In 1987, when the United Network for Organ Sharing began keeping records, there was a gap between supply of organs and demand. With time, that gap has become a chasm. Last year, more than 120 000 people were in need of a kidney, liver, heart, or lung; roughly 7000 of them died while waiting.1
During the past 2 decades, states have tried several ways to encourage nondirected organ donation from deceased and living donors. These methods have included, for example, a state tax deduction for expenses incurred by living donors. But do such policies wield a meaningful effect? In this issue, Chatterjee and colleagues,2 to our knowledge, conduct the first examination of the national effect of a variety of policies on organ donation, and find that the policies barely made a dent.