Removing financial barriers to organ and bone marrow donation: The effect of leave and tax legislation in the U.S.

Abstract

Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. www.econstor.eu The Institute for the Study of Labor (IZA) in Bonn is a local and virtual international research center and a place of communication between science, politics and business. IZA is an independent nonprofit organization supported by Deutsche Post Foundation. The center is associated with the University of Bonn and offers a stimulating research environment through its international network, workshops and conferences, data service, project support, research visits and doctoral program. IZA engages in (i) original and internationally competitive research in all fields of labor economics, (ii) development of policy concepts, and (iii) dissemination of research results and concepts to the interested public. Terms of use: Documents in D I S C U S S I O N P A P E R S E R I E SIZA Discussion Papers often represent preliminary work and are circulated to encourage discussion. Citation of such a paper should account for its provisional character. A revised version may be available directly from the author. In an attempt to alleviate the shortfall in organs and bone marrow available for transplants, many U.S. states passed legislation providing leave to organ and bone marrow donors and/or tax benefits for live and deceased organ and bone marrow donations and to employers of donors. We exploit cross-state variation in the timing and passage of such legislation to analyze its impact on organ donations by living and deceased persons, on measures of the quality of the organs transplanted, and on the number of bone marrow donations. We find that these provisions did not have a significant impact on the quantity of organs donated. The leave legislation, however, did have a positive impact on bone marrow donations. We also find some evidence of a positive impact on the quality of organ transplants, measured by post-transplant survival rates. Our results suggest that these types of legislation work for moderately invasive procedures such as bone marrow donation, but may be too low for organ donation, which is riskier and more burdensome to the donor.JEL Classification: D64, H41, I12, J18, K32

Living-Donor Kidney Transplantation

“…At the time of this writing, 35 states had passed legislation to offer tax deductions or credits, or other benefits, to living organ donors (34). These programs vary state by state, are underused, and are of unknown effectiveness.…”

“…Fifteen of these living organ donor tax laws function as deductions (and therefore require the LKD to itemize taxes to use them), which may affect the utility of tax relief for low-income earners. Comprehensive reviews of these types of legislation found no statistically significant effect on organ donation for paid-leave legislation or for tax credits or deductions (34,35). However, the effect of this legislation on LKD financial burden (as opposed to donation rates) has not been studied.…”

Living Donor Kidney Transplantation

“…In addition, although many states offer tax deductions or credits for living donors who incurred expenses, many transplant providers and living donors are unaware that these programs exist. Tax relief programs have not affected rates of LDKT and LKD, perhaps because they require itemization of taxes (75,76). Because lower-income donors, who would benefit most from tax relief related to LKD expenses, are least likely to itemize tax returns, we recommend that all states consider establishing a tax credit (versus deduction) based on actual costs incurred by donors.…”

Paying for Altruism: The Case of Organ Donation Revisited

“…They hypothesize that the statistically indistinguishable effects may stem from low cash value of the tax deduction to defray costs faced by donors, lack of public awareness and a depletion of organ donor pools in the pre-legislation period. Lacetera et al (2014) find significant effects for bone marrow but not other organs. Boulware et al (2008) find that state legislation and federal policies are not associated with living related or overall donations.…”