In my post of 4/3/12, I cited a New Jersey Star-Ledger editorial that called for a mandatory organ donor law. In that editorial, the Star-Ledger implied that the main sponsor of the proposal, the NJ Sharing Network, supported such a compulsory law. But that in fact may not be the case, so, to be fair, I want to examine a related article by the Network's president.
The NJ Sharing Network, a private non-profit “organ procurement organization responsible for the recovery of organs and tissue” for New Jersey residents awaiting organ transplantation, is proposing a new law that “would permit health insurers in New Jersey to limit transplant coverage for people who decline to register as organ donors.” Dubbed “The Golden Rule proposal,” Network president Joseph S. Roth, citing cases of people refusing to donate dying family members’ organs despite members of the same family benefiting from organ donations, argues in a recent NJ Star-Ledger op-ed that such a law would “encourage all New Jerseyans to become organ donors.”
Of course, in a free health insurance market, no such law would be necessary. Insurers could include organ donor requirements in their policies with the mutual consent of their customers, and the government would have no business interfering in such voluntary contractual agreements.
But, given the government’s massive regulatory controls over private health insurance, such a “Golden Rule” law could easily become mandatory. Indeed, the NJ Star-Ledger, as I noted in my post of 4/3/12, was quick to recognize the inherently compulsory nature of such a law, calling it a “bigger stick” that would “force people” to become organ donors. Roth himself approvingly cites a compulsory Israeli law that is the world’s first “to incorporate ‘nonmedical’ criteria into the system”; an apparent contradiction of his stated position, which would merely “permit health insurers...to limit transplant coverage” according to their own judgement; i.e., would be voluntary.
It’s not hard to imagine where the principle of “nonmedical criteria” could lead; perhaps, denying obesity-related medical treatment for exceeding government-approved weight standards or lung-related treatment for not installing “clean energy” devices like solar panels. If you think I am exaggerating, consider this actual case in Britain, where the NHS denied surgery to a woman at the facility of her choice, because she lived too far away from it, making her "carbon footprint" too large. Yes, her "carbon footprint"! There would be almost no limit to what politicians can “encourage” us to do, if they are allowed the power to hold a person’s medical treatment hostage to politically correct dictates.
The NJ Sharing Network’s mission to encourage people to become organ donors is laudable, but only if done privately and voluntarily. That may well be the case, but Roth is not clear on the issue of voluntarism vs. force. Whatever the case, any law essentially compelling people to sign organ donor cards is morally wrong. That some people may be hypocrites does not justify compromising anyone’s liberty.
Insurers’ should certainly be free to set their own organ transplant policies, and any legal restrictions preventing them from doing so should be removed. More important would be to advocate broader free-market reforms like repealing the 1984 ban on compensation for organ donors and eliminating all government interference in the contractual relationship between healthcare providers and their customers. Every individual’s right to pursue free and voluntary contracts with others must be fully recognized.