ABSTRACT
This chapter aims to put organ transplantation in perspective by examining how catastrophic or high-cost illness has more pervasive implications than most recognize. As is true of the need for transplantation, the availability of donor organs is determined by selection criteria. If these criteria are relaxed, as some have argued they should be, there could be a substantial increase in donor supply. At the most elementary level, an analysis of the costs of transplantation should distinguish between procedure costs and program costs. Procedure costs refer to the expenditures associated with performing a single transplant, whereas program costs refer to the economic liability a payer incurs when offering coverage for a given procedure or medical service. The preventionist ideology is also subject to criticism on the ground that preventive health care strategies can be as cost-ineffective as major catastrophic health care interventions.
