Organ Socialism

Imagine Congress passed a law making it illegal to buy or sell pianos, so the only pianos available were donated pianos.

Imagine this law paid for the formation and operation of piano procurement organizations to identify potential piano donors, acquire donated pianos, and transport them to piano distributors.

Imagine this law created a Piano Procurement and Transportation Network to set standards for the acquisition and transportation of donated pianos by piano procurement organizations, coordinate the distribution of pianos from piano procurement organizations to piano distributors, maintain a national piano waiting list, and establish a national system to match pianos and individuals on that list.

Imagine this law ordered a Washington bureaucrat to outsource the operation of the Piano Procurement and Transportation Network to an organization whose board had to include representatives of piano procurement organizations and piano distributors. Imagine this bureaucrat then hired an organization titled the United Network for Piano Sharing.

Imagine you could only get your name added to the piano waiting list by a government-approved piano distributor, and only if you paid a listing fee to the United Network for Piano Sharing. Imagine you could then only receive a donated piano if you paid a fee to the piano distributor.

What a nightmare for people who want pianos!

Substitute "organ" for "piano" and this is reality, not an absurd fantasy. And because we are talking about human organs, not musical ones, the cost of this idiocy is thousands of lives lost every year.

Congress passed the National Organ Transplantation Act in 1984, making it illegal to buy or sell human organs. That law funded organ procurement organizations, which find organ donors, acquire organs, and ship them to transplant hospitals. It also created the Organ Procurement and Transplantation Network. It made the Secretary of Health & Human Services responsible for outsourcing OPTN's operation. HHS hired the United Network for Organ Sharing. People who need transplants can only be put on the waiting list by government-approved transplant hospitals, and only if they pay UNOS a listing fee. Transplant patients pay hospitals for the donated organs they get from organ procurement organizations.

How's this system working? Over 6,000 people on the transplant waiting list died waiting in 2005. Another 1,800 left the list because they became too sick for surgery. They'll die soon — if they're still alive. The waiting list has doubled in ten years to over 92,000 people. Most people on the list will die waiting.

It's a good thing we don't have a system like this for food or clothing — or pianos.

Our organ collection and distribution system looks like something designed by socialist central planners, with help from Rube Goldberg. But our system is actually worse. Socialists may control prices, but they don't usually set them at zero. That's the price Congress set for human organs, and that's guaranteed to create a shortage. If Congress set the price of food at zero, would anyone be surprised to see lots of hungry people?

Please don't mistake this for an economics lesson. Organ socialism kills people. Replacing it with a free market system would save thousands of lives every year. But that's just not going to happen in the foreseeable future. It's a complete non-starter from a political standpoint.

Fortunately, you can opt out of organ socialism. The bureaucrats don't like it, but your participation is voluntary. If you need an organ, you don't have to just hope the bureaucrats find one for you. You can get one directly from another individual. You also don't have to let the bureaucrats decide who gets your organs when you die. You can decide for yourself who gets them. The process is called directed donation, and it's legal under federal and state law.

If you're going to decide who gets your organs, why not give them to others who are willing to return the favor? That's the idea behind LifeSharers, a grass-roots organ donation network. Members use directed donation to offer their organs first to other members. Joining LifeSharers could literally save your life, because you'll get preferred access to the organs of every other member. Membership is free and open to all at

By forming a pool of organs available first to registered organ donors, LifeSharers creates a powerful incentive for everyone to register as an organ donor and join the network. This incentive becomes stronger with each additional member. As LifeSharers expands, it will eventually save thousands of lives every year. Your life could be one of them.

LifeSharers can't fix the mess caused by organ socialism as fast as a free market in organs could. But until Congress sees fit to repeal the absurdity it enacted in the National Organ Transplant Act a free market in organs is illegal. So for now, LifeSharers is the best available alternative.

May 11, 2006