30 Kidney Transplants, a Reason for Hope

Despite plenty of disheartening news in the world, one masterful act can restore my faith that there are always reasons to be hopeful, even optimistic. A recent case in point: The New York Times article, 60 Lives, 30 Kidneys, All Linked, relates a chain of anonymous kidney transplants among 30 donors and recipients. Why would I, a financial planner, write about this?  Besides being a magnificent example of the human spirit, I see intriguing connections between the process, and the way our markets frequently overcome challenges the way they do.

The article is so breathtaking that it takes time to appreciate its impact and implications. While I recommend that you read the entire piece, here is how the Times summarizes the two-page story: “A record chain of kidney transplants resulted from (a) mix of medical need, pay-it-forward selflessness and lockstep coordination among 17 hospitals over four months.” The article also mentions Garet Hil, who was inspired by his own daughter’s kidney transplant experience to found the National Kidney Registry, which was behind the successful chain of events.

In financial planning, we do not know what medical expenses might be. This story merely hints at how complicated that can be. In addition, bad things happen to good people, and as much as we can plan for the future, there will always be unhappy surprises and setbacks. That’s why we buy all kinds of insurance: car, life, umbrella, and long-term care. It’s also why we should have wills and other estate planning documents.

Ever since I studied economics in college and graduate school, I have been curious about when markets work beautifully and when they don’t. Milton Friedman (and other free-market economists) argued that central planning doesn’t work very well compared to the decisions of millions of people acting in their own interests. (See the Power of the Market – The Pencil) 

But by law there cannot be a market in body organs; you cannot legally pay someone for his or her kidney.  (I’ll leave it to the bioethicists to argue why that should be.)

Is it stretching the point too much to suggest that Garet Hil created a “market” by forming the National Kidney Registry?  It may not depend on buyers and sellers using prices to allocate scarce resources, but the ability to coordinate 60 (or more) anonymous donor/recipients toward a common cause is a comparable, if not greater challenge.  Certainly Mr. Hil’s computer programming prowess was complemented by his ability to convince hospitals to accept his better way for finding matches for kidney transplants.  People (mostly) responded to understandable incentives although a totally selfless donation started the whole process this time.

As an ex-Marine and M.B.A. from the Wharton School, Mr. Hil is worthy of a book or article by Michael Lewis. Brad Pitt, are you free to make a movie in 2014 ?

And personally I am always amazed and inspired when someone experiences adversity or loss and then resolves to change the world so someone else does not have to suffer the same fate.  (It’s worth noting that Hil’s daughter did find a donor, but not without some touch-and-go moments that Hil felt should have been avoidable.)

So what did it take to accomplish this particular “miracle”? (1) someone had the idea of transplant exchanges and wrote a journal article in 1986; (2) someone else witnessed suffering first hand and had the motivation, financial resources and expertise to do something about it; (3) there have been amazing changes that computers and information technology make possible; (4) doctors and hospitals had to get over the “not invented here” syndrome; (5) altruistic individuals wanted to make a difference and were willing to undergo surgery and some suffering to accomplish that; (6) trust was needed that people would honor their commitments; (7) coordination, logistics and persistence all played their part; (8) and finally old-fashioned chance and luck contributed to the final result.

If you take a moment to view Friedman’s short pencil-example video, you’ll find it succinct and persuasive, but isn’t the “60 Lives, 30 Kidneys” story so much more powerful?  It is, especially if you happen to know someone who needs a kidney transplant.