It Is Dangerous to Be Right When the Government Is Wrong Page 16

  In 1984, an “overzealous entrepreneur” testified before Congress of his plans to ship in impoverished people from developing countries, remove their organs to undergird our shortage, and return the “donors” to their homelands with a sum of money to compensate them for their efforts.14 Appalled, Congress, spearheaded by Al Gore, a Tennessee congressman at the time, enacted the National Organ Transplant Act. While the legislature may have been well intentioned, the consequences have been highly intrusive and purely negative. People are dying, and the need for organs has increased yearly. Although Gore did propose “a voucher system or a tax credit to a donor’s estate” if “efforts to improve voluntary donation are unsuccessful,”15 the United States continues to flounder despite attempts to promote donation after more than twenty-five years. Clearly, the government’s efforts have been unsuccessful with more than 80,000 people on kidney-transplant waiting lists. The system is broken, and the time for change is now. It is time to look to compensation, incentives, and market practices to solve the problem. However, under current federal law, we can’t. In Pennsylvania, for example, the state legislature proposed an allowance of a mere three hundred dollars to go toward funeral expenses if an individual were to donate organs.16 The bill, however, failed because government officials feared that it might violate federal law. Whatever happened to federalism?

  Sally Satel, M.D., who received a kidney transplant in 2006, tells a story in her article, “The Waiting Game,” about a proactive young man on dialysis.17 Amazingly, Alex Crionas met a man at a party who offered to donate one of his kidneys to Crionas. Unfortunately, Crionas had also created a Web site to help attract potential donors via the Internet, violating parts of the National Organ Transplant Act. As a result, the transplant center refused to perform his surgery, even though Crionas and the donor did not even meet on the Web site (they met at the party). The surgery center’s reasoning for denying him the transplant: Brokered transplants “undermine trust in the whole system.”18 It seems to me the system has already been undermined. Fortunately, after seeking out a different transplant center, Crionas was finally able to receive his transplant, which was a success.

  Bad Effects and the Black Market

  The organ black market is alive and well. In fact, the black market may account for 5 to 10 percent of transplants worldwide.19 I do not have to look to faraway places like India or the Philippines to back up my claim; I can look as close as my home State of New Jersey. In July 2009, Rabbi Levy Izhak Rosenbaum was accused of conspiring to broker the sale of a human kidney for a transplant. The recipient would pay $160,000 while the donor received $10,000. According to the complaint filed in federal district court in New Jersey, this was not Mr. Rosenbaum’s first dance. He had brokered many deals over the past ten years.20

  Unfortunately, the effects of criminalizing organ donation are exactly opposite of the government’s intent. Dr. Satel states that the strategy of “cracking down” on organ trafficking is doomed because “it ignores the time-tested fact that efforts to stamp out underground markets either drive corruption further underground or cause it to flourish elsewhere.”21 So, instead of allowing people to be compensated for their altruistic act of donation, the government must monitor and build criminal cases against rabbis selling organs in New Jersey. In addition to the danger of black markets, there is the threat of physicians being forced to use organs of lesser quality because of such low supply. The United States’ intense shortage has increased the use of these so-called expanded-criteria organs—in other words, organs that are not suitable for transplant.22 Kidneys are not as “good” when they are donated by people over sixty years old or by people who have a history of medical problems. These organs are more likely to fail in the recipient than organs from younger, healthier donors. Because of the federal government’s restrictions, these lesser quality organs are transplanted anyway.

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  In his Wall Street Journal piece, “The Meat Market,” Alex Tabarrok described the level of desperation reached by those in need of organs. The situation is so dire, “at the University of Maryland’s School of Medicine, five patients received transplants of kidneys that had either cancerous or benign tumors removed from them.”23 These acts of desperation are forced upon these ailing individuals based on rules and regulations passed by the government. Tabarrok goes on to explain that while expanded-criteria organs can be a useful (albeit dangerous) alternative to the shortage, their use also means that the organ shortage is even more drastic than it appears “because as the waiting list lengthens, the quality of transplants is falling.”24 These “alternatives” are not alternatives at all. The fact that people are resorting to these extreme measures to access organs when organ donors could be compensated is unacceptable and immoral. The government must take a second look.

