Kidney transplants generally improve both the quality of life and longevity of patients with end-stage renal disease (ESRD). The National Organ Transplant Act of 1984 currently bans commercial transactions in transplant organs. An unregulated market for live kidneys would eliminate the shortage of transplant kidneys. Senator Smith presented the reader with a specific policy problem, the long waiting list for kidney transplants, and asked the policy to consider a class of alternatives, policies that would increase the availability of kidneys for transplantation from living donors. Such comparisons are important, because it is the possibility that the policy client could influence policies offering improvement that turns an undesirable condition into a policy problem. In view of the large losses in quality of life and longevity of patients that result from the prohibition of commercial transactions, alternative policies involving commodification that substantially mitigate the disadvantages of an unregulated market deserve consideration.