May 29, 2007

Game show: dying woman chooses who will get her kidneys.

No, it's not some dystopian film. It's a real show -- "The Big Donor Show" -- in that brilliantly enlightened place, the Netherlands. Don't freak out yet. Go through the thought experiment: What if you had to argue that this is a very good thing?
The 37-year-old donor, identified only as Lisa, will make her choice based on the contestants' history, profile and conversation with their family and friends.

Viewers will also be able to send in their advice by text message during the 80-minute show....

The former director of TV station BNN, Bart de Graaff, died from kidney failure aged 35 after spending years on a transplant waiting list.

"The chance for a kidney for the contestants is 33%," said the station's current chairman, Laurens Drillich. "This is much higher than that for people on a waiting list."

"We think that is disastrous, so we are acting in a shocking way to bring attention to this problem."
So the positive side of it is that it's drawing attention to the problem of the need for more donations. One might also say that decisions are currently made according to the priorities developed by health care experts and ethicists, but if there is a TV show, ordinary people become immersed in the process of decisionmaking. The viewers are drawn into thinking deeply about the difficult decision that they are normally content to leave to experts. I don't think we should picture the audience as idiotically gaping at a morbid spectacle. The show may develop their moral thinking and make them more compassionate... and more likely to respond to the need that the show is informing them about.

I acknowledge, as I must, that making a game show out of this seems so wrong, for so many reasons, but nowhere near as wrong as the fact that Bart de Graaff, died from kidney failure aged 35 after spending years on a transplant waiting list.

UPDATE: This turned out to be a hoax -- intended to draw attention to the shortage of donors. ADDED: That is, there really was a show, but the donor, in the end, was revealed to be an actress. The contestants were really individuals who needed organs, and the show was not meant to trick people but to care about the problem and to feel moved to become donors.

118 comments:

Roger said...

Is the ultimate trajectory of reality shoes? Ewwww.

Tim said...

"I acknowledge, as I must, that making a game show out of this seems so wrong, for so many reasons, but nowhere near as wrong as the fact that Bart de Graaff, died from kidney failure aged 35 after spending years on a transplant waiting list."

Bart de Graaff dies from kidney failure at 35 after spending years on a transplant waiting list; the Netherlands has a government run health care system.

These two facts are not unrelated.

Freder Frederson said...

Bart de Graaff dies from kidney failure at 35 after spending years on a transplant waiting list; the Netherlands has a government run health care system.

These two facts are not unrelated.


Of course they are unrelated. Don't be such a twit.

Roost on the Moon said...

High Five Freder!

That was the best immediate slapdown of a closed-minded knee-jerk sentiment I've ever seen around here.

Galvanized said...
This comment has been removed by the author.
Eli Blake said...

The fact is, it doesn't matter where, the problems are the same-- too few donors.

I had a friend who died while waiting for a liver. He had ruined his own liver with alcohol. When I knew him he had been sober for years, but the damage had been done already.

I have told my family that I want to be an organ donor. I used to have it noted as such on my driver's license too, until the state of Arizona did away with the place on the license where I could denote that, when they went to the permanent licenses.

I've also discussed organ donation with my children. One of them said yes, she would like to be a donor, the other said she doesn't want to (so therefore I already know what I would say if that day ever comes.)

Being an organ donor costs you nothing, involves a relatively short conversation with your family members so that they know what you want (though including it in a living will or other official document is another way, if you have one) and could save someone else's life.

Please think about it.

Roger said...

It isn't just kidneys--there are shortages of transplantable organs for all conditions; please consider becoming an organ donot if you arent already!

Freder Frederson said...

Please think about it.

Of course before you do, be sure to watch Monty Python's The Meaning of Life.

Galvanized said...

One should ask people if it's really so bad for television to address a public need? True, it's a bit unorthodox, but if a system has to go out of the lines to get the job done, then so be it.

I assumed that I was still signed up to be an organ donor on the back of my driver's license. I checked it, and I'm not anymore because you can no just sign it for that. It changed a while back, and I didn't even notice. It's no longer binding to sign the back of one's driver's license, and there's not even a place for it. This intention, if not decided by your loved ones' wishes, must be indicated in a will or a donor card. Here is where you can download a donor card in the U.S., with specifications by state:

Organ Donor card by U.S. State - www.jrifilms.org/register.htm

Fen said...

I acknowledge, as I must, that making a game show out of this seems so wrong, for so many reasons

But America is so much worse. Laugh tracks for home video's of peeps getting injured... the FOX underwear-sniffing rubberneck of Chandra/Lacy/Natalie/Anna Nicole... Law & Order's Special Victims Unit on sex crimes. Who is their audience? It all seems designed to titilate a segment of society that gets off on such trash.

Eli Blake said...

roost and freder:

OK, what is better than a slapdown?

How about an even better slapdown if people think a private (non-government run) health care system is better.

Eli Blake said...

Though I'd like to mention that the post I linked to is NOT how the system is in general run and if you donate an organ it will in general go to the person who needs it the most/has been waiting the longest.

Galvanized said...

My bad -- Just to clarify -- one cannot just sign the back of the driver's license, but one can request being indicated as a donor when one renews the driver's license. :) Sorry.

Roger said...

Here's an interesting article on ESRD Treatment in the Netherlands. As an aside: ESRD treatment is specifically convered by the US in the medicare/medicaid programs (although the reason why ESRD was covered, is a interesting political vignette.)

Hoosier Daddy said...

the fact that Bart de Graaff, died from kidney failure aged 35 after spending years on a transplant waiting list.

Too bad he didn't live in Cuba, what with thier crack medical system.

Roger said...

Eli's post raises a great discussion issue: should all organ transplants go through some government, non-profit, private, or combination of the above system? Who should make the decision and on what basis? If you have nothing to do between midnite and 5 AM mull that one around.

Hoosier Daddy said...

Of course they are unrelated. Don't be such a twit.

Which I guess speaks to the fact that government funded health care is not necessarily superior to our private system.

The point which gets missed all the time is that somehow if we went the way of Canada or France, everything would be peachy yet the same kind of issue would remain the same. That is the problem, the mentality that the government will fix all the ills of the world.

Bissage said...

I used to be an organ donor, but then one day it occurred to me, "Hey, wait a minute, why does everybody make money off of this arrangement except me?"

Understand now, I'm not greedy.

If I could decide who gets my organs, I'd sign up immediately. That would be compensation enough.

I must admit I find the game show model appealing. I have been blessed with enormous genitals and I could give away the whole shebang on "The Dong Show."

Roost on the Moon said...

Eli,

That's more of a substantive argument. I'm not surprised that the wealthy are better served by a free-market system, and no one should be. I suspect that we agree that this unfairness should be guarded against, but that is to some degree an ideological position. A reasonable libertarian or pro-business conservative might point out that the social injustice inherent in such a system is a worth it because the R&D-funding advantages of a free-market system make it possible to provide better overall treatment, or that competition will help ensure competence. My point is, there are good arguments against a centralized medical system.

But Tim's blaming the problem on "socialism" when the problem is plainly a shortage of donors is such an obviously thoughtless response, I thought Freder deserved some love.

Good article though. Down low!

Richard Dolan said...

How to choose where tragic choices are unavoidable?

