ConsiderationConsideration for a for a Donation Donation

Economic Aspects Economic Aspects

Dr. Samuel Jellinek LL.DDr. Samuel Jellinek LL.D

Faculty of LawFaculty of Law

The Hebrew University of JerusalemThe Hebrew University of Jerusalem

Presented at Maastricht Medicine & Law Conference - 2002Presented at Maastricht Medicine & Law Conference - 2002

Content of considerationContent of consideration

Arrangements by the National Insurance InstituteTaxation arrangementsInsurance arrangementsLegal arrangementsHealth system arragementsSocial arrangements

GUIDING PRINCIPLESGUIDING PRINCIPLES

Purchasing or buying organs only by official body

Organs distribution will remain as today

Receipt of organs will not be conditional upon any payment

Fundamental AssumptionsFundamental Assumptions

Life and Death

Right to Privacy

Money

Money – Two AspectsMoney – Two Aspects

Blood DonationSurrogate MotherhoodI.V.FAdoption ProceedingsPrivate MedicineVolunteers in dangerous

units (police, army etc.)

Financing for obtaining Financing for obtaining the organs will be covered the organs will be covered totally by the vast saving in totally by the vast saving in health budget and social health budget and social resources.resources.

0

50

100

150

200

250

Fee

Year

NISus $

NIS 91 152 180 190 209 217

us $ 19 32 38 40 44.5 46

1995 1996 1997 1998 1999 2000

Payments for Dialysis Patients in Payments for Dialysis Patients in NIS/US$ ThousandsNIS/US$ Thousands

2 ,084

2 ,6192 ,755 2 ,749

3 ,023

3 ,537

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

1995 1996 1997 1998 1999 2000

Number of Dialyis PatientNumber of Dialyis PatientIn IsraelIn Israel

Kidney PatientsKidney Patients

Direct Medical ExpensesDirect Medical Expenses oIncrease of Dialysis Patients is greater than the sum of all transplants.oKidney patients are 65%-70% of those awating transplants.oOne third of them are suitable for transplants.

Dialysis - 46,000.- $

Other exp. 4,000.- $

Total - 50,000.- $

General CostsGeneral Costs

Loss of family income 100,000 NIS

Increased expences 25,000 NIS

Raised Costs /Social Welfare 50,000 NIS

Disability Pensions 48,000 NIS

Other Benefits 60,000 NIS

Total 283,000 NIS

Aprox. 60,000 $

Kidney Transplant Operation & Kidney Transplant Operation & Treatment FollowingTreatment Following

Operation;

Israel: 32,000 $

U.S.A:(AV.) 100,000 $

Treatment: 1st / 2nd year

14,000 / 10,000 $

20,000 / 15,000 $

Economic EquationEconomic Equation

Direct Medical exp. + General Costs = Kidney Transplant + 1st year treatment =

45,000- 110,000 $

“The costs of treatment in the first year of transplantation were approx. the same as the average costs of dialysis”.

(Charro Th. & De wit A.)

Conclusions-AConclusions-A

With each kidney transplant there will be a total saving for the economy starting from the 2nd year or from the 3rd year, if the “consideration basket” would be the total value of the savings for one year. This will finance the consideration for the donation according to the model that have been presented!

Conclusions-BConclusions-B

If we encourage organ donations from deceased persons, all of those waiting for organ transplants of various types that could be made ‘at the same opportunity’ would be bound to benefit by reduced costs because of the financial saving as a result (at least) of the kidney transplantations.

Thank you Thank you

very very muchmuch