Dynamist Blog

I'm Not Making This Up

The Dallas Morning News reports that the Secret Service has busted a Dallas-area tract house--not a suburban ranch but a religious ministry printing evangelical materials. The suspected crime: counterfeiting. The evidence: fake $1,000,000 bills (a denomination that doesn't exist). The DMN's Donna Fielder describes them:

The fake bills are the same size as U.S. currency. They have the distinctive peach and green coloring of new $20 bills and appear to carry the Department of the Treasury and U.S. Federal Reserve seals. But the Treasury seal reads, "Thou shalt not steal."

The back of the bill also looks like the $20 bill, but around the edges are admonitions against looking at a woman with lust and other sins, and repentance is urged.

According to federal Web sites, the largest bill printed is a $100,000 bill, but it circulates only among Federal Reserve banks. Grover Cleveland's picture, which appears on the $1 million religious tracts, actually appears on the $1,000 bill.

Nobody has been arrested, but the counterfeiting cops did seize the group's inventory and may issue a formal "cease and desist" order later this week.

Organ Donation Incentives, Cont'd

In response to a post and comments at Marginal Revolution, I wrote the following, which I'm cross posting here:

The objections to incentives fail to adequately consider a) the range of incentives that might be considered or b) the way organ markets, if such things existed, would in fact operate within a system of insurance (including federal programs) and transplant centers. Incentives, for instance, might include tax advantages of interest primarily to the wealthy. One, proposed by my economist husband, would be a one-year exemption from federal income tax. That would result in organs going from the rich to the poor.

If there were a fully open market, organ acquisition would become just another cost of the transplant, like immunosuppressant drugs or transplant surgeons' fees, to be covered through the normal channels. The problem is when you don't make payment an above-board part of the medical system. That's when you get the many problems we currently observe in black markets, ranging from inadequate care and contract/financial protections for those who sell organs to the availability of organs only to those who are willing to break the law and have the means to travel abroad.

I don't believe that permitting payments, whether for organs outright, through tax incentives, or simply to make up for lost wages (which isn't illegal but doesn't happen today in large part because people think it's illegal), would make unpaid donations disappear. Blood donations coexist with blood banks that pay for blood. Volunteer fire fighters work alongside professionals. I would have donated a kidney without compensation even if it were legal. But I am a relatively affluent person who can afford to take such risks, and miss a certain amount of income, without compensation.

Expecting people to take risks and give up something of value without compensation strikes me as far more blatant exploitation than paying them. I don't expect soldiers or police officers to work for free, and I don't think we should base our entire organ donation system on the idea that everyone but the donor should get paid. Like all price controls, that creates a shortage--in this case, a deadly one.

While giving up a kidney has risks, it is no more risky and far less emotionally fraught than being a surrogate mother, something many women receive both money and personal gratifications from doing. I suspect that if, like the people who use surrogates (or egg donors), kidney patients were affluent professionals with political clout, markets in kidneys would also be legal. Unfortunately, the typical kidney patient tends to be a relatively low-income wage earner without the time, education, or social capital it takes to get policies changed.

As for the idea [from an earlier commmenter] that "Most people view the body/life/health as a sacred matter much like religion is," I certainly agree. When people hear that you are going to donate a kidney, they tend to be repulsed, though after the fact they dole out lots of praise. But we don't need everyone to think it's OK to give or sell kidneys. A tiny minority will do. The rest of the world can simply tolerate their odd behavior.

When I write about "organ donors," I am referring to live donors, primarily of kidneys, but many of the same arguments would apply to incentives for families considering donation of a deceased loved one's organs.

The issue of lost wages is a significant one, especially since kidney patients and their friends and families are disproportionately likely to be of lower socioeconomic status. In many cases, people who might be willing to serve as living donors simply cannot take the chance of financial ruin posed by losing a few weeks of pay (and that's assuming their understanding bosses would give them leave).

Addressing this problem does not require changing federal law--or any government policy. It can be done on a local level by voluntary donations. A philanthropic fund at a major transplant center like Washington Hospital Center, where our surgeries took place, could be established to cover documented lost wages of living donors, presumably with some income cap. Churches could do something similar for members who serve as living donors, presumably for relatives or other church members. This would be particularly valuable in the African-American community; black Americans make up about a third of the people who need kidney transplants.

The National Kidney Foundation's Baleful Effects, Cont'd

Reader Chaim Katz writes:

You may not know this, but in 2004 the state legislature of South Carolina passed a bill authorizing tax credits for [cadaver] organ donors. (The $1000 credit was to have been redeemed by the family.)

The Governor of the state, Mark Sanford, vetoed the bill. His veto message is here.

I found this veto ironic, tragic, and mysterious given that Sanford is ostensibly one of the most libertarian governors in the country. This isn't just my opinion--The State newspaper uses the 'L word' regularly to describe Sanford.

As examples of Sanford's libertarians bona fides, you might note that he was self-limited U.S. Congressman; as Governor he proposed statewide universal school choice (through tax credits); and he has vetoed such measures as increased fines for failure to use child safety seats and an unconstitutional ban on protesting within 1000 yards of a funeral.

