.
(27:25):
And the really encouragingthing is that that bill was
passed with you in.
That bill was passed withunanimous bipartisan support
because kidney disease impactseveryone, republicans and
Democrats alike.
So we're fortunate that kidneysare bipartisan.
Speaker 1 (27:41):
Yeah, the poorer we are, the less healthy we are as
a country.
That's why so many middle andlow income Americans have no one
in their social circle who ishealthy enough to donate when we
have a surplus of kidneys.
All Americans will benefit,regardless of their economic
background.
Speaker 6 (27:57):
This proposal is both financially responsible and the
humanitarian thing to do, andso it's really a win-win for the
American people.
Speaker 2 (28:07):
I was recently speaking with a New York City
firefighter who gave his kidneyto save a stranger, and this
person had not told anyone abouthis gift, not even his family.
When he heard about the HeroAct, he said that among the
firefighters, the mantra iswhatever it takes to save a life
, and that's what the Hero Actis all about.
We only need to compensatedonors until we come up with the
(28:27):
high tech or Zeno replacementfor disease kidneys.
But we know that this is yearsaway and in the meantime, we
cannot stand oddly by as peopledie from a preventable death.
We had a shortage of sperm,eggs and plasma, and so we pay
the donors.
In all but three states,surrogate pregnancy can earn a
person up to $100,000.
And that is exactly what weneed to do to end the deadly
(28:51):
kidney shortage.
Speaker 1 (28:53):
Right now, the number of Americans with end stage
renal disease would barely fitin the five largest NFL stadiums
.
Picture that Now.
Picture a world after the HeroAct has been passed.
Picture the line outside of thetransplant centers of people
who are willing to donate life,saving kidneys.
(29:13):
Now that they will becompensated, let's turn back to
those stadiums full of peoplewho can attend their children's
weddings, finish college, belong living parents and enjoy
this gift of life.
With so much life in them, itis unethical to let them die.
Speaker 4 (29:32):
Wow.
Well, that's a powerful imageto leave everyone with.
Ned.
You nailed our closing today.
Thank you Well.
I can't thank you guys enoughfor joining me today.
I'm genuinely proud to havedonor friends who are up to such
incredible things.
The work you are doing is soimportant to future donors and I
can't wait to do a follow uppodcast in the future where
(29:56):
maybe we're going to talk aboutthe olden days when donors
weren't compensated.
Thank you so much.
Keep up the great work.
Speaker 3 (30:03):
Thanks for having me, Laurie.
Yeah, thank you so much, Laurie.
Speaker 4 (30:07):
Thank you, guys.
We referenced lots of resourcesin this episode today and I
hope you check them all out inthe show notes, making sure to
click on the link the coalitionto modify, not a home page where
it says join the coalition.
Here you can endorse themission statement and it will
also sign you up to be invitedto the coalition's monthly
(30:27):
meetings.
And to the listeners out there,I just want to say thank you so
much for listening to donordiaries.
As long as you keep listening,the podcast will keep coming.
If you're enjoying this podcast, don't forget to hit your
subscribe button so you getalerts as we drop new episodes.
You can also find us onFacebook and join the
conversation there.
This is your host, laurie Lee,signing out for 2023.
(30:47):
See you next year.
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