It is National Donate Life Month, but there are no high-profile advocates for sufferers of severe or “end stage” kidney disease, unlike breast cancer and AIDS. In 2005, the latest data available, kidney failure killed 85,790 people — twice the estimated 40,000 deaths from breast cancer. It’s symbolic of the disparity of effort that the National Kidney Foundation holds a “Kidney Walk” whereas breast cancer has a “Race for the Cure.”

The reason that kidney disease, which is often linked to hypertension and diabetes, gets so little attention from politicians and Hollywood activists is that it occurs disproportionately among lower-income people who cannot mobilize for their cure.

People have two kidneys, but can manage with one, enabling patients to be cured by transplants from live as well as recently-deceased donors. But there aren’t enough donated organs. There are 75,000 people on a kidney waiting list. Others are too sick to join the list, or drop off it when their condition worsens.

The average wait for a kidney has grown from about a year in 1983 to eight years today. Patients on the list are about as likely to die, or to become too sick to be eligible, than to receive a donated kidney.

The shortage of kidneys may be self-aggravating. The fewer kidneys available, the less likely it is that people will donate one to a stranger, because they might want to save their “extra” kidney for the possible need of a close friend or relative.

While waiting for a kidney, patients have dialysis, an expensive process paid for by Medicare, Medicaid, or private insurance. They visit a clinic three times a week and spend four hours each time having their blood cleaned of impurities. This severely cuts into the time needed for family and work responsibilities.

Why don’t Americans get more kidney donors? The National Organ Transplant Act of 1984 specifically prohibited organ donors from receiving any compensation, under penalty of a possible $50,000 fine and up to five years in prison.

Perhaps the law made sense in 1984, when the wait for a kidney was relatively short. But it makes no sense now, and it deserves a second look.

A fellow and physician at the American Enterprise Institute, Sally Satel, is the editor of a remarkable new book on incentives for kidney donation to be published later this year, “When Altruism Isn’t Enough — The Case for Compensating Kidney Donors.”

Dr. Satel knows her subject from personal experience; after her kidneys failed, she spent more than a year on the waiting list. She was rescued by a stranger, the Atlantic contributing editor Virginia Postrel, who heard of her predicament through friends and donated a kidney.

In her book, Dr. Satel proposes a state-based program so states could experiment to find the best incentive model. Financial incentives would be non-cash, to avoid likely criticism of encouraging poor people to sell organs. Instead, donors might be offered lifetime health insurance, contributions to their retirement plans, loan forgiveness, or tuition vouchers. By not offering up-front cash, and requiring a three to six month waiting period before donation, the program would be protected from applicants desperate to sell organs.

Eliciting more live donations could not only pay for itself by reducing the costs of dialysis, but also could cut the costs of medical care. Dr. Satel said, “The law should be changed so that state and federal governments can offer incentives. There’s no other disease whose fate could be changed overnight, enabling so many people to live a normal life tomorrow.”

The National Kidney Foundation, based in Manhattan, however, disagrees with the notion of repealing the ban on compensation. The senior vice president of the foundation, Dolph Chianchiano, said that allowing material compensation would not increase the overall supply of donors.

Mr. Chianchiano explained that a move to compensate donors would “cheapen the gift” of a kidney. “People who might have contributed altruistically would be turned off,” he said, and donations would come from low-income people who need money.

The National Kidney Foundation prefers to try to increase the number of those who choose to donate organs after death, rather than live donors. But the lengthening list and wait times show that this is not effective. Furthermore, kidneys from live rather than deceased donors last longer. It is difficult to explain to the 75,000 people waiting for a kidney donation — a number that will only increase as the population ages — why anyone would stand between them and a potential donor.

In July 1983, Al Gore, then a representative, stated in hearings that if there were not enough voluntary organ donations, Congress should consider “provision of incentives, such as a voucher system or a tax credit for a donor’s estate.” That time has arrived now.

Ms. Furchtgott-Roth, former chief economist at the U.S. Department of Labor, is a senior fellow at the Hudson Institute. She can be reached at dfr@hudson.org.