Free the Market. Save Lives.

by Don Boudreaux on November 21, 2011

in Civil Society, Health, Hubris and humility, Nanny State, Other People's Money, Video

Here’s David Henderson on LearnLiberty’s fine new video featuring philosopher James Stacey Taylor on human-kidney sales.

The prohibition on human-kidney sales is a perfect example of uncompensated third-party harms – negative externalities – inflicted on innocent people by political decision-making.  A chief (tho’ not the only) reason given to justify this prohibition is that many people find the thought of a free-market in kidney sales to be distasteful.  As a fellow student at UVA Law informed me 20 years ago, “I [my fellow student] just don’t want to live in a society that allows such commerce.”  She advised that it’s just so distasteful that it shouldn’t be allowed to occur.

This woman was willing to vote for a policy that results in unnecessary suffering and premature deaths simply so that she and her tender sensibilities might be spared what for her is the unsavory knowledge that somewhere in America some people voluntarily and peacefully engage in exchanges that are mutually agreeable and, frequently, life-saving.  Having her ‘say’ in other people’s lives – without her having to pay to exercise that say or to compensate those people harmed by her vote – is an instance of a politically induced negative externality.

…..

More broadly, this example highlights the strength of Carl Dahlman’s important 1979 argument (in the Journal of Law & Economics) that, ultimately, what is and what is not a policy-relevant externality is not a matter of objective science but, rather, of value judgments.

My law-school classmate from long ago might well reply that the psychic harm inflicted on her by the knowledge that legal kidney sales are taking place would itself be a negative externality unleashed by the legalization of such sales.

And she’d be correct.  Or, at least, neither I nor anyone else would be able to disprove her positive claim of being severely psychically harmed by knowing that such legal sales occur.

Some value judgment must be exercised to weigh the value of saving people from suffering and dying prematurely against the value of saving the tender psyches of people such as my former classmate.

Most people, I believe, value saving innocent lives and preventing unnecessary physical suffering more highly than they value preventing the ethically sensitive among us from having to endure pangs of anguish caused by the knowledge that other people are buying and selling human kidneys.  (This case isn’t close to being ‘close’ – for example, as between valuing the farmer’s desire to grow crops without worrying about those crops being set afire by sparks from a passing locomotive, and the railroad’s desire to run its train at top speed over its tracks that abut a cornfield.)

Trouble is, each person is intimately familiar with and concerned with his or her own personal psyche – each person gets the full measure of pleasure from gratifying that psyche and suffers the full measure of disappointment or anguish from irritating that psyche.  A busybody – especially one unaware of the unintended economic and medical consequences of banning kidney sales – is too likely, then, to gratify his or her psyche by imposing uncompensated burdens on those people who wish to purchase kidneys and on those who wish to sell their kidneys.

If we agree that saving lives is more important than saving tender psyches, then the policy of preventing the buying and selling of kidneys at market prices inflicts on innocent third-parties a policy-relevant negative externality – and, frankly, one that is especially heinous.

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{ 176 comments }

Chris O'Leary November 21, 2011 at 2:05 pm

I think a lot of this falls under the topic of, “Protecting people from themselves.”

That seems to go along with the typical conceit of liberals — just this morning I had someone imply that the reason Republicans are Republicans is that they are too stupid to know any better — whereby they know that they are smart enough to make their own decisions but they assume that everyone else isn’t nearly as smart as them and needs the government to protect them.

I’m not sure if this is precisely the conceit that Hayek was referring to, but it’s certainly in the ballpark.

P.S. That Hayek was a pretty smart guy.

Ken November 21, 2011 at 3:56 pm

What is the matter with Kansas, anyway?

Stone Glasgow November 22, 2011 at 12:46 am

Some people do need to be protected from themselves. Would it be okay with you if a 60 IQ wanted to sell his or her organs? If that is not okay, what about a 65 IQ? At some point, a decision must be made regarding an individual’s ability to make their own decisions, and most people feel strongly that no one in their right mind would sell a body part.

I don’t agree, but that is the general feeling of most people. To them, all organ sales would be an abuse allowed to happen to an innocent, stupid, irrational or reckless person who does not know any better.

vikingvista November 23, 2011 at 1:14 pm

It simply is not a significant issue. Anecdotal incidents occur in any case, whether today, or in a free society. Such people, like children, commonly voluntarily defer judgement to a guardian. And anyway, there aren’t enough to impact the market.

Stone Glasgow November 23, 2011 at 1:41 pm

“Anecdotal incidents?”

vikingvista November 23, 2011 at 1:59 pm

Think of any event involving some individual person that you personally would not ever like to see. It likely has already happened. You can’t judge a social structure by the merely possible or the anecdotal.

Stone Glasgow November 23, 2011 at 1:47 pm

“such people?” Who defines them? How dumb does a person have to be before you feel intervention is necessary? If an 18 year old mentally retarded boy wants to sell his body parts, and has no friends and no guardian, is that ok with you? Is that moral in a free society?

vikingvista November 23, 2011 at 1:49 pm

Nobody has to define them. That’s my point.

Stone Glasgow November 23, 2011 at 1:48 pm

At what age is a child an adult in a voluntary society? And who sets that number?

vikingvista November 23, 2011 at 1:56 pm

Because it is a voluntary society, there is no imposed number. Nor should there be. Such numbers besides being arbitrary and unnecessary, necessarily violate people’s rights.

Voluntary orders are emergent, following the natures of the individuals involved, not coerced. Why is it so hard for you to imagine life without a powerful authority telling you and everyone else what to do?

LowcountryJoe November 21, 2011 at 2:25 pm

Could muirgeo be silly enough to come onto this thread and take the opposite position? Absolutely he could be. But will he?

Jon Murphy November 21, 2011 at 2:30 pm

I bet $5 the first post of any of the trolls will be to say what horrible people we are. Any takers?

PrometheeFeu November 21, 2011 at 2:34 pm

We are horrible people. We allow ourselves to be dirties by the stain of commerce for the meager benefit of saving a life. I don’t know how I sleep at night.

Greg Webb, librarian clowns, et al November 21, 2011 at 2:50 pm

You, in particular, are horrible and fatuous. You also own me $5. I wouldn’t give you a kidney to save your life for $5,000,000.

Greg Webb November 21, 2011 at 3:27 pm

So says the typical leftist hater.

Jon Murphy November 21, 2011 at 6:20 pm

Sorry man. You were ineligible for my challenge seeing as it would be a conflict of interest.

Michael November 22, 2011 at 12:31 pm

I didn’t know Greg Webb was a librarian…

Greg Webb November 21, 2011 at 2:50 pm

No. I do not want to bet. Leftist trolls pretend at a lot of things, including knowledge and moral superiority. Nothing matters, but this desire to feel intellectually and morally superior to others. As a result, logic, coherence, knowledge, facts, supporting evidence, etc does not matter to leftist trolls.

Jon Murphy November 21, 2011 at 6:21 pm

It’s too bad. I would have made an easy $5 :-P

vikingvista November 21, 2011 at 8:31 pm

“Nothing matters, but this desire to feel intellectually and morally superior to others.”

I agree. It is hubris for so many of them to desire to feel what so few of us actually possess. :)

PrometheeFeu November 21, 2011 at 2:33 pm

I think this is why we need clear principles which define where our rights lie and then simply state that the only limits of our liberties are the rights of others. So for instance, if that woman has a right to her psychological integrity, then it might make sense to ban things which make her unhappy. But if she doesn’t have such a right, then it does not make any sense to ban something which makes her unhappy no matter how trivial the benefits to others. The farmer has a right to not have his crop set on fire by others and the railroad owner has a right to dispose of his property as he sees fit. So, the railroad owner may run the locomotive as fast as he wants. But if that sets the crops on fire, then he must face liability and make the farmer whole.

Adam W. November 21, 2011 at 2:46 pm

What about the people who are unduly harmed by not being able to afford a kindey? If all kidneys and organs are placed on the market, I imagine the price would be fairly significant (after all, most people place a pretty high value on their life. I know I do!) Wouldn’t this lead to only people with means able to have many kinds of life saving surgery?

Michael November 21, 2011 at 8:39 pm

Right now the price is infinite, so it would be lower than it is now. You would see fundraisers for people who can’t afford organs, which is better than the deaths sentence we give them now. But suppose it did mostly help the well off. How many of those deaths are tolerable to avoid saving some people but not others?

LowcountryJoe November 22, 2011 at 1:51 am

There are enough people who die every day — most of whom are not organ donors — to make the supply of organs [and, by extension the price] drastically change. The families who lose a love one could be compensated; the money going to the deceased’s estate. If I’m correct about the supply, the compensation is going to become quite manageable…all things considered and relative to the benefits gained.

Urstoff November 22, 2011 at 9:56 am

Why wouldn’t insurance pay for it like they pay for everything else? Does legalizing the market for kidneys suddenly do away with health insurance?

