It’s The Design, Not The Label

I posted earlier about a Hopkins Business of Health Initiative debate on the organ donation dilemma, focused in part on the End Kidney Deaths Act.

My latest substack reflects on one theme that kept recurring: debates over kidney donor benefits often ask labels to do more ethical work than they can bear.

Is a refundable tax credit a payment, a reimbursement, an incentive, or compensation? Those words matter legally and rhetorically. But the harder question is institutional design: who provides the benefit, whether there is bargaining, whether allocation remains based on medical need, and how donors are screened, protected, and followed over time.

The piece is here: https://kimberlydkrawiec.substack.com/p/its-the-design-not-the-label?r=4uxr2y