Bryan Caplan  

Organ Selling in Singapore: The Sad Real Story

Morning Reading (Somewhat Depr... Russ Roberts on "Stimulus"...
My sources in Singapore inform me that a real free market in human organ donations isn't in the cards - and never was.  An econ prof at a Singapore college explains:
My colleagues at the ministry of health tell me that we're NOT legalizing compensation or sale of kidneys as such. Instead what we're doing is to amend the law which currently prohibits any kind of payment to allow for the "comprehrensive reimbursement"  of the "costs, expenses, and loss of earnings reasonably incurred by altruistic living organ donors."  (Don't ask me what the difference is between legalizing compensation and allowing reimbursement; my MOH colleagues always seem prickly about one thing or another).

They also tell me that the amendment will bring the currently outdated organ transplant law at par with other international legislations, eg US, UK, which allow for donor to be paid for expenses incurred in relation to donation in the interest of donor welfare. In addition to allowing payments for expenses, the govt will be putting in many big donor welfare initiatives such as donor care registry to follow-up donor over long term to understand the health and social outcomes of living donation, donor counselling and education programmes, etc.

On your question abt health tourism, i doubt this will happen because there isn't much spare capacity in our public health sector to service foreign patients. In our private health sector, there already are quite a lot of efforts in this direction, but i'm not sure whether this new business of organ transplants will be all that lucrative.
Or as the summary section of the new legislation states:


It's better than nothing.  But looks like the world will be waiting for a real organ market for some time to come - and Singapore will miss a golden opportunity for health tourism. Alas.

Comments and Sharing

COMMENTS (3 to date)
Sasha Volokh writes:

It seems pretty obvious what's the difference between compensation and reimbursement.

Reimbursement only means you can get your actual costs back -- but different legal regimes could define "actual costs" differently, so Singapore seems to be adopting a more reasonable definition that would come closer to reimbursing the true cost.

But compensation -- which is what we really want -- would allow payments substantially in excess of real cost, according to market conditions. This could in no sense be characterized as reimbursement.

Zac writes:

Compensated organ donation is a 'textbook' case of anti-market bias. We know that economists suffer from anti-market bias less than average. Anecdotally, whenever I see an argument in favor of compensated organ donation it is usually from an economist.

Would you guess that economists, in general, are more amenable to the idea than average? Is there any other group that we might see this trend in? How about people who need organ donations? How about physicians?

RL writes:

Without compensation, they'll get my kidneys when they pry them from my cold, dead retroperitoneum...

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