One approach is to turn it over to "the priorities developed by health care experts and ethicists," and presumably they will come up with fair and efficient protocols to distribute a scarce good in an economically rational (utilitarian) way. But the "scarce goods" here aren't public goods; nothing requires anyone to donate an organ, or to allow an organ to be taken from a deceased relative. In practice, when it comes to organ donation, fairness and efficiency often take a back seat to more personal priorities -- a donor giving a kidney but only because the donor wants to benefit a particular person (e.g., spouse, child) in need. How different is that in kind from allowing a donor to choose the donee based on other criteria -- whatever may strike the donor's fancy, so long as the articulated criteria don't violate some important non-discrimination policy? So, as long as the donor can survive a Batson challenge, what's really the problem?

Ann says that "making a game show out of this seems so wrong, for so many reasons." The "game show" method of allocating this kind of resource is certainly tacky, but is tackiness -- an aesthetic objection rooted in a concern not to trivialize life-and-death matters more generally -- the real objection to it? I don't know whether a case could be made to argue that the availability of the "game show" alocation system will impact on the number of organs available for distribution according to "the priorities developed by health care experts and ethicists." That doesn't seem intuitively likely. It's hard to see how the "game show" shtick would impact on the number of organs made available by a family member who is donating an organ to save another family member. If there is any negative impact on the supply available for distribution using the protocols devised by the "experts," it would more likely be on the (presumably) exceedingly rare case where a living donor acts out of heroic generosity to save a stranger. Perhaps the allure of 15 minutes of fame on this game show might have some impact there. But one would have to weigh against that possibility the chance that the same fame factor may increase substantially the overall number of such heroic donors (now acting slightly less like your standard-issue hero). Quite apart from any impact on "heroic" donors, the publicity rationale -- the "game show" will call attention to the need for donors -- may increase the supply from the more traditional source (the recently deceased and the heirs that get to make the decision).

From a utilitarian perspective, the "game show" allocation method may be a net positive even if it is an aesthetic negative. But the fact that it vests the donor with decisionmaking power in a life-and-death matter that the donor can exercise arbitrarily (but subject to Batson-like constraints) doesn't strike me as a ground for objection.

Freder Frederson said...

The point which gets missed all the time is that somehow if we went the way of Canada or France, everything would be peachy yet the same kind of issue would remain the same.

Name one advocate of radical health care reform for this country (call it "socialized" medicine, single payer or whatever you like) who says everything would be "peachy" under a system similar to Canada's or France's. We are the realists. We know no system is perfect. We are just looking for something better.

It is those who advocate for the status quo, or mere tweaking around the edges, who insist that there is nothing fundamentally wrong with the current system in this country that insist everything is "peachy" and that any problems are the cause of too much government, not too little, while ignoring the one in eight who are without insurance.

Freder Frederson said...

A reasonable libertarian or pro-business conservative might point out that the social injustice inherent in such a system is a worth it because the R&D-funding advantages of a free-market system make it possible to provide better overall treatment, or that competition will help ensure competence.

Of course, a reasonable libertarian or pro-business conservative might reasonably be asked to provide proof that our profit-driven system actually produces such results.

halojones-fan said...

Freder: "Name one advocate of radical health care reform for this country (call it "socialized" medicine, single payer or whatever you like) who says everything would be "peachy" under a system similar to Canada's or France's."

Have you been paying attention to these discussions? (the answer is "almost all of them".)

As for the article: Big whoop, it's directed donation. Although putting it in the format of a game show seems a bit cruel. Is this 'The Running Man'?

Fen said...

We are the realists. We know no system is perfect. We are just looking for something better.

No, you're not realists, your part of the locust generation - you want cheap drugs at the expense of future cures for cancer, etc.

gg said...

Why is the wait list for kidneys "more wrong" than this show? There's a transplant shortage due to problems in any given health care system, unwillingness or forgetfulness of potential donors, and the likelihood of finding a match, among other issues. The show is wrong because the producers are doing something immoral: inflicting public trauma and using personal bias over who should live or die to make them a profit. One is a social problem, the other is a bad act.

Even most utilitarians (Mill) would recognize that the issues are on different moral plains.

Luckyoldson said...

I'm not sure if this has been posted, but Chuck Barris (The Gong Show) has a novel out right now that is about a game show offering a massive prize...but if you lose...you die...on air...after drinking poison.

It's titled: "The Big Question"

Luckyoldson said...

By the way, we'd have plenty of organs for transplant if every state had a box to check on driver's licenses...but...only if you DIDN'T want to take part, opposed to the checked box indicating you are ALLOWING the organs to be used.

Why we haven't implemented this is hard to understand.

GeorgeH said...

"Eli Blake said...

---- if you donate an organ it will in general go to the person who needs it the most/has been waiting the longest."


And who decides?
A semi-socialist big brother that takes possession of your organs as soon as you die. They pass them out to deserving doctors and Hospitals so they can charge huge fees for the surgery. What does the donor get out of it?
Usually he gets his estate stuck with the huge medical bill his carcass racked up as it expired.

The laws on who owns a body after death have always been preposterous. Your estate owns it, but not really, because it can't profit from it or use it to settle the estates debts.

We need new legislation allowing an estate to do whatever it wishes with a body, whether it is auctioning the organs to the highest bidder, donating them to loved ones, giving them to the socialist nannies, or selling the whole mess for dog food or kinky sex.

That is capitalism, and that is the only thing that is going to make more organs available.

Jeff said...

It'll all be Soylent Green in the end...

Roger said...

LOS: While your suggestion is a and sensible solution to a thorny problem, I suspect the reason why being designated an organ donor is a decision that requires some form of "positive" informed consent; Perhaps some of the lawyers out there could comment.

Roger said...

LOS: While your suggestion is a and sensible solution to a thorny problem, I suspect the reason why being designated an organ donor is a decision that requires some form of "positive" informed consent; Perhaps some of the lawyers out there could comment.

Roost on the Moon said...

Ok, this is off-topic, but we're far enough down-thread that I don't feel like I'm hijacking:

A couple of posts above really jumped out at me and strongly reminded me of an argument Thomas Frank makes:

"But America is so much worse..." - Fen

"...or selling the whole mess for dog food or kinky sex.

That is capitalism, and that is the only thing that is going to make more organs available."
- georgeh

Now, here is the Thomas Frank:

Another thing, and this is one of the most fundamental contradictions in the conservative worldview, is that they object so bitterly to American culture as a whole. They hate it. You pick up any of their bestsellers and the authors feel out of place in America. They complain about the culture but it never seems to come up that this culture is the product of capitalism and that capitalism is something they profess to love.

The basic contradiction is that on the one hand, they are so pro–free market, and on the other hand the free market hurts them in many ways that they never talk about.


The rest of the interview is here.

Luckyoldson said...

Roger,
the states that have enacted the method i describe have had enormous increases in donors. it's not a legal matter, it's a metter of logic...something our government lacks.

Luckyoldson said...

Become an organ donor.

http://www.organdonor.gov/

Roost on the Moon said...

Back on topic, to Lucky:

I'm a potential organ donor myself, and I think everyone should be encouraged to do that. But I'm uneasy about the government assuming default ownership of its citizen's bodies. Its easy to imagine a family horrified by the feeling that a loved one is being 'repossessed' by the government and desecrated against their wishes (in many cases deep/foundational/spiritual beliefs) because they failed to fill out the correct paperwork.

