Category Archives: Healthcare

Free Market Organs: The Case for Capitalism in the Organ Transplant System

A 10-year old Pennsylvania girl by the name of Sarah Murnaghan could die within a few weeks if she doesn’t receive a lung transplant soon. There’s currently a petition on Change.org directed at HHS Secretary Kathleen Sebelius to alter the current policy so that Sarah is made a higher priority on the donor list because the clock is ticking at least somewhat faster than some who are ahead of her.

I’ll leave it to the readers to determine if this petition is the right way to go in the case of Sarah, but I think there is a much larger problem with the organ donation system that I believe could be addressed by the free market. Back in 2008, I wrote a post about why a regulated, above board organ market would be superior and much more moral than the current “altruistic” system. Some of my examples might be a little dated (Hanna Montana is all grown up now) but my overall point stands. Though this post is mostly about live donations, compensation going to an individual’s estate would give Sarah and countless others a much better shot at living.

Free Market Organs (Posted January 24, 2008)

Last week, Doug linked a post about British Prime Minister Gordon Brown’s support for a policy that would allow hospitals to harvest organs without prior consent of the decedent or his/ her family. In essence, the organs of all deceased British citizens would belong to the government’s healthcare system except for those individuals who “opted out” prior to death. The policy in the U.S. is an “opt in” approach rather than “opt out.”

Why is this distinction important? Answer: the presumption of ownership. If citizens have an option of opting in, this shows that individuals own their bodies; to suggest that an individual has to opt out shows that citizens’ bodies are property of the government (unless s/he makes an affirmative claim on his/her body).

The reason for Brown’s support for this policy is quite obvious: like just about everywhere else in the world, Britain is having an organ shortage. So if presumed consent is not the answer to solving the organ shortage, what is? Randolph Beard, John D. Jackson, and David L. Kaserman of Auburn University published a study in the Winter 2008 issue of Cato’s Regulation Magazine. The team studied the effectiveness of current policies aimed at maximizing donor participation and organ matching. Among the policies they analyzed were: increased government funding for organ donor education, organ donor cards (such as having the words “organ donor” on driver’s licenses), required request, kidney exchange programs, and donor reimbursement. None of the policies have come close to solving the shortage. The researchers estimate that roughly half of the potentially viable cadaver organs are ever harvested. With the exception of the inefficient kidney exchange program, one feature that all of these programs have in common is that they each rely on altruism on the part of individuals to donate organs without any sort of compensation.

The one solution which the researchers believe would be effective, monetary compensation to organ donors or their families, is illegal almost everywhere. In 1984, the National Organ Transplant Act was passed making it a crime in the U.S. for a surviving family to receive payment for their loved one’s organs. The law was passed mostly on ethical grounds without any consideration for what would happen to the supply of available organs. The researchers estimate that some 80,000 lives from 1984 to present have been lost because of the bill’s passage and other subsequent policies in the current “altruistic” system. The researchers further project that another 196,310 lives will be lost between 2005- 2015 (and this is what they consider a “conservative” estimate!).

As controversial as compensating families organs of deceased family members is, the thought of an individual driving to a hospital, removing an organ (such as a kidney), and selling that organ to someone in need of the organ for a profit is a complete non-starter. This shouldn’t come as a shock given that in today’s lexicon; the word “profit” is a dirty word. The people who scream bloody murder whenever people decide to “scalp” tickets to sporting events or tickets for Hanna Montana concerts (what’s the big deal with Hanna Montana anyway?) will not likely be in favor of selling vital organs. Anti-capitalist objections aside, free market buying and selling of organs appears to be the most practical solution.

Cato Institute’s Director of Bioethics Studies Sigrid Fry-Revere found that Iran is the only country that does not have an organ shortage and has not had a shortage in ten years. Why? Because Iran (of all places!) is one of the only countries where it is legal for individuals to buy and sell organs from live, voluntary, donations. Revere’s findings also revealed that even if all the viable organs were taken by force by the government from cadavers, there would still not be enough organs to provide an organ to everyone who needs one (Cato Daily Podcast dated January 15, 2008). Maybe the Iranians are on to something here? David Holcberg, writing for Capitalism Magazine agrees arguing in favor of a free market system for organs on both practical and moral grounds:

