Marta López-Fraga and Beatriz Domínguez-Gil make their point about our Health Policy on the ethics of the Global Kidney Exchange (GKE) programme1 by asking us to imagine that Alyson, an Ohio farmer, is willing to donate a kidney to her daughter but unable to afford the surgery. Medicare pays for kidney transplantation surgery in the USA, even for people younger than 65 years, so there is no way in which GKE could prevent Alyson's daughter from receiving a kidney from her mother. Kidney transp...