Regulation Policy

Government Policies Create Organ Shortages

A market-oriented approach to making human organs available for transplants would increase their supply, some observers contend. At present the number of people needing organ transplants far exceeds the available supply. That is largely due to federal policies based on the premise that human organs should not be bought and sold, critics say.

  • Some 55,000 individuals are now waiting for donated organs so they can receive transplants.

  • The list of would-be recipients is maintained by the United Network for Organ Sharing -- a quasipublic agency operating under a federal mandate.

  • The policy has been to factor in medical compatibility, the severity of the recipient's condition and the location of the donor and recipient in deciding who gets an available organ.

  • But the Department of Health and Human Services wants to give priority status to potential recipients who are in the worst medical condition.

Critics warn that this is dangerous public policy, since the sicker a recipient is, the worse the chances the operation will succeed. Seriously ill patients have at times needed a second transplant when the first one failed -- thereby using up more scarce organs.

Competition for organs between smaller, local transplant centers and big-city hospitals is so fierce that local centers sometimes delay reporting availability until it is too late for an organ to be shipped out. Critics of the new policy expect that practice to increase under a fully nationalized system.

Right now, two-thirds of those on the waiting list need kidneys. Nearly 30 percent of the 11,000 kidney transplants performed in 1996 were from live donors.

Those who advocate applying a market approach to the system point out that it would not only increase the supply of kidneys from the dead, but induce healthy individuals to sell one of their kidneys.

Moreover, such a policy would eliminate many of the conflicts and problems that plague the present system.

Source: Richard A. Epstein (University of Chicago Law School), "Sell Your Body, Save a Life," Wall Street Journal, April 16, 1998.

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