Greg Webb, librarian clowns, et al November 21, 2011 at 2:47 pm

Psychic harm is real harm, and shouldn’t be pooh-poohed. It is not clear to me why someone would be offended if someone sells their kidney to someone that may save another’s life. What may be offensive is the fact that the price systems fails to reflect the true cost of such a sale. Nature gave mammals two kidneys for a reason and one shouldn’t be cavalier about selling one. If your remaining kidney fails you, you will be at deaths door. The medical costs you will face will likely far out distance the money you made by selling your kidney. Who will have to pick of the expensive tab for your kidney dialysis treatments?

I don’t know if I’d sell a kidney for any price. I have health problems as it is and I would be foolish to add to them.

My offhand guess is that a proper price for a human kidney would be around 1 million dollars. So, I’m all in favor of government creating a price floor for kidneys at that price. Either the government would have to subsidize the transaction or charities will have to do it. Insurance companies will balk at paying that high a price. Since I’m a librarian, I favor the rich voluntarily picking up the tab to save peoples lives. If they don’t do it voluntarily, then we will have to tax them more and have the government do the right thing by the sick and desperate.

Greg Webb November 21, 2011 at 3:27 pm

Swing and another miss.

Adam Smith November 22, 2011 at 12:42 pm

This morning I put a sign in my yard that said “Moustache Rides $10 Inquire Within.
Explain how this harms you and my neighbors, which I’m sure you think it does.

rbd November 21, 2011 at 2:47 pm

Couldn’t a recipient compensate a donor in ways that are legal – or at least not illegal? Waiting for government to bless this is akin to waiting for the tooth fairy. Gotta think around government.

Don Boudreaux November 21, 2011 at 3:24 pm

FYI, #OWS, I support legalizing prostitution.

But I’m also going to delete your comment. The exclusive reason is that it contains pointless vulgarity that Russ and I wish to avoid here.

PrometheeFeu November 21, 2011 at 3:49 pm

I didn’t read his comment and you and Russ are obviously free to police the comments section however you see fit, but I would urge you to reconsider. A moderated comment section does tend to chill discussion in my experience. Perhaps you should consider blanking out the words you find offensive or minimizing the comment allowing those who click on a link to see it.

Don Boudreaux November 21, 2011 at 3:55 pm

Our comments section is indeed almost totally unmoderated (or, more precisely, unedited). And it will remain so.

But our policy has always been, and I believe will continue to be, that gratuitous vulgarity is one of the few justifications that we will use to delete a comment. That was the case here.

This is a forum for civil discussion. It obviously gets rough; it’s no choir room or chapel. But nor is it a gutter.

We never delete comments that express opposition to our views.

vikingvista November 21, 2011 at 3:59 pm

Except your views on vulgarity.

Don Boudreaux November 21, 2011 at 4:07 pm

Touche.

Andrew_M_Garland November 21, 2011 at 5:36 pm

A comment could vigorously oppose Boudreax’s views on vulgarity, as long as it was not itself obscene.

anthonyl November 21, 2011 at 11:31 pm

Not a kernel of corn in that pile?

Adam Smith November 22, 2011 at 12:21 pm

Incorrect. This blog is about 15% gutter.

Without gutters, this blog would be almost impossible to read.

Gutter, in interface design, the blank spaces that separate rows and columns in screen. Sometimes using a small graphic file which has the background color to make space for layout.
Gutter, in page layout, is the blank space between a column or row.

PrometheeFeu November 22, 2011 at 6:37 pm

Fair enough.

brotio November 23, 2011 at 12:33 am

They don’t moderate.

Our hosts have said all along that they will delete vulgar comments. To my knowledge, they’ve had to resort to that measure fewer than ten times in the six (or more) years I’ve read this blog.

W.E. Heasley November 21, 2011 at 4:14 pm

Dr. B.:

Re: legalizing prostitution.

Not sure I have a particular position on this particular topic.

However, a commonly repeated concept is that prostitution is the oldest occupation. Basically the concept is left exactly at that point: historically oldest occupation. This begs a question rarely asked: why has prostitution endured as the oldest occupation? Is it merely a natural supply for a natural demand? Or is it beyond simple demand and supply as it has proven itself, century after century, as highly cost effective? Is it the business model? Is it the enduring voluntary mutual self interest at the point of exchange? A combination?

Ah, the evil of it all!

Russ Fan November 22, 2011 at 10:55 am

No reason to ever delete the myriad of insults or completely unproductive comments directed at the few who refuse to participate in the group-think circle-jerk that this comment section consistently turns into.

Wanna buya kidney? November 21, 2011 at 3:56 pm

Violet woke and a man was sitting on her bed. “Hi,” he said.

She scrambled away, pulling the blankets with her. “Who are you?”

“I’m a friend of Hack’s. But he didn’t say anything about you. Are you his girlfriend?” He sat down on the bed. “You have nice shoulders.”

“Where’s Hack?”

“He went for a walk.” The man’s face was smooth. His suit was dark and anonymous. “He won’t be back for a while.”

“Please leave.”

“But Hack invited me in. What’s your name?”

“I want you to go.”

“I’m John Nike.” He smiled, his teeth gleaming faintly in the gloom. “Who are you?”

“Violet.”

“Violet who?” He shifted closer. “Are you unemployed? It’s all right. It happens, sometimes. I tell you what, unemployed Violet. I’ll give you a hundred dollars for a kiss.”

She tightened her grip on the blankets. “Get out. Now.”

He raised his eyebrows. “That’s pretty generous. Considering you’re in no position to negotiate.” His hand touched her thigh.

“Let go of me!”

“You need to be enterprising to get ahead, Violet. You need to take advantage of opportunities.” He squeezed.

She reached for his hand. He grabbed her wrists and pinned them to the wall. The blanket dropped. “Hoo,” he said, looking down. “Those are nice puppies.”

Jennifer Government, Max Barry

Don Boudreaux November 21, 2011 at 4:07 pm

This dialogue above is suppose to prove what, exactly? No one argues that rape should be legal. What in the world would cause you to equate legalizing kidney sales with rape?

And – perhaps I’m being too generous here in guessing at your reasoning or anticipating your response – concerns about kidneys being forcibly removed from unwilling “donors” would be lessened if kidney donors could be paid for their donations. Today’s situation of an artificially created shortage of kidneys heightens incentives for black-market and other illicit (and even downright criminal) activities of the sort that you hint at to occur. Legalizing donor payment would dramatically reduce these incentives.

Here’s a quiz question for you: If donor sales of kidneys were made legal, what would happen to the marginal value of kidneys – that is, what would happen to the maximum price that people would be willing to pay for a kidney? Would it rise or fall?

tdp November 21, 2011 at 4:15 pm

If kidneys are sold on the market and the price is too high for poor people, poor people are screwed and rich people are not. Now, with organs illegal, poor people get stuck on a waiting list and rich people can buy them off the black market or afford expensive procedures to keep them alive while they wait…at least for the first problem you can increase the supply so that poor people could afford kidneys if, for example, someone helped them defray the cost through a charity or whatever.

Don Boudreaux November 21, 2011 at 4:20 pm

The full cost of kidney transplants would unambiguously fall if kidney donors were allowed to sell their kidneys at market-determined prices.

Think of the matter this way. Suppose, in an attempt to increase the access that poor people have to gasoline, government prohibits gasoline sales at positive prices: oil companies can donate gasoline, but not sell it. What would happen to the real price of fueling your automobile? What would happen to poor people’s ability to get gasoline relative to that of rich and politically or commercially well-connected people? What would happen to the incidence of theft of gasoline from automobiles and storage tanks?

Hal November 21, 2011 at 5:01 pm

“people get stuck on a waiting list”

Why is there a waiting list at all?

There are no waiting lists for gas, but there were in the 1970′s when the government stopped markets from working, creating the gas shortage. It’s exactly the same for kidneys. The only reason there’s a line at all is because the government has stepped in to create the shortage. In other words, markets aren’t the reason kidney shortage exists, government is.

Trying to ensure “rich” people die because a “poor” person *might* die (unlikely if kidney sales weren’t banned) is morally reprehensible. Are “rich” people’s lives really so expendable?

Gil November 21, 2011 at 9:03 pm

Kidneys can’t just mined from the Earth but have to come from healthy people. Of there will always be shortage unless people take better of themselves.

Jon Murphy November 21, 2011 at 9:06 pm

I understand your point, but it doesn’t necessarily lead from “only come from healthy people” or “there will always be a shortage.” I mean, beef only comes from healthy cows, but there isn’t a shortage of beef. If the price mechanism is allowed to operate, then the number of kidneys demanded will equal the number of kidneys supplied.

Hal November 21, 2011 at 10:07 pm

There are about 47,000 people in the US on the kidney waiting list, about 0.015% of the population. Do you really think that given the opportunity to profit from the sale of one of their kidneys 15 people out of 100,000 wouldn’t sell one of them?

