In this article, economists enter the discussion of methods to increase potential organs, particularly kidneys (more desirable from a living donor). Levitt and Dubner, authors of the well-known book “Freakonomics,” argue that the ‘repugnance factor’ many associate with monetary incentives for living donors would recede over time. Citing the dramatic change in social attitude toward life insurance and charging interest amidst the sobering facts that more than 3500 people die a year waiting for a kidney. The article closes with a description of the New England Program for Kidney Exchange (NEPKE), an innovative collaborative effort that pairs those in need of a kidney and their loved one (proven not to match the recipient) with other similar couples for simultaneous donation. This idea of incentive alignment eliminates the ‘repugnance factor’ and the need for monetary incentives, which are morally questionable and could put undue pressure on the indigent.