Hoosier Daddy said...

It is those who advocate for the status quo, or mere tweaking around the edges, who insist that there is nothing fundamentally wrong with the current system in this country that insist everything is "peachy" and that any problems are the cause of too much government, not too little, while ignoring the one in eight who are without insurance.

The status quo as it is, is one in which no responsibility whatsoever is placed on the individual to actually be a factor in their own health care. By that I mean, there is no accountability for actually taking care of yourself other than to pay your $10 copay.

Want to fix the system? Make people more accountable for their health care and that starts with actually taking care of themselves. Institute mandatory deductibles to drive down premiums, refuse to pay use of the emergency room for non-emergency treatment (a HUGE reason hospital costs are high), provide incentives for individuals to adopt healthy lifestyles by offering optional personal underwriting for a reduced premium. Think that will run in the Democratic/Progressive circles? Don’t hold your breath.

So for the uninsured the alternative is a government funded system ala Medicare which everyone says is just swell expect for that looming insolvency issue that’s coming up in about 12 years (Thank you Dubya and Part D). Remember something else Freder, a lot of those 1 in 8 are uinsured voluntarily, particularly younger workers who see that health insurance premium deduction as less money they can spend on (insert whatever). So if we want to offer a single payer system for the uninsured, I say fine as long as 1) its optional 2) coverage is bare bones and fancier coverage will require a larger out of pocket premium from the individual. Anyway you cut it, you’re advocating yet another massive entitlement program that is going to be borne on the backs of the US taxpayer.

Luckyoldson said...

roost,
Every indicidual has the option to check or not check the box on a driver's license. I just think Americans need to be better educated regarding organ donations.

I gurantee you this: The instant anybody finds out a mother, father son or daughter needs an oragan...everybody's onboard.

Luckyoldson said...

The fact that the wealthiest country on the planet doesn't have a national health care program for their citizens is beyond comprehension.

Period.

Dewave said...

"The chance for a kidney for the contestants is 33%," said the station's current chairman, Laurens Drillich. "This is much higher than that for people on a waiting list."

I thought a socialized government run health care system was supposed to solve all these problems? Maybe they could ask Castro for some tips.

And to the suggestion that people have to 'opt out' of being an organ donor: I don't like that idea at all. The default should be, you control your body, not the government. It would be like having a system where we had to check a box to not give all our property to the government on our death.

Anyway, it's not hard at all to become listed as an organ donor. I've done it, as have many others.

Christy said...

I'm a donor.

Larry Niven did a novel, Patchwork Girl, where those found guilty of capital crimes were harvested for organs. The problem was, at least in the novel, is that society greedy for organs, gradually lowered the bar for the death penalty.

I've a friend who has had two kidney transplants. The first one didn't take. I know she passed up several kidneys because she wanted more "factors" to match up. She was even offered the kidney of an HIV positive donor. Which, I guess if one is dying tomorrow without a kidney that may kill you in 5 (and now longer) years, makes sense.

Luckyoldson said...

dewave says: "And to the suggestion that people have to 'opt out' of being an organ donor: I don't like that idea at all. The default should be, you control your body, not the government."

Uh, what does the government have to do "opting out" or "opting in?"

Either way, unles of course, you have the "government" filling out your forms...it's YOU who makes the decision.

From what I've read, most people are willing, but forget to do either...making the "opt out" method more effective.

Bissage said...

I agree with Luckyoldson's 11:38.

The default setting should be that the state gets your organs, same as your money, personal possessions, real estate and children.

Soul, too, if you've got one.

nick danger said...

The basic contradiction is that on the one hand, they are so pro–free market, and on the other hand the free market hurts them in many ways that they never talk about.


The implied argument here seems to be that if you are opposed to the culture of a free state, the only logical position is to favor a friendly tyranny.

I suspect this is only sensible to a leftist.

Roost on the Moon said...


From what I've read, most people are willing, but forget to do either...making the "opt out" method more effective.


More effective I agree, but at what price?

Not everyone has a driver's license. I don't know what the Amish take on donation is, but we should be squeamish about deeding their corpses to the government unless they get their licenses. Obviously, there would be another way, a notarized certificate or whatever. But that's a burden with high stakes.

You and your family have should have some basic right to your own remains, and it shouldn't be contingent on having a driver's license or visiting the notary.

LoafingOaf said...

Something tells me this show will turn out to be different than the pre-airing publicity is making people think. I hope, anyway. You know, like how Survivor made people worried that they were gonna have a racist season and it turned out to be the opposite. So, I'll wait before condemning. Does sound kinda disgusting though. Why would this woman actually wanna decide who dies? They must have a trick up their sleeves.

Anyway, if you don't have an organ donor thingie on your Driver's License you're kind of a dick. IMHO. Since society is so full of dicks, obviously it's gonna take some form of monetary incentive to get them to stop the preventable deaths occuring every day. Apparently having the opportunity to save lives with zero effort beyond giving consent is not appealing enough to a substantial percentage of assholes and paranoids out there.

Tim said...

"But Tim's blaming the problem on "socialism" when the problem is plainly a shortage of donors is such an obviously thoughtless response, I thought Freder deserved some love."

Right. While donor shortages are clearly (and I never wrote otherwise – you all might try learning to read before ascribing thoughts to me I did not make) a large part of the problem, they are not the only problem.

"There may be other causes as well. Another ET study analysed patients in The Netherlands with long waiting times (>5 years). It was concluded that the vast majority of the patients were placed on the waiting list at the time the dialysis centre started its work-up of the patient as a potential transplant candidate. The patients were listed as `non-transplantable' until the patient has been fully assessed for, and accepted by, the transplant programme. The time the patient had already spent on the waiting list, i.e. often 6–9 months, was counted as official waiting time. In other ET countries, it is common practice to enter the patients on the waiting list only after they have been definitively accepted by the transplant programmes."

Do your own research. As for "slapdowns," generally they must reflect, even tangentally, some aspect of reality. That certainly did not.

Better luck next time.

Bruce Hayden said...

The basic problem is that the current system ignores economics. It is illegal in this country to pay for organs, so the demand is far higher than the supply for many organs. The obvious solution would be to pay for organs. Thus, one could conceivably provide something for one's heirs this way. Kidneys are a bit different here, since it is quite possible for someone to donate one while still alive. Not so with most organs.

But as noted above, the flip side of that was pointed out by Larry Niven in that book, with the state dropping the bar in order to increase the supply.

I am uncomfortable with the government getting ownership of organs as a default due to the high possibility that that will be abused. After all, the government also controls capital punishment. Besides, governments are notorious for rigging this sort of thing based on political pressure - for example prohibiting discrimination against either the aged or those who are HIV positive, despite the fact that in many cases, organs might extend the life of others longer. Add to this that the government also controls capital punishment.

Finally, while it is illegal right now to pay donors for organs right now in this country, that is not necessarily true around the world. So, there is a potential for a gray market for organs installed in other parts of the world. Thus, if you aren't going to get your heart soon enough to survive, just go to 3rd world country X and get one.

LoafingOaf said...

From what I've read, most people are willing, but forget to do either...making the "opt out" method more effective.