  And the Money?!?

  Kidney dialysis is a federal entitlement (no) thanks to the 1972 End Stage Renal Disease (ESRD) component of the Social Security Act. In 2006, Medicare spent almost $23 billion on ESRD, and the total cost per person, per year, was $61,164.25 The real punch: Only one-third of dialysis patients survive after five years. More specifically, a thirty-five-year-old spending nine years on dialysis will accumulate a total cost of $600,000 while a sixty-four-year-old over four years will cost $300,000. Now compare these extravagant treatment costs with the $75,000 onetime cost of the “surgeries and hospital stays of the donor and recipient, plus the first year of follow-up care (including medicine).”26 It is more cost-effective to cure than to treat, and we already have the cure. It is called a transplant.

  And check out this number crunch. Virginia Postrel of The Atlantic magazine suggests transplant centers pay $25,000 or $50,000 to each living kidney donor.27 As a result, taxpayers would save billions: “Eliminating the waiting list would save taxpayers $8 billion, or $4 billion if each living donor received a lump-sum payment of $50,000.”28 To make an even starker point, Nobel Laureate economist Gary Becker and economist Julio Elías estimated that a mere payment of $15,000 per donor would eliminate the kidney shortage in the United States. These economists suggest the federal government make the payments so as to avoid any inequality in allocation.29 That, of course, would be unconstitutional.

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  The bottom line is transplants are cheaper than dialysis, and since dialysis treatment is paid by Medicare’s ESRD program, it is in our interest to cut costs. Even more convincing, these monetary calculations completely ignore the benefits enjoyed by the recipient in the form of health, happiness, and quality of life. It seems like a no-brainer, but our government cannot seem to pull it off.

  Success Stories Around the Globe

  There is only one country in the world that has eliminated its shortage of transplant organs. Interestingly enough, it is Iran. Iran began its system of organ donation incentives in 1988 and eliminated its shortage by 1999.30 If Iranian patients are not assigned a kidney from a deceased donor or cannot find a family donor, they apply to a non-profit called Dialysis and Transplant Patients Association (Datpa). Datpa finds donors in its pool of applicants, and an independent third party evaluates them. The government pays the donors $1,200 and provides one year of limited health coverage while those that worked through Datpa receive an additional payment (from Datpa) between $2,300 and $4,500.31 Although the Iranian donor system is not fully a free market system, it does demonstrate that an organ shortage can be fixed by offering financial incentives. The United States government could learn a thing or two.

  Singapore and Israel, on the other hand, use non-monetary methods of incentivizing their people to donate. Alex Tabarrok calls the program, “no give, no take.”32 If an individual “opts out” of Israel’s presumed consent system, he or she is assigned a lower priority on the transplant list should one day he or she need an organ.33 In other words, if you do not give, you do not receive. While this presumed consent program may seem potentially harmful to an individual’s autonomy, anyone can “opt out” at any time. Other countries that hav
e adopted presumed consent have had great success in decreasing their waiting lists. Spain, for example, adopted presumed consent in 1989, and within a decade had doubled its donor number.34 Austria quadrupled its donation numbers when it adopted presumed consent.35

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  Whatever Happened to Personal Autonomy?

  Our government has done it again. The rules of the kidney game are wholly dictated by a governmental monopoly. As a result, you cannot determine what is best for you and your body. However, by attempting to quell organ trafficking, all the government is doing is running the black market further and further underground, making it more and more dangerous for everyone involved.

