OT Rant***Doctors sell your heart*** People 'donate' their heart in a good cause. Doctors sell their skill in a restrictive trade practice cartel. You say $750,000 for a transplant, and presumably that includes hospitals, nurses, a bunch of doctors and anaesthetists, post-operative care, bandages and stuff.
So, how does that $750,000 arise? Much of it is from competitive economic activity and in the end the price each charges is 'what the market will bear'. Doctors have a Medical Guild to ensure their prices are high by restricting entry. They would have a high value anyway because ability is in short supply, but they boost that by restricting supply. There are even moves afoot [in NZ] to make Aspirin a prescription drug, which would boost prescription writers' fees enormously. Nurses choose to be nurses or air line hostesses. Construction companies build hospitals or apartments in free tendering processes.
Anyway, getting back to the $750,000 figure, there is a supply and demand price for a heart operation. There is a limited supply of hearts. People who want to stay alive have limited amounts of money. Their insurers include heart replacements, or don't, depending on the payments people are prepared to make.
So one way or another, the market price for a replacement heart is shared out among those who take part in the process. Those who are less directly involved, such as the builder's labourer who pours the concrete gets little of it as their price is determined by the market rate for builder's labourers. Those most involved who are the only ones who can do it, the heart surgeon, get the most. Since surgeons are in limited supply, they can charge heaps. You either accept their price, or die.
BUT, the heart surgeon can only charge their extorquerationate fee by getting hold of a still-living heart!
So, the question is, how do they come by that heart? This is the process where the surgeon scores the dosh! They will be the resident heart surgeon in a particular area, so, if there is a heart there, they get the money!
I suppose the usual process is a luck-of-the-draw system, whereby the road crash patients are taken to emergency treatment centres in the immediate vicinity where they are pronounced DOA or maybe die not too much later from an injury not damaging their heart. With the next of kin approval, [who are in a traumatized state and easily agree to help some other person who will otherwise die], the heart is removed and installed in a tissue-matched person. Maybe the best tissue-matched person, but that would be hard to organize; more likely a near-enough one.
So the best tissue-matched person who can afford the operation or has the insurance to pay for it gets to live and others get to die. Sorry to those who die, but if you don't have the money or insurance, the shortage of hearts means that somebody has to die and you are it. So it is the price which decides who lives and dies.
So, how come the kin of the person who died don't get the money? Everyone else gets paid the market rate or the cartel rate. But not the person who actually provides the most important piece of the puzzle.
Maybe we could look at it a slightly different way. Many of the heart donors would not be road crash patients but gunshot patients. Gunshot patients are inner city victims of trigger-happy criminals. Many if not most of them are melanin-rich people who normally are considered disadvantaged and worthy of special help from the taxpayer. But not this time! This time they have something too valuable - a beating heart.
So the black gun-shot victim is carted off to hospital, their heart removed and installed in a wealthy white man's body. The wealthy guy's money goes to the white surgeons, doctors, nurses and others. Yes, yes, I know that is not always the case, but this race stuff is done by wild generalisations which are meaningless in individual lives, so why not here too?
It would be much more equitable if the dead person's kin could sell their relative's heart to the highest bidder. The total price would still be around $750,000 if not exactly on that figure because that is the supply and demand balancing figure already. But the surgeons would not get such an obscenely greedy share of the loot. The victim's estate beneficiaries would have some benefit - say he had 3 children who needed education, but he was no longer alive to provide that help.
It seems much more fair for the heart donor's children to get some education than for a heart surgeon to add another wing to their mansion to hold their third 7-series Mercedes for their 17 year old son.
I'd like to see the objections some medical ethicists have to this.
Mqurice
PS: Maybe minority tissue doesn't match rich people's tissue and that might be an objection, but there might even be a few matching minority rich people who want hearts.
Maybe there would be a trade in 'shot to order' victims? No chance - because tissue-typing and normal criminal prosecution processes would preclude that. The criminals would have no way of knowing that the buyer of their services would get the heart - gunshot victims don't carry their tissue-typing around on their sleeve.
I'd be more worried about early pronouncements of death by the hospital, or bribes to the ambulance drivers in the existing system. Stuff like that is where the real crooks will be lurking.
New all-time high in Mighty Q! $440... Wow!! Now some of you can buy somebody's heart. A Qillionaire's dream. I bet LindyBill has a story about THAT one...
With a market in hearts, more people would be saved as more kin saw some benefits to them as well as the sick person needing a heart. |