How do they forget? In Ohio, they specifically ask you to your face, "Do you want to be an organ donor?" Apparently millions of people say, "Nope," which blows me away. I think the problem is that when people are asked they haven't given it any thought and are afraid to say "yes" off the top of their heads, because when you say "yes" they put a donor symbol on your license that will be there for years. Then they forget about it till years later when renewing again. Also, the environment at the DMV and the crappy people they have working there does not exactly create the best environment for someone to wanna smile and say they wanna donate their organs if they haven't thought about it before walking in.

Do they not orally ask you the question and require you to accept or reject in other states?

Roost on the Moon said...


The implied argument here seems to be that if you are opposed to the culture of a free state, the only logical position is to favor a friendly tyranny.

No, not that simple.

The implied argument you get from it seems to assume that there is no gradient between total economic libertarianism and tyranny. Of course, there is, and some amount of wealth redistribution and regulation are necessary for the stability of any society.

I suspect this is only sensible to a leftist.

Perhaps. He takes for granted the truth of the idea that the deregulation, privatization, and the flattening of the tax code are responsible for the widening gap between rich and poor. If you don't believe that, fine, and you won't like Thomas Frank. If you do, he makes an interesting proposition; that our coarse, materialist culture isn't unrelated to this widening gap.

It's just an idea, you don't have swallow it whole or burn it on sight.

Luckyoldson said...

loaf,
you actually think every state asks people for a yes or no?

as for "forgetting,"...yeah, I think people forget all kinds of things...especially if they don't even know about it in the first place.

you'd be surprised at how many people know nothing about having the choice.

Luckyoldson said...

bissage,
Welcome, dumshit.

Roger said...

Loafing Oaf: I was asked specifically in WA state if I wanted to be an organ donor, and then again when I renewed my license. I have no idea how many other states ask, but I am generally in agreement with LOS that an opt out system should produce more donors than not.
I would also assume there would be some kind of religious exemption clause.

blake said...

It seems wrong that nobody has mentioned (libertarian) Virginia Postrel's kidneyblogging. There's nothing free-market about the way organ donation works in this country. And there are all kinds of barriers against donating!

Also, how brainwashed are we to believe that we currently have a "private" health care system? A substantial percentage (over half?) of all medical dollars pass through the system. We're just not fully socialized yet.

As for how we can be so wealthy and not be completely socialized yet, well, yeah, there may be a connection there.

Thorley Winston said...

The fact that the wealthiest country on the planet doesn't have a national health care program for their citizens is beyond comprehension.

Not really, the fact that we haven’t made the boneheaded mistake lesser nations have made in trying to create a national health care program is undoubtedly one of the reasons why we’re the wealthiest country.

Thorley Winston said...

the states that have enacted the method i describe have had enormous increases in donors. it's not a legal matter, it's a metter of logic...something our government lacks.


Which states would those be?

Revenant said...

Why we haven't implemented this is hard to understand.

For the obvious reason that "the government gets to seize your property" should never be the default position.

The correct way to eliminate the organ shortage is to make it legal for people to sell their organs.

Roger said...

Re Thorley Winston's question: I went through the states listed here and was unable to identify any state that had an "opt in" method. The donor was required to check yes or no, usually at the time of application or renewal. sometimes a separate registry was in effect.

Perhaps I am misunderstanding what LOS means an opt in system.

Thorley Winston said...

Re Thorley Winston's question: I went through the states listed here and was unable to identify any state that had an "opt in" method. The donor was required to check yes or no, usually at the time of application or renewal. sometimes a separate registry was in effect.


I think you mean an “opt out” system (if you don’t indicate your preference, it is presumed you consent to donate) which IIRC is what France has. Every State has an “opt-in” system as they’ve all adopted the Uniform Anatomical Gift Act. Under the UAGA, a donor can indicate their desire to donate their organs or tissue on their driver’s license, will, or other type of documentation. In the case where someone dies without documenting their preference, hospital administrators are required by law to discuss organ donation with the family members (although it varies between States who can consent on behalf of the decedent).


IMO the reason we don’t have more viable organs being donated has little to do with whether people can sell their organs or choose who receives them. It’s more mundane things like someone dies and the decedent isn’t identified (hard to determine whether they consented if you don’t know who they are) in time to make use of their organs. Or you have someone at the hospital who isn’t familiar with the legal criteria for donation or the family members have some misperceived notions. IMO we’d probably get better results just educating people about how they can donate a loved ones organs or how to determine whether someone has consented.

Freder Frederson said...

The correct way to eliminate the organ shortage is to make it legal for people to sell their organs.

If you would read the link I pointed to when tim implied this had something to do with the Netherlands having a government run health care system you will see that even if everyone who was eligible to donate did, there still wouldn't be enough organs to go around. So just making it legal to sell organs isn't going to solve the problem.

Freder Frederson said...

Remember something else Freder, a lot of those 1 in 8 are uinsured voluntarily, particularly younger workers who see that health insurance premium deduction as less money they can spend on (insert whatever)

We don't let people drive cars without insurance, why should we let people voluntarily opt out of health insurance? Young people who think they can't get seriously ill or injured are stupid and should not be allowed to put other people (that's right, other people) at the financial burden they will create in the case of even a minor mishap. I tore my ACL skiing ten years ago. That is the most common injury skiing. By the time I was done with the surgery and therapy, total bills amounted to $35,000. I bet it is well over $50,000 today. Do you think somebody in their twenties is going to be able to pay that out of pocket? God forbid they come down with something like testicular cancer (most common among males under thirty). Heck a routine visit to the emergency room for stitches will set you back close to $1000.

Freder Frederson said...

Right. While donor shortages are clearly (and I never wrote otherwise – you all might try learning to read before ascribing thoughts to me I did not make) a large part of the problem, they are not the only problem.

Nice attempt at backpedaling.

Fen said...

the fact that we haven’t made the boneheaded mistake lesser nations have made in trying to create a national health care program is undoubtedly one of the reasons why we’re the wealthiest country.

its also important to remember, these lesser nations [like Euro]have only been able to indulge in welfare state programs because America is paying for their big-ticket items like Defense. Just one example of many: calculate the cost America incurs keeping the sea lanes [trade] open and free of piracy.

Freder Frederson said...

the fact that we haven’t made the boneheaded mistake lesser nations have made in trying to create a national health care program is undoubtedly one of the reasons why we’re the wealthiest country.

Of course don't let the facts get in the way of this theory. It would be a really good one if not for the fact that we spend a bigger chunk of our GDP (16--17%) on health care, and get considerably less for it, than any other nation on the face of the earth. The next closest is France at about 11%.

Fen said...

What about our R&D freder?

Pogo said...

In the 20th century, one can find no examples of a successful socialist program.

Following the Great Depression and World War II, Britain nationalized multiple industries, as socialism appeared to be the answer to the widespread misery of the times. By the 1970s, the telephone and water systems, the National Health System, British Steel, British Airways, British Gas (which also made stoves), British Coal, British Rail (which owned gas stations, highways and hotels) and the massive state electric power monopoly controlled huge sectors of the economy.

And they were failing. Inflation and unemployment were high, taxes were punitive, and labor strikes were frequent. In 1973, coal and power supplies were so disrupted that British businesses only operated three days per week, and families spent their evenings by candlelight. When hospital workers struck, medical care had to be severely rationed. Work stoppages resulted in uncollected garbage and unburied coffins. By 1976, Britain was forced to borrow money from the International Monetary Fund in order to remain solvent.

