Putting a Price on Kidneys

Josh Barro wants to set up a marketplace for human organs. He thinks it’s a good idea, I presume, because he never saw Repo Men (a junky sci-fi movie in which the production of synthetic organs leads to a class of debtor patients who have their organs reposed once their behind on too many payments).

The “organ shortage” could be eliminated, according to Barro, through “better public policy.” He sees two barriers to fixing the shortage: 

“A 1984 law prohibits providing financial compensation to organ donors, living or dead. Price controls reduce supply, and price ceilings of $0 especially reduce supply.

Organs can only be taken for donation from the dead bodies of people who agreed, in advance, to be donors.”

Lots of people need organs, and lots more people would give them, according to Barro, if they could make some money off it. I have no doubt this would be the case.

“Allowing payment would increase the supply of organs available, just as it does now for blood plasma, which can legally be bought and sold,” he explains.

Except that blood plasma replenishes—kidneys do not.

Barro goes on to admit that people tend to be “squeamish about the idea of paying for organs,” because of the potential for exploitation. But a well-designed market he reassures us, won’t have these problems.

His solution is to introduce middlemen into the market. That is, for profit entities like insurance companies would negotiate the prices like “any other medical supply” which, when combined with universal coverage, would ensure transplanted organs would not just be for rich people.

Yes, Barro admits, most donors would be poor, but the risks are small, and people make all sorts of life choices, and we should let them literally sell parts of their body if they need the extra money to say, pay the rent, or part of their child’s tuition, or the next month’s groceries.

What is so ridiculous about Barro’s proposal isn’t it’s necessary tendency toward exploitation, but the fact that he thinks of it as a market solution despite the fact that it would require the government to run it (unless he has some other plan for instituting universal health care).

After all, I assume that instances in which one person sells a kidney because they can’t afford to pay their own hospital bills, for some other operation they just had, won’t occur because those hospital bills will already be paid by the government (either directly or indirectly through subsidies to insurance providers).

In which case the only real thing going on here is that the government is now paying people for organs—organs which will necessarily be sold by people who need the money more than the organ—and this is presumably a good thing because it gives other people a chance at a better life, which is a net good, in which case why not alleviate the impoverishment which is helping to create the supply of organs in the first place? Yes, some people might still sell a kidney so they can have their kitchen redone, or finally buy that muscle car they always dreamed of having, but one presumes that the net-good is zero when the government preys on one group of people to help out another.