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Kidney Stoned

Everson Walls is a hero – and not because he made four pro-bowls as a defensive back for the NFL’s Dallas Cowboys or won a Super Bowl with the New York Giants. No, he is a hero for saving the life of former Cowboys teammate and friend, Ron Springs, by donating him a kidney on February 28th.

“It’s brotherly love,” Springs tearily expressed his gratitude to Walls. Springs and Walls hope to inspire others to become donors. With nearly 1,500 Massachusetts citizens and over 70,000 Americans currently on the waiting list for kidneys, the need for more donors is apparent.

Ron Springs’ kidneys failed because of a 16 year bout with diabetes – he had been on the national transplant waiting list since 2004. The disease has led to the amputation of his right foot and the big and middle toes on his left foot, and caused his hands to curl into knots. He also was forced into a wheelchair and needed dialysis three times a week. Attempts to secure a kidney from family members failed twice. His kidneys may have failed him, but insane government regulations have been the real culprit.

The perpetrator is an utterly indefensible organ policy in America which prohibits the use of “valuable consideration” to purchase a kidney. In other words, the maximum price of kidneys has been mandated to be zero dollars. This failure to permit the voluntary exchange of kidneys in an open marketplace results in the deaths of thousands of humans every year, and is the cause of unimaginable suffering for thousands more. The prohibition does this because the way in which kidneys are now allocated to those that need them – first come, first served – is that long-waiting lists of patients emerge.

In most situations, people at the back of the line have strong incentives to get to the front. Thus, queues usually give rise to “black markets” to achieve the result that the price system would have accomplished for a much lower cost. But the nature of organ transplant operations make “illicit” trading difficult, if not impossible, and there is little else people can do to get to the front of the line. Such arrangements are impossible in the kidney “market” because the kidney transplant system in America is run by the United Network of Organ Sharing (UNOS), which is the recipient of a federal statutory monopoly.

UNOS, like Ron Springs, relies on the donations of kidneys from family members and close friends to allocate scarce kidneys to those in need of them. But there’s not enough “brotherly love” to go around. Millions of Americans are able to make kidney transfers with minimal risk to their own lives and health, yet only a handful make them outside of their own family connections. The “warm glow” people get from doing good is clearly not enough to offset the discomfort and inconvenience from donating an organ. If it were, the supply of organs would be large enough to satisfy demand, yet only 16,000 people received kidneys last year, and the waiting list continues to expand.

Only mutually assenting financial transactions would insure that the supply of kidneys would grow and that those for whom the benefits of a new kidney would be largest (such as young mothers) would be able to get them. Despite the resounding evidence in support of the price system as both the most efficient and just method of allocating scarce resources, UNOS, Congress and the transplant community continue to prefer queuing sick patients instead.

Why are these waiting lists tolerated in matters of life and death (the average wait time for kidneys is nearly 4 years), but completely unacceptable when the stakes are far lower (JetBlue makes you sit on a tarmac for 6 hours during an ice storm and Congress immediately moves to pass a “passenger bill of rights”)? Simply, nobody is held responsible for the problems created under systems of collective choice, whereas the managers and owners of JetBlue face immediate and serious negative economic consequences resulting from their poor decision making. So, while JetBlue works hard to gain the trust of its customers, the transplant community stumbles over itself looking for non-price alternatives to allocating kidneys.

Suffering appears to matter little to market opponents. Typical arguments are hollow and inconsistent. Some lament the commoditization of body parts, but overlook that most people rent their entire selves in the labor market. Others worry that supply responses will largely come from the poor, but neglect to explain how the poor are better off with fewer options. Still others find it unfair that poor patients may not be able to afford organs. They neglect to acknowledge that the actual organ represents a small fraction of the over $100,000 cost to transplant a kidney – and that charities and insurance exist to address these needs – or that shorter waiting times would substantially reduce the financial and emotional costs of treating kidney disease with dialysis. About the only legitimate concern is that some people may impulsively sell organs, but mandatory pre-sale cooling off periods would easily mitigate this problem.

The inconsistency of such moral objections to organ markets are benign when juxtaposed with the typical argument in favor of abortion – a woman’s right to use her own body as she wishes. I simply cannot accept that a right to use one’s own body in ending a life is sacred, while the right to use one’s body to voluntarily save a life is considered profane.

Anti-market moralists who loathe humane efforts to save lives via market incentives should be viewed with suspicion. How would they justify the extreme suffering to Ron Springs and the thousands of other patients waiting for kidneys? Altruism as an organizing social force has proven not just ineffective, but deadly – killing millions in the USSR, China, Cambodia, etc. How can we allow it to kill thousands within our own borders? I challenge readers to offer a superior solution to the one I have here proposed.

One Response to “Kidney Stoned”

  1. Sherlock says:

    Wow. I was going through the “Writing” section of your blog and happened to click on this article. About an hour ago, I read that Ron Springs had passed away after being in a coma for 4 years. The world is crazy sometimes.

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