As you read this, more than 100,000 Americans are waiting for donor organs they may never receive. According to the United Network for Organ Sharing, the number of Americans on the waiting list is 100,612 and counting. As of Dec. 5, the number in Pennsylvania was 7,068. More than 70 percent of these patients need a kidney, and most will languish on dialysis or die before they get one.

Every year, 3,000 Americans die for lack of a needed kidney. While kidney disease is a fact of life, the inability to get a transplant is a death sentence from Washington: U.S. law forbids Americans suffering from kidney disease and their health-care providers to offer any "valuable consideration" for organs.

Of course, people of means don't let the law get in the way. Those with status, connections or money jump the queue. They network to find living donors or pay for organs on the black market. It can cost a patient as much as $200,000 to procure a kidney on the black market from countries like India or the Philippines, and the World Health Organization reported in 2004 that as much as 98 percent of such payments goes to middlemen.

Even if every American signed an organ donor card, there wouldn't be enough people who die in a way that produces viable kidneys for transplantation. As for live donors, people are usually born with two kidneys and can donate one with little risk to themselves, but the procedure takes months to arrange and requires donors to take weeks off work.

Legalizing the sale of kidneys by live donors would not end poverty, nor would it end kidney disease, but it would significantly improve the lives of poor and middle-class people who need kidneys and those willing to sell one. It could create unforeseen possibilities for abuse, but that would be better than condemning innocent people to easily avoidable deaths.

The most common argument against legalizing the sale of kidneys is that the poor would be exploited. Every day, poor people make difficult decisions about how to improve their conditions. It's easy for ivory tower intellectuals and bureaucrats to say it's unethical to sell a part of your body, but the cruel reality of a law that says no price is high enough for an organ is that the vast majority of patients cannot buy life-saving treatment.

Poor people who need kidneys don't have the resources to find donors. They can't afford to advertise, nor do they have social networks of people who can take three to six weeks off work. Least of all do they have the capital necessary to purchase organs on the black market.

Why should the government tell people they can risk their lives by enlisting in the military or working in coal mines and battery factories but not receive compensation for helping patients in need? Or that it is acceptable for them to risk their health disposing of other people's garbage but not to save a life by selling a kidney?

If the United States allowed the sale of kidneys, it could end the shortage and simultaneously give many Americans more immediate economic assistance than they would ever receive from government programs. Even if the government were to require donors to receive payments in the form of health-care savings accounts or educational scholarships instead of cash, imagine what a tremendous benefit it would be.

If selling kidneys were legal, they would both cost less for patients and provide more money for donors. When the only way to purchase a kidney is on the black market, criminal brokers are free to exploit desperate recipients and desperate sellers who have no legal recourse if they are cheated. The supply of kidneys for transplant is kept artificially low, the price artificially high and brokers profit at a rate 10 times that of those who sell their kidneys.

If patients could broker their own deals, with appropriate medical and legal oversight, those who otherwise would die on the waiting list could get organs that would save their lives, and people who deserve to be compensated for their service could be fairly paid.

One hundred thousand Americans are waiting for organs. Each day we do nothing, another eight or more die waiting for a kidney. What are we waiting for?