Why our plan achieves efficiency

We believe that public policy regarding a distribution of a scarce resource should always be guided by two most important principles. Firstly, the distribution should be as efficient as possible; secondly, the distribution should comply with the conception of fairness and justice. These aims tend to be somewhat contradictory, but we believe that the model that we have proposed reconciles both of these ideals. So our burden of proof in this debate is to show why our model is efficient and why it achieves the fair distribution of resources. In this argument we will show why it is efficient. In general, we believe that governments always have a mandate to be utilitarian, i.e. strive for biggest possible good in the society. Why is that? Well, state ideally is a social construct designed to achieve the biggest possible good/happiness/utility etc. It would be a bit awkward if people would not require the government to do that. Of course, these positive aims can also include ethical considerations or other things - the utilitarian government framework does not require us to become ruthless pleasure seekers. Of course, we can all agree that there are some problems with the utilitarian doctrine. For instance, it usually is hard to agree on what is the "good" we should strive for. However, we believe that our moral intuition can help us in this task. For instance, most of us who do not have psychopathic tendencies would agree that death is preferrable to non-death. Most of us would also agree that one death is preferrable to two deaths of human beings. We strongly believe that these beliefs have universal moral value and always should be encorporated in government policy. We will be operating under these reasonable assumptions about what is good and what is not in the following argument. We have no doubts that giving livers to alcoholics is a waste of resources and prevents us from saving lives of other citizens. Why is that so? Well, we believe that is clear that if a liver is given to an alcoholic and he is often not saved anyway (as we shall see in a moment), we have wasted an organ that could be used to save another, equally valuable life instead. So why is our model the best way to distribute livers efficiently? There are three mechanisms through which this efficiency is achieved: (1) The chances of a successful transplantation are lower for alcoholics A very important factor influencing the success of any transplantation is the way the body of the patient responds to the new organ. It is crucial that no complications arise; otherwise, the procedure is likely to fail. Unsurprisingly, these risks are higher for chronic alcoholics. Firstly, alcoholics usually have other alcohol-related disorders, like chronic pancreatitis [[http://digestive.niddk.nih.gov/ddiseases/pubs/pancreatitis/]] and cerebral atrophy [[http://www.alcohol-drug.com/neuropsych.htm]]. Secondly, alcoholics very often have nutritional deficiencies [[http://www.about-alcohol-facts.com/Alcohol_Nutrition_Facts.html]] that strongly complicate the transplant acceptance process. All of these aspects show that there is a significantly bigger chance of a failed operation and recovery process, thus wasting organs that could be used to save other patients. (2) There is a significant risk of a relapse of alcoholism, thus ruining the implant. It should come as no surprise that alcoholism is a very complicated disease to deal with. Using alcohol for a long time creates both a psychological and physiological addiction, and it is very complicated to supress the desire to drink. We believe that there is a significant risk that these patients will continue drinking after the procedure. Even though there is a six-month sobriety period before any liver transplantation, empirical evidence shows that heavy drinkers go back to their old ways and start drinking again [[http://psy.psychiatryonline.org/cgi/content/abstract/42/1/55]]. Why is this likely to fail the procedure? Firstly, all receivers of a liver always face a high chance of getting an infection, so they have to take immunosuppressant drugs that strengthen their immune system. Using alcohol is extremely detrimental for the immune system. It also negatively effects the impact of the immunosuppressant drugs. [[http://www.guardian.co.uk/science/2005/oct/05/drugsandalcohol.medicineandhealth]] Thus alcoholics effectively open themselves up for infections and often ruin the transplant. Secondly, if alcoholics start drinking again, it can once again lead to the alcoholic liver disease and other alcohol-related disorders. This would once again put the burden on the health care system and maybe even generate the necessity for another transplant. On the other hand, if we reject giving transplants to alcoholics, they could be assigned to patients with much bigger probability of survival after the operation, thus achieving distributional eficiency. (3) The plan sends a message about the use of alcohol & deals with the moral hazard. Finally, we believe that this plan sends a very bold message that heavy use of alcohol is something very negative and undesirable. It sends a clear signal from the government about the detrimental effects of alcohol use. We believe that government can influence its citizens in this way. In addition, it would simply deal with the moral hazard that sometimes is prevalent in the behaviour of individuals. At the point when they are not yet addicted, this plan can act as an active deterrent for people to take up drinking, since they will know that the downside of this decision will be faced by themselves. We think these two effects are likely to decrease the overall amount of alcoholics in the society. Why is that efficient? Well, less health care resources will have to used to cure alcohol-related disorders. Also alcohol has other negative externalities that would be prevented. This is definitely beneficial for society.