  While opponents of organ trade argue that it is an exploitation of the poor, who am I (or the government) to say that the poor should not be able to make a rational decision to part with an organ—and free themselves from poverty at the same time? That decision is entirely theirs. While outlawing payments to donors is technically a way to keep the system “fair” by giving the rich and the poor equal access, it is only “fair” insofar as both the rich and the poor have an equally rotten chance to receive a healthy kidney. It is simply unfair that people at all economic levels have to succumb to that sad destiny. Why is it that I can purchase poison with which to kill a rodent, but I cannot purchase a finger to replace the one I lost to my saw?

  The fact that healthy (and redundant) kidneys are a scarcity makes a compelling case for their economization. We should be using our resources more carefully. If there are thirteen people dying every day because they need a kidney, surely we can incentivize free people in some way. Altruism, apparently, is not enough. The government’s plan is not working. We must leave this predicament, like any supply-and-demand scenario, to the markets. While other governments are actually searching for answers to the organ shortage problem, our government is unnecessarily policing—and failing in the process.

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  And Lastly, the Drugs . . .

  Drug prohibition is a failed public policy that must be abolished in the United States. Drugs continue to be available (whether you are looking for them or not) on street corners and in schools across America. Surveys taken of high school seniors, year after year, reveal that 85 percent say that marijuana is “easy to get.”36 You can smell pot at concert venues in San Francisco. You can witness cocaine residue in bathrooms in New York City restaurants. You can see the explosions of meth labs in small Nebraska towns. It is no secret. Drugs (and their dealers) flourish just fine under the “watchful” eye of the United States government.

  No drug in this country was illegal prior to 1914. Hemp is the product from which marijuana is made. In fact, for much of our history, school textbooks were made from hemp! Even many of the Founding Fathers, including Jefferson and Washington, grew hemp. So why then did drugs go from being a major lawful industry to the scourge of society? Early in the twentieth century, a number of business tycoons saw the hemp industry as a major competitor, and thus a barrier to growth (hemp was an alternative to wood in paper production, for example). These tycoons included the DuPonts, Andrew Mellon, and William Randolph Hearst. They began by initiating a smear campaign against marijuana, portraying it as a great social evil, causing everything from insanity to violence (watch the vintage film Reefer Madness if you don’t believe me). The public bought this nonsense hook, line, and sinker. If this was not enough, congressional hearings on the matter contained deliberately falsified information, such as the following letter from an editor of a newspaper:

  Two weeks ago a sex-mad degenerate, named Lee Fernandez, brutally attacked a young Alamosa girl. He was convicted of assault with intent to rape and sentenced to 10 to 14 years in the state penitentiary. Police officers here know definitely that Fernandez was under the influence of marijuana. But this case is one in hundreds of murders, rapes, petty crimes, insanity that has occurred in southern Colorado in recent years.37

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  In reality, Fernandez was drunk, not high.38 Eventually, in 1937 the Marijuana Tax Law was passed, which made marijuana illegal. Thus, a mainstay of the American criminal law was based off of nothing more than a secretive attempt to destroy business competitors. Put that in your pipe and smoke it!

  Since President Nixon’s declaration of the “War on Drugs” in 1970, the government has spent over one trillion dollars trying to combat them. Law enforcement agencies have locked up more than 2.3 million people, a higher incarceration rate than any other county.39 What’s more, 60 percent of these incarcerations are for non-violent crimes. What’s the point? These people are not invading my body or my rights or my property, or yours. These people are not harming anyone but themselves—and they have the freedom to do that. What’s more, the state is spending vast amounts of our nation’s resources (tax dollars) attempting to fight an un-winnable fight. When something like drugs (or prostitution) is prohibited, black markets pop up with all the corollary problems that surround them. When free exchange is permitted, a legitimate and workable market develops with supply and demand to act as a check.

  The Lies the Government Tells You 2.0

  My Fox News colleague John Stossel recently aired a show on the Drug War and debunked some government-created myths like “some drugs are so addictive that you are hooked the first time you use them.” John makes the argument that drugs are not quite as addictive as the government wants us to believe, and the statistics back him up.