T Rich November 22, 2011 at 6:13 pm

In a related story to Hal’s post, there are about 30,000 traffic accident fatalities per year in the USA. There are also about 14,000 homicides annually. Granted that there are many of these instances which destroy one or both kidneys or other vital organs, and it is likely that many next of kin would be too out of sorts to agree to a financial transaction after such a tragedy. However, just the available supply from these two sources would likely sate the demand that exists.

At the least, it would drastically reduce the number of living donors that would have to decide to undergo risky surgery and the concern that you may one day need the spare.

WhiskeyJim November 24, 2011 at 5:59 pm

@T Rich

It is entirely feasible that a market in kidneys would be almost fully met by people checking the organ donor box on their driver’s license if the money went to their survivors.

Fantastic point.

Andrew_M_Garland November 21, 2011 at 5:32 pm

As a first measure of freedom, we (the govt) could offer payment for organ donor kidneys and other organs. Many more people would choose to be donors if a payment could go to their heirs.

We have no idea what the market for organs would be, because even the first tier market in cadaver organs does not exist.

Greg Webb November 22, 2011 at 12:11 pm

What in the world would cause you to equate legalizing kidney sales with rape?

Because “Wanna buya kidney?” is an idiot who, like all leftists, cannot make a coherent, logical argument with supporting evidence. The “dialogue” posted has nothing to do with the issue of legalizing kidney sales. It is a non sequitur, which is a frequent leftist debate tactic.

anthonyl November 21, 2011 at 9:36 pm

What’s wrong with you?

LowcountryJoe November 22, 2011 at 2:02 am

While John Nike was distracted, Violet reached for her snub-nosed 38 which she kept close by — the one chambered for six rounds and could fire without cocking the hammer back by simply exerting more pull on the trigger. John was impressed by Violet’s ‘nice puppies’ but her jacketed 110 grain hallow points were to die for. The end!

Greg Webb November 22, 2011 at 12:14 pm

LOL! That’s a great ending to the story, LowcountryJoe!

T Rich November 22, 2011 at 6:15 pm

I like it when a story has a happy ending!

Ubiquitous November 22, 2011 at 6:43 pm

but her jacketed 110 grain hallow points were to die for. The end!

+1. Like!

brotio November 23, 2011 at 12:24 am

:D

Krishnan November 21, 2011 at 4:01 pm

The fact is that too many people are dying OR living a terrible life because they are unable to get a donor organ – and they cannot legally “purchase” an organ from someone.

Yes, if we “allow” such sales, we could have unscrupulous people taking advantage of the “poor” or “uneducated” or “whatever” – there are some things we can never control. Overall, I cannot see anything BUT an improvement in the availability of organs from those that have to those that desperately need them. A true win/win – material comfort for the one that donates, a life saver for the one that gets/buys it. Yes, it has to be voluntary and there must be no coercion.

I do not consider it moral to let people die because it is considered immoral to buy/sell organs. It is time we took a look at it. Sally Satel has written about this, quite often, quite well.

Gil November 21, 2011 at 9:04 pm

Not necessarily. The problems with organs is they aren’t fungible. Chances are the best fit is a close relative hence someone who more obliged to donate a kidney than sell it.

Krishnan November 22, 2011 at 9:31 am

Yes, today a immune matched organ is best – tomorrow, we may discover how to use chemicals to help non matched organs do just as well (never underestimate the power of the human to find out how)

T Rich November 22, 2011 at 6:18 pm

Great point, Krishnan. Research needed for such donations may be back-burnered right now because the doctors know that it is very unlikely that non-relatives would donate an organ. The picture changes when one does not have to hope for a donor, but simply for a seller.

Bastiat Smith November 21, 2011 at 4:02 pm

It’s very close to people banning drugs. Even without evidence of real 3rd party effect, some people are willing to exert their own coercion to prevent the ‘moral anguish’ of knowing that others are enjoying something. Something that their lack empathy, for better or worse, does not allow them to respect as a just right.

I think I’ll start a petition against churches because I am caused moral anguish by the mere knowledge that others are, in my opinion, are willfully deluded.

(Please don’t crucify me. I’m pointing out an absurdity, not flaunting my opinion.)

W.E. Heasley November 21, 2011 at 4:30 pm

“As a fellow student at UVA Law informed me 20 years ago, “I [my fellow student] just don’t want to live in a society that allows such commerce.” She advised that it’s just so distasteful that it shouldn’t be allowed to occur“.

If she desperately needed a kidney would her notional position change? Would she abandon her notional position and suddenly feel a need to find “evidence”?

This is a perfect example of “the way things ought to be” being a notional propostion that ends in painting the world in one’s own self image. Change the conditions so that the presenter is directly affected by the outcome of the notion, and suddenly the notional position is abandon in search of evidence.

Evidence is very necessary when the presenter is directly affected. When truths are conveniently notional as the presenter is unaffected, that is, the presenter casts the notion upon others, then notions become evidence as what is good for geese does not affect the gander.

David Johnson November 21, 2011 at 4:37 pm

This reminds me of an econtalk with Mike Munger. In a nutshell, the supposed reason some economic transactions are considered distasteful is the wide disparity between the parties. For a kidney sale, one party comes to the table with a dangerous operation and the loss of a body organ, another has their very life on the table, and then a middleman comes long to mediate a price.

Even as a radical market libertarian, the idea of haggling over the price in that situation is still distasteful to me. We are not members of the species homo economicus. In such cases members of homo sapiens would rather forego the maximization of gains rather than to profit off of the misfortune of others.

Don Boudreaux November 21, 2011 at 4:50 pm

Why do you suppose there would be haggling? Why do you suppose that market prices for kidneys wouldn’t be set in the same was as market prices for attorneys’ services?

Looked at differently, is there currently haggling over the price of cardiovascular surgery? Such surgery is often vital to the saving of lives. Why wouldn’t kidney prices be set in a similar fashion?

And if there were to emerge haggling over the price of cardiovascular surgery, would you then endorse a government prohibition on the sale of such surgical procedures?

LowcountryJoe November 22, 2011 at 2:06 am

Looked at differently, is there currently haggling over the price of cardiovascular surgery? Such surgery is often vital to the saving of lives. Why wouldn’t kidney prices be set in a similar fashion?

And a similar point to this was just what I was waiting to spring on our ‘resident’ physician.

GAAPrulesIFRSdrools November 22, 2011 at 8:33 am

Why do you suppose there would be haggling?

Because Kidneys are not fungible.

vikingvista November 23, 2011 at 2:09 am

What is this theory of yours regarding the relationship between haggling and fungibility?

Methinks1776 November 22, 2011 at 9:03 pm

Even as a radical market libertarian, the idea of haggling over the price in that situation is still distasteful to me.

What luxury you have. People in need of a kidney don’t have the luxury of turning up their noses at the brutal realities of life. Trust me, if you were ever in need of a life-saving procedure, haggling will suddenly become a lot less distasteful for you. If it doesn’t, you’re free to abstain and die, but you are morally not free to prevent others from doing everything they can to save their own lives and the lives of their loved ones.

Jon Murphy November 22, 2011 at 9:08 pm

On top of that, Methinks, that is what is great about a market-oriented economy. If you don’t like the good/service being sold, you don’t have to participate in the market!

Dan J November 22, 2011 at 9:31 pm

With Obamacare, that notion of choosing to not participate no longer exists.

Jon Murphy November 22, 2011 at 9:45 pm

That’s why it’s not a market.

Dan J November 23, 2011 at 12:36 am

Obamacare sets a precedence, if upheld, that markets in the US are no longer a choice in participation just as Wickard v. Filburn Set precedence in disallowing the free practice of bringing product to market.
Sssssssiiiiggghhhhh……..

brotio November 23, 2011 at 10:57 pm

In that vein, I’m sure our Dear Ducktor wouldn’t be opposed to making it mandatory that (if you still have both) you donate a kidney when you turn 65. After all, if you’ve lived that long without needing a transplant, the odds are that you’ll live the rest of your life just fine with one kidney.

TSowell Fan November 21, 2011 at 5:02 pm

I’m going to go out on a limb and guess that Dr. B’s former law classmate endorsed the feminist doctrine that women have an exclusive right to decide what to do with their own bodies — well, at least, when it comes to abortion.

Again, it’s just a guess, but I doubt that she believed that abortion is “just so distasteful that it shouldn’t be allowed to occur”.

leoncaruthers November 21, 2011 at 5:09 pm

I don’t see how selling a kidney is fundamentally different from being a football lineman. In both cases you’re starting off poor, but with a god-given gift that someone else is willing to pay for. Statistically, you shorten your life a little bit either way, on average (moreso for the lineman than the donor, amusingly), in the process of selling what the other — vastly wealthier, I might add — party is buying. The biggest difference is whether it’s a lump sum of exact value or a variable annuity depending on your injury rate and performance.