If you were sick and needed a kidney transplant, you would soon find out that there is a waiting line–and that there are 70,000 people ahead of you, 4,000 of whom will die within a year. If you couldn’t find a willing and compatible donor among your friends and family, you could try to find a stranger willing to give you his kidney–but you would not be allowed to pay him. In fact, the law would not permit you to give him any value in exchange for his kidney. As far as the law is concerned, no one can profit from donating an organ–even if that policy costs you your life. Patients’ attempt to circumvent this deplorable state of affairs has led to the emergence of “paired” kidney donations, an arrangement whereby two individuals–who can’t donate their organs to their loves ones because of medical incompatibility–agree that each will donate a kidney to a friend or family member of the other. But this exchange of value for value is precisely what today’s law forbids. Thus, under pressure to allow this type of exchange, in December the U.S. House and Senate passed The Living Kidney Organ Donation Clarification Act, which amends the National Organ Transplant Act to exempt “paired” donations of kidneys from prosecution.

The congress says that kidneys can be exchanged without sending anyone to jail; how thoughtful. While this is an encouraging step in the right direction, why won’t our elected officials go the rest of the way? Is it the potential risks for the donors? Holcberg points out that the risk for a healthy person dying from donating a kidney is about .03% and usually live normal lives without reducing his or her life expectancy.

No, I suspect the objection to selling organs is more rooted in the overall distain far too many people have towards capitalism. It’s simply unethical to make a profit off of something that someone else “needs” whether its gasoline, Hanna Montana tickets, or a kidney. Only the “privileged” will be able to buy organs if such a system were adopted, they would argue.

Even if this were true, denying a person the right to purchase an organ to save his or her own life should not be subject to a vote or someone else’s ethical hang-ups. If I want to remove a kidney and sell it to a willing buyer for $30,000 (or whatever the going market rate is) I ought to have that right. Why must we assume the government has the right to tell us what we can do with our bodies whether it’s selling our organs by our own choices or government taking them from us after we die without prior consent? Our individual rights of life, liberty, and property demand that we have the ability to make these choices for ourselves.

Hey Ann, the War on (Some) Drugs is a Welfare Program

According to Ann Coulter, libertarians are “pussies” for wanting to end the war on (some) drugs and for agreeing with the Left on certain social issues such as gay marriage. Coulter was a guest on Stossel at the Students for Liberty Conference.

Coulter elaborated:

We’re living in a country that is 70-percent socailist, the government takes 60 percent of your money. They are taking care of your health care, of your pensions. They’re telling you who you can hire, what the regulations will be. And you want to suck up to your little liberal friends and say, ‘Oh, but we want to legalize pot.’ You know, if you were a little more manly you would tell the liberals what your position on employment discrimination is. How about that? But it’s always ‘We want to legalize pot.’

[..]

Liberals want to destroy the family so that you will have one loyalty and that is to the government.

Clearly, Ann Coulter hasn’t spent much time hanging around libertarians, going to libertarian events, or reading anything libertarians write. The war on (some) drugs is but one issue. The welfare and warfare state receives at least as much attention by libertarians as the war on (some) drugs. Libertarians have certainly been more vocal about the welfare state than the conservatives of her ilk. I suppose when we agree with her on these issues, progressives should say we are ‘sucking up’ to our conservative friends. It couldn’t be that we have our own principles (such as the non-aggression principle which neither the Left nor the Right practices) and our own reasons for having them.

And speaking of destroying families, what does she think the war on (some) drugs does to families? What about the “magnificent war” in Iraq (her words), war in Afghanistan, or war in general? I wouldn’t suppose war plays any role at all in destroying families. There are the multiple long deployments, soldiers coming home physically and/or mentally disabled, or worse, come home in a box. For all the concern about the destroying of families, one would think that Ann Coulter would want to be a little more careful about when troops are called to risk life and limb (maybe she should consider the Just War Theory ). I would further argue that the military adventurisim our military is engaging in is its own kind of welfare. Most of what our military does is defend other countries rather than ours.

When respoding to a question from a young woman in the audience asking Coulter why it’s any of her business what someone else puts in his or her body Coulter responded:

It is my business when we are living in a welfare state. You get rid of the welfare state then we’ll talk about drug legalization but right now I have to pay for, it turns out down the pike, your healthcare. I have to pay your unemployment when you can’t hold a job. I have to pay for your food, for your housing…

Coulter went on to say that if not for the welfare state, she would be okay with legalizing drugs.

What does she think incarceration does? When someone is incarcerated, s/he is quite literally being housed, fed, and provided healthcare at the taxpayers’ expense. In California, it costs taxpayers $75,000 per year for each inmate. As terrible as the welfare state is (and yes, it is terrible), I cannot imagine that ending the war on (some) drugs would be any worse for taxpayers as what drug prohibition has done. The drug war costs state and federal government over $30 million per day.

