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Case for an American Market

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There are currently more than 118,000 people waiting for organ transplants in the United States. In 2012, a total of 6,115 Americans died while waiting for an organ transplant. This is an average of 18 people dead every day, according to the New York Organ Donor Network. The number of deceased people in 2012 displays an enormous spike over the average of 4600 people who die each year, according to Forbes Magazine's Marc Siegel. Though breakthroughs in the biomedical field have made it easier for the process of organ transplantation, the supply of organs is still lacking. With such a large shortage in organ supply, demands for organs are not being answered. Over the past two decades, the gap between the number of organ transplants and the number of patients waiting for a transplant has substantially widened. According to Donate Life America, 28,052 organ transplants were performed and 14,013 donors were counted in 2012.

The federal government's first concern regarding organ donation resulted in the proposal and passage of the Uniform Anatomical Gift Act (UAGA) in 1968, giving individuals the right to donate their organs prior to death. However, the general public's mistrust in medical institutions during the time made people fear donating organs. Many were afraid that if they carried an organ donor card, they would not receive the best treatment in a medical emergency. When individuals chose not to obtain a donor card, there were concerns as to how else vital organs could be acquired. Other solutions included the creation of a market that regulated the sales of organs.

This idea, unfortunately, was quickly shut down when the government adopted the National Organ Transplantation Act (NOTA) in 1984, which attempted "enhance the system of voluntary provision of transplantable organs contemplated by the UAGA" (Hansmann). This policy, identified by psychiatrist Sally Satel, had a "hidden within the new organ agenda was a symbolism so severe that it undermined state autonomy and crippled the flexibility of organ exchanges for time to come" (Goodwin 329). The bill made it a federal crime for individuals to sell organs, as explained by Satel.

The main cause of the organ shortage points to the National Organ Transplantation Act of 1984, which prohibits the buying and selling of organs. The Campaign for Liberty's support of the CATO Institute's Eric Schansberg's free market proposal for health care, which will legalize the sales of organs, is the best solution to the organ shortage crisis because by lifting the burden that was put upon organ sales by the government, the potential for an enormous inflow of organs and the affordability of these organs is high. Schansberg's proposal was first offered in a journal report from the CATO Institute in Winter 2011. Labeled Envisioning a Free Market in Health Care, he criticizes President Barack Obama's bipolarizing health legislation, the Affordable Care Act, for it's lack of real health care reform because it only raises the cost of insurance on the American public. Medicare costs have increased and care from physicians has degraded. By identifying the costs of the president's health care bill, Schansberg is able to persuade his audience towards a free market view in health care, a vision that he believes could reduce the cost of health care, end the war on drugs, encourage market competition, and most importantly end the organ shortage crisis. First, if a free market policy were to be implemented now, it could initially lead to dramatic increases of organs into the market, and in the long run, assuming that as more people find an interest in compensation for their organs, they too will put their organs up for sale. Secondly, there is no question that this proposal will only benefit the estimated 120,000 people waiting for an organ transplant because the incentives of offering organs up for sale will only encourage people to "donate" their organs. A free market will promote the sale of organs and people who need them will buy them. Finally, a change in economic policy will cost literally nothing, and it will also remove all government regulation on organ sales, allowing the market to set prices. The benefits are limitless.

First, one of the reasons why the free market proposal is the best alternative solution to the organ shortage crisis is because it has the potential to become one of the most biggest and helpful markets if implemented. As of now, according to Dr. Benjamin Hippen, the approximate waiting time for an organ is approaching 10 years. The effects of implementing a free market for organs could bring a large supply of organs that is enough, according to Schansberg, to "eliminate this shortage, saving thousands of lives and tens of billions of dollars annually." Doing so would also reduce our reliance on "Band-Aid solutions" like dialysis, a process of removing waste and excess water from blood, for those with kidney problems. Michele Goodwin, a professor of law and medicine and public health at the University of Minnesota, calls ten years for kidney patients a "death sentence" because 90% of patients who use dialysis as a treatment for kidney failure die within 10 years. If the right people were in place in the federal government, meaning if Congress members were those who advocated free market economics, this policy would have been put into effect a long time ago. It can be concluded that altruistic donations are not the answer to the shortage crisis. In her journal article, "Confronting the Limits of Altruism: A Response to Jake Linford," Goodwin criticizes the effect of NOTA's approval, claiming that the transplant-donation gap "has widened so severely that claims of Americans engaged in black market trades in organs can no longer be dismissed" (333). By creating a legal market where organs could be bought and sold, we could end the organ black market, where organs are removed unsafely and in poor conditions.

Additionally, the amount of lives that will be saved is another reason why the organ market is the best proposal for this issue. Legalizing the sale of organs will encourage people to sell their organs because of the benefits that they will receive in return. As a result, there is a win-win situation for both the buyer and the seller. The buyer receives an organ transplant they desperately need, while the seller walks away with a compensation. Countless lives could be saved with this process. David Holcberg of the Ayn Rand Institute, a nonprofit think tank located in Irvine, CA, writes, "The right to buy an organ is part of your right to life. The right to life is the right to take all actions a rational being requires to sustain his life. This right becomes meaningless when the law forbids you to buy a kidney or liver that would preserve



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