That and it’s legal to get beat up on a football field, but not to sell a kidney.

RC November 21, 2011 at 5:14 pm

Great post, Don.

Frankly, the “it’s distasteful” argument strikes me as bizarre and stupid.

Usually, the left will explain their opposition to kidney sales by claiming that it will harm the poor. Since poor people are more of need of money, then they will be more likely to value the money more than their body organs. If they had more money, they would be less willing to sell their kidneys.

Milton Recht November 21, 2011 at 6:19 pm

Market prices, or as might be said in a Coasean framework, negotiated prices, include a bundle of legal rights and warranties related to the sale in addition to the item. Markets are most liquid and most accurately priced when all relevant information is available, such as when there is some standardization or fungibility of the product for sale. To me, market impediments and not illegality are stopping the sale of organs and development of an organ market.

In an organ sale, there is a lot of asymmetric information. The provider of the organ knows a lot more about his/her health, family’s medical history and previous habits, such as alcohol use, drug use, smoking, high fat diets, exercise, etc.

The organ providers who are younger, healthy, ate healthy diets, exercised, refrained from drinking and smoking, and come from families with long life expectancy will want a market that allows them to capture a higher price for their better quality organs. The others with the less healthy organs will want a market that obscures or ignores the quality of their organs in order to obtain a price higher than under full disclosure.

Since standardization is impossible for organ sales (the organ quality will vary by individual), attaching product warranties to sales facilitates market transactions and alleviates many asymmetric information problems, but creates a new set of problems.

Should someone who gives up a kidney for cash, have to return the cash if the kidney is defective, disease-ridden, short-lived, fails in the recipient, etc?

Should organ sales be limited to only those providers who have healthier lifestyles, better genetics and who can provide a higher quality organ?

If sales of different quality organs occur, market prices will reflect quality (poor quality – lower price, higher quality – higher price) and have a range. Will society allow the sale of cheaper, poorer quality organs to poorer members of society who cannot afford to pay more for a better quality organ? Will society tolerate that some in poverty with unhealthy poverty related lifestyles will get less for their organs than those who are rich and can afford healthier lifestyles?

Who owns a child’s organs? Can a parent ever sell a child’s organ? Suppose, it is the only available means to raise funds for expensive medical treatments to save the child’s life from another disease? Or child’s organ, but parent’s or sibling’s life?

If the market will price younger organs at a higher price, are we creating a new risk for children?

As far as I know, there is not a significant black market selling and buying of organs in the US, despite severe shortages and the availability of wealth among some of the future recipients.

The lack of a sizable black market despite the apparent need for more organs indicates to me that market transaction impediments, and not morality or illegality, is the major obstacle to organ sales.

When the market can resolve the asymmetry information problems, sale transactions in organs will start to occur (probably underground and in a black market). When enforceable legal rights and warranties attach to the sales, a full-blown, visible and legal, organ market will develop.

CalgaryGuy November 22, 2011 at 3:46 am

I would think the ability to resolve the asymmetrical information problem is hindered by the illegality of organ sales. Insurance companies are able to obtain a lot of information about a clients medical past and family history but I doubt many doctors would reveal that sort of information for an illegal, black market transplant even if the donator/seller wanted the release of the info.

Jon Murphy November 21, 2011 at 6:38 pm

I’d like to make several points. I’d have made them earlier, but busy day in the office.

“A major source of objection to a free economy is precisely that it provides what people want rather than what some group thinks they ought to want.”

First, Don, I respect you for this post. In my short experience with life and politics and economics, I have found no issue more divisive, more volatile, and more incendiary than this one. It takes guts to stick your neck out like this.

Second, I’d like to refute the “psychic damage” argument. It is a valid argument, but it is hardly a reason to ban the sale of a good/service. Some may find it psychically harmful that we have to pay for food while people die of hunger. But is that a reason to ban the sale of food?

Third, this is also an interesting validation of the Milton Friedman quote I opened this post with. The great thing about a voluntary market is that those who do not agree with the market do not have to participate in it. Example, I do not like marijuana. other people do. I do not participate in that market. My money is not going into that market, but other people’s are. That market is being supported by their money, not mine. So I am unharmed in that market.

Fourth, this is an interesting situation that was brought up a few posts ago by a commenter (forgive me, but I forget who). He asked, if there was a scheme that came about that made everyone better off, would it be a moral imperative to participate in such scheme? Apparently, it is not. One can still object to the scheme on moral grounds even though it is in everyone’s best interest. Fascinating.

Fifth such a market would reduce the price of kidneys worldwide: higher supply, lower prices.

Sixth, if such a market would be made legal, then the back-door organ rings would not be able to keep up. It would reduce the power of the black market, and make the system safer for all involved.

This is a really fascinating topic. I know this is something of a long shot, but I hope there can be a rational discussion on this topic.

Jon Murphy November 21, 2011 at 6:43 pm

A few more points.

This one’s more just an interesting observation: It’s funny to see something that is gaurenteed to save lives to objected to on moral grounds. It’s a lot like stem cell research in that regard.

vikingvista November 21, 2011 at 8:10 pm

Not really the same. Organ transplants save lives all the time. The evidence of their success in that regard is comparable to the evidence of the efficacy of antibiotics in treating infections. It’s called “stem cell *research*” because there is no good evidence of its practical applications. There may be one day, but there isn’t today.

Jon Murphy November 21, 2011 at 8:11 pm

Ok, I’ll give you that one, Viking Vista.

brotio November 23, 2011 at 12:28 am

I’d also point out that the objection is to embryonic stem cell research. As far as I know, the only way to harvest embryonic stem cells is to destroy the embryo. Hence the objection.

Steve Ducharme November 21, 2011 at 7:05 pm

I’ve been stumping my more “sensitive” friends for years with the premise that any law that is created merely because it makes you feel icky is a bad and almost universally foolish law that does more damage than good. It’s a long list topped by the anti gay marriage laws, organ sales, marijuana laws etc. and often the results are fatal as in the drug “war” on our own citizens and early death. But hey, as long as you don’t have to feel icky or risk the vapors I guess it’s worth it. Feh..

SmoledMan November 21, 2011 at 7:19 pm

What person in their sane mind would sell a kidney? We do have to protect people from their insane selves at times.

vikingvista November 21, 2011 at 8:06 pm

I would, if it would help pay for my child’s brain surgery. Is that insane? You need to send armed men in to prevent me from saving the life of my child? What kind of a person are you?

Jon Murphy November 21, 2011 at 8:07 pm

Sarcasm.

vikingvista November 22, 2011 at 12:32 am

Ah.

Stone Glasgow November 22, 2011 at 12:55 am

Using this logic, it should be legal to kill one child to harvest organs to save your mother and sister. Why should armed men come to your home to stop you from saving two people?

If you accept that you don’t own your young children, produced and maintained with your own personal efforts and at your expense, why is it so hard to accept that you don’t own your own body?

vikingvista November 22, 2011 at 2:51 am

Me selling my kidney is the same as me killing children? I’ll resist ridicule, and give you the benefit of the doubt. You apparently are asking a question about the meaning of rights, specifically property rights. Okay then, I’ll lay it all out for you, and give you more than probably even want…

“If you accept that you don’t own your young children…why is it so hard to accept that you don’t own your own body?”

It isn’t hard to accept that I don’t own my own body. Rather I choose to own it.

If nobody contests, then such ownership is an inescapable fact of my body’s biology. I decide, and my body responds. I control it and use it just as I control and use the stones or food that I grab with my hands. It’s all my property, because I control it.

If somebody does contest, then I decide how I will attempt to satisfy my desires. If my desire is to be a slave, then I suppose I might just obey. If my desire is to continue to utilize my body to satisfy my own ends, then I will attempt to persuade, with is the least costly approach. If persuasion doesn’t work, I may calculate that resistance–running, threatening, striking, killing, etc.–is in my best interest.

Among me and any very young children, babies essentially, there is only one willful decision-making entity–me. So for all intents and purposes, I do own them, or cast them away, since any decisions about them are 100% mine, whether I like it or not.

Add another decision maker, say a neighboring fisherman, and he and I will separately have to decide if we are going to attempt to persuade the other, or treat the other as a piece of property or natural element. If one of us claims the babies as property for one use (say organ harvest), and the other for an incompatible use (say rearing), then we have a conflict. If we both value the peace, we can reason about who will respect whose wishes, and come to an agreement (perhaps using rather persuasive and reality-based Lockean-type arguments, which for brevity I will here leave out). Or one of us can veto all respect for rights, and we have war.

If I convince the fisherman to not harm the babies, and to allow me to rear them, the decisions are entirely mine and the fisherman’s, since the babies lack those faculties. So the fisherman’s decision to leave the babies alone is him respecting MY rights, not the babies’ rights. I *value* the babies. The fisherman respects *my* rights to them. Values are motivators, including very strong motivators, but they are not rights. Rights are mundane, but exist because communicating entities value things.

