Elaine Perlman
Bio
Participation1
Columbia University Professor turned President of the Coalition to Modify NOTA & Executive Director of Waitlist Zero advocating for the passage of the End Kidney Deaths Act (H.R. 2687).
How others can help me
Since 2024, I’ve been working on passing a bill which I think is the most promising way to address this problem: the End Kidney Deaths Act (H.R. 2687), a ten year pilot program, which aims to provide kidney donors who donate to a stranger with a refundable tax credit of $10,000 per year for five years, $50,000 in total. Because around $500,000 tax dollars are saved every time someone donates a kidney, the bill would likely save billions of dollars annually. The impacts of the bill are necessarily hard to estimate (as it is difficult to know just how many people would come forward to donate), but our best guess is that this bill would save tens of thousands of lives by encouraging kidney donation.
For more, you can read the bill text here and an article in Notes in Progress here.
Our team has had hundred meetings with Congressional staffers about this bill, and there are currently 43 House sponsors from both parties. We consistently hear that a key barrier to getting more Congressional support is simply that too few people are calling and writing their members of Congress.
I am posting with the hope of mobilizing more people to get involved. It doesn’t take long! How you can help
- Write and call your Senators and Representatives.
Ask them to cosponsor and champion the End Kidney Deaths Act (H.R. 2687). You can use this form.
If you are writing to a Democratic Senate office, please edit your default email asking them to join Senator Jerry Moran as the co-lead. - Sign up to help advocate.
Visit EndKidneyDeathsAct.org to join our team or email me at Elaine@WaitlistZero.org with your zip code. You will receive updates, guidance, and opportunities to meet with congressional offices. We have Action Fridays and monthly virtual meetings to galvanize our progress. - Share this with friends and family
The more people who write letters and publicize this bill, the faster it will pass.
How I can help others
Reach out if you have questions about the End Kidney Deaths Act, the Honor Our Living Donors Act, kidney donation, 21 Day Jumpstarts to reverse or prevent chronic disease or teaching grades preK-12th grades.
Posts 2
Comments8
That’s a fair critique, and I agree that EA and the U.S. government are obviously distinct actors.
My argument wasn’t meant to conflate them. It was meant to highlight a broader lesson that I think is relevant to both.
The U.S. kidney system is an example of a domain where enormous resources already exist, Medicare spends billions on dialysis annually, yet poor institutional design prevents those resources from translating into optimal outcomes.
My broader point is that EA may face analogous problems if funding grows dramatically. The central constraint may increasingly shift from, “How do we raise more money?” to “How do we build mechanisms that reliably convert money into public good?”
The kidney shortage feels like a useful case study because it demonstrates that abundance of capital alone doesn’t solve coordination failures, incentive failures, or policy failures.
In other words: the government example is illustrative, not identical.
And I’d argue that this lesson becomes even more important in a world where EA capital scales rapidly.
Please consider signing our petition to help get the End Kidney Deaths Act to the finish line. 100,000 Americans (the total number that will be saved over the ten year pilot program) are relying on us to save their lives. https://forms.gle/rVmseMDioZmazLQXA
25 people in the USA will die today because the kidney shortage denied them a transplant.
Congress must act.
Thanks, Mihkel! I spoke with the leader of transplant in Egypt who told me that "Egypt needs the End Kidney Deaths Act." A doctor from Nigeria said the same thing about Africa where in all but SA, there is not deceased donation program. Once the End Kidney Deaths Act passes here, we can provide support for all countries to pass similar laws.
Thanks for reading and for considering ways to expand the impact of this effort! I’d greatly appreciate feedback.
Thanks for the fair critiques.
On the writing style: I did use ChatGPT as an editorial tool for structure and phrasing.
On the second point: I agree that EA absolutely talks about talent, coordination, and institutional bottlenecks not just money. My argument was narrower than perhaps the opening suggests.
I was responding explicitly about navigating a potential influx of capital, and trying to argue that even in a world with much more funding, mechanism design may matter more than additional grant-making in some domains.
The kidney shortage (that we are working hard to end) presents a case study because it’s a place where enormous resources already exist (billions spent on dialysis), but poor institutional design prevents those resources from producing better outcomes.
So I agree the opening could have been more precise. The stronger version of the claim is probably:
“Even when funding is abundant, poorly designed systems can still produce scarcity.”
This is relevant both to kidney policy and to EA more broadly.
Please consider signing our petition to help get the End Kidney Deaths Act to the finish line. 100,000 Americans (the total number that will be saved over the ten year pilot program) are relying on us to save their lives. https://forms.gle/rVmseMDioZmazLQXA