Yet given a solution that could possibly save thousands of lives while coercing no one--and costing zero political capital--Sanford punted. My mind boggles.

Sanford may be correct that a state tax credit would violate federal law--a test case would be needed--but there is no reason to deem it immoral, except that the National Kidney Foundation says so. Sanford cites the NKF's opposition in his veto message, on the false assumption that they speak for the interest of people with kidney disease. I'm not sure how big a difference a tax credit would make, but it is worth a try, especially since the very existence of the credit could encourage more people to sign organ donor cards.

Credit Check

For those who want a better credit card deal, Postrel family friend (and Dynamist weblog advertiser) "Mycroft" has some suggestions, especially for gas guzzlers like him. And if you're sick and tired of getting 50 million credit card solicitations in the mail, you can now opt out at this site run by the major credit bureaus.

The National Kidney Foundation vs. Open Debate and Increasing Kidney Donations

The National Kidney Foundation is behaving reprehensibly, especially given its mandate. When I first got interested in organ donations, I naively thought that the foundation would be in the business of doing everything possible to encourage kidney donations. I was terribly wrong. The group vehemently, and successfully, opposed a bill that would have allowed tests of incentives for organ donors. (CEO John Davis brags here, scroll to second item.)

So determined is the NKF that kidney donors should never, ever, in any way be compensated for their organs--no matter how many kidney patients current policy kills--that the organization is now trying to stamp out public discussion of the idea. When they heard that AEI is planning a conference on the subject for June 12, they wrote a letter to AEI president Chris DeMuth suggesting that the conference shouldn't be held. The letter from NKF chief Davis (PDF available here) opens:

The officers and staff of the National Kidney Foundation (NKF) were surprised to learn that AEI has scheduled a forum entitled "Buy or Die: Market Mechanisms to Reduce the National Organ Shortage" that will be held on June 12, 2006. We agree that there should be open discussion of all reasonable approaches to increase organ donation, and that the shortage of organs for transplantation deserves greater attention by policy makers. Nevertheless, we believe that the concept of financial incentives has been adequately debated for 15 years, begining with the National Kidney Foundation's 1991 workshop on "Controversies in Organ Donation," and culminating in the definitive Institute of Medicine (IOM) report that was issued late in April 2006. We don't see how an AEI forum would contribute substantively to debate on this issue. [Emphasis added.]

In other words, "We'd like to maintain our monopoly on the policy debate, so please shut up."

Keep in mind by way of context that there are 66,000 Americans on the waiting list for kidneys and that if every single person in the country agreed to be a post-mortem kidney donor, that would only double the supply of cadaver kidneys to about 13,000 a year, since a relatively few causes of death allow for organ transplants.

For more background on the policy debate, see previous posts here, here, and here. Marginal Revolution blogger and GMU economist Alex Tabarok takes a detailed look at incentives here.

What Will Those DIYers Think of Next?

CNet's Esoterica blog reports on a computer printer made from Legos. Ho hum, you say? Anyone can make a printer from Legos? Yeah, but check out what the printout is made of.

Cultural Complexity

This LAT article by Reed Johnson starts out as sarcastic fluff, but analyzing the cultural significance of Eva Longoria eventually leads to some valuable insights--the sorts of things that should be blindingly obvious to anyone actually living in contemporary American culture but that are too often obscured by various political blinders. Here's one:

This phenomenon of inhabiting more than one culture simultaneously, without feeling a sense of conflicted loyalties, differs in important ways from Chicanismo, the political-cultural movement that arose among Chicanos (people of Mexican descent born in the United States) in the 1960s. Chicanismo was a survival strategy for members of a minority group struggling to get along in a society that treated them as third-class citizens. By necessity, its supporters felt, Chicanismo often took an aggressive stance of resistance toward mainstream U.S. culture.

The new dualism favors assimilation over resistance. Rather than being grounded in identity politics, it's being fueled by technology and the free flow of goods, ideas and talent across an increasingly open and globalized border. This border is not merely a physical place. It exists on the airwaves and in cyberspace as well, in big urban centers and remote pueblitos.

Its influence is especially evident among Mexican Americans and other Latino American youth, who are seeing themselves reflected not only in TV, movies and books but on millions of individual MySpace.com pages. They're wearing LeBron James jerseys, but they may root as hard (or harder) for El Tri, the Mexican national soccer team, as for the U.S. squad in the upcoming World Cup.

Despite an off-putting lead, the whole article is worth reading.

Mixed Message

The folks who decided that mailing bricks to Congress is a good way to lobby against immigration picked an ironic symbol. Who exactly do they think builds America's brick walls? Have they been to a construction site lately?

Real invaders don't build buildings. They blow them up.

UPDATE: This Fortune article estimates that "up to 40 percent of new-home construction in the U.S. is being done wholly or partly by undocumented immigrants," possibly as much as 80 percent in Texas. Referring to Latino immigrants, legal or illegal, one contractor says, "If for any reason we lose that work force, you're going to see the time required to build a house double or triple and the cost of new homes increase 30 to 40 percent." And don't even think about remodeling.

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