A Regulated Kidney Market Designed To Minimize Social Harms

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Libertarians endorse unregulated organ markets, but that would bring many social harms. Single buyer markets where the payments go to the donor's choice of charity might solve most of the problems.

Kidney markets are problematic for a number of reasons. This is a short and simple attempt to design a solution. Matching Theory might have solved this problem without markets.

The Problems

  • Bodily integrity is an important value, including retaining all one's organs.
  • Creating an organ market might work like payday loans, as a way of transferring even more resources from the poor to the wealthy. We might be creating conditions so that the same poverty traps that force people into payday loan interest payments force them into organ donation as well.
  • Creating a market for organs commodifies them, rendering them subject to ordinary laws in the market, such as liens, repossession, bankruptcy, alimony, taxation, etc.
  • Commodified organs imperil the poor, who now have an increased need to protect their organs from legal judgements, theft, etc.
  • The risk of coercive organ theft would necessitate concealment of medical data and expensive guarding of those with scarce types.
  • Non-renewable organs such as kidneys are at greater risk if the second, backup organs are removed.

The Proposed Single-Buyer Market

  • Licensed and regulated non-profit institutions would be created for purchasing kidneys. They could make offers for kidneys to individuals, and then resell the kidneys to those in need.
  • Transport, transplant, purchase, or sale of organs without proper documentation of origin would be a crime.
  • Payment for kidneys would NOT be to the individual: it would be to a licensed non-profit charity, much the same way you could donate a car to Public Radio.
  • Individuals and the industry would be protected by government-protected insurance against complications of removal, much as the vaccine insurance program works.

How The Proposed Market Solves The Problems

  • Supply of kidneys goes up, prices go down.
  • Individuals seldom have opportunity to make a significant donation to a non-profit cause they consider important. This would enfranchise the poor to make such a donation.
  • Bodily integrity is protected from legal procedings.
  • The poor are not endangered by risks of organ theft, allowing greater medical transparency.
  • Black markets are minimized.