Whether the fisherman or I believe in mystical powers or not, higher authorities or not, logical moral imperatives or not, “life begins at conception” or not, babies are nobody’s responsibility or not, the objective facts and available actions in this scenario are unaffected. Natural rights are, objectively, the agreement of volitional communicating entities.

Stone Glasgow November 22, 2011 at 2:46 pm

“If one of us claims the babies as property for one use (say organ harvest), and the other for an incompatible use (say rearing), then we have a conflict. If we both value the peace, we can reason about who will respect whose wishes, and come to an agreement.”

In the case of organ trading, our neighbors are claiming an alternate use for our organs, claiming some ownership over them. The agreement currently reasoned is to avoid organ sales (and baby sales). In Iran s organ sales are permitted; they have come to an alternate understanding.

I don’t see that we disagree on this topic. We both seem to understand that there are no God-given rights and that property is always an agreement made to avoid conflict between sentient parties.

Stone Glasgow November 22, 2011 at 2:49 pm

BTW I responded in the other thread on rent seekers. I continue to welcome an email or other direct communication. I find your opinions to be quite valuable.

vikingvista November 22, 2011 at 3:21 pm

“In the case of organ trading, our neighbors are claiming an alternate use for our organs, claiming some ownership over them.”

That isn’t true today, and it certainly isn’t true under a free market. The most that can be said, is that the US government forcefully acquires a degree of ownership of our bodies, by violently prohibiting us from using them freely.

“The agreement currently reasoned is to avoid organ sales (and baby sales).”

It isn’t an agreement if the property owners do not agree. The problem with today’s situation, is the forceful prohibition on agreement.

“In Iran s organ sales are permitted; they have come to an alternate understanding.”

The Iranian government permits a greater degree of property rights/agreement in this regard than the US government. But they still dictate the price. Calling it an “understanding” is an exaggeration. For the most part, the relevant parties are still denied their rights.

Stone Glasgow November 23, 2011 at 2:39 am

The situation becomes much more complex when three sentient beings are negotiating, and infinitely complex when 300 million are attempting a peaceful arrangement of property rights.

Stone Glasgow November 23, 2011 at 2:41 am

And how can you claim that it isn’t true that your neighbors are claiming ownership of your organs? Most of them favor the laws as they stand today, and they would vote to reinstate them were they removed.

vikingvista November 23, 2011 at 4:16 am

“And how can you claim that it isn’t true that your neighbors are claiming ownership of your organs? Most of them favor the laws as they stand today, and they would vote to reinstate them were they removed.”

Because most of them don’t think about it or even know about it, let alone favor it. And merely favoring something when asked is quite a passive matter.

You have to get over this idea that in a democracy, the laws reflect popular sentiment. My neighbors never voted for the current laws, will never get a chance to vote to repeal them, and would not be asked to vote to reinstate them–regardless of what happens to those laws in the future. Small numbers of people impose their wills upon others (claim ownership of others, as you would say) via the actions of government. Without that nearly uniform undefiable tool, such widespread imposition simply could not occur, even if people’s attitudes on an issue (like organ sales) were negative and unchanged.

Government is mostly NOT an agent of popular will, not even in a democracy. Nor could it be. It is an institution for very small numbers of people to impose their wills almost uniformly upon everyone who disagrees with them.

Sadly, however, the legitimacy of the existence of this vile institution does have very widespread acceptance.

“The situation becomes much more complex when three sentient beings are negotiating, and infinitely complex when 300 million are attempting a peaceful arrangement of property rights.”

No. All interactions are ultimately reducible to two people. And although all the individual relationships in society are complex and always beyond anyone’s complete understanding, an individual only needs to know the few relationships that he’s chosen to engage in. So what any person needs to know, is simple enough, no matter how large the society.

Stone Glasgow November 23, 2011 at 2:02 pm

Ok. So three men are on an island. Each owns 1/3 of the island, and one man has a baby girl. He rapes and beats his 12 month old in full view if the other two men, every day. Is that okay? If not, who decides?

What if other moral transgressions occur, like gay sex or abortion? Who among three has the right to intervene on another man’s peaceful, voluntary actions? How old must a child be before it is permitted human rights, and who decides?

vikingvista November 24, 2011 at 12:25 am

“Is that okay?”

You tell me.

If not, who decides?”

Anyone and everyone capable of making decisions. In spite of the universal statist indoctrination into the myth of collectivism, decision making is entirely an individual capability. There is simply no escaping it. I’m familiar with your desire for a father figure authority, who happens to share your values of the moment, to tell you what is right and what is wrong, and to tell you what to do. But to the extent that can even be said to exist, is entirely ALSO your choice (until that choice comes back to brutally end your ability to effectively choose).

Sorry, but you must judge and act for yourself, and only you can grasp reality for yourself. These are the facts of nature.

The particular facts of this matter is that there are only 3 entities on that island capable of making a decision. Each must, and each will. Imagine you are one of them. What are you going to do? Join in with the abuse? Cheer him on? Show him how he can do it more skillfully?

Or maybe your values instead lead you to want him to cease that behavior. Will you kill the guy? If so, I recommend you get the approval of the third guy first, rather than risk living on an island with someone who thinks you are a dangerous man killer.

Or maybe you can relate your value for the baby in terms of something else the abuser might also value. Perhaps you can buy the baby from him.

Or maybe, having all discovered the profound mutual benefits of trade, you declare you will make all relationships with him conditional on his ending the abuse, hoping that the loss, worthwhile to you, is not worthwhile to him.

Or maybe you can convince him that a horned pointy-tailed red ghost will torment him to the point of extreme regret if he doesn’t stop. A lot of people buy that line of “reasoning”.

Or maybe, if for some awfully peculiar reason this abuser is also a thoughtful intellectual, you can lay out an argument that will appeal to his desire for both logical internal consistency and consistency with observable nature, that will persuade him that his best interest lies in stopping the abuse. Good luck doing that with this guy.

But the nice thing is, you have many more options for advancing your values in this scenario than you would have if it were a bear tormenting the baby. The reason for more options, is rights.

Stone Glasgow November 24, 2011 at 3:24 am

“I’m familiar with your desire for a father figure authority.”

I have no desire for an authority to tell me what to do. I am asking the most difficult questions I can think up. I want to know the answers to these questions.

What if he won’t stop and the other man does not consent to using force against him?

vikingvista November 24, 2011 at 12:09 pm

“I have no desire for an authority to tell me what to do.”

“Who decides?” is a question with assumptions.

“What if he won’t stop and the other man does not consent to using force against him?”"

How are these hard questions? If *you* are the man who wants him to stop, then you will have to decide what you are going to do about it, what actions you are willing and able to take, rationally consistent with your values. I can’t get into your head, so you’re going to have to tell me.

Or are you asking me what I personally would do?

There are no objective values. The objective nature I have already given. The rest depends upon the particular individuals involved.

anthonyl November 21, 2011 at 9:41 pm

No one is asking you to sell your kidney if you don’t want to.

Invisible Backhand November 23, 2011 at 3:11 am

No one is asking you to sell your kidney if you don’t want to.

OK, but what if I just want to rent it out for a while?

jorod November 21, 2011 at 8:44 pm

When cloning becomes practical the problem will solve itself.

Gil November 21, 2011 at 9:07 pm

Indubitably, grow your kidney from a few healthy cells. No rejection pills needed.

Not Sure November 21, 2011 at 8:47 pm

“As a fellow student at UVA Law informed me 20 years ago, “I [my fellow student] just don’t want to live in a society that allows such commerce.” She advised that it’s just so distasteful that it shouldn’t be allowed to occur.”

I wonder… if she should find herself with a child needing a kidney, the only way of obtaining one was through purchase, doing so was legal and she had the means, would her distaste prevent her from making the purchase?

Nikolai Luzhin, Eastern Promises November 21, 2011 at 8:51 pm

given that Don supports slavery, it comes as no surprise that he supports any lessor form of human degradation.

of course, what is implicit here is what he makes explicit, elsewhere by advocating prostitution.

He knows the weakest, being women and children, will be preyed upon the most.

Don needs to listen to a few hundred hours of FBI tapes of drug dealers exploiting people, not that anything would penetrate his amoral soul.

He ought to see what meth does to people, the horrible desperate things people will do for $3.00, here in this country.

unbelievable

Jon Murphy November 21, 2011 at 9:01 pm

Good lord, your grammar is terrible.

Jon Murphy November 21, 2011 at 10:14 pm

I agree with you that women and children are the most at risk.

BUT

If you were to legalize prostitution, would you not be able to control that aspect? With a black market situation, the government cannot control who becomes prostitutes. If it were legal that can be controlled (regulated, if you will). In many of the Nordic countries, where prostitution is legal, I am not aware of increased cases of child prostitutes. In fact, I believe it has fallen. Unless, of course, you are suggesting the regulation has failed?

