20101123 surgery 35
A surgeon and his theatre team perform key hole surgery to remove a gallbladder at at The Queen Elizabeth Hospital on March 16, 2010 in Birmingham, England. As the UK gears up for one of the most hotly contested general elections in recent history it is expected that that the economy, immigration, industry, the NHS and education are likely to form the basis of many of the debates. - 


Bob Moon: Time for the folks who explore the hidden side of everything, even when if it might be repugnant. Every couple of weeks, we bring you Freakonomics Radio. And we've got Stephen Dubner, co-author of the books and blog of the same name. Now most of us like to stick to ideas that are politically and socially palatable, but some people are attracted to repugnant ideas -- ideas to solve tough problems, even if they might be greeted with disgust.

Our Freakonomics team are connoisseurs of these kinds of repugnant ideas, and they've been tracking a few that took root in 2010. So here's Dubner.

Stephen Dubner: My co-author Steve Levitt is a research economist at the University of Chicago. His most famous piece of work? A paper arguing that the massive drop in crime that began in the early 1990s was due in large part to legalized abortion. The paper took no position on abortion, per se. It only examined the cause-and-effect. Still, a lot of people, whatever their religious or moral feelings about abortion, found the idea entirely repugnant.

Steve Levitt: One of the easiest ways to differentiate an economist from almost anyone else in society is to test them with repugnant ideas. Because economists, either by birth or by training, have their mind open, or skewed in just such a way that instead of thinking about whether something is right or wrong, they think about it in terms of whether it's efficient, whether it makes sense. And many of the things that are most repugnant are the things which are indeed quite efficient, but for other reasons -- subtle reasons, sometimes, reasons that are hard for people to understand -- are completely and utterly unacceptable.

Here's an inefficiency that drives some economists crazy: Organ donation. Every year, thousands of people in the U.S. die while waiting for a new kidney. Meanwhile, millions of people are walking around with a second, spare kidney that they could donate. But the incentives to do so aren't strong. Some economists have proposed a market, paying people for their organs. Pretty repugnant, right?

Professor Jacob Lavee is a transplant surgeon near Tel Aviv. Frustrated by Israel's low organ-donor rate, so this year he helped champion a new law.

Jacob Lavee: I'm fully aware of the fact that it's a very drastic law. It's a very drastic law, and it had to be drastic because the situation is drastic.

The new law is called "Give Life, Get Life." It means that if you sign up to be an organ donor, then you get preference if you ever need an organ yourself. Instead of being prioritized solely by medical need -- which is the custom around the world -- you'll be punished for not participating.

Desperate times call for repugnant measures. Sometimes the level of repugnance may mess with your morals, and sometimes, just grosses you out.

Brad Hawn: It's a psychological stigma about the water...

That's Brad Hawn, a councilman in Modesto, a city of 200,000 in California's fertile Central Valley. Hawn is trying to get Modesto to do what other places around the world have done: Treat its sewage waste water and pipe it off to farmers who need it. In this case, for their almonds and apricots. It's a program you might call "crap to crop."

Hawn: Really what's happened in California is that the need for water has gotten so great that the stigma is starting to go away. Because when you're thirsty, you start being a little less particular about what the water is, where it comes from.

Another repugnant idea from the past year comes out of the health care debate. Remember the proposal to reimburse doctors for counseling patients about end-of-life care? This idea, which came to be known as "death panels" was repugnant to a lot of people, even Steve Levitt. But what he really finds repugnant is that the end-of-life debate doesn't follow the rules of the marketplace. If it did, says Levitt:

Levitt: There won't be a need for death panels, because actually your children will be your personal death panel, right? Because you're 85 years old, you're on life support, if your children are paying a substantial part of the bill, then they'll face an awkward trade-off: Would I rather have money to send the grandchildren to college or would I rather keep my mother, who's in a coma and is 85-years-old, would I rather keep her alive for another two more weeks?

Ah, economists. "Children as death panel." Now there's something to look forward to in 2011.

For Marketplace, I'm Stephen Dubner.