Nationalized firms were highly inefficient, inflexible, and incurred massive deficits. In 1979, 1,274 working days were lost due to strikes for every thousand people working, and interest rates hit 16 percent.

The economic spiral was halted when Prime Minister Thatcher began privatization of most of the nationalized industries. By 1992 two-thirds of state firms (some 46 businesses with 900,0000 employees) were moved to the private sector. Even the historically socialist Labour Party agreed: “The battle between market and the public sector is over”, declared Tony Blair.

Healthcare is the last bastion of the socialist belief system. They failed in China, they failed in Russia, they failed in Vietnam, they failed in all of Africa, they failed in Cuba, and they are failing in Venezuela. But still they try, despite all evidence, they still have to give it one more go. Why?

Freder Frederson said...

In the 20th century, one can find no examples of a successful socialist program.

Before I shoot you down I need to know what you mean by "socialist program". Are you referring to a public agency that performs a traditionally private function or a state owned industry?

Freder Frederson said...

What about our R&D freder?

What about it?

Jonathan said...

"We don't let people drive cars without insurance, why should we let people voluntarily opt out of health insurance? "

Unless they've changed the laws in VA since I held a VA driver's license, VA does in fact let you drive without insurance. (You pay the state $400/annum for the privilege, IIRC). And I believe that VA is not unique in that regard.

Even in a state where drivers are required to carry insurance, I carry insurance to cover me and mine against being in an accident involving an uninsured motorist. Why do you think that might be?

Revenant said...

If you would read the link I pointed to when tim implied this had something to do with the Netherlands having a government run health care system you will see that even if everyone who was eligible to donate did, there still wouldn't be enough organs to go around.

I generally ignore your links, Freder, since they're usually to things you obviously didn't read or understand. This latest is a good example of the trend -- the article says nothing like what you're claiming it said.

First of all, we have kidney transplants -- the vast majority of organ transplants needed in America. Cadavers can't meet that demand (as the article notes), but there are hundreds of millions of kidneys in LIVING eligible donors which can.

Secondly, the article notes that only half of those eligible to donate did so. Items 20 and 21 demonstrate that raising that percentage -- by, for example, PAYING people for their organs -- would swiftly eliminate all organ shortages, with the possible exception of livers.

Tim said...

"Nice attempt at backpedaling."

N.B.: Successful reading requires comprehension. It is just as important to understand what was communicated and what was not. You can get by every now and again without fully comprehending what you are reading, but not for long. The fact is, folks have waited longer for kidney transplants in the Netherlands also because they have a government-run health care system. On behalf of the reality-based community, I am sorry this fact conflicts with your worldview.

Revenant said...

We don't let people drive cars without insurance, why should we let people voluntarily opt out of health insurance?

We don't let people drive cars without liability insurance -- i.e., insurance against damage to other people. There's no legal obligation to by insurance to cover personal losses.

Health insurance is insurance against personal losses.

Thorley Winston said...

Of course don't let the facts get in the way of this theory. It would be a really good one if not for the fact that we spend a bigger chunk of our GDP (16--17%) on health care, and get considerably less for it, than any other nation on the face of the earth.

Wrong again

Freder Frederson said...

Health insurance is insurance against personal losses.

As I pointed out, the uninsured who incur unanticipated injuries or illnesses do not suffer purely personal losses, the burden is shared by everyone when their bills go unpaid.

Thorley Winston said...

We don't let people drive cars without liability insurance -- i.e., insurance against damage to other people. There's no legal obligation to by insurance to cover personal losses.

Health insurance is insurance against personal losses.


Agreed a better comparison to mandatory liability insurance is mandatory vaccinations for certain contagious diseases. It’s one thing to require people to take actions to prevent them from harming others. It’s another to require people take measures to protect themselves.

Tim said...

"In the 20th century, one can find no examples of a successful socialist program."

Pogo, please forgive my pedantry, but the answer is yes, yes you can find an example of a successful socialist program in the 20th century.

It was the conscripted U.S. Military, which won our wars against the Germans, Italians, miscellaneous European forces allied with Germany, and Japanese forces in World War II. This same, conscripted force held massive numbers of the Chi-Com People's Liberation Army to a standoff on the Korean peninsula, and never lost a battle or colors in Vietnam. They also held the Soviet Red Army and it’s allied Warsaw Pact forces in check during three-fourths of the Cold War, albeit primarily with assistance from new technology in weaponry and our own allied NATO forces.

Now, I think we would agree there are good reasons not continue that socialist program; further, I am sure we would agree that is not exactly the example the advocates of socialism would embrace, let alone to which they would point (or even one of which they would think).

But the fact remains, our socialized military pretty much kicked the *ss of any other nation's socialized military it confronted on the battlefield, and held off another nation's socialized military during the Cold War.

Anticipating your argument, and Adam Smith would agree, yes, it is a poor example because national security is a public good that should be publicly provided, and is fact, as Smith pointed out, one of the three primary duties of the sovereign.

Otherwise, of course, socialism is a disaster, one that requires capitalists to pay the bills. Socialism cannot sustain itself.

Revenant said...

It was the conscripted U.S. Military

Under what definition of "socialism" does the US military -- conscripted or otherwise -- qualify as such?

Revenant said...

As I pointed out, the uninsured who incur unanticipated injuries or illnesses do not suffer purely personal losses, the burden is shared by everyone when their bills go unpaid.

The obvious solution is to not treat people who have refused to purchase health insurance.

Bissage said...

Cash works too.

Used to, anyway.

Revenant said...

we spend a bigger chunk of our GDP (16--17%) on health care, and get considerably less for it, than any other nation on the face of the earth.

That's true only if you lump people who pay for health care together with people who don't.

The United States has, as health care obsessives are fond of pointing out, tens of millions of people who can't afford decent health care, plus another ten or twenty million illegals from Nth-world nations. It also has about 250 million people with fantastic health care that they're paying for themselves.

This latter group is responsible for virtually all of American health care costs, and lives longer than the population of any nation with socialized medicine. The first group, on the other hand, pays basically nothing and has a relatively crappy lifespan.

In other words -- if you can afford health care, you're better off than anyone in the world. If you can't, you're worse off than much of the western world. Thus, a supermajority of Americans would be worse off under socialized medicine.

Tim said...

"Under what definition of "socialism" does the US military -- conscripted or otherwise -- qualify as such?"

First, it's critical to strike the "or otherwise," as a voluntary military (or voluntary anything, for that matter) is clearly not socialism. Second, the conscripted military was (and prospectively is) based upon socializing the cost/burden of mounting the nation's defense.

Technically speaking, anything that is "socialized" by law is, by definition, a manifestation of "socialism." For example, unemployment insurance programs are socialized (lawful employers pay the UI tax, generally depending upon community or experience ratings, with additional factors for wages); states with no fault insurance have socialized the risk of driving (the principle underlying this model is generally one the pro-socialized medicine crowd orients toward); there are similar as well as lesser examples as well.

But, and I think this should be clear, no one would (or rightfully should) argue the conscripted military was a function of the free-market (although the wealth created by the free-market - capitalism - certainly paid the bills). The term "socialism" itself has evolved in technical usage from a broader definition relating to production to a narrower one relating to political economy. That is unfortunate, although I understand why.

Freder Frederson said...

