Art Carden  

Reverse Mortgages in Organs

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Bryan's post below inspired me to think about an idea Mike Hammock and I first talked about while we were colleagues at Rhodes College that, I think, carries Zac Gochenaur's* argument a bit further: reverse mortgages in organs (here's an FTC primer on reverse mortgages).

Zac's argument makes an important and tragically overlooked point: there are a lot of people in the world who are "poor" because--to put it bluntly--wealthy elites privilege their own aesthetic sensibilities over the well-being of the least of these among us. We condemn a lot of people to poverty by forcibly preventing them from selling their most valuable assets: their organs.

We can carry Zac's argument a step further by allowing markets in all organs organ-backed securities. Someone who wants to consume the value of his or her organs now might be willing to accept a reverse mortgage: a bank or other firm makes an annual payment to someone and then gets title to the person's organs when they die. There's an obvious moral hazard problem here: I can sign a reverse mortgage for my organs and then destroy them with wine, women, and song, but this can be solved pretty easily by a requirement that I get a regular checkup or that the contract is void if my cholesterol gets too high or something like that.

For the comments: what would a free market in organs (including reverse mortgages) do to the overall health of the general population, and why?

*--I was very happy to learn that Zac is joining an excellent group of colleagues at Western Carolina, which has basically become the George Mason of the SoCon. I expect great things from him.


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COMMENTS (8 to date)
Pajser writes:

"We condemn a lot of people to poverty by forcibly preventing them from selling their most valuable assets: their organs."

About 30000 people per year in USA need new kidney. About half of the need is satisfied with live or death donors. Hence, need of USA for kidneys is at most 15000/year. Indian is paid for kidney 1000-10000. If import from India is legal, USA needs only 75 millions dollars to import all kidneys it need.

If your motive is to help poor people in the world, increase the tax for 0.0005% and give that to foreign aid. The result will be the same, plus poor people wouldn't have to stay without their kidneys for that money. And occasionally die due to surgical complications.

gwern writes:
wealthy elites privilege their own aesthetic sensibilities

Wait, there are polls showing that a majority of poor people favor legalizing organ sales?

Mr. Econotarian writes:

I think this would be like a reverse mortgage on a purchased car than a purchased house...20 years later, the car/organ is very likely to be in far worse shape.

Andrew Pearson writes:

@gwern: My guess is that a lot of poor people would instinctively express distaste for a market in organs, but if such a market were actually legalised would put these qualms aside in order to sell their organs - social desirability bias vs revealed preference.

Whether this should count as "wealthy elites privileging their own aesthetic sensibilities" is still dubious, of course. If people's support for a market in organs is conditional upon such a market already existing, then a political-decision-maker would see only opposition for legalising a market in organs.

Philo writes:

Song is unlikely to destroy your organs.

MG writes:

@Pajser --

I think that Art's ideas -- because of the analogy to reverse mortgages -- contemplates the transfer of the organ to occur only at death.

But let's assume that your objection transcends the practical, and that it simply deems any such transaction unjust. My question is how is it just to deprive a forward-thinking, generous, individual bequestor of the organ the opportunity to leave his heirs a substantial amount of money, (you say, $1,000 to $10,000) so that the population at large be simply entitled to a rebate of less than a dollar?

Art Carden writes:

@gwern: good question. I've perhaps fallen victim to availability bias as almost all of my conversations about this are with relatively well-to-do academics, students, and others ("How could Nixon have won? I don't know anyone who voted for him!").

The quality question is a good one, but any institution willing to offer a reverse mortgage on organs will account for it in the contract.

Larry writes:

I was thinking of the moral hazard that leads wives to do in their life-insured husbands...I guess there would be a murder exemption, too...

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