Megan McArdle
- Megan McArdle is the business and economics editor for The Atlantic. She has worked at three start-ups, a consulting firm, an investment bank, a disaster recovery firm at Ground Zero, and the Economist.
Megan McArdle was born and raised on the Upper West Side of Manhattan, and yes, she does enjoy her lattes, as well as the occasional extra dry skim milk cappuccino. Her checkered work history includes three start-ups, four years as a technology project manager for a boutique consulting firm, a summer as an associate at an investment bank, and a year spent as sort of an executive copy girl for one of the disaster recovery firms at Ground Zero . . . all before the age of 30.
While working at Ground Zero, she started Live from the WTC, a blog focused on economics, business, and cooking. She may or may not have been the first major economics blogger, depending on whether we are allowed to throw outlying variables such as Brad Delong out of the set. From there it was but a few steps down the slippery slope to freelance journalism. For the past four years she has worked in various capacities for The Economist, where she wrote about economics and oversaw the founding of Free Exchange, the magazine's economics blog. She has also maintained her own blog, Asymmetrical Information, which moved to the Atlantic Monthly, along with its owner, in August 2007.
Megan holds a bachelor's degree in English literature from the University of Pennsylvania, and an MBA from the University of Chicago. After a lifetime as a New Yorker, she now resides in northwest Washington DC, where she is still trying to figure out what one does with an apartment larger than 400 square feet.
I'm a big fan of the Institute for Justice, which fights the good fight on issues like economic liberty and eminent domain. Today they're launching what may be their biggest case ever: a fight to allow compensation for bone marrow donors.
For reasons that aren't entirely clear, the 1984 National Organ Transplant Act forbids people to sell their bone marrow, as well as their kidneys, lungs, and so forth. By which I don't mean that the ban is merely stupid; I mean there's apparently some reason to believe that Congress simply did this as a mistake, adding bone marrow into the bill at the last moment without really thinking things through.
Donating bone marrow
is a lot more like donating blood than it is like donating a kidney,
because of course, your body just makes more marrow to replace what you
give up. These days, they don't even have to stick a big needle into
your pelvic bone, as they used to; instead, they give you a drug to
stimulate blood stem cell production and filter the cells from your
blood, using the same apheresis machine that they use to harvest plasma
cells from (paid) donors. The risks are extremely minimal, and mostly
limited to the side effects from the drug they give you to stimulate
cell production.
Nonetheless, it is very, very illegal to
compensate donors. That means that people die for want of a
transplant. The problem is worst in minority communities, because of
the peculiar problems of marrow donation.
In most
transplants, you run the risk that your body will decide that the new
organ is a foreign object and send white cells to attack it; this is
what's called "rejecting the organ", and it's why you have to use
immunosuppressant drugs. In the case of marrow transplants, however,
the problem is more serious, because marrow is what produces those
white blood cells. The risk you run is that those white cells will
decide that your body is a foreign object, and attack everything in sight.
That
means that marrow donors have to be matched very, very carefully to the
recipients--much more carefully than we match other kinds of organ
donations. Since there is a strong ethnic component to the matching,
minorities who need transplants have the smallest chance of finding a
match--just 25%, according to the folks I spoke to at IJ. That's
compared to 75% for whites.
It's true that I don't find any of
the arguments about the coercive effects of money on peoples' decisions
particularly compelling. But at least in the case of kidneys or parts
of livers, I can see how you might want to keep people from making a
very permanent sort of mistake. I just don't see that sort of
rationale in the case of bone marrow. The worst that happens is that
you end up with some unobtrusive round scars over the veins in the
crook of your arms. There are dozens of professions that are likely to
leave you with more impressive legacies. Moreover, if it's really so
awful and demeaning, then probably we shouldn't pay for plasma, eggs,
or sperm, either.
The purpose of this lawsuit is not to set up
an actual market. There are reasons to think that you can't actually
build a functioning market in bone marrow, because the number of
matches is typically so small, turning every donor into a monopsonist,
and every recipient into a potential monopolist. Instead, the idea is
to use market incentives to increase the number of donors. Ultimately,
the plan is to set up a foundation to offer some sort of modest grant
for those who decide to become marrow donors. The process will remain
anonymous, and the donor and recipient will never interact. Nor will
the foundation negotiate.
It's a great idea. But in order to
implement it, they have to get the law to the point where doing so
won't get them sent to the pokey.
Of course, just because the
law doesn't make any sense, doesn't mean that it will be struck down.
But one can hope . . . and wish the folks at IJ godspeed.
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