Items 20 and 21 demonstrate that raising that percentage -- by, for example, PAYING people for their organs -- would swiftly eliminate all organ shortages, with the possible exception of livers.

Certainly you're not suggesting that we pay people for live organ donations? Because that is potentially the only way the numbers will work to satisfy the need for kidneys.

Tim said...

"This latter group is responsible for virtually all of American health care costs,..."

They subsidize the vast majority of global investments in research and development of new medical devices, prescription medications, treatment protocols and procedures too.

On numbers alone (6.6 billion to 250 million), never have so many owed so much to so few. It dwarfs the debt owed by the British to the flyers of the RAF during the Battle of Britain. Without the American consumer underwriting the profits that fund new investments, the world would be a sicker place.

Freder Frederson said...

Technically speaking, anything that is "socialized" by law is, by definition, a manifestation of "socialism."

Since Pogo hasn't come back with his definition, I'll run with this one. He can dispute my examples. I will limit them to inarguable raving successes of "socialism" in the U.S. (even though by my definition they don't even come close).

1) (Actually of all time and the most brilliant "socialist" program ever dreamed of) The land grant colleges.

2) The Manhattan Project

3) The Bell Labs

4) The National Labs

5) The TVA

6) The Rural Electrification Program

7) The Hoover Dam and most of the other dams built by bureau of reclamation.

8) The Inland waterways and flood control system on the Ohio/Missouri/Mississippi River system (admittedly this is a mixed bag).

9) The Panama Canal

10) Almost the entire drinking and waste water system in this country.

11) The irrigation systems that supply the water that provides us with fresh fruits and vegetables from the west, especially California, from November to March (when Florida comes back into play).

Is that enough or shall I go on?

Freder Frederson said...

On numbers alone (6.6 billion to 250 million), never have so many owed so much to so few. It dwarfs the debt owed by the British to the flyers of the RAF during the Battle of Britain.

What an utter crock of shit. What it means is that U.S. drug companies research drugs to fix the ailments of rich westerners (high cholesterol and limp dicks) while ignoring the diseases that kill most of the people in the world. We have four drugs for ED but exactly how many new treatments for malaria? Every year there is a shortage of flu vaccine, not because of a fear of lawsuits, but simply because there is no money in producing it.

Revenant said...

Second, the conscripted military was (and prospectively is) based upon socializing the cost/burden of mounting the nation's defense.

Conscription was based on wanting to fight a war without having to pay the soldiers what they'd actually want to be paid. It predates socialism by thousands of years.

Revenant said...

Certainly you're not suggesting that we pay people for live organ donations?

Do I have to say it in one-syllable words before it sinks into your head? Yes, I'm suggesting we allow living people to sell their organs.

Price controls always cause shortages. Right now there's a legal price control setting the price of a living person's kidney at $0.00, so obviously few people donate one.

Tim said...

"What an utter crock of shit. What it means is that U.S. drug companies research drugs to fix the ailments of rich westerners (high cholesterol and limp dicks) while ignoring the diseases that kill most of the people in the world. We have four drugs for ED but exactly how many new treatments for malaria? Every year there is a shortage of flu vaccine, not because of a fear of lawsuits, but simply because there is no money in producing it."

Indeed, another insightful analysis.

Start your own drug company then and tell us all how that works out for you.

Tim said...

"It predates socialism by thousands of years.

Socialism predates "socialism" by thousands of years.

A rose by any other name...

Freder Frederson said...

Indeed, another insightful analysis.

Start your own drug company then and tell us all how that works out for you.


So I guess this means you have no rational response to this?

Freder Frederson said...

Socialism predates "socialism" by thousands of years.

True, most of the pre-Columbian societies of the Americas were socialist by almost any definition of the term. Many were very successful (e.g., the Inca). If not for the diseases and genocide that wiped out up to 95% of the native population of the Americas between 1500--1700, who knows how different the history of the world would have been.

Eli Blake said...

Freder:

Although I understand what you are saying about the Incas, I'd caution against using them as an example. It may be that most people were treated more or less equally, but a society which practices human sacrifices will, by its very definition, treat some people differently than others.

Tim said...

"So I guess this means you have no rational response to this?

High Five Freder!

That was the best immediate slapdown of a closed-minded knee-jerk sentiment I've ever seen around here.

Actually, I commend you for guessing - it improves your odds of being correct tremendously.

Anyway, that aside, the rational responses (there's a biblical verse for this...) are: 1) U.S., western European and Japanese drug companies research drugs to fix the ailments of rich westerners (high cholesterol and limp dicks) while NOT ignoring the diseases that kill most of the people in the world. Anyone with basic information on these matters understands the same diseases kill most of us, regardless of location (and how charitable of you to deem high cholesterol equivalent to ED - I'm sure folks with life-threatening heart disease appreciate, deeply, your abiding concern...). 2) Malaria is PREVENTABLE with DTT - but rich westerners have deemed DTT inappropriate for any purpose, complicating its use in sub-Saharan Africa, where it is desperately needed.

Every year there is a shortage of flu vaccine, EXACTLTY because of a fear of lawsuits, NOT simply because there is no money in producing it.

Additionally, there are other complicating factors, relating to socialism and confiscatory licensure (that I don't have time to go into - do your own research), resulting in American consumers subsidizing the vast majority of global investments in research and development of new medical devices, prescription medications, treatment protocols and procedures too.

And, if that's a crock of shit to you, then start your own damned drug company then and tell us all how that works out for you.

Freder Frederson said...

It may be that most people were treated more or less equally, but a society which practices human sacrifices will, by its very definition, treat some people differently than others.

While the Aztecs and Maya did practice human sacrifice, I'm not sure if the Inca did. Regardless, at the time, the Europeans were still regularly burning witches and their routine use of public execution for petty crimes probably resulted in a similar death rate among their own people as the ritual murder taking place in the cruelest societies in the Americas (and that doesn't even account for the wholesale slaughter they were visiting on the native people they were encountering in their expeditions).

Freder Frederson said...

Malaria is PREVENTABLE with DTT - but rich westerners have deemed DTT inappropriate for any purpose, complicating its use in sub-Saharan Africa, where it is desperately needed.

Its DDT, and that's another crock of shit btw.

Tim said...

"Its DDT, and that's another crock of shit btw."

Fairy tales are big sleepy-time reading in your house, evidently.

Pogo said...

Re: "inarguable raving successes of socialism in the U.S."

1) The land grant colleges.
Success compared to what? Private universities? At what opportunity cost?

2) The Manhattan Project
Provision for the national defense is the most basic raison d'etre for any government, and is not "socialism" by any definition.

3) The Bell Labs
Not socialism, but a government-mandated monopoly. It was not government-run.

4) The National Labs
I disagree that government research laboratories are competing with private companies. Research can be a useful role for government, when limited. Especially when private companies can use the results for profit.

5) The TVA
Ha ha ha. What an effin' disaster. You must be kidding.

6) The Rural Electrification Program. As infrastructure, a benefit. As a going concern, no.

7) The Hoover Dam and most of the other dams built by bureau of reclamation.
Infrastructure,and of uncertain utility.

8) The Inland waterways and flood control system on the Ohio/Missouri/Mississippi River system (admittedly this is a mixed bag).
Admittedly. New Orleans a case in point.

9) The Panama Canal.
Military.

10) Almost the entire drinking and waste water system in this country.
Again, infrastructure, like roads.


