Privatize Everything

Privatize Everything

Wednesday, November 7, 2013

The market is fine for some things, people will say, but other activities are too important to be left to the market. Or too complicated. Or too fundamental to our democracy.

I say: Privatize everything.

To some of you, that will sound callous — but failure to privatize services, keeping them in government hands instead, is what impoverishes and kills people. Nothing compassionate about that.

Take organ donations.

Regulations forbid buying and selling organs, so the market cannot operate. Desperate patients must wait and hope someone gives out of sheer generosity, that someone dies at just the right time, and that hospital administrators bump their case to the top of the list.

In the U.S., 100,000 people are on waiting lists for kidneys. Kidneys make up 80 percent of the organ shortage. We have two kidneys but only need one. Donors could save many lives, but not enough choose to donate. By contrast, in Iran, there's often a waiting line of willing donors. That's because in Iran, it's legal to sell organs. It's the rare thing that Iran does right.

People still buy and sell organs even when it's illegal, but, as is so often the case, the black market produces horrors that are unlikely to occur when people can trade in the open. So we get headlines like “Girl smuggled into Britain to have her 'organs harvested'” and “Chinese boy, 6, has eyes gouged out for organ transplant black market.”

Surely, it is better if organ exchanges — like any other exchanges — take place voluntarily.

Bioethicist Sigrid Fry-Revere, founder of the Center for Ethical Solutions, went to Iran to meet organ sellers and buyers.

After, she told of people like “an apprentice who needed the money to start his own shop … He had his own shop now. He gave his kidney to a 15 year-old girl, who is going to school and doing well. He checks in regularly with her mother because it gives him such a lift to hear that the girl is doing fine.”

Fry-Revere says organ trading in Iran is much like open adoption in the U.S.: The two parties can decide whether to visit and get to know each other. Other times, the donation is anonymous. Both are much better than kidnapping and eye-gouging.

In America, we let people sell blood. And sperm. And eggs. Why not kidneys? Why do politicians recoil at the idea of a legal market? Fry-Revere says, “I think it's just, old habits die hard.”

There are all sorts of services that people think the market can't handle. It's like they have some sort of mental block. President Obama says that without government, we can't put out fires. But almost half the people government pays to fight wildfires work for private companies. In parts of America, private companies also put out house fires. They get to the fire sooner.

The city of Sandy Springs, Ga., contracted out most of its services. Residents were surprised to notice that the streets got cleaned faster, and traffic lights were synchronized. It's not that the old government workers were lazy — they just didn't have the same incentive to find better ideas. They figured they'd never lose the job if they just did what they'd always done.

Some things ought to be done by government: things like running courts, policing pollution and protecting the border. But most everything else should be left to private actors.

Government offers guarantees on paper and promises in speeches. But government rarely delivers. Private companies did brilliant Internet work for President Obama's election campaign. But when it came to his health insurance website, the president put government in charge. We saw the result.

Markets aren't perfect, but they allow for a world where prudence is rewarded and sloth punished, a world in which more people take risks and innovate. That's a world where people prosper.

Some prosper instead of waiting — and sometimes dying — while hoping government will eventually get things right.

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