Tsk, see, we can't rely upon altruism

Not that we’d want this to be taken entirely and wholly seriously:

Hospitals have been told to cancel thousands of operations as blood supplies threaten to run dry.

After years of rejecting donors, NHS Blood and Transplant (NHSBT) issued its first ever amber alert status on Wednesday - meaning there are just two days of some types of blood supplies across hospitals in England.

The agency asked all existing donors who are types O negative or O positive to come forward and book an appointment to give blood.

But if this were a paid market - say, energy, food, trains, housing - then you can imagine the calls that this must be removed from being a paid market and made something different, reliant upon government or altruism or summat.

Because any stutter in a paid market always does lead to such calls. So, here we've an altruistic market which has a stutter - logical fairness requires us to insist that it can no longer be an altruistic market, right?

The not seriousness of the comment - except as a logical point - is that we've actually tried paid and altruistic markets here. At least, the US has. And the voluntary donations vastly outcompete the paid ones for whole blood. The consumer preference is overwhelming. So, altruism in whole blood it is then.

Not because there's any a priori proof that this should be so. Or that paying for whole blood is immoral - despite what many will say. But because we used the market system properly. To test, try out and find out which arrangements do work.

That is, we use that free part of free markets to find out whether cash on the nail markets work here. That use leading us to the finest solution we have in these specific circumstances. Which is the part that does need to be taken entirely and wholly seriously. This whole concept of free markets is, in one way of looking at it, a method of evidence gathering and decision making. At the start we don’t know. So, what is our method of finding out?

The value of using this method rather than - say - some insistence that money and body parts must not be mixed is that a purely altruistic system for blood products does not work. Certainly, as the continuing scandal over haemophiliacs and HIV infections shows, a paid market can have its problems here. But there is no country that successfully relies upon an altruism only collection system for blood products like plasma. Everyone, but everyone, relies at least in part upon a payment to the donors system - largely the US one.

That is, without the cash based collection system people die for lack of plasma. We can even go on to think that this is less effective than an altruism based system. Or that voluntary donations of plasma lead to higher quality - as with whole blood. Even, that it’s still immoral, money for bits of humans - as long as we’re willing to accept the cost of that moral imposition, death for some.

Again, this is the value of the free part of free market. We’ve two very closely related products and markets here, whole blood and plasma (or blood products, if preferred). In one altruism outperforms cash. In the other cash creates the supply that altruism doesn’t. And that’s the value of that free part. Without actually trying this out we’d not know that, would we? And we’re now able to manage our world because we do know.

Having plucked the logically important part out of this of course the lesson is of wider import. Only one country in the world has payment for kidney donation. Only one country doesn’t have a queue of people dying while awaiting a kidney. It’s possible to supply a part of your liver and recover just fine - as is the person it’s implanted into likely to recover just fine. Gametes, surrogacy, can be both donated and bought - well, which system actually works, in the sense of producing the optimal, even maximal, amount of bouncing babies?

Shouldn’t we find out, rather than allowing the self-appointed to determine our morals for us? After all, once we have found out then at least we’d know what those morals are costing us. Or even, what their morals are costing us.

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