A Research On The Establishment Of Incentive Mechanism Of Organ Donation In China

In most countries of the world,there is a huge gap between the supply and demand of organ transplantation,and the shortage of donor in China is more serious.In 2015,China began to ban the use of organs from death row and the organ donation rate is the lowest in the world.To increase the rate of of organ donation,countries take the corresponding incentive mechanism including financial incentives,changing the default rules,or changing the organ allocation,etc.But studies suggest that the same incentives may have the opposite effect on organ donation.In China some provinces and cities have also carried out the pilot policies of donation incentives,such as exempting the funeral expenses of donors,providing humanitarian assistance and introducing the priority rights.This paper mainly studies the effects of organ donation incentives in China by the method of experimental economics.This not only provides an empirical test for the policy taken by the pilot province in China,but also provides a strong support for the promotion of corresponding incentives to the whole country.This paper first uses the time bias of behavioral economics to describe the individual organ donation behavior through the analysis framework of cost-benefit.Results show that to increase the rate of organ donation,the government can improve the benefit of organ donation on the one hand and reduce the cost of organ donation on the other hand.In addition,the government also can adjust the short-term cognitive bias by change the default rule.And then,we analyzes the presumed consent,per capita health expenditure,religion,internet users and cerebrovascular disease mortality and road traffic mortality effects on organ donation rates through the random effects model using panel date.And we found that the first three had a significant positive effect on organ donation rate.As the organ of death row is banned,China is aware of the importance of voluntary organ donation and begin to reform donation system.But the incentive system design is still in the pilot stage in our country.This paper utilizes three laboratory experiments to evaluate the effectiveness of alternative public policies targeted at increasing the rate of deceased donor organ donation.The experiments include discount combined with the default mechanism,rebate combined with the default mechanism and priority rule combined with the default mechanism.The experimental results show that switching from an opt-in to an opt-out public policy has a significant positive impact on individual organ donation decisions.we also find that combining both an opt-out and discounts,or combining both an opt-out and rebates,or combining both an opt-out and priority rule policy will provide the largest gains in the organ donation rate and that gains are substantially different from the individual effect of each public policy change.In addition,with informed consent,discount,rebate,and priority policies can have a positive effect on organ donation.But among the three,the incentive effect of priority is the largest,significantly better than the equivalent of discount and rebate policy.Furthermore,when the participants familiar with the rules of the experiment,the priority assigned to the donation rates incentive effect is still very significant.Rebate also has incentive effect for organ donation,but the effect is less than priority allocation,whereas the impact of the discounts on individual donation decision is not significant.In addition,we added four sessions of experiment by introduce positive and negative information stimulation to examine the effect of organ donation.When the positive and negative information was introduced,the difference of donation decision between the two groups was significantly increased.For our country,raising organ donation rates in short time,the key is to further improve the system of organ donation.Lessons of Spain and Croatia,which organ donation rate ranked first and second place in the world,We propose(1)the patient sorting should be open to people,the distribution of organ distribution must be transparent,the sale of organs must should be severely punished and the public is very trusting for the donation system.(2)The government should force the public to sign organ donors to enlarged potential organ donors and increased organ donation rates.(3)Draw lessons from the Spanish model,the government should build a transplant coordinating network,implement the whole process of medical training on organ donation,provide financial support to hospital,reform and perfect our donation systemChina is still in the informed consent.So the current incentive mechanism should focus on distributing priority combining subsidies to the whole country.Although the result of the experiment also found from informed consent to presumed consent has a significant positive impact on individual organ donation decisions and the combination of priority and rebate with an opt-out system will provide the largest gains.But our country currently does not have the conditions to switching from an opt-in to an opt-out.However,with the improvement of the organ donation system,the state may use incentives such as priority to combine with the presumed consent to further increase organ donation rates in the future.In the process of pushing forward,it may be possible to start with the weak presumption,and then over to the strong presumption.In addition,there is also a need for a coordinated mechanism.The economic incentive mechanism combines the legal supervision mechanism and the moral guidance communication mechanism together to promote the improvement of organ donation rate and actually increase people’s welfare in China.