The price of "free" organs

That's blunt, isn't it?

All across the nation people are tearing their out hair trying to figure out what to do with our organ supply. Should we supply organs on a strict first-come, first-served basis? Should emergency transplant cases move to the head of the line? Should we refuse transplanted organs to people who--like Mickey Mantle and Larry Hagman--have organ-abusive lifestyles? Should famous people--like Mickey Mantle and Larry Hagman--get preferential treatment?

What's wrong with this picture?

They are not "our" organs.

Unwittingly, we have adopted the worst sort of Socialist argument with respect to the distribution of transplantable organs. We argue that organs should be distributed on the basis of need, perhaps taking account of--and penalizing--behaviors of which we disapprove. Or we argue that organs should be distributed on the take-a-number plan, like croissants at the bakery.

What we don't say, but should, is that organs available for transplantation should be sold to the highest bidder.

What!?! Let people live or die on the basis of their ability to pay?

Yes. That's the way we do everything else. People with money eat better food and thus tend to live longer. People with money live in safer neighborhoods and thus tend to live longer. People with money drive newer, better-equipped cars and thus tend to live longer. People with money buy better health care generally and thus tend to live longer.

There are those who oppose this way of disbursing property, of course. But, in fact, the only alternative to decision-making by economic criteria in the marketplace is decision-making by political criteria in the legislature. If you need a transplanted organ, in a free market you can decide how much it is worth to you. But if the organ supply is nationalized, then some politician or functionary will be empowered to decide how much you are worth to him or her.

And it is important to reiterate: they are not "our" organs. We can dispute the nature of property--chattels and livestock and securities and copyrights and real estate. But surely no one is willing to argue that the stuff that is housed within your own skin is not your property. Your organs are yours, yours alone, yours to dispose of however you choose.

At present, you are forbidden by law to do anything with them but trash them or give them away, and then only post mortem. And yet demand far exceeds supply, a clear indication that Socialism has failed. Again.

In a free market, the price of organs would rise so that demand moderated itself to the available supply. Grandpa might decide that he'd prefer to endow a trust fund for little Jenny rather than push a walker around for another year or two. And because of the institution of a price system, the supply of available organs would rise dramatically and permanently. Instead of the emphemeral satisfaction of checking a box on a driver's license application, voluntary organ donors could look forward to leaving a substantial cash legacy.

Moreover, people in need of money could sell their spare organs while they are still alive, if they wanted to. It makes me a little queasy, too, but either we own ourselves or we don't. If we don't, then we have bigger problems than this. But if we do, then, surely, we have the right to do whatever we wish with our bodies, no matter how disturbing this might be to others.

The supply of organs would increase. The quality of organs would increase. And the price system would have the further advantage of encouraging research into how better to make use of transplantable organs. Very likely, it would bring into being a whole new industry, artificial organs. We know this from 500 years of studying free markets: innovation happens where the money is.

That's the up side. What's the down side?

The instantaneous objection is the one named above: why should people live or die just because they have money? Because they have money. The only alternative is for people to live or die just because they have political clout or notoriety or some other arbitrary asset. If you want to start a charity called Organs for the Poor, go right ahead. It's still a free country, after all.

Well, what if people who really need organs are denied them because some fat plutocrat has bid up the price? You can substitute any value you want for "organs" and arrive at the same objection. Why do the rich get better cuts of meat? Why do they get radial keratotomy when the rest of us are stuck wearing glasses? Why do they live on the hill when we live in the valley? Short of a surgical envy extraction, there's not much that can be done about this.

But what if someone like Mickey Mantle ponies up the price for a new liver? He was a lousy stinking drunk; doesn't he deserve to do without a replacement, since he destroyed the original equipment? The question is: shouldn't I be empowered to decide who should live and who should die? If you want, go to church and pray for god to smite the wicked. But please don't presume to smite them with your own hands. We call people who do this murderers.

Well then, what if the poor are exploited by unscrupulous organ brokers? Should people have to sell their bodies out from underneath them just for filthy lucre? Frankly no. They should discover how to remain alive by more lucrative means. But many refuse to, as is obvious to anyone who has ever driven past a commercial blood bank. So the question is, should people who have learned how to pay their own way in life be forbidden to purchase organs from people who own them and have every right to sell their property? So that we can feel better about ourselves? If we injure the would-be buyers and injure the would-be sellers, then how is what we're doing good?

Fine. But what if criminals start stealing and selling organs just like they do now with car radios? We have cops and courts and jails for criminals, haven't we?

The bottom line is this: the organs are not "ours", and they should not be discussed in group-interest terms. But every supposed group-interest objection is fallacious anyway.

People are dying, and we are gravely trying to figure out how best to be the choosers of the slain. But we need not choose the slain, and we are criminals--murderers--when we do. If we free the market, people will decide for themselves what is best within the context of their own lives, just as they do with cars and houses and vacations and legacies for their children.

And if we refuse, we won't stop the dying. We may even cause deaths that might have been prevented in a free market. What we will do, without doubt, is assure that organs will be distributed by means that are arbitrary, capricious, senseless and corrupt.