The Medical Free Market: Is Safety or Choice a Priority?

Posted by Mike Merritt in Politics, Society on

This article was originally posted on Poligazette.

Watching CSI: Miami on Monday, I was intrigued by a question: Do state mandated safety regulations trump free market choice in the medical field?  Or should consumers be allowed to choose to undergo a medical procedure that might cost less than what you could get at a hospital, even though it might not meet all the standard safety requirements?  For those of you wondering what in the world I’m talking about, I’ll see you after the jump, so CSI junkies don’t try and murder me.  For those of you on the RSS feeds, you have been warned: spoilers abound.

So the underlying story of this episode is a surgeon found dead in an attic.  That’s not so important to this article, though.  The more important thing is that this doctor had been performing illegal organ transplants at his apartment in his off hours to make a buck.  Well, there’s a long list of people needing transplants, so they went to this doctor, because hey, the transplant was available.  The doctor’s assistant scoped out some needy people who were willing to part with an organ.  They’ve got an organ to give to someone who needs it.  Done deal, right?

Well, of course, the thing here is that the doctor was stealing equipment from the hospital and his assistant can most likely be described as taking advantage of people who needed money in a tough time.  The donor, a real estate agent, gave away his kidney in order to get through the tough housing market.  Add on the fact the doctor was doing all this to fund his heroin habit, and this situation become murky.  An implantee died because the doc was high.

But lets say a doctor was completely clean and respectable.  Could there ever be a situation where someone could sell a kidney and it was then sold to a needy person?  Seems like the perfect free market situation, yes?  Someone has a demand for an organ and someone else is able to supply that demand.  Why not allow that transaction?

Or does safety always triumph?  Do we always need a supposedly sparkling clean state licensed hospital room with a team ready and waiting to address any problem?  Of course, despite their reputation, hospitals don’t always do the job right.  Complications happen all the time, and hospital surgeons do make mistakes.  Just look at all the medical malpractice suits.  And this is even in situations where implantees have waited forever on a list for an organ to become available.

Essentially, the free market scenario becomes a contract between the giver and the surgeon and the surgeon and the organ needer.  For those concerned over safety, it seems the libertarian thought would be, “Well, they make a decision.  They have to live with it.”  As you may be able to tell, I’ve been spending a significant amount of time on libertarian blogs over the last several months, which is what probably brought this question into my head in the first place.

While I know this site doesn’t cater to purist libertarian thought, it does attract a lot of conservatives who would consider themselves free-marketeers.  So, how about it?  If a nice clean (or not so clean, depending on your choice) operating room with a respectable surgeon could be provided, would buying and selling organs for transplant needs be acceptable?  My argument is that this is the free market solution.  Or should it be regulated by the state to licensed hospitals?  My argument is that this is the liberal paternalistic solution.

So, which is better?  Choice or safety?

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