to the End Stage Renal Disease Program, with dialysis costing Medicare over $87,000 per patient per year, as Federal law dictates that Medicare will cover dialysis for everyone who has made minimal Social Security tax payments. (10) A kidney transplant pays for itself in less than two years, with each transplant saving an average of over $700,000 in medical costs over a 10-year period, 85 percent of which is savings to the taxpayers. (11) Experts project that if the supply of transplant kidneys could be increased to meet the demand, taxpayers would save more than $12,000,000,000 per year in medical costs. (12) The World Health Organization estimates that 10 percent of all transplants take place on the international black market, the last choice for desperate patients facing an alternative of death, however recipients often face infected kidneys and have poor health outcomes and donors are often victimized. (13) Present policy on domestic donation, which is not evidence based and has never been subject to studies or pilots to determine effectiveness in increasing the availability of donated organs and the effectiveness of safeguards that prevent coercion or exploitation, precludes all but altruistic donation, prohibiting any form of incentive or benefit for donors. (14) Experts are arriving at a consensus that trials are necessary to find new methods of promoting additional organ donation which will save lives and reduce organ trafficking. 3. Clarification of certain provisions of the National Organ Transplant Act (a) Relation to other laws Section 301 of the National Organ Transplant Act ( 42 U.S.C. 274e ) is amended by adding at the end the following: (d) Relation to other laws (1) Governments encouraging organ donation This section shall not— (A) apply to actions taken by the Government of the United States or any State, territory, tribe, or local government of the United States to carry out a covered pilot program