TCS Daily


Congress: Please Sell My Kidneys

By James Freeman - April 10, 2000 12:00 AM

Congress and the Clinton Administration are debating how to fix a system that cannot be fixed. Each year, thousands of Americans die waiting for an organ transplant, and their deaths are the direct result of government policy. There is a chronic shortage of donated human tissue, because the Federal government prohibits the one thing that for thousands of years has solved the problems of supply and demand - a free market. Thanks to a 1984 law sponsored by then-Senator Al Gore, donated organs are allocated by a group of un-elected bureaucrats with life-or-death power over terminal patients. The sale of organs is prohibited.

None of the current reform proposals before Congress will end the organ shortage. The pols are just debating which bureaucrats will have the power and what criteria they will consider in managing the allocation system. People will continue to die, because the government will not allow the market to solve this problem.

The shortage will continue for the same reason that store shelves in the old Soviet Union were constantly empty. When you don't reward people for providing valuable goods, lots of people choose not to provide them.

Biotechnology offers a way out of this tragic mess, assuming alarmists don't shut that market down, too. Pigs could be bred especially to grow organs suitable for human transplant. Am I saying that I want lots of animals to be used simply as a source for human spare parts? Absolutely not. If we really get this technology clicking, maybe we could breed the same pig to produce not only a transplant-ready liver and kidney but also delicious country ham with just a hint of honey dijon flavoring.

I shouldn't make light of this. The possibilities to alleviate suffering are amazing, and heck yeah I want to use a pig for spare parts if it means that somebody's child can live. I also don't want to suggest that human embryos should be used in this way. But eliminating human illness is a noble calling for pigs, and so is feeding the population. Biotech in farming means more food at lower prices, and that means fewer hungry people in the world.

Scientists should be free to develop new life-saving innovations, but that won't help people who need transplants right now. The shortage could be solved immediately if we allow people to buy and sell the rights to organs in the event of death. I know it sounds a little creepy, but I don't think anyone can argue that it won't save thousands of lives.

Of course some people will point out that prices may move beyond the reach of many patients. That's true. Operations are expensive, and obtaining the organs will make them more so. The challenge is to bring this wonderful technology to all patients in need. I believe there is a group ready and able to overcome this challenge.

Let's say we offer families of the deceased $10,000 for the right to recover life-saving organs - much more than enough to cover burial costs. Some family members might choose to have the money donated in the deceased's name to a favorite cause. Others might choose a special event to honor and celebrate the memory.

Ten grand is probably on the high side, given that each year thousands of people already offer the gift of live-saving organs for free. But just for the sake of argument, let's say it costs $10,000 to obtain organs from each suitable donor. As of March 19th, almost 69,000 patients in the US were awaiting a donated organ (a tragic testament to the failures of the current system).

Given our assumptions, eliminating the organ shortage would cost about $690 million. It's difficult to say exactly, since some donors would provide multiple organs for transplant, while some patients would need more than one new organ, but let's say $690 million is in the ballpark.

That's a lot of money, but I believe the money is available. $690 million is less than four tenths of one percent of the money in America's 135 wealthiest private foundations, according to the Chronicle of Philanthropy. In fact, $690 million is less than a third of the 1999 increase in the Ford Foundation's assets. Thanks to excellent results in its investment portfolio, according to the Chronicle, the Ford Foundation grew 24% last year to $11.9 billion.

If I'm right about the costs of encouraging organ sharing, this big charitable foundation could single-handedly end the organ crisis by spending a little more than 5% of its total assets each year. And Ford would still continue to grow its assets, if it's anywhere near as successful at investing as it was last year.

So I think we've identified able buyers and I'm convinced there would be willing sellers. Now Congress and the President should let the market do for dying patients what it already does in every other facet of our lives - end shortages and create abundance.
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