  According to the National Survey on Drug Use and Health gathered by the Substance Abuse and Mental Health Services Administration, 8.5 million people have tried crack, while only 359,000 are regular users (regular users are defined as those who use it at best once in thirty days); 3.8 million have tried heroin, while only 213,000 are regular users. If these drugs are so addictive, why is there not a greater retention rate? Where are these first-time user addicts of whom the government speaks?

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  Also, the government wants us to believe that if drugs were to be legalized, there would be far more abuse of them. John Stossel maintains that there is very little evidence to support this assumption. As many know, in the Netherlands, marijuana has been legal for years. The Dutch, however, are far less likely to smoke than Americans. Fully 38 percent of American adolescents have smoked pot, while only 20 percent of Dutch teens have; in other words, marijuana rates in the Netherlands, where pot is legal, are half the rate of those in the United States, where pot gets you jail time!40 The Dutch government’s answer to this discrepancy is telling: “We’ve succeeded in making pot boring.”41 The United States government should follow suit.

  Drug Legalization Would Save the Government Money!

  Jeffrey Miron, a professor of economics at Harvard, authored a study on the economics of marijuana legalization. He concluded that marijuana legalization would reduce government spending by $7.7 billion annually.42 Its legalization would generate $2.4 billion of tax revenue annually if marijuana were taxed like all other goods and $6.2 billion annually if marijuana were taxed at rates comparable to those on alcohol and tobacco.43

  To put this amount in perspective, Miron takes this calculation and asserts that the $14 billion in combined annual savings and revenues would “cover the securing of all ‘loose nukes’ in the former Soviet Union in less than three years.” “Just one year’s savings would cover the full cost of anti-terrorism port security measures required by the Maritime Transportation Security Act of 2002.”44 Talk about putting money to good use! The esteemed Nobel Laureate in Economics, Milton Friedman, and more than five hundred economists called for this drug debate to be brought to light as there is taxpayer money to be saved and government power to be tamed.

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  Surprise, Surprise: The State Breaks Its Own Laws in Combating the “Drug War”

  If the government would profit financially from the legalization of drugs, why won’t it concede? Because it likes to waste your tax dollars and assert control over you by violating your privacy and other rights in the process. Don
’t believe me?

  Every day, the government uses unconstitutional means to conduct SWAT raids on homes that may (or may not) have drugs inside. Often, these police tips come from unreliable sources, but the government goes in anyway. According to these police, no judicial due process or search warrant is required, and the government is not obligated to knock at your door. Law enforcement may enter your home, unannounced, in the dead of night.

  While SWAT raids are supposed to be used to disperse violent situations, they are increasingly used in non-violent situations to search and seize the premises of homes, thereby violating every civil liberty held by you or me as a human being. There are 100 to 150 SWAT raids per day in the U.S. and about 50,000 performed per year.45 Since the late 1980s, SWAT raids have increased dramatically, almost 1,500 percent.46 Many of these raids end up at mistaken addresses, causing injury, deaths of dogs, and deaths of humans. The only common thread is the lack of consideration for freedom to live safely and peacefully in one’s own home.

  Gore Vidal, a playwright and novelist, sees through the government’s lies clearly:

  The bureaucratic machine has a vested interest in playing cops and robbers. Both the Bureau of Narcotics and the Mafia want strong laws against the sale and use of drugs because if drugs are sold at cost there would be no money in it for anyone . . . will anything sensible be done? Of course not. The American people are as devoted to the idea of sin and its punishment as they are to making money—and fighting drugs is nearly as big a business as pushing them.

  Ironically, the actions our government seeks to control and regulate are the creations of the government itself. The state has perpetuated the dreadful consequences of prostitution—violence and disease—by attempting to prohibit it. The government has lengthened the kidney waiting list by outlawing compensation and incentives to donors. The government has brought on its war on drugs by trying to quash their use. When will it ever learn? It is time the government gets out and stays out of our bodies.