Historically, people feel there is a risk to signing their organ donor box without any incentive. For example, they fear being declared brain dead for their organs when they’re still alive. As a result, I’ve know people waiting for years for an organ, sometimes dying while waiting. We need an incentive.
Solution = if you sign your organ donor card before you get sick, when your need arrives you go to the top of the list with other donors. I believe this would end the waitlists for organs as they would be plentiful, using the “invisible hand” that Adam Smith talked about. People will sign their donor cards because it’s in their best interest, and there would be no waiting lists anymore.
I was about to put my issue in when I found this. Like you, I believe we need to introduce free market principles to the organ donation process. However, I believe basing the transplant on when you signed your organ donor card would be open to fraud since this card can be changed/forged.
Instead, I think when a person donates organs, their siblings, children, and grand children should get points. The specifics of the point system would need to be worked out but perhaps more points get assigned to children and siblings, and maybe less grandchildren.
Assigning who gets an organ could be half based on need as it is today, and half based on points. So if your family has donated organs, you would have more points and would move up the list over other similar patients whose families have not donated organs.
I believe this would be less prone to manipulation since you can’t forge a heart but would still provide the incentives that would increase the organ donor pool
Perhaps also, when you donate blood, plasma, bone marrow, or even liver or kidney, you get points! The more blood you donate, the more points you get. Kind of a pay it forward type deal. Unfortunately some people don’t have families who care enough about them to donate organs for their sake.