Why are so many people so hostile to free markets?
Markets provide miracles that
we take for granted. Clean, well-lighted supermarkets sell 30,000 products.
Starvation has largely vanished from countries where private property and economic freedom are permitted. Free markets have rescued more people from poverty than government ever has.
And yet, when innovators propose extending this benign power, people shriek in fear.
This was clear reading The Wall Street Journal not long ago.
The “Letters” section led with
complaints about Bob Poole’s column on well-maintained private highways that
keep traffic moving.
One writer complained that such highways exist for “the privileged ... who can afford surprisingly large ... fees ... to drive a very boring 45 minutes around metropolitan Toronto. Highway 407 is certainly a great success — for its bondholders.”
Surprisingly large fees? Only if you are clueless about what you pay for “free” roads. And why is success for the bondholders a bad thing? Is the writer envious?
If the ride is boring, he doesn’t need to take it. No one forces anyone to use a private highway. Why do so many begrudge the successes that voluntary private exchanges bring?
That same day’s Journal also included a story on the “radical” idea of kidney selling.
Why is selling an organ “radical”? Banning the sale of kidneys kills thousands of people a year. That should be considered “radical.”
Today, 74,000 Americans wait for kidney transplants while enduring painful, exhausting and expensive hours hooked up to dialysis machines. The machines are technological miracles that keep many alive, but dialysis is not nearly as good as a real kidney. Every day, about 17 Americans die while waiting for a transplant.
Yet plenty of Americans would give up a kidney if they could just be paid for their trouble and risk. Ruth Sparrow of St. Petersburg, Fla., ran a newspaper ad saying: “Kidney, runs good, $30,000 or best offer.”
She told “20/20” that she got a couple of serious calls, but then the newspaper refused to run her ad again, warning her that she might be arrested.
Why isn’t someone with two healthy organs allowed to put one on the market? Because in 1984, U.S. Rep. Al Gore sponsored a law making the sale of organs punishable by five years in jail. Congress couldn’t contain its enthusiasm; the bill passed 396 to 6.
So giving someone a kidney is a good deed, but selling the same kidney is a felony.
When I confronted Dr. Brian Pereira of the National Kidney Foundation about that, he said, “The current system functions extremely well.”
I asked him how the system could be working “extremely well” when 17 people die every day because they can’t get kidneys. He said that the “desperate (situation) doesn’t justify an unwise policy decision.”
The Kidney Foundation fears that poor people would be “exploited.” But what gives the foundation the right to decide for poor people?
The poor are as capable as others of deciding what trade-offs to make in life. No one forces them to give up an organ. To say the poor are too desperate to resist a dangerous temptation is patronizing.
But gatekeepers like Dr. Pereira say there should be “no barter, no sale of organs. That’s where we have to step in.” When I asked him who that “we” is that has the right to “step in,” he replied, “The government (and) the professional societies.”
That conceit — that the government and “professional societies” must decide for all of us, and the underlying hostility toward commerce — kills people.
Money shouldn’t make giving up an organ suspect. As one kidney patient told me before he died, “The doctors make money, the hospitals make money, the organ procurement organizations make money. Everybody gets something except for the donor!”
If you think it’s immoral to sell an organ, don’t do it. But sick people shouldn’t have to die because some people despise markets.
9 comments from readers
I think that the organizations covering transplant costs are the ones most likely to quietly campaign against anything that widens the availability of donor organs. Additionally, "professional societies" do not represent the interests of patients, but those of the professionals in question. Increased procedure costs because of increased organ acquisition costs, along with payors' increased scrutiny because of an increase in total number of procedures, might reasonably be expected to squeeze profits for the professionals who materially profit most from the transplant business.
So, we have insurers on the one hand for whom it's cheaper for the patients to die, and professionals on the other who are likely concerned about the impact of free-market organs on their own profitability. Both are likely to have access to lobbying organizations that can efficiently bring government coercion to bear.
