Highlights

Issues in organ transplantation

• Along the way, organ transplantation in India (this includes Tamil Nadu) largely became a private sector activity. Hence while the act of donation is a public act and the organs a public good, from that point onwards whatever happens is largely under the private sector.
• The rules of market medicine thus dictate who the organs go to. And hospitals that invest large sums in transplantation programmes which include huge payouts to surgeons look for returns.
• Organ transplants are largely performed in corporate hospitals, the costs in India are well beyond a large majority of the local population. This is where foreigner nationals who are often able to pay gets treated.

Need for policy corrections

• While ensuring the credibility of the process in the public eye lies at the heart of deceased organ donation, we need to go beyond just general calls for transparency.
• Considering hard policy changes that include strengthening the capacity of the public sector, subsidising transplantation and perhaps enabling affirmative action in the allocation process in favour of public hospitals. 
• Every fifth or sixth organ could be mandatorily allotted to a public hospital or the private centre can be asked to perform a certain proportion of transplants free.
• While India has enthusiastically embraced the idea of a liberalised economy and immediately applied it to health care, many countries have insulated their health-care systems from the ravages of the market. This too is at the heart of this matter.

Source: The Hindu