Nikolai Luzhin, Eastern Promises November 21, 2011 at 10:20 pm

we don’t have enough police, especially honest police, in this country to make legalized prostitution work

Jon Murphy November 21, 2011 at 10:22 pm

Why would you need more police? Prostitution could be confined to certain establishments and through records kept, much like a casino.

Jon Murphy November 21, 2011 at 10:24 pm

Or a pornography studio.

Jon Murphy November 21, 2011 at 10:33 pm

Really, the only difference between porn and prostitution is one is filmed.

Nikolai Luzhin, Eastern Promises November 21, 2011 at 10:41 pm

Jon you know nothing about anything, truly. you have no idea what our police are like, how hard it is to manage them now, given the opportunities for bribes and extortion. We do not have the numbers of honest police it would require to police lawful prostitution on any scale that would make a difference in this country. If we only a “casino” for prostitution, someone would have to watch it. We don’t have the people to perform that task and we don’t have the people to watch the watchers

Jon Murphy November 21, 2011 at 10:43 pm

So, what your saying is regulation doesn’t work? Good, I’m glad I have finally gotten you around to our way of thinking.

Jon Murphy November 21, 2011 at 10:45 pm

My job is done. Bedtime.

Nikolai Luzhin, Eastern Promises November 22, 2011 at 3:42 am

Jon Baby

Your such a drooling idiot

Changing the oil on you car doesn’t work, if you only do such every 200,000 miles

If we wanted to legalize prostitution we would have to hire, train, and deploy a large number of honest police officers, of whom we don’t have enough now.

A good example would be casinos in Nevada from the 1940s to 1970s, when there were no enough honest police men to police what was happening. Sometimes it is easier to ban an activity than make it legal and regulate it.

Prostitution, today, would give a new meaning to the concept of extortion

But, your an idiot so why bother writing any more

CalgaryGuy November 22, 2011 at 3:53 am

Nik, you still haven’t answered the question (not surprising really). Why would we need MORE police officers if prostitution was legal as compared to while it’s illegal?

Jon Murphy November 22, 2011 at 7:23 am

Nik, you did not answer my accusation.

You admitted there are not enough “right” people to regulate the small prostitution industry. How could there possibly be enough of the “right” people to regulate the massive banking industry? You yourself said that adding more regulation would just create more corruption (“you have no idea what our police are like, how hard it is to manage them now, given the opportunities for bribes and extortion.”). A very Libertarian principle.

Then, you make the great Libertarian argument “Who Watches the Watchmen?” That argument is as old as the Limited Government movement itself. It’s the thrust of Paul’s book “End the Fed.”

Game, Set and Match

All we need is you to see freedom is actually a good thing and you’ll be in the club.

Dan J November 22, 2011 at 1:11 am

Good, Lord!!!

For Nik and Muirgeo…..
If only we had more police, more perfect policeman, perfect legislators, perfect CEO’s, perfect board members, perfect officials of the executive, perfect legislation, incentives for neighbors to turn in illicit or illegal behaviors of other neighbors, more legislation, benevolent elected officials, etc.,…..
All we really need are the ‘right’ people. Maybe, if we write up 18billion rules and regulations and hire a policeman to police the policeman……..
Or take away many of the worthless rules and regulations and allow for rewards and consequences to take their role in guidance of moralities.

Jon Murphy November 22, 2011 at 8:49 am

We want angels to lead us. The problem is even angels can fall.

Greg Webb November 22, 2011 at 12:23 pm

Yep. All these leftist idiots do not understand that the people elected to government office are not angels and must be expressly limited in what they can do.

Jon Murphy November 22, 2011 at 12:24 pm

Even if they were angels, I’d limit them. Lucifer was once an angel.

T Rich November 22, 2011 at 6:36 pm

James Madison said that “If men were angels, no government would be necessary.” This was the crux of the argument for a highly constrained government with maximum freedom for the individual.

However, for the progressive, men must be angels to serve in the government. Sadly, they believe that these angels exist and in most cases that they (the progressive) are them (the angels).

CalgaryGuy November 22, 2011 at 3:26 am

I agree with Nik, drugs can make people do horrible desperate things, why do we allow a completely free market in drugs? If only government made them illegal we wouldn’t have any problems with them.

Nikolai Luzhin, Eastern Promises November 22, 2011 at 3:48 am

CalgaryGuy

I would be the last person to support the current way we fight the war on drugs and the last person to support legalizing drugs.

You have no idea what addiction is, how it happens, how it works, how people who are addicted are unable to deal with such. It’s not some clever intellectual game or some philosophical debate.

CalgaryGuy November 22, 2011 at 3:56 am

Really, how do you know I don’t know any of those things? What else do you know I don’t know?

LowcountryJoe November 22, 2011 at 10:36 am

It’s not some clever intellectual game or some philosophical debate.

Because if it had been, you would have mistakenly overestimated yourself in that affair as well and tried to join it, too. You would have been horribly out of your league instead of just being tremendously over-matched.

Jon Murphy November 22, 2011 at 10:53 am

“You would have been horribly out of your league instead of just being tremendously over-matched.”

Right? I was able to run rings around this guy without even breaking a sweat.

steve November 21, 2011 at 10:08 pm

“The full cost of kidney transplants would unambiguously fall if kidney donors were allowed to sell their kidneys at market-determined prices.”

What is the evidence for this? Did the cost of a transplant drop in countries where sales were legalized? At present, living donors do not get paid. The costs involved are the costs of harvesting (including prep), the cost of implantation and the follow up. If you are assuming that the volume of transplants would increase enough to bring down costs, I think that is not so certain. These are pretty routine procedures now. The rejection drugs are either drugs also used for other therapies, so we wont see enough volume to matter, or specialty drugs that will still see a fairly small market.

I have no problem with the idea of selling kidneys, provided we take steps to look out for black market sales and illegal harvests. However, I doubt that it would lower costs, and may increase them.

Steve

Jon Murphy November 21, 2011 at 10:10 pm

“What is the evidence for this?”

Simple, as supply increases, price decreases. There is no such empirical evidence in this market because no country has ever had it legal, but the evidence from other markets is overwhelming that when the supply increases, the price decreases.

steve November 21, 2011 at 11:00 pm

I guess you dont do kidney transplants. I do. We do not currently pay people for kidneys. If we start paying for them, this will be an added cost. I see no reason why doing more kidney transplants will necessarily bring down costs. It is a mature technology/procedure. As the number of joint replacements has doubled over the last few years, the cost per procedure has not decreased. Unless you have real evidence that legalizing sales has reduced costs, I would predict an increase in total cost per procedure if we start paying for kidneys.

Steve

steve November 21, 2011 at 11:06 pm

Oops, almost forgot. The real reason to want to legalize is that it would take a lot of people off of dialysis. Even with the increased cost of the procedure from having to buy kidneys, we would save money in the long run from less dialysis. It would also let more people return to being gainfully employed (hard to do on dialysis).

Steve

lamp3 November 22, 2011 at 4:48 pm

The costs of lives lost and time waiting will go down.

Non-pecuniary factors matter!

Dan J November 22, 2011 at 1:23 am

Assuming that the supply would often meet demand in an open market on kidneys, it would seem that the process would make dialysis a treatment only done while awaiting for an open surgery room.
Who pays for the process involving donated kidneys, now?

Regardless of theorizing on whether costs would go up or down in an open market on kidneys, I feel absolutely confident that less lives would be lost due to lack of supply.

Yergit Abrav November 22, 2011 at 1:42 am

Steve – you do realize this is like saying we shouldn’t privatize bread production in the soviet union because the price will go up. Or we shouldn’t lift rent control. Or we shouldn’t lift price caps on gas (70s). The problem is the shortage! People on the wait list and dying is a real cost. I am actually sad that you don’t see that as a cost. Really.

steve November 22, 2011 at 8:57 am

It is not at all like bread production. Rent control makes no sense. However, being able to sell kidneys will most likely increase the cost of a kidney transplant. The cost of buying the kidney will have to be added on to the current costs. We are not currently buying them, so this si a completely new cost. Supply and demand is not an issue as it is a new cost.

As I said above, the reason to legalize sales is because it will allow more people to get off of dialysis and save money in the long run in that area.

Steve

steve November 22, 2011 at 9:00 am
Yergit Abrav November 22, 2011 at 10:56 am

@steve

So sad. Yes, it will increase the cost of a donated kidney, assuming the doner decides not to donate and instead sells the kidney.

But the overall supply of kidneys will increase.

In this sense it is EXACTLY like privatising bread, eliminating rent control, eliminating price caps on gas. Common thread is: freeing up a price cap (zero in the case of kidneys) will increase the price but decrease the COST for individuals who are getting a kidney when otherwise they would have died… sort of like how people don’t have to wait in line for bread anymore in Russia………………

Is my explanation helping?

steve November 23, 2011 at 12:14 am

@Yergit- I have been responding to the line I quoted from Don.