If Ms. Coulter wants to talk about people not being able to hold a job she should consider what wonders a criminal record does for a person’s job prospects. All too often, the only kind of job an ex-con can get is selling illicit drugs which s/he will eventually get arrested and be incarcerated once again. For some repeat drug offenders, the thought of going back to jail or prison isn’t much of a deterrant. It’s ‘3 hots and a cot’ plus security and structure (believe it or not, there are some people who don’t know how to live outside of prison).

Far from being pussies, Ann Coulter, we libertarians have the balls to be consistent in our criticism of the welfare state. Yes, Ann, we should join hands in opposing Obamacare, the out of control welfare state, and reckless spending. Rather than providing drug users food, housing, and healthcare via incarceration, why not join with us and say that everyone should be responsible for their own lives?

With freedom comes responsibility. Is that manly enough for you?

Dr. Ben Carson Speaks Truth to Power

Until yesterday, if someone asked me what I thought about Dr. Ben Cason, I would have had no idea who you were talking about. After listening to his speech (below) from the National Prayer Breakfast from a few days ago with President Obama just a few feet away, I thought this speech was too good not to share.

As an atheist, there were obviously some points I disagreed with. Theological disagreement notwithstanding, overall there was a great deal of wisdom in what he had to say about history, political correctness, personal responsibility, morality, education, healthcare, the national debt, and the tax code. There was easily more intelligent ideas being spoken here than last night’s State of the Union.

If you don’t watch any other part of this speech, start watching around the 18 minute mark where Dr. Carson talks about the immorality of class warfare the progressive tax code and watch the president’s face (spoiler alert: he doesn’t seem too amused). I honestly don’t know how this guy got in the room, much less had the opportunity to speak!

“Common Sense” Legislation to Curb Gun Violence?

Like most people who value individual liberty, I listened to President Obama’s speech about reducing gun violence with a great deal of trepidation. He presented several ideas such as limiting the size of magazines to 10 rounds, banning “military-style assault weapons” (i.e. any gun that looks scary to progressives who know almost nothing about firearms), and “universal” background checks for anyone trying to buy a gun just to name a few “common sense” reforms. In so many words he basically said that anyone who doesn’t favor these proposals is getting in the way of preventing future gun violence (Why even St. Ronald Reagan was even in favor of some of these proposals!)

One point of particular irritation for me is this notion being promoted by the Left that AK-47’s and other “weapons of war” should not be made available to “civilians.” President Obama rightly pointed out that these weapons with these magazines “ha[ve] one purpose: to pump out as many bullets as possible, to do as much damage using bullets often designed to inflict maximum damage.”

Well if we civilians do not “need” these weapons, why should the police have them? Someone correct me if I’m wrong, but aren’t the local police also considered “civilian”? (i.e. civilian law enforcement). Why do the police “need” these awful “weapons of war” which “inflict maximum damage” to serve a warrant for a late night drug bust?* If everyone else should be limited to certain weapons with magazines containing 10 rounds or less, they too should be limited to what weapons are permissible (or at the very least, what situations these weapons should be used). To suggest otherwise would be to suggest that the police are “at war” with the “civilians” since war is all these weapons are good for.

As some who are critical of the president’s approach have correctly pointed out, these reforms would not have prevented the killing at Sandy Hook Elementary. Obama and his allies like to say “if these proposals save only one life…” but they fail to recognize that these reforms might save one life in one situation but might cost a life in another situation (such as a home invasion; the homeowner runs out of rounds due to smaller magazine capacity etc.). Most, if not all of these reforms are meaningless measures to prevent guns from falling into “the wrong hands” (at best) so that the president can say he’s “doing something” to prevent mass shootings.

Some of these proposals do seem reasonable based only on the broad outlines (as always, the devil is in the details). I don’t have a problem with person-to-person background checks** in the abstract. Why shouldn’t an individual be subjected to the same background check as when buying from a gun dealer when s/he is buying from someone who posted his firearm on Craig’s List? I would think that the seller would want to have the peace of mind and/or limit any exposure to liability for any misuse of the firearm.

There are many proposals that are being floated that need to be thought through rather than rushed through to score cheap political points. These proposals go well beyond the 2nd Amendment into areas such as free speech (i.e. censorship), doctor/client privilege (privacy), state’s rights, and more. I do think that we supporters of the right to bear arms need to try to offer up some “common sense” solutions of our own to reduce illegitimate force that either enhance liberty or at the very least, do not tread on the liberties of others.***

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