The organ shortage issue can be broken down and analyzed from a
number of different perspectives. My view is that the key issue is
*not* the supply of organs per-se but rather the *supply of people who
sign their organ donor cards*. Take care of this and the other problems
are of second-order. Most people express strong support for organ
donation but nevertheless do not sign their organ donor cards. I
believe that a small incentive at the organ donor signing stage could
alleviate the organ-shortage problem. The no-give, no-take system
provides such an incentive and at the same time changes how people think
of the supply of organs. In the no-give no-take system those who sign
their organ donor cards would belong to a special club the club of
people that get special preference in receiving organs. Signing your
organ donor card is the ticket into the club.
Now if we think of the total value of organs to recipients and the
total costs of signing the organ donor card the no-give, no-take rule is
essentially efficient in maximizing net "revenues."
I qualify by saying "essentially" for the following reason. The
plan is about increasing the incentive to sign the organ donor card and
not about allocating organs. Thus, suppose a rich person is willing to
pay someone higher up on the list to trade places with them or is
willing to pay someone near death to get their organs. In a technical
sense, allowing this would be an increase in efficiency that would be
allowed for by a pure market in organs. Most people, however, find this
distasteful and the arguments for efficiency as a normative guide are,
in this context, quite weak. Thus, I am not that bothered by the
failure of the "no-give, no-take" rule to be efficient in this context.
The same thing goes for inducing people with especially good organs to
sign - I think this is a second (or less) order problem.
An analogy is to the tragedy of the commons. You can get efficient
results by parceling out a commons in individually owned freehold plots
but this is not necessary. Ostrom and others have shown that property
held in-common areas can be well maintained if there are
incentive/exclusion systems so that only people who do not abuse and/or
contribute to the commons get access to the commons. Villages, for
example, can maintain highly functioning commons without resort to
individual ownership if incentive/exclusion systems exist. The point
here is that even if you don't get 100% efficiency collective ownership
with incentive/exclusion systems need not be a tragedy.
Alex
--
Dr. Alexander Tabarrok
Vice President and Director of Research
The Independent Institute
100 Swan Way
Oakland, CA, 94621-1428
Tel. 510-632-1366, FAX: 510-568-6040
Email: [EMAIL PROTECTED]
