The following editorial is reprinted from the Washington Post.

In the course of this year, about 8,000 Americans will die waiting for an organ transplant. As surgical techniques have improved, the number of people who could benefit from a transplant has increased. Meanwhile, partly because of welcome road safety improvements, the supply of usable organs has not kept up. In 1990 some 22,000 Americans were on the waiting list for a transplant. Today there are 93,000, of whom 68,000 are waiting for a kidney and 17,000 for a liver. In some parts of the country, delays are particularly extensive: In Indianapolis only 1 percent of patients who need a liver transplant have to wait for three years or more, but at Manhattan’s Mount Sinai Hospital, fully 69 percent are forced to wait that long.

The extended and sometimes fatal wait imposes suffering on patients and families. It induces people to give organs while they are alive rather than posthumously. Last week Hall of Fame basketball coach Morgan Wootten received a kidney from his son Joe; of the 17,000 transplants performed nationwide in the first seven months of this year, almost 4,000 used organs from living donors. And although financial considerations should not be paramount, it’s worth noting that forcing patients to do without transplants costs the nation money. Because dialysis is expensive, kidney transplants pay for themselves in two to three years; one in two transplanted kidneys lasts eight years or more.

This suffering and waste could be alleviated if more people agreed to give organs posthumously. Currently only a little more than half of the 14,000 people annually who die in circumstances that would make them suitable donors give organs. All state governments and Washington, D.C., have tried to encourage donations by asking people to sign up when they apply for a driver’s license. But not enough people respond to this prompting.

Three types of extra incentives merit attention. The decision to pledge organs could be linked to the chance of receiving one: People who check the box on the driver’s-license application when they are healthy would, if they later fell sick, get extra points in the system used to assign their position on the transplant waiting list (other factors include how long you have waited and how well an available organ would match your blood type and immune system). Another sort of incentive is financial: Georgia has experimented with a $9 discount on its driver’s-license fee. A final reform would shift from opt-in organ donations to an opt-out system: Unless you went out of your way to check a box on your driver’s license application to indicate that you did not want to give organs, you would be considered a potential donor.

These reforms don’t raise significant ethical issues. They would not allow people to buy and sell organs, and they would not allow patients to pay their way to the top of the organ-transplant queue. Each reform, or some combination of them, would save money and relieve suffering. State governments shouldn’t wait.