As of right about now, there are about 122,447 people on the waitlist for an organ transplant in the United States. With about 20,704 transplants being performed this year, the situation is not hopeful for those awaiting a vital organ. But what is the cause of this shortage, and why is it so big?
An article by Jane E. Brody of the New York Times explains the cause of such a large shortage lies with the lack of donors while the solution consists of simply increasing the supply organs available for transplant. This claim is not wrong, but her recommendations, similar to those of our government, are unfortunately mistaken.
In short, Brody’s solutions consist of convincing people to become organ donors, instituting policies in hospitals to foster organ donation, using more organs from victims of brain and cardiac death, and increasing the number of live donations.
These are all well and good, but they’re based on the assumption that everybody will at some point be willing to donate if only the right policy is in place or the right person persuades them to do so. What Brody and our government misunderstand is the concept of subjective value, the idea that everyone’s tastes and preferences vary and we all place different degrees of value on everything, including organs.
While moral suasion seems to fail, a solution lies within the free market. Why not legalize the buying and selling of human organs? Let a price be set for these organs, and let people’s subjective value determine whether or not to enter the market on either side of the transaction.
Under a free market, prices serve as signals to buyers and suppliers by explaining what a product is worth. If there is a kidney shortage in a free market, the price of the now scarcer kidney increases, more potential sellers of kidneys enter the market seeking the profits from a higher price landing at a new equilibrium. By pursuing the profit motive, more kidneys become available for those in dire need through voluntary exchange.
In this scenario, not everyone in need will be able to get a kidney, which is, of course, a tragedy. However, giving people the option to pay for one seems more ethical than making those who are suffering sit and wait for a miracle that may or may not happen. Currently, 22 people on the organ waitlist die every day when a free market has the potential to save these lives. Unfortunately, people are misguided by anti-market bias, preventing many from seeing the benefits from legalizing organ sales.
But will legalizing organ sales really accomplish anything? Could a kidney be such a strange “commodity” that people will simply turn their noses up at the very idea of paying money (or accepting money) for one?
To answer these questions I would like to travel to Iran. In 1988, the Middle Eastern nation developed a program to compensate living kidney transplant donors. According to a study by Ahad J. Ghods and Shekoufeh Savaj, by 1999, Iran saw its kidney transplant waitlist completely disappear. In just eleven years the wait time for those in need of a kidney became nonexistent. By allowing people behave in accordance with the profit motive, lives are being saved in Iran.
It is also important to think about the value added effects of selling organs. What are the kidney selling entrepreneurs of Iran doing with their earnings? Are they starting a business? Are they putting it towards schooling for their children? Allowing people to exchange makes everyone better off and creates value in unexpected areas. This is how societies grow and how the world becomes a better place to live in.
If the United States wants to get serious about combatting the organ shortage, it should consider allowing people to sell them rather than allowing people to die by the day from the associated social stigma and a fear of markets.