The High Cost When Life is Priceless

More than 150 people in Michigan died last year while waiting for the organ transplant that might well have saved their lives.

As of New Year's Day this year there were over 2,000 more men, women and children desperately hoping to win what is literally the lottery of a lifetime.

Unfortunately, the odds are only about one in five that a donor will be found for them by year's end -- and about one in 13 that they will die first.

The Transplantation Society of Michigan, the non-profit organization that coordinates the whole organ donor system, is struggling valiantly to expand the pool of potential organ donors.

They have faced a recent, additional hurdle when the State of Michigan, in making us national ID compatible, added bar-coding to the back of operators licenses. This new data, of course, has nothing whatever to do with the already infrequently utilized organ donor stickers that can appear there.

The group is now in the process of building a computer database to supplement the existing system. But the opportunity to register via this method is much less widely available, much less convenient, and much less well known. Consequently, they currently have only about 14,000 volunteers.

No one likes to talk about it, but the biggest hurdle for the Transplantation Society to overcome in filling their new database with the names of potential organ donors is that, aside from pure altruism, there is simply no incentive for anyone to join the list.

There is an obvious answer to this problem: pay them.

Begin by offering something to qualified donors to register with the database. Since allowance has to be made for those who might subsequently change their minds and withdraw from the program, this initial consideration probably shouldn't be cash. Making organs available to donors and, perhaps, their immediate family members at no charge or, at least, a reduced rate would probably suffice.

Once registered, the commitment to be an organ donor would amount to a simple instruction to an individual's estate (and a de jure addendum to any will.) Should some tragedy -- usually but not always a traffic accident -- befall a registered donor that would make him or her a suitable candidate for a particular donation the transplant, having been pre-authorized, would proceed immediately with compensation then paid to his or her heirs.

As to determining the specific monetary value of various organs, left to itself, the market will reach an optimum compensation based on scarcity in terms not only of kind but also any other limiting factors such as unusual blood types, etc.

Fortunately, demand is relatively static so, as the supply rises, prices will necessarily fall.

Aside from the obvious tragedy of the circumstances for the registered donor, this is a win-win situation for all concerned. A critically ill person receives the gift of life. The heirs of the deceased receive some additional compensation for their loss. And the donor goes to his grave having exchanged organs that are no longer of any use to him anyway for not just one but two good deeds -- helping both a desperate stranger and his own family.

Unfortunately, this whole scenario is impossible because it is currently illegal.

There is little doubt that such a system would end the shortage of transplantable organs, so why does the law stand in the way?

One might assume that the reason for the prohibition is to prevent a black market in organs that were not given voluntarily but rather stolen. Not so. Due to the constraints of matching blood antigens and other specific, screening requirements transplants cannot be made from utterly anonymous donors. And transactions in stolen goods do not generally include disclosure of the legitimate owner.

Or one might assume that such a system would lead to a situation in which only the rich can get transplants. Also not so. Of course, the rich have first and easiest access to the best medical care, just as they do the best homes, automobiles and everything else. But increasing supply in a market with limited demand cannot help but reduce prices for everyone. Just as that metaphorical "rising tide lifts all boats," so falling prices benefit all consumers.

And it ought to be noted that cost is not currently the obstacle to anyone, rich or poor, anyway. As with so many other egalitarian-minded policies the ultimate effect of current law is not to elevate the impoverished to the same level of opportunity as the prosperous but rather to equally condemn everyone.

In any case, there would, of course, still be nothing to stop the more charitably inclined from simply donating their organs as they do now or starting a fund to cover the costs for the indigent.

The only real impediment here is the moral indignation of those who find our market system inherently offensive and insist that organ donors must not be compensated in any way (though their insistence on absolute altruism does not seem to extend to the doctors and hospitals who charge millions for performing the actual transplants.)

I suspect that there were over 150 families in Michigan last year that would have gladly traded liberal sanctimony for their loved ones' lives.

One can't help but wonder how many more will join them this year.

Tim O'Brien is the Executive Director of the Libertarian Party of Michigan.