““The full cost of kidney transplants would unambiguously fall if kidney donors were allowed to sell their kidneys at market-determined prices.””

I dont believe the costs of transplants would decrease. The costs for total care would decrease since a transplant costs about the same as 2 1/2 years of dialysis. Also, as I noted previously, more people would be able to return to work.

Steve

yet another Dave November 22, 2011 at 2:02 pm

steve,

You may be correct that the costs of surgery won’t change, but that is only part of the full cost Don referred to. The most obvious additional cost is associated with the lack of supply – time waiting (or dying without ever getting a transplant), reduced quality of life, dialysis (as you already noted), etc. Other costs would include reduced economic output of those waiting for kidneys due to limitations in what they can do, reduced wealth of patients because they’re spending money on management treatment rather than moving on after a transplant, and so on.

Dan J November 22, 2011 at 9:39 pm

Lets think of all of the costs associated with a person whose kidneys are failing or not working properly to require all of the services needed to keep them alive…….
Wouldn’t they likely be offset with the huge increase in supply of kidneys in the market?

Jon Murphy November 21, 2011 at 10:18 pm

Hypothetical: If a good/service is found morally objectionable, isn’t that all the more reason to legalize it? It can be controlled, monitored, regulated, and taxed.

PoliteEdward November 22, 2011 at 12:34 pm

I think Walter Block once said something along the lines that the argument that legalizing drugs will allow them to be taxed is the only good argument against legalizing drugs. Coercive taxes and coercive control over voluntary interactions are bugs, not features.

Also, murder is morally objectionable, but I would not wish it legalized.

Jon Murphy November 22, 2011 at 9:47 pm

Murder is not a good/service. Remember, in order for a market to operate, it must be a voluntary exchange where both parties benefit. I highly doubt murder is voluntary and one party most certainly does NOT benefit.

GAAPrulesIFRSdrools November 21, 2011 at 10:54 pm

(This case isn’t close to being ‘close’ – for example, as between valuing the farmer’s desire to grow crops without worrying about those crops being set afire by sparks from a passing locomotive, and the railroad’s desire to run its train at top speed over its tracks that abut a cornfield.)

Don, steam locomotives haven’t been on American rails as anything but curiosities since 1960, and railroads learned a long, long time ago “top speed” was not nearly as important as controlled speed.

Jonah Houston November 22, 2011 at 12:34 am

I wonder if the core of the problem isn’t linked to more to psychology than economics.
As you point out, “If we agree that saving lives is more important than saving tender psyches, then the policy of preventing the buying and selling of kidneys at market prices inflicts on innocent third-parties a policy-relevant negative externality – and, frankly, one that is especially heinous.”
But if we accept that homo economicus is dead (or at least not holding down a policy-making position anywhere) than appealing to a rational, economic-based argument for the legalization of a kidney trade (why stop there, shouldn’t eyes, lungs, and livers be similarly traded since we can live without our given allocation) is necessarily fruitless.
It’s such an obviously rational choice to allow people to sell their kidneys but it is culturally unacceptable (just as eating horses is seen as grotesque in the U.S. but acceptable in France) so the approach to gaining acceptance would have to step beyond a strictly rational argument.
What would the emotional appeal be of allowing this type of market? Could you tell the story of mutual gains (a child, perhaps, who’s life is saved and an adult who is similarly saved from economic ruin) as a means of appealing not just to the head but to the heart (so to speak).
It is a seemingly typical approach for economists to find a more efficient solution to a vexing problem (like kidney shortages) and give little or no thought to how to tell the story of an overall societal increase in utility that appeals to the emotional brain.
And while that may seem like it’s own exercise in inefficiency, it might prove to be a more efficient approach to solving real problems rather than coming up with clever solutions that never see the light of implementation.

Dan J November 22, 2011 at 12:52 am

Grossly detailed vulgarity does exactly what for a conversation?
Muirgeo, IB, etc,…. Bring an opposing opinion even when they regress to their violent behaviors in speech…..
But, when something you have put much effort and work into, for providing discussion on a particular field of study you have spent your life on becomes a target for attack with graffiti of vulgarity, it seems appropriate have some self-interest in cleaning the slate.
I would see it as cleaning a sculpture after being tagged by teenagers.
Of course, what would you expect from someone aligning himself/herself with the cretins Of OWS.
I would support a one way ticket for them all to Cuba, Venezuela, Zimbabwe, Burma, or Russia, etc.,…..

Ubiquitous November 22, 2011 at 4:42 am

http://www.msnbc.msn.com/id/32103250/ns/us_news-crime_and_courts/t/arrested-nj-corruption-probe/#.TstrwGBLeZY

Reminded me of the above story from 2009:

44 arrested in N.J. corruption probe
Suspects include rabbis, mayors; probe involved black-market kidneys

NEWARK, N.J. — An investigation into the sale of black-market kidneys and fake Gucci handbags evolved into a sweeping probe of political corruption in New Jersey, ensnaring more than 40 people Thursday, including three mayors, two state lawmakers and several rabbis.

Yep. Black-market kidneys and fake Gucci handbags. The story gets weirder as you read on.

But not so surprising was this statement from the article regarding the politicos involved:

“All but one of the officeholders are Democrats.”

SaulOhio November 22, 2011 at 7:57 am

How about the damage to MY psyche from the knowledge that there are people out there whose lives couldbe saved by a trade in kidneys, but instead, die because people like that student of yours don’t want their psyche damaged?

We are talking about people’s LIVES here.

SaulOhio November 22, 2011 at 8:00 am

Sorry. Classmate.

Economiser November 22, 2011 at 9:55 am

Thank you. Agreed.

Economiser November 22, 2011 at 10:02 am

This issue more than any other gets me visibly angry. Most nanny state actions have harms that are unseen, or diverse, or unknown. Clearly there are harms; we all recognize that. But the argument is by nature more abstract.

With kidney sales, the harm suffered by the potential buyer, dialysis and death, is very real and very known. Also, the surgery is advanced with high success rates. One who objects to a kidney market is not only impeding free and voluntary commerce but is also quite literally sanctioning a death sentence for tens of thousands of people in this country alone. I find it morally repugnant and physically nauseating.

Invisible Backhand November 22, 2011 at 10:57 am

One day I went into the school grounds. There were some Chinese soldiers of the resistance army and some peasants being held there, and Japanese soldiers were smoking and joking around among themselves. I still had a conscience then, and I asked if someone had done something bad enough to warrant an execution. The Japanese soldiers snickered derisively. “All resistance soldiers get executed,” they answered. Living persons are good for scalpel practice, so people were brought in to the hospital by the kenpeitai to get cut up just like the maruta in Unit 731.

One day soon after I started at that assignment, the hospital head told us, “Today we will have surgery practice.” I was startled. It was an order. There was no getting out of it. Normally, we dissected people who had died of such diseases as typhoid fever, dysentery, and tuberculosis. Now we were being taken to the dissection room for a different type of exercise. Soldiers came along as observers.

When we opened the door, there was a colonel waiting. We saluted. In the room were two Chinese who had been brought in by the kenpeitai. One looked like a soldier, the other was a farmer. There were two operating tables, and doctors and nurses; there were saws for cutting bones, and scissors and other equipment.

What did these people do? It must have been an act of patriotism. But I couldn’t think about things like that back then. I only wanted to look good. We had an education in militarism, and in racism. We thought, “Ah! They surrendered to the Japanese army.”

Everything started with a signal from the hospital head. One Chinese had big thighs and walked slowly and calmly. He lay down and had no sign of fear, no stress on his face. He was composed. Someone else used him for surgery practice.

I went over and pushed the other one to the operating table. I had no feeling of apology or of doing anything bad. The farmer was resigned to his fate, and he lowered his head and walked forward. I didn’t want to get my clothes dirty from him; I wanted to look sharp. He went as far as the operating table but didn’t want to lie down. A nurse using broken Chinese told him, “We’re using ether; it won’t hurt, so lie down.” She gave me a wry smile when she said that. She had been working there for a long time, and when I happened to meet her again much later and asked her about it, she didn’t remember. She was handling so many vivisections it was routine. People who repeat evil acts do not remember them. There is no sense of doing wrong.

War means this, also. War is not just shooting. In order for Japan to win, all the Chinese were made prisoners, women’s bellies were cut open, homes were burned. If you couldn’t do this, then you weren’t a loyal soldier of the emperor.

The scene in the room was not a typical one of preparing for an operation, but a clamor. It was practice for army doctors for winning a war. If you made a disagreeable face, when you returned home you would be called a traitor or turncoat. If it were just me alone, I could tolerate it; but the insulting looks would be cast on parents and siblings. Even if one despises an act, one must bear it. From there, a person becomes accustomed to it.

