For economists, America’s organ shortage is a perplexing public health problem. About 37 million Americans suffer from kidney disease, and more than 800,000 live with kidney failure. At this advanced stage, patients either receive a kidney transplant or remain on dialysis — an expensive and often debilitating treatment — for the rest of their lives. Of the more than 90,000 Americans placed on the kidney transplant waitlist, only about 1 in 4 in 2024 received a kidney.

There are simple steps we can take to radically increase the number of kidneys available for transplant, but political and institutional inertia has stood in the way of these changes. By changing incentives for prospective donors and transplant centers, we could save thousands of lives every year.

The first and best step toward this goal is passage of the End Kidney Deaths Act, or EKDA, a piece of legislation just reintroduced in Congress that would secure $50,000 in refundable tax credits for living kidney donors who donate to someone they don’t know.

The gold standard treatment for end-stage kidney disease is a transplant from a living donor, which can last its recipient up to twice as long as one from a deceased source. Kidney donation is remarkably safe — donors have the same life expectancy as nondonors, and the operation has better outcomes on average than childbirth and appendectomies.

However, only a third of transplanted kidneys come from living donors. Why is that?

One barrier is a lack of willing donors. Despite the low level of risk associated with kidney donation, it remains an intensive process with a recovery time that can vary from weeks to several months. Donors miss weeks of work during the evaluation, donation and recovery process on top of transportation and caretaking costs.

In the United States, it remains illegal to provide donors with any valuable consideration for kidney donation. This not only prohibits financial compensation, but also prevents donors from receiving health care coverage or other benefits following donation.

We can spur living organ donation by revisiting the National Organ Transplant Act, which makes compensation for kidney donation illegal. The EKDA, a 10-year pilot program proposed by the Coalition to Modify NOTA, offers a sensible approach in the form of refundable tax credits of $50,000 for nondirected living donors.

If the act passes, the coalition estimates that 100,000 Americans would receive healthy kidneys from living donors over the course of 10 years. Taxpayers would save $10 billion to $37 billion in averted dialysis costs over the same time period.

By implementing commonsense reforms, voters, policymakers and medical institutions can team up to radically reduce death and suffering as a result of this devastating disease.

Steven Levitt, an emeritus professor of economics at the University of Chicago and co-author of “Freakonomics,” is co-founder and faculty director of the university’s Center for Radical Innovation for Social Change. Ruby Rorty is a senior analyst at the center. Together, they lead the initiative Project Donor./Tribune News Service