You are mistaking all government intervention for socialism.

Hayek:
"In particular, there can be little doubt that the manner in which during the last hundred years man has learned to organize the forces of nature has contributed a great deal toward the creation of the belief that a similar control of the forces of society would bring comparable improvements in human conditions. That, with the application of engineering techniques, the direction of all forms of human activity according to a single coherent plan should prove to be as successful in society as it has been in
innumerable engineering tasks, is too plausible a conclusion not to seduce most of those who are elated by the achievement of the natural sciences."

Revenant said...

We have four drugs for ED but exactly how many new treatments for malaria?

We have plenty of drugs for malaria already. Countries with serious malaria problems have them because of a lack of health care infrastructure, a lack of law and order, and a lack of mosquito control -- not because of a lack of effective medications.

Revenant said...

Socialism predates "socialism" by thousands of years.

Well, no, it doesn't. The notion of command economies and government control of the means of production is fairly new.

Pogo said...

In 1919, the German scientist Karl Ballod published Der Zukunftsstaat, advocating the 'all-electric state'. This was the book that led Lenin to pronounce, "Communism is Soviet power plus electrification of the whole country".

Revenant said...

True, most of the pre-Columbian societies of the Americas were socialist by almost any definition of the term. Many were very successful

Assuming that you define "successful" as "five thousand years behind Europe, technologically, morally, and socially". The Incan empire was ok, assuming you were an Incan noble, but it was a shithole by the standards of the civilization that conquered it.

happyamsguy said...

Lots of misinformation in the comments here. The Netherlands does NOT have socialist health care. The problem is that we do not have the so-called "opt-out" system in which everyone is automatically a donor unless they have opted-out. Belgium has such a system and they have much shorter waiting times than the Netherlands.
"Socialist health care doesn't work?" Go to Cuba and you'll see that it does work: that country has a life expectancy that is higher than that of the US.
And to all who write that this show is bad taste. Please switch on your TV now and try to find murder, rape, bodies chopped to pieces, etc., etc. Far more distasteful than any donor show.

Pogo said...

Re: "Go to Cuba and you'll see that it does work"

Not according to the May 27th NY Times:

‘Sicko,’ Castro and the ‘120 Years Club’
"“Actually there are three systems,” Dr. Cordova said, because Cuba has two: one is for party officials and foreigners like those Mr. Moore brought to Havana. “It is as good as this one here, with all the resources, the best doctors, the best medicines, and nobody pays a cent,” he said.

...But for the 11 million ordinary Cubans, hospitals are often ill equipped and patients “have to bring their own food, soap, sheets — they have to bring everything.” And up to 20,000 Cuban doctors may be working in Venezuela, creating a shortage in Cuba.

...Until he had to have emergency surgery last year, Fidel Castro — who turned 80 this year — was considered a model of vibrant long life in Cuba. But it was only last week that he acknowledged in an open letter that his initial surgery by Cuban doctors had been botched. He did not confirm, however, that a specialist had been flown in from Spain last December to help set things right."

Roger said...

With respect to drug development, the creation of anti-cholesterol medications have been influential in reducing the the overall rate of heart disease which was one of the top ten causes of death in the US; drugs like ED meds and now, presumably menstrual control, help subsidize other costs the drug companies incur.

No health care system is perfect; but what is the alternative to a private system? A Government system--and by what procedures would the government identify drugs to be produced--is a woman's breast cancer more important than a man's prostate cancer or testicular cancer more important than ovarian cancer?

The thought of turning the process of drug development totally over to the government really scares me.

Big Pharma is much like Big Oil--a convenient whipping boy--yes there are problems, the the alternatives are even worse. IMO

Tim said...

"The notion of command economies and government control of the means of production is fairly new."

Yes, strictly speaking; but just as economies existed before the Greeks coined the word, so too is history replete with examples of public projects and functions preceding Marx in which the cost and production was socialized. Using the narrow definition "government control of the means of production" is fairly absolute and unsatisfactory; it implies that as long as government does not completely control the means of production, the condition is something other than "socialism."

By that standard, very few nations (i.e., Cuba) have socialized medicine, as persons can opt-out and purchase private fee for service, even in the U.K. Canadians do the same, albeit externally by scooting across the border (international medical tourism is a growing phenomena in health care).

Many public programs, in and out of the economy, are socialized by mandate, like K-12 public education or (previously) compulsory military service; are they "socialism" in the common usage? Most don't think so, yet they are produced by the government, and they surely aren't private, or even quasi-private, and the opt-out provisions are tightly regulated. And just calling them "government (or public) programs" really isn't very clarifying, either. What about parks? I can go to Disneyland, and/or I can go to Yellowstone. Both are parks, yet their ownership and management are completely different. I pay nothing for Disneyland until I decide to go; my taxes pay for Yellowstone even if I never go.

So, while we aren't socialists, we have socialized a great deal (certainly too much - but that's a conversation for another time).

Tim said...

"The thought of turning the process of drug development totally over to the government really scares me."

As well it should. Profits drive innovation. Kill profits, kill innovation.

Turning it over to the government should terrify you, unless, of course, one is entirely satisfied with the level of treatment available for cancers, heart disease (someone named "freder" thinks drugs for high cholesterol an unnecessary, profit-driving luxury), stroke and high blood pressure, Alzheimer's, Parkinson's, diabetes, Multiple Sclerosis, Muscular Dystrophy, Cystic Fibrosis, HIV and AIDS, etc., etc., etc.

Some believe in fairy tales, in which the elves make all this stuff for free, and then we all go to sleep - pleasant dreams!

Freder Frederson said...

Assuming that you define "successful" as "five thousand years behind Europe, technologically, morally, and socially". The Incan empire was ok, assuming you were an Incan noble, but it was a shithole by the standards of the civilization that conquered it.

You are way overestimating the technological, moral and social structure of sixteenth century Europe. There is no doubt that prior to the plagues (brought by the Europeans) that raged through the native populations, your average Indian was healthier and better fed than the average European. Personal liberty was an alien concept to the vast majority of Europeans and society was extremely hierarchical even in the most progressive European nations. Most were still absolute monarchies, and would remain so well into the nineteenth century.

Technology is a very tricky issue. The pre-columbian Americans were certainly not 5000 years behind the Europeans. Their agriculture methods, considering they had no draft animals, were vastly superior to that of the Europeans, who had exhausted the soils of their homelands. Using traditional mixed crop methods (planting a variety in the same fields) some plots in the Maya areas of Mexico have been cultivated continually for 2000 years while the European practice of single crop cultivation will exhaust those same fields in a few years. The Mexican plateau, at the time of the Mexican conquest supported a population as dense as it is today and the Aztec capital was probably as large as the any city in Europe. Although the Americans lagged in metal work they were masters of textile work and well ahead of the Europeans in that technology (the Europeans were amazed by the Incas' suspension bridges made entirely out of rope).

Freder Frederson said...

The notion of command economies and government control of the means of production is fairly new.

Actually it isn't. The Inca practiced it and were extremely successful at it. They had one of the largest empires on the face of the earth when they were brought down by the Spanish.

Freder Frederson said...

You are mistaking all government intervention for socialism.

