John Q. and the Market for Organs John Q., the movie about a father holding a hospital hostage because his insurance company won't pay for his son's heart transplant, has caused a political storm in Washington – which is also where the dreadful economics of organ markets finds its home. In the US, you see, markets for organs are verboten. If you are in desperate need of a heart, or a liver, or a kidney, you cannot just go and buy one, even if there's a willing seller. Instead, you are at the mercy of moralists who tell you that you can't have what you need. You can buy the surgeon's and the hospital's services, but you can't buy the organ itself. No, in the US it must be "donated" free of charge. Now we all know that at a price of zero, the supply of goods is small. After all, how many hours of work would you supply to the labor market at a wage rate of zero? If you are in  desperate need of a heart, or a liver, or a kidney, you cannot just go and buy one, even if there's a willing seller.    Instead, you are at the mercy of moralists who tell you that you can't have what you need. A kidney from a live donor can extend your life by about 20 years (and roughly half as many years for a cadaver kidney). Since that's a major benefit to you, it is reasonable to believe that you and your family and friends might well be willing and able to pay for a kidney (the world market price ranges from $1,000 to $10,000; the transplant procedure, all-in-all, runs at perhaps $100,000 to $150,000). Kidneys are relatively easy to deal with: the transplant technology is well developed and donors can live well with only one kidney (and there is in fact an ample global supply of them).  Live liver-segment transplants are harder on the donor, and heart transplants of course require a suitable cadaver. The point, though, is that a dying person and his/her family might well be willing to sell the right to harvest a healthy organ to benefit another human who then need not suffer and die prematurely. At a price of zero, many people (myself included) nonetheless are organ donors in case of accidental death, just as many of us supply voluntary work hours for good causes. But at a price greater than zero, many more people would be willing to make organs available, just as we make more labor hours available when we are paid. If there were an organ market, organ supply would increase, and the current gap between demand and supply would be closed. The immorality of the moralists is that by outlawing a market for organs they thereby condemn people in need of an organ to death. In the US alone, about 50,000 people are on kidney-transplant waiting lists, and 5,000 are waiting for a heart. Many physicians argue that it is somehow immoral to sell body parts for "profit." But the immorality of the moralists is that by outlawing a market for organs they thereby condemn people in need of an organ to death. What's so moral about condemning sick people to death? To be sure, reports abound about shady kidney supply operations in Turkey, Iran, India, China, and other places, and the Internet swarms with myths about people being abducted and waking up, minus one kidney, in iced bathtubs. But the evidence for something so gross is thin. There are legitimate concerns about improper supply practices and plenty of documented evidence exists of fly-by-night kidney removals involving substantial negative side-effects on donor or recipient (or both) and of the withholding of agreed-upon payment. But the underlying reason for why there is this health and financial risk on the supply side is because the organ demand that does exist creates a black market which, by definition, cannot be regulated and properly monitored. Instead of forcing the market for organs underground, and forcing people to needlessly suffer and die, let physicians stick to medicine and medical safety, not morals and market meddling. There is a crucial difference between free markets and unfettered markets. To ensure health and safety standards, obviously organ markets would need regulation and monitoring just like the financial markets are regulated and monitored. Why, you can't even drive a car legally without a driver's license and insurance coverage, i.e., without some degree of regulation and monitoring. Contrary to public perception, economists are not opposed to market regulation per se. Indeed, the proper functioning of markets actually requires a certain amount of regulation, namely exactly that amount of regulation needed to facilitate safe, voluntary exchange between buyer and seller for mutual gain and with provisions for contract enforcement. So, instead of forcing the market for organs underground, and forcing people to needlessly suffer and die, let physicians stick to medicine and medical safety, not morals and market meddling. And let sellers sell, and buyers buy. Dr. J. Brauer is Professor of Economics at Augusta State University's College of Business Administration. He can best be reached via his web site (http://www.aug.edu/~sbajmb).