Outside the Yard
Kidneys for Sale
Most proposed changes to the healthcare system involve a tradeoff between costs and health outcomes. A potential exception to this rule would be a policy that increases kidney donation, which would allow substantial savings on dialysis therapy for patients with end-stage renal disease. The policy would also improve these patients’ quality of life and reduce the kidney shortage that causes black market organ trafficking. While it would be controversial, a regulated market in which living persons could accept monetary compensation for kidney donations may be the best way to boost transplants.
About half a million Americans are being treated for kidney failure, also known as end-stage renal disease. The average wait for a kidney transplant, which is usually the optimal treatment, is about five years, and those without access to a donated kidney receive expensive dialysis therapy. Dialysis patients experience deteriorating health and living conditions, and many die waiting for a transplant. While donations have increased modestly in the past few years, demand has surged thanks to success with transplantation as well as an aging population and higher rates of chronic disease that cause kidney failure.
Free to Work for Free
If you work without pay at a for-profit company this summer, the federal government should fine your employer. At least that’s the position of many academics who have argued that unpaid internships unfairly advantage wealthier students who can afford to work for free. It was about this time a year ago that the Obama administration announced a crackdown on unpaid internships in the for-profit sector, sparking a debate at Harvard and other campuses about the scope for regulation of these on-the-job training experiences. While unpaid jobs might disproportionately benefit the upper class, enforcing restrictions on internships undermines labor market protections for those who most need them.
The New York Times reported last April that unpaid internships have proliferated over the past two decades, accompanied by violations of federal employment law. The U.S. Department of Labor has hired 250 more investigators to bring firms into compliance with the Fair Labor Standards Act, which establishes a minimum wage and stipulates circumstances under which compensation for work in the for-profit sector may deviate from the legal wage floor. The Labor Department has developed six guidelines based on the FLSA that must be fulfilled for such jobs to be uncompensated, including that the intern must not displace paid workers, and that the employer must derive no immediate benefit from the intern’s work. Any labor that directly benefits a for-profit company, in other words, must be compensated even if the employee is willing to work for free.