Over the past decade there have been numerous proposals to use market system incentives to attenuate the persistent shortage of transplantable human organs. While shortages have grown, opposition to market-based solutions has remained adamant. Much of the opposition has focused on monetary incentives. This article explores an alternative—a mutual insurance pool to increase the supply of organs. In the process, criticisms of earlier proposals (specifically the future delivery scheme) are addressed, the operation of an insurance pool is described, and problems associated with insurance markets are identified and addressed. The article concludes that an insurance pool could overcome public and political resistance to more explicit market-based solutions.

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