2. 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

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

5. 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

6. Fundamental Assumptions Fundamental Assumptions Life and Death Right to Privacy Money

7. Money – Two Aspects Blood Donation Surrogate Motherhood I.V.F Adoption Proceedings Private Medicine Volunteers 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.

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

9. Number of Dialyis Patient In Israel

10. Kidney Patients Direct 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.- $

12. General Costs  Loss of family income100,000 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 $

13. 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 $

14. Economic 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.)

15. 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!

16. 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.

17. Thank you very much