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A Free Market for Organs Could Save Lives

June 28, 2012

Apply economic theory to solve a difficult social problem, argues professor Gary Becker

Roughly 4,000 lives could be saved in the United States every year, and the quality of life of many thousands more would be improved, if the country removed its ban on the buying and selling of organs, according to Gary Becker, University Professor of Economics and Sociology.

“Thousands of people die while waiting for a [donor] kidney,” Becker said at a brown bag lunch for students on May 16 sponsored by the Becker Friedman Institute for Research in Economics. “When you’re on dialysis, your life expectancy is not very long. If you pay people for kidneys, you clear out the waiting list in a very short period of time. It’s a natural solution for anybody who thinks about economic issues.”

Becker admitted that this sounds like “a radical solution,” but argued that an application of economic theory to this intractable social problem is not only useful, but morally necessary.

Steven Levitt, a member of the center’s Institute Research Council and author of the popular Freakonomics books, introduced Becker as “the most influential academic economist in the world.” Becker was awarded the Nobel Memorial Prize in Economic Sciences in 1992 for extending the domain of microeconomic analysis to a wide range of human behavior and interaction. With Julio Jorge Elias of the Universidad del CEMA in Argentina, he has been studying the imbalance of demand and supply for transplantable kidneys for some years.

The altruistic organ donor system has failed, Becker said. In 2005, the median wait time was four years. Now it is six years. Whereas 18,000 people were on the kidney transplant wait list in 1990, now there are 90,000. Meanwhile, the total number of transplants rose somewhat, but not nearly as much as the need. The number of transplants even declined after 2006. “It’s gotten worse over time, not better,” he said.

Recently, Becker noted, there has been much talk of kidney “exchanges,” a form of linked organ barter, and the possibility of switching from an opt-in system, which presumes a dead person has not allowed removal of the organs unless specifically stated in advance, to an opt-out system. Neither of these developments would solve the problem, he showed in his analysis.

Those who die awaiting a kidney forfeit about 15 years of life on average, according to Becker’s calculations. Figuring in the costs of surgery and dialysis, he estimates an annual cost to the economy of $7 billion for those whose lives end too soon.

“Organ shortages are contrived by the policy we impose. There is nothing natural about these shortages,” Becker said. If selling organs were legalized, he told the 250 students at Harper Center, the market price would likely settle around $15,000 to $20,000 a kidney.

The idea that a person could sell a kidney “creates a lot of emotion,” Becker said, and has been denounced as immoral.

“Morality is a term thrown around very loosely,” he said. “People often say, marketing kidneys is a commodification of human organs; it’s immoral to allow people to sell an organ, that organs would be sold by relatively poor people.

“How moral is it to allow 4,000 people to die each year when you could change the system?” he replied.

J. Duncan Moore Jr.