I suggest that the reason isn't conceit, but the familiar reality that lies at the crossroads of an industry's drive for economic expedience and the government that might become its instrument of oppression.
We should bow our heads at the needless loss of life, but never forget to follow the money in asking "who has to gain from this and why?"
Why is it OK to donate an organ, but wrong to sell it? Why is it virtuous to wait for a donated organ, or die while waiting, but evil to buy an organ rather than wait in agony or die?
The legalization of the sale of organs would save lives, and help remove people from the wait list who could afford to pay for an organ. Those who wanted to donate could still do so, and the organ could go to someone on the waiting list which would be much, much shorter.
The ban on the sale of organs seems to be deliberately devised to kill people without money, in the interest of maintaining a bitter envy in some people of those who have money. This ban further seems nothing more than an attempt to stop those with the money to buy organs from doing so.
It appears to me not to be any kind of effort to help the "poor," but rather an effort to stymie those who do have money.
How is it that some people have come to believe that wealth is evil, that if you have wealth, it was necessarily taken dishonestly from someone else as if there is a finite pie and some people have just too much of the pie?
How did so much ignorance and spite creep into our culture, and what is its source?
In my current location, Northern California, most murders go unpunished (no prosecutions). Of those prosecuted, the penalties sought were universally light. Of a dozen killings by authorities, every single one was decided as "justified" (not by a judge either).
Nationally, hospital "mistakes" supposedly kill thousands of people every year. These are almost never prosecuted.
In this climate, I have no doubt that the rampant organ theft and murder that is rumored in other countries, like China, would be a problem here too. Would an organ market, without a decent justice system, lead to organ "pawn shops"? Do we really want to create strong incentives to corrupt our health care workers?
If an organ market is abused, who will be blamed, a corrupt justice system or "big corporations"?
So, I respectfully suggest that we postpone a push for an organ market until we have tackled the bigger problem of corrupt: laws, courts, and police organizations.
Of course, people who vote these laws don't consider that the opening of markets might very well create a fall in the stolen organ black market. And again, redundant organs extracted from a live donor at the time of the transplant like kidneys might be a different case from non-redundant organs like hearts, usually removed and brought to the transplant room accompanied only by paperwork.
For kidneys, the economics of it will depend on the floor payment required by the thieves. Stealing a kidney requires a skilled criminal MD to extract it and properly store it, even if they plan to let the victim die. Some thug had to capture the victim and dispose of the victim (dead or alive) too. All of that incurs costs and the risk premium is large. In the end, I wouldn't be surprised if the price of black market stolen kidneys would end up being higher than if coming from a competitive free market.
Now what do we do.....let free market prevail and people riot for a basic necessity like flour or should government intervene (which is against the free market principle) and which it is trying to do but failing miserably to achieve any results.
I have failing kidneys. When the time comes (inevitably so, according to my doctor) I may be fortunate to be able to receive a kidney from my sister. For the last few years this fact has comforted me and I have never really thought much about it.
To discover that 17 people die every day while waiting for a kidney shocks me. I was diagnosed 7 years ago. In all the consultation I have received never has any doctor made me aware of this shortage, nor about the debate regarding selling organs. It never occurred to me to ask.
I've read several books on kidney disease. None mention the shortage or the debate.
I use the internet to research my condition and to understand the transplant process. I have NEVER come across a such a resource that even brings up the debate.
Each day 17 nephrologists in this country watch their patients die, and they do so knowing full well that a kidney could have made the difference. You'd at least expect patients and their doctors to come together into a huge group and fight this insane ban in the courts. Is this happening?
I think that the health care industry is the prime example of why big government is a BAD thing. By mandating insurance coverage, manipulating prices, and most of all by insulating the consumer from the financial considerations involved, the nanny state rewards, and so perpetuates, the health consumer's ignorance. Ignorant consumers perpetuate bad business practices. And bad business practices perpetuate BIG BAD GOVERNMENT by making it easier to convince the ignorant health consumer that MORE financial insulation is needed to protect us. It's a insidious circle.