July 30, 2005

Organ Donorship and the Hidden Costs of Welfarism

Wretchard, at the Belmont Club, posted a compassionate reference to an urgent appeal by the family of 25-year-old Shari Kurzrok for a donated liver, to save her life. Here's hoping the appeal is picked up by bloggers more prominent than myself, and that the effort bears fruit. There's a good discussion of the organ scarcity problem in the comment section to his post, most of it centering on the need to create an organ market. A friend, Lloyd Cohen, has written a radical proposal to create such a market motivated by the desperate circumstances of scarcity. He proposes to make organs even more scarce, by appealing to potential donors to boycott unless they're compensated. His proposal is discussed on the Volokh Conspiracy here.

So, this whole issue got me thinking about the nature of the welfare state as a writ-large example of the organ transplant problem.

It seems to me that if altruistic motives can't be counted upon to produce an adequate supply of donor organs, when the alternative is that the organs are just dumped in a hole in the ground, the conservative notion that altruism or philanthropic largesse can meet the needs associated with periodic or chronic unemployment and misfortune must largely be a fantasy. This isn't to say that there aren't an awful lot of faith-induced contributions to meet the shortfall need. It's just that any notion that supply could ever be adequate is predicated on the assumption that the "real need" must be quite small. It's possible that expectation isn't based on the realities of a modern economy.

Now, don't get me wrong. I'm well aware of the problems of the welfare state. Basically they're twofold:

1. Problems associated with the distribution of power between the individual (and non-state associations) and the State, whereby making the State responsible for redistribution of income gives it ultimate power as well as ultimate potential for corruption.

2. Problems associated with moral hazard, not the least of which is that redistribution of income on the basis of need essentially pays people to be non-productive. Whether intended or not this amounts to a perverse incentive. It's also, well... perniciously counterproductive.

The current resolution of these problems seems to reside in the establishment of limits to the State's benefactor role. One could argue whether this stopgap is adequate to meet the economic need, but whether that's true or not (and there's at least some evidence that it isn't) such a resolution clearly doesn't eliminate either of the two big problems. It merely attempts to minimize their impact. People who are periodically but acutely dependent on the State, however, still experience that dependence as near-absolute for the simple reason that a bridge too short might as well be no bridge. It still influences people to behave in ways that give the State critical deference. Plus, any large scale long term unemployment, which must happen eventually in the same way that droughts are inevitable, will produce calls to expand welfare entitlements, under any economic system in which the majority of citizens make the majority of their income from their labor.

And as labor becomes less necessary, both due to capital expansion and the globalization of labor markets, the income and employment mismatch will exacerbate the calls to "expand the safety net." It's important to recognize that these calls are occasioned by real, not imagined, need. Surrendering to the calls will, because it subsidizes non-productivity, ironically produce more need

Yes, this logic cautions that we ought to minimize the welfare state... but it doesn't actually suggest a solution to the underlying problem: the non-productivity of labor relative to capital.

Now, I realize that there are people who don't believe that this problem really exists, and I don't have time or space at this point to present a definitive or exhaustive case, but it seems to me that if one favors a capitalistic economy then, by definition, a situation where over 90% of the capital is owned and controlled by less than 10% of the population can't really be called "capitalist." At best, it's a version of moderated serfdom. And one has to distort the capital ownership data quite a bit to argue that things aren't actually worse than the 90::10 relationship. In addition, it ought to be clear from the example provided by transplant organ scarcity in the absence of markets that altruism and philanthropic largesse simply aren't going to bridge the gap. Besides, in the same way that meeting the organ need by compelling people to give up their organs when they approach death has some rather serious ethical implications the forced altruism of the welfare state simply can't be viewed as a non-problematic solution to economic hardship.

We are really presented with a pretty stark set of options:

1. Accept some version of the welfare state, attempting to mitigate the two problems and their implications, while taking the risk that a mismatch between forced altruism and need won't lead to further economic, social and political disruption (and I think this is a bad bet, in the long run); or

2. Convert an economy where the majority are forced to rely on income from labor to an economy where the majority can rely on income from capital.

Both George W. Bush and Tony Blair have at least recognized that the second option is desirable, having identified it as the "ownership society" with a few token reforms. To invoke Michael Ledeen's now-familiar phrase often used to prod the national security strategy of the Bush administration: "Faster, please!"

Posted by Demosophist at July 30, 2005 12:21 PM | TrackBack
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