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will bring the currently outdated organ transplant law at par with other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.
READER COMMENTS
Sasha Volokh
Feb 3 2009 at 5:39pm
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
Feb 3 2009 at 5:42pm
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
Feb 3 2009 at 9:16pm
Without compensation, they’ll get my kidneys when they pry them from my cold, dead retroperitoneum…
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