Like I said, I didn't consider them socialism either, but I was running with tim's definition since you haven't provided me with a definition of "socialist program". You have claimed that "[i]n the 20th century, one can find no examples of a successful socialist program." But you don't define "socialist program" so I threw some examples out that I thought might fit your definition.

So apparently anything that is part of the infrastructure can not be part of a "socialist" program? Yet in your example of Britain you specifically mentioned the water system and the gas and electricity grid. Does that mean if the government nationalized the power industry it wouldn't be socialism? Neither is anything that has a research or military purpose.

Then you dismiss the TVA out of hand. How exactly is the TVA an "'effin disaster"? It took one of the most poverty plagued regions of the country and made it reasonably prosperous. It provided the power that produced the uranium for the Manhattan project. Today it supplies power to many of the most successful automobile assembly plants in the country.

Pogo said...

The term 'socialism' is appropriate when markets are replaced with the bureaucratically determined rationing of goods and
services (i.e. by government).

Hence, massive public works projects like water and electricity can make sense, sometimes, where the market is insufficient to meet a need, but not everywhere or always. And once completed, the government best get out, and let private enterprise run it, because wihtout a doubt the State is less efficient.

Military protection is not socialism.

The TVA issue is a long discussion, I'd wager, one left for another time.

Tim said...

"Military protection is not socialism."

With conscription, it is.

blake said...

True, most of the pre-Columbian societies of the Americas were socialist by almost any definition of the term. Many were very successful (e.g., the Inca). If not for the diseases and genocide that wiped out up to 95% of the native population of the Americas between 1500--1700, who knows how different the history of the world would have been.

That word "successful"--I do not think it means what you think it means.

Freder Frederson said...

The term 'socialism' is appropriate when markets are replaced with the bureaucratically determined rationing of goods and
services (i.e. by government).


Well, thats a pretty damn narrow definition of socialism and doesn't even fit the situation of Great Britain (where nationalized industries competed in a free market). What it does describe is the command economies of eastern Europe. There are very few true believers in those systems left.

Most of the "socialized" medical systems so many of you deride don't even fit this model (the NHS in England nearly does, although not strictly because private competition is permitted). Most systems are single payer systems where the medical care system is in private hands but the insurer is the government or a government backed entity (think Medicare covering everyone or a Fannie Mae type entity being the health insurance company for the entire country).

And once completed, the government best get out, and let private enterprise run it, because wihtout a doubt the State is less efficient.

This is simply a matter of faith and is simply not backed by empirical evidence.

In the electrical generation industry in this country (the only major infrastructure sector where there is significant participation by both the private and public to make meaningful comparisons), the not for profit electrical generators (rural electrical coops, city owned utilities) as a group provide energy at a lower price with equivalent service levels as the for profit sector.

Pogo said...

Re: "This is simply a matter of faith and is simply not backed by empirical evidence.

False; there is overwhelming evidence that State-owned enterprises do not perform better than privately owned companies, but more often perform worse.
1. Yergin D, Stalislaw J; The Commanding Heights: the Battle for the World Economy, Touchstone New York, 1998 and 2002, pp. 74-133, 315-335.

2. Berger PL, The Capitalist Revolution: Fifty Propositions About Prosperity, Equality, and Liberty; Basic Books, New York; 1986 pp. 20, 70-3, 134-5, 146, 175-87, 208-9.


While socialists have claimed that state ownership and central planning would prove more just, efficient and productive than capitalism, that dream has been disproved in practice. “Today, it is all but universally acknowledged that the wealth that sustains the public sector is created in the private sector. This means any attempt to expand the public sector beyond a certain point will backfire…if the private sector is squeezed too hard, government revenues dry up.”

3. 65. Muravchik J., Heaven on Earth: the Rise and Fall of Socialism; Encounter Books: San Fransisco; 2002, p.304, 314, 315, 319.

It is unclear at what point the political and inefficient planned market will result in stagnation of the larger economy. Michael Porter remarks that international competitiveness unavoidably suffers under centrally planned economies. Limited buyer choice eliminates the pressures to respond to consumer demands, and the lack of competition further distorts exchange among related and supporting industries not under control of the government monopoly. The dearth of both information and the corresponding motivation to act retards upgrades and growth. As a result, national prosperity declines.
4. Porter ME, The Competitive Advantage of Nations; The Free Press, New York; 1990, p.676.

And Economist Robert Heilbronner, no free market enthusiast, wrote in 1993, “There is today widespread agreement, including among most socialist economists, that whatever form advanced societies may take in the twenty-first century, a market system of some kind will constitute their principal means of coordination. That is a remarkable turnabout from the situation only a generation ago, when the majority of economists believed that the future of economic coordination lay in diminution of the scope of the market, and an increase in some form of centralized planning.”
5. Heilbronner R, 21st Century Capitalism; Norton, New York 1993, p. 97.

Pogo said...

I disagree. A single payer system is socialist, because the primary animating force is the government. Pre-WW2 Germany had a similar mechanism, with the goverment deciding everything, but handing out contracts to ostensibly privcate companies.


(No fair calling 'Godwin' here, because it is a fact.)

Tim said...
This comment has been removed by the author.
Tim said...

"...the not for profit electrical generators (rural electrical coops, city owned utilities) as a group provide energy at a lower price with equivalent service levels as the for profit sector."

You are stealing bases AND moving goal posts at the same time. The non-profit electrical generators and others like them generally purchase electric power from federal dams at a rate discounted from the rate power is sold to commercial power companies. Under the terms of purchase, your non-profits, publics, et al, are REQUIRED to sell their power at lower rates. They couldn't it for more if they wanted to. Regardless, the argument they are more efficient is bogus too, as the taxpayers subsidize both the federal and local public power generators and sellers. They don't have to make profits to survive.

Revenant said...

There is no doubt that prior to the plagues (brought by the Europeans) that raged through the native populations, your average Indian was healthier and better fed than the average European.

That is true only if you compare the Black Plague years of Europe to non-plague-year Incans. If you compare non-plague years the Incans were inferior on all counts.

Their agriculture methods, considering they had no draft animals, were vastly superior to that of the Europeans, who had exhausted the soils of their homelands.

The Incan methods were completely inferior to that of the Europeans, producing less food per acre despite the supposedly "exhausted" soil of Europe. The lack of domesticated animals was another example of technological inferiority.

Technologically, morally, and socially, Incans were approximately where the Egyptians had been thousands of years earlier. They enjoyed no freedom, no liberty, and no rights; unlike Europeans, they could be slaughtered simply because their rulers felt like it, and often were. That's why Pizarro was able to easily recruit tens of thousands of local natives eager to throw off the yoke of Incan oppression. Indeed, the Incan society was so rigidly hierarchical that Pizarro's capture of the emperor paralyzed most of the Incan military. That would never have happened in Europe, even in so-called "absolute monarchies" (which in reality were never anything close to absolute. Europe, even during the feudal period, had ideas of democracy and human rights going back to Greece.

Dorshorst said...

This was all a hoax.
http://www.cnn.com/2007/WORLD/europe/06/01/kidney.show.reut/index.html
And all of you, especially Althouse who posted the story, did just what they wanted you to do.

...In the last minutes of the program, she was revealed as a healthy actress and producers stunned viewers by saying "The Big Donorshow" was a hoax...

...Dutch Education Minister Ronald Plasterk hailed the show as a "fantastic stunt" and an intelligent way to draw attention to the shortage of donor organs...