Scott Sumner  

Slippery slope? Let's hope so

Cash for Health Care... The Slippery Slope Not Taken...

The Washington Post has an interesting article on the shortage of organs available for transplant. The article actually quoted something I wrote on the subject, and then goes on to discuss other views:

From Sally Satel of the American Enterprise Institute:
[To] save lives, let's test incentives. A model reimbursement plan would look like this: Donors would not receive a lump sum of cash; instead, a governmental entity or a designated charity would offer them in-kind rewards, such as a contribution to the donor's retirement fund; an income tax credit or a tuition voucher; lifetime health insurance; a contribution to a charity of the donor's choice; or loan forgiveness.
The legislation introduced last week, sponsored by Rep. Matt Cartwright (D-Pa.), wouldn't set up a specific incentive system as Satel suggested. It would, however, make it legal for donors to accept reimbursement for the costs of giving their organs, such as for travel, lost wages, medical expenses, legal costs, etc. -- all expensive burdens that currently land on the shoulders of private donors.

If passed, the bill would also allow the Department of Health and Human Services to run pilot programs to see how non-cash incentives could affect organ donations. This could boost the number of organs available, which has stagnated, especially during the recession.

In my view this proposal will start us down the slippery slope toward a full fledged commercial market for organs. At some point in the future people will say "If we allow this sort of compensation, then why not try Sally Satel's proposal?" And once her proposal is adopted, my even more radical proposal will start to look less extreme.

If someone had advocated gay marriage back in the 1950s, the public would have freaked out. Instead, gay rights progressed one step at a time, and eventually even gay marriage didn't seem to be such an outlandish idea. Slippery slopes can be good things, if they lead us in the right direction.

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COMMENTS (6 to date)

The thing I do not like about this idea of a slippery slope is that it seems to await action on the part of government.

In the decades of slipping toward legality for gay marriage, did government meddling in private lives increase or decrease? I suspect government grew, and now recognizing gay marriage is a requirement from the capital.

I would rather see resolution to bar government from regulation of marriage. Let private lives be private. But such deregulation is hard to sell in a country where everyone has been trained to look longingly to government for good things.

Scott Sumner writes:

Richard, You said:

"I would rather see resolution to bar government from regulation of marriage. Let private lives be private. But such deregulation is hard to sell in a country where everyone has been trained to look longingly to government for good things."

I agree.

Toby writes:

Let's say that we do go down that path eventually. Let's also say that benefits will increasingly be means tested. Ought it then become government policy that if a healthy person has two kidneys that one kidney would count towards the threshold above which benefits will not be paid out?

Similarly, I recall once reading that unemployment benefits could be forfeited if you would fail to apply for a vacancy as a prostitute in a country where prostitution is legal and is considered a profession like any other.

What are your thoughts on that Scott? I don't like it, but this seems where you could slide too if such a slippery slope exists by legalizing what today is considered a taboo.

michael pettengill writes:

How about buying the surplus frozen embryos and growing them far enough to produce organs that can be sold for transplants?

Livers are already harvested as small portions that the grow to the full size needed. Grow an embryo until the liver is big enough to graft into an adult's blood vessel so it can grow.

Probably could do the same for the heart, tho getting it connected to the multiple blood vessels is an interesting problem.

A researcher has grown an embryo in a tank for ten days, stopping because of government regulation limiting it to 14 days, which is half the time until the heart begins pumping blood. Mice have been grown much further in development.

The economics of growing organs to order are certainly very favorable, prevented only by opposition by authoritarians who prevent the free market from meeting a market demand through science and technology.

Lorenzo from Oz writes:

Won't we be growing organs way before this slippery slope has unfolded?

Tom West writes:

I read my Larry Niven (The Jigsaw Man) as a child. I know where the slippery slope leads :-).

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