We all received practice. It was normal to smile at this. The crimes committed during our aggressive wars are forgotten, gone from memory. At the time they were “right.” If you are praised, you must go ahead and perform.

Surgery began. The man was given ether and dissected. His appendix was so small that it was like looking for a burrowing worm. I had to cut and search repeatedly. The blood flow was stopped, nerves were cut, bones were cut with a saw, and a tracheotomy was performed. Blood and air escaped from his body, and blood came foaming up. Practice time was two hours. The man died, and his body was thrown into a hole and buried. The burial area near the operating room was full, so we had to dig a hole farther away. We had received a request from a Japanese pharmaceutical manufacturer; I scraped samples from the outer covering of his brain, placed them into ten 500-cc bottles with alcohol, and sent them to the company for rheumatism research.

The other man, the soldier, was still panting. The hospital head used him for hypodermic practice and injected air into him. Then, to kill him, he injected the same liquid used for anesthesia.

That was my first crime. After that, it was easy. Eventually I dissected fourteen Chinese.

Unit 731 Testimony, Hal Gold

SaulOhio November 22, 2011 at 1:18 pm

And what does this have to do with the issue of saving lives with legal transplants?

Jon Murphy November 22, 2011 at 1:52 pm

After consuming a handle of Smirnoff in order to simulate his state of mind, I think I have an answer.

He is trying to equate the voluntary exchange of the free market to a government-mandated exploitation. However, as is common with most of these examples, the facts are hidden and one sentence, taken grossly out of context, is highlighted and presented as the crux of the argument (in this case, the bold sentence-fragment). The main thing to remember when analyzing the arguments of tolls and idiots is that, rather than focus on the whole story, all the evidence, they focus on what is inflammatory/controversial. If you’ll notice, not one of the… fervent objectors presents an entire piece of evidence. They provide one page of a paper, or one sentence of a speech, or one sentence-fragment of a report. Don & Russ present the evidence for our consideration and then add commentary. These guys refuse to show us the evidence and then explain why we are wrong. In their minds, it’s the same thing. But in the eyes of the intelligent and rational, we see it is nothing more than the final bubbles rising to the surface as we hold their head under the waters of knowledge.

Invisible Backhand November 22, 2011 at 4:24 pm

He could be trying to say that the pharmaceutical company is inherently amoral, or that an exchange absent coercion is can be only one step away from a coerced exchange, or that the profit motive introduces a moral hazard, or that all that poetry about a voluntary exchange goes out the window when they want to hold someone else’s head under the waters of knowledge.

Jon Murphy November 22, 2011 at 4:29 pm

You got all that from one random sentence?

Wow…no wonder why the politicians love you people. They don’t need to form arguments. Sound-bites will do.

“pharmaceutical company is inherently amoral”

I didn;t realize companies that make cancer killing drugs are amoral. But now that I do see that, let’s ban all medications!

” exchange absent coercion is can be only one step away from a coerced exchange”

Correct. That that step is coercion.

“profit motive introduces a moral hazard”

You keep using that word. It doesn’t mean what you think it means.

Invisible Backhand November 22, 2011 at 6:15 pm

and the voluntary exchange via drowning?

Jon Murphy November 22, 2011 at 6:54 pm

It’s a metaphor. I’m drowning you with facts, evidence, historical precedence and common sense. I though that was obvious. I guess not

Invisible Backhand November 22, 2011 at 6:57 pm

Or he could be trying to say that baseball is America’s favorite past-time, or that being more talented than others is inherently amoral, or that being less talented than others is inherently amoral, or that being just as talented as others is inherently amoral, or that one should never draw to an inside straight, or that one should always draw to an inside straight, or that light beige crayons labeled “Flesh Color” were inherently immoral by the Crayola Corporation.

These are just a few of the obvious things that pop into my head after reading that sentence. I’m surprised none of this ever occurred to you.

For shame.

Invisible Backhand November 22, 2011 at 6:50 pm

And what does this have to do with the issue of saving lives with legal transplants?

Absolutely nothing. I’m a professional troll, remember?

“Irrelevance is m’name; non sequitur’s m’game.”

Invisible Backhand November 22, 2011 at 8:00 pm

Oops, you let the non sequitur slip in, Non sequitur Ken.

It’s a metaphor. I’m drowning you with facts,

This is very specific violent imagery from inside your head, Jon:

…we see it is nothing more than the final bubbles rising to the surface as we hold their head under the waters…

Got some pent up revenge fantasies, Jon?

Invisible Backhand November 22, 2011 at 8:44 pm

Oops, you let the non sequitur slip in, Non sequitur Ken.

Oops, I did, too.

Jon Murphy November 22, 2011 at 8:48 pm

“Got some pent up revenge fantasies, Jon?”

Yeah, so I usually play some unnecessarily over-the-top violent video game like Call of Duty MW3 or Warhammer 40,000 to release the anger.

Jon Murphy November 22, 2011 at 11:57 am

Going back and re-watching the video, as well as thinking more on the topic, I have come to this observation:

Isn’t it interesting that we are willing to allow people to die simply because we feel uncomfortable?

Why is it that when a person dies in the pursuit of profit (to use a tried anti-business accusation) it’s morally reprehensible, but if the person dies because of collective inaction (It don’t want to because it makes me feel uncomfortable) it’s morally acceptable? In both cases, a life was unnecessarily wasted. Shouldn’t both be morally objectionable?

Stone Glasgow November 23, 2011 at 2:14 pm

Would you object if a homeless mentally disabled 18 year old wished to sell his kidney and a lung for $20 each?

Adam Smith November 22, 2011 at 12:07 pm

What no one seemed to notice was the ever widening gap between the government and the people. And it became always wider. The whole process of this gap coming into being, was above all diverting. The gao provided an excuse not to think for people who did not want to think anyway. The gap gave us some dreadful, fundamental things to think about and kept us so busy with continuous changes and ‘crises’ and so fascinated by the machinations of the ‘national enemies,’ without and within, that we had no time to think about these dreadful things that were growing, little by little, all around us.

Each step was so small, so inconsequential, so well explained or, on occasion, ‘regretted,’ that unless one understood what the whole thing was in principle, what all these ‘little measures’ must some day lead to, one no more saw it developing from day to day than a farmer in his field sees the corn growing. Each act is worse than the last, but only a little worse. You wait for the next and the next. You wait for one great shocking occasion, thinking that others, when such a shock comes, will join you in resisting somehow.

You don’t want to act, or even talk, alone you don’t want to ‘go out of your way to make trouble.’ But the one great shocking occasion, when tens or hundreds or thousands will join with you, never comes. That’s the difficulty. The forms are all there, all untouched, all reassuring, the houses, the shops, the jobs, the mealtimes, the visits, the concerts, the cinema, the holidays. But the spirit, which you never noticed because you made the lifelong mistake of identifying it with the forms, is changed. Now you live in a world of hate and fear, and the people who hate and fear do not even know it themselves, when everyone is transformed, no one is transformed. You have accepted things you would not have accepted five years ago, a year ago, things your father could never have imagined.

Sagittarius A November 22, 2011 at 6:18 pm

No offense, but I don’t think you are being honest about how difficult it is for most people to engage in “mutually beneficial” transactions when the transaction involves enormously complex information.

You realize, of course, how hard it is for an average person to calculate the true value of his own kidney or liver? You do, but you don’t want to bring it up because it’s a can of worms. That you can throw out a price, say $2000, and assume that a supplier will match that up against a neat utility function and call it about right?

How, precisely, is that person supposed to know he is getting a fair price? What argument do you propose to convince me that most people can draw indifference maps for a kidney?!

Maybe you’ll argue that someone that can’t calculate the value of his own kidney shouldn’t be allowed to live a normal life anyway. Competition baby. Let the weak sell their kidneys and suffer.

It’s their own fault.

Jon Murphy November 22, 2011 at 6:34 pm

Every transaction involves enormously complex information.

The value of the kidney is what the seller values you it at and what the buyer values it at. Don’t forget how prices arise: buyers and sellers jointly determine a price. There would be no arbitrarily set price of kidneys; it would arise organically just like all prices. If, at the given price, the seller is unwilling to sell, then no transaction would occur. Likewise for the buyer.

Economiser November 22, 2011 at 8:41 pm

In addition to the great point Jon Murphy made, you’re also ignoring one of the beautiful functions of prices: the potential for a market.

If I want to sell something as complicated as a house or a car, I don’t have to “calculate the true value” from first principles. I can instead look to the market, find comparables, and extrapolate a good approximation of the price. In a world of kidney sales, I expect nearly all Americans would find the price too low to want to sell their own kidney.

vikingvista November 21, 2011 at 7:04 pm

Mir widersprechen, du verdammter Schwanzlutscher?

;^)

Wilhelm November 21, 2011 at 8:51 pm

Duzen wir uns hier?

vikingvista November 22, 2011 at 12:30 am

Nur Ironie.

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