Mises Daily Articles
Death Toll Still Rising
Terrorists killed nearly three thousand people on
These official figures actually understate the true number of deaths, because many people who need a transplant are denied access entirely, and as the shortage of organs grows, the standards for entering the waiting line are becoming even more stringent. Worse still, people waiting for a transplant are taken off the list if they become too weak for the transplant operation. Many of these people die shortly thereafter but are not counted in the official body count. As the shortage becomes more acute, waiting times increase, suffering increases, and the number of unofficial deaths skyrockets.
The current system is one in which the government manages the supply of organs by a system of regional nonprofit monopolies which are suppose to seek out permission to obtain the vital organs of accident and stroke victims. The organs are then given to the transplant centers for the patients at the top of the waiting lists. The government pays most of the cost of the transplant and subsequent treatment. This is a "market" in which the government controls production, distribution, and consumption, and where the market is explicitly banned.
The National Organ Transplant Act of 1984, sponsored by Senator Al Gore and signed into law by President Ronald Reagan, set up this bureaucratic killing machine that imposes a five-year sentence and a fine of $50,000 for anyone willing to invade its turf by offering "valuable consideration" to a family that would donate the organs of a deceased family member to save someone else’s life.
Naturally, a government-managed monopoly does a lousy job of obtaining a sufficient supply of organs. They often fail to ask permission to obtain usable organs or are ineffective when they do ask. As a result, they only collect about a fourth of the available organs. After years of double-digit growth, the supply of cadaveric organs abruptly leveled off after the passage 1984 Transplant Act.
Allow me to read through the author’s neoclassical economics and well-couched scientific analysis and tell you that the bureaucrats and surgeons find the market system repugnant because they make monopoly profits off the current "altruistic" system. Individually, they may or may not realize that their ethical view is responsible for so much unnecessary death and suffering, but collectively, they understand that it is what protects the pocketbook of the bureaucracy and the medical transplant establishment.
Organ procurement is an issue that deserves the attention of the general public. Our authors here have done an excellent job of explaining the current system, the extent of the shortage, the suffering it brings, the cause of the shortage, and its cure. It would make an excellent case study for courses in economics, public policy, and philosophy.
One hidden advantage of the book is the lesson it provides for the debate over the legalization of drugs. The current organ procurement and allocation policy is, after all, a prohibition of the market and free-market forces. The important difference is that in the case of the government's prohibition of drugs, a black market replaced the market, while in the case of organs, bureaucracy and government intervention displaced a nascent market.
Most advocates of drug "legalization" argue that drug prohibition should be replaced with bureaucracy and intervention, not free-market forces. Disheartened by the prospects for policy reform, and inspired with the concept of "harm reduction," they advocate a system where government regulates the supply of drugs and determines who is allowed access to drugs, what drugs are permitted, and how much you are allowed to consume.
Some drugs might be subject to high taxes while the government would provide other drugs for free. Government would regulate drug treatment centers, and addicts would be subsidized and required to participate in treatment and rehabilitation. Government would register, monitor, and study drug addicts. The market would be limited to government contracts for nonprofit organizations and heavily regulated for-profit firms, but government would ultimately control all of the major decisions and functions in this "legalized" market.
The disastrous results of government control of organ supply should give these advocates great cause for concern. The real free market is the only policy of providing economic rationality to human organ procurement, and it is the only policy that can address the issues of dangerous and addictive drugs.
When particular issues are raised in either case, policymakers should always move in the direction of freer market forces and less government intervention. Contrary to popular belief, government is particularly inept at handling the new and complex problems of society. Only the free market can handle the daunting the tasks of society, a point well illustrated by Professors Kaserman and