I don't get it. In the American capitalist way, we let 45,000,000 people live on the verge of bankruptcy because they can't afford health insurance; it's the "free market." We let kids live in rotting homes in dangerous neighborhoods with bad schools. Why? because their folks can't or won't work. It's the "free market." We let people swelter in the summer and freeze in the winter if they can't afford energy costs. We let people wander through the streets homeless because they have psychiatric disease. All free market based policies.
But organs? Not a free market. Selling organs is illegal. Verboten. c'est defendu. The organ procurement businesses make a ton of money, which they pay out to their employees and boards because they are "not for profit" (snort, snort, chuckle, chuckle). The hospital makes top dollar, as do the pharmaceutical companies that provide the immuno-suppressants. But for the donors and their families; nothing. nada. zip. "The good feeling that comes from having saved a life."
As a consequence, we have a shortage of organs, and a nightmare of a procurement system that is willy-nilly inefficient, with the kind of sub-rosa black market that we all piously denounce as it periodically bubbles to the surface in the media, where some rich guy buys an organ outright and pays some willing team to install it. Sounds like a UK-style two-tiered healthcare system to me; doesn't it to you?
I'm a yellow dog democrat and a Wisconsin democrat, so I believe in markets; regulated markets; and no black market would benefit more from being brought in from the darkness to the light than the organ market. Imagine that the family of the deceased received a payment of $10,000 for a kidney, or $20,000 for a liver or heart; organ availability would skyrocket, poor families would have funeral expenses defrayed, or might have the money to pay for an education or other needed care. If living donations were allowed, they would require a guarantee from the recipient's insurance company that all expenses incurred as a consequence of complications of the donation procedure would be covered; fair is fair. Probably the government (medicare, medicaid would not participate in paying for living organ donation; too dangerous) I could spend the rest of the day refining the regulatory aspects of this scheme, but you get the idea.
So, does this seem despicable? No more despicable to me than the self-righteously hypocritical ways in which we manipulate free market principles when it suits us. A regulated market in organs, especially cadaver organs, would solve a significant societal problem; the scarcity of such biomaterial, and it ought to be put on the table...