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Consideration for a Donation Economic Aspects Dr. Samuel Jellinek LL. D Faculty of Law Consideration for a Donation Economic Aspects Dr. Samuel Jellinek LL. D Faculty of Law The Hebrew University of Jerusalem Presented at Maastricht Medicine & Law Conference - 2002

Content of consideration Arrangements by the National Insurance Institute Taxation arrangements Insurance arrangements Legal Content of consideration Arrangements by the National Insurance Institute Taxation arrangements Insurance arrangements Legal arrangements Health system arragements Social arrangements

GUIDING PRINCIPLES Purchasing or buying organs only by official body Organs distribution will remain GUIDING 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

undamental Assumptions Life and Death Right to Privacy Money undamental Assumptions Life and Death Right to Privacy Money

Money – Two Aspects üBlood Donation üSurrogate Motherhood üI. V. F üAdoption Proceedings üPrivate Money – Two Aspects üBlood Donation üSurrogate Motherhood üI. V. F üAdoption Proceedings üPrivate Medicine üVolunteers in dangerous units (police, army etc. ) Financing for obtaining the organs will be covered totally by the vast saving in health budget and social resources.

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

Number of Dialyis Patient In Israel Number of Dialyis Patient In Israel

Kidney Patients Direct Medical Expenses Dialysis - 46, 000. - $ Other exp. 4, Kidney Patients Direct Medical Expenses Dialysis - 46, 000. - $ Other exp. 4, 000. - $ Total - 50, 000. - $ o. Increase of Dialysis Patients is greater than the sum of all transplants. o. Kidney patients are 65%70% of those awating transplants. o. One third of them are suitable for transplants.

General Costs § § § Loss of family income 100, 000 NIS Increased expences General 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 & Treatment Following Operation; Israel: 32, 000 $ U. S. A: Kidney Transplant Operation & Treatment Following Operation; Israel: 32, 000 $ U. S. A: (AV. ) 100, 000 $ Treatment: 1 st / 2 nd year 14, 000 / 10, 000 $ 20, 000 / 15, 000 $

Economic Equation Direct Medical exp. + General Costs = Kidney Transplant + 1 st Economic Equation Direct Medical exp. + General Costs = Kidney Transplant + 1 st 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-A With each kidney transplant there will be a total saving for the economy Conclusions-A With each kidney transplant there will be a total saving for the economy starting from the 2 nd year or from the 3 rd 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-B If we encourage organ donations from deceased persons, all of those waiting for Conclusions-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 very much Thank you very much