I request you to kindly read up more on this subject. Your 'big issue' already exists today! The poor in countries like India are already forced to sell their organs to rich donors in the West through the black market where they are paid a pittance. Debt collectors in India make a killing by preying on the poor. The rich pay the middle-men a truck load of money, but the actual donor gets very little at the end. Formally paying donors will at-least give them a much better price without the middle-men taking most of the money.