Dwek introduced Rosenbaum to an undercover FBI agent posing as his secretary, who claimed to be searching for a kidney for a sick uncle on dialysis at a hospital in Pennsylvania.
"I am what you call a matchmaker," Rosenbaum said in a secretly recorded conversation. "I bring a guy... I believe he's suitable for your uncle." Asked how many organs he had brokered, he said: "Quite a lot," the most recent two weeks earlier.
Each of the four counts carries a maximum five-year prison sentence plus a fine of up to $250,000. Rosenbaum also agreed to forfeit $420,000 in property that was derived from the illegal kidney sales.
Many believe in banning kidney sales from living donors to move to a new equilibrium (state of balance). Opponents believe that legalisation may drive kidney prices up, reduce the number demanded (willingness/ability to purchase a quantity of a good at a given price/time period) and price low-income people with kidney disease out of the transplant market. Laws currently prohibit the sale of organs and so kidney donors are providing “free” kidneys to hospitals. Those willing to provide kidneys legally are scarce.
In Figure 1, with the level of demand after the shift in supply, price P2 should be charged. The service being free, there is excess demand (Qe-Q1) although less than before (Qe-Q2). This creates the near 100,000 Americans on waiting lists. Several European countries, including Spain, have shifted up the supply (willingness/ability of producers to supply a quantity of good at a given price/time) curve by presuming citizens’ consent of having their organs transplanted when they die unless otherwise specified.
Kidneys are no ordinary goods, thus becoming increasingly scarce as demand increases at a faster rate than supply. With fewer kidneys supplied, the marginal value of each kidney is higher. This means the implicit price that hospitals can charge for “free” kidneys and transplant operations are higher. The result is that the overall price of a kidney transplant is higher than if kidney sales were legal.
Demand for kidneys is based on several factors. This ranges from the size of medical institutions to the number of people experiencing kidney disease to daily habits and higher life expectancies. Furthermore, the demand for kidneys is related to the cost of alternative treatments for transplanting. Perfection of such techniques would increase doctors’ willingness to operate and therefore, increase demand for transplantable kidneys.
Supply and Demand of Transplantable Kidneys: Figure 2
Demand has a downward slope: as price rises, more people would rather have the then-cheaper dialysis than get a kidney, and others may be excluded from the market due to insufficient funds to buy at higher prices. Quantity Q1, reflects the altruism of some. As price increases, hesitancy to donate is eliminated. After Q1, the supply curve rises with a positive gradient, illustrating a larger quantity for buyers with increasing price.
The total ban of trade has caused a free-market to arise, where customers unable to buy in legal markets, are prepared to pay higher prices. This slightly increases supply as more are willing to supply at higher prices/benefits.
Figure 2 shows the limited quantity, Q1, selling for P2 (assuming demand at Q2), the profit maximizing level of output for hospitals. If kidneys were sold to patients at P2 before a free-market in kidney sales, the advent of a free-market in bodily organs would cause a drop in the price of kidneys from implicit P2 to explicit P1.
With free-markets, explicit costs of kidneys increase towards the intersection of supply and demand (P1). At P1, the number of kidneys (Q2) exceeds Q1 and the number provided when at zero price.
Figure 3 shows an ideal situation: governments acting impartially to maximise consumer surplus. Maximised community surplus is at PQ, the optimal allocation of resources. Firms sell the last product produced at a price equivalent to cost of production.
Encouraging supply could be done through the legalization of kidneys. This would eradicate large portions of the free-market, eliminate the waiting lists, and prevent many premature deaths and suffering among consumers and suppliers.
Many problems lay in the ethics of donation whether it be pressure, radical altruism or other psychological motivations.
To some, the organ is a “gift of life”, not a commodity to be bought and sold, whereas others argue that just as we have a right to donate to whomever we want, so should it be with organs.
Some of the most ethically problematic cases are those in which the recipient is chosen on the basis of race, religion, or ethnic group.
Also, the desperate open themselves to exploitation and deceit, and organ sellers are easily exploited and deceived in free-markets.
There is much controversy on the true benefits of donation, as well as how motives may drive one to do so.
With the legalization of sales, it seems all stakeholders benefit. Producers could be checked for disease and drug use whereas consumers would receiver better quality quickly. Both would do better than the free-market, where money goes to the middleman.
Governments also benefit as citizens would become healthier and transactions recorded accordingly. Unemployment may drop as patients can return to the labour force instead of suffering for longer durations.
Katherine Wang | Neil Elrick