And in the "you just can't please some people" department, the head of the American Masage Therapy Association has written the magazine to complain about the article.

The National Kidney Foundation, represented by its chairman, Charles B. Fruit, takes the "just let them die" view. Fruit's article includes this misleading little math exercise:

Payment stands as an affront to those families that have already donated organs of loved ones out of charity. There is evidence to suggest it might prove similarly offensive to future donors. In 2005, the National Survey of Organ Donation found that 10.8% of those polled would be less likely to grant consent for the organs of a deceased family member to be used for transplant if they were offered payment; 68% said they would be neither more nor less likely to grant consent. Thus, there is little data to show that financial incentives would increase donation rates.

So, to round the figures a bit, 70 percent would be unaffected, and 11 percent would be less likely to grant consent. What happened to the other 19 percent? They were, ahem, conveniently left out--because they would be more likely to grant consent. That's what's called a net increase.

The argument that paying organ donors is "an affront" to unpaid donors is disgusting. Are unpaid donors giving organs to save lives or just to make themselves feel morally superior? Even in the latter case, they shouldn't care if other people get paid. They can still hold their noses in the air. Underlying this argument, which the NKF loves, seems to be a nagging sense of guilt: The current system takes something valuable without offering anything in return. It is, in other words, highly exploitative. If that exploitation suddenly goes away, the people who've been exploited in the past will realize they've been used and be mad. Personally, I don't think that's terribly likely, because most of today's donors are, in fact, motivated by sympathy for recipients. But the fact that defenders of the system keep making the argument suggests they know they're doing something a little shady.

Here is Steve in front of a re-creation of Galileo's inclined plane in the science museum. There are bells along the top, spaced at proportional intervals. As the ball rolls down the incline, it rings the bells, making it possible to time the descent.

We were going to take a photo of me in front of Galileo's actual telescopes, but it turns out you aren't supposed to take pictures, and we were busted--very politetly and apologetically--as I was posing.

The anti-photo policies of museums don't necessarily make sense, except as some kind of revenue enhancer. Prohibiting flash is one thing. And I don't blame the Louvre for blocking photos in the often-crowded Italian painting gallery. But prohibiting all photos in an uncrowded museum filled with works in the public domain is unnecessary--unless you think it will generate sales in the museum store. But the very cool, and virtually empty, science museum, which hardly even has a bookstore, would get more visitors if it let them pose for photos.

Back in 1985, when personal computers were strange and wondrous inventions just filtering into American homes, Chip Morningstar and his colleagues created an online world in which Commodore 64 owners could meet, play, and communicate with each other. The computers were simple, the modems slow, but the world--called Habitat--quickly became complex. Habitat provided its users with an animated landscape, props, activities, and cartoon personas called avatars. Users could send each other e-mail or converse through text in word balloons. Working from this underlying structure, Habitat's virtual citizens developed a wide variety of social activities and institutions. They invented games and dance routines, went on treasure hunts and quests, published a newspaper, threw parties, got "married" and divorced, founded religions and businesses, wrote and sold poems and stories, and debated weighty issues.

Watching Habitat develop made Morningstar think seriously about how rules shape societies, and what the limits of rule making are. "It was a small but more or less complete world, with hundreds and later thousands of inhabitants," he recalls. "And I, along with my coworkers, was God." In theory, the programmers made the rules, knew them thoroughly, and could change them at a stroke. But their godlike powers weren't as limitless as they seemed. Says Morningstar: "Again and again we found that activities that we had planned based on often unconscious assumptions about user behavior had completely unexpected outcomes....We could provide opportunities for things to happen, but we could not predict or dictate the outcome."

If there were chinks in the rules, the players found them. A few enterprising souls spent hours shuffling between a "Vendroid" machine selling dolls for 75 tokens and a pawn machine in another region buying them for 100 tokens. When the arbitrageurs had enough profit to buy crystal balls for 18,000 tokens, they repeated the same procedure with a pawn machine paying 30,000 tokens, until the Habitat money supply had quintupled overnight. When questioned about the source of their newfound wealth, they replied, "We got it fair and square!"

"Unintended consequences really have to do with naive people believing that there are no holes [in the rules]. It's very easy to seduce yourself into thinking that you've got everything under control," says Morningstar. "And the reality is, it's almost never true." Clever people will always come up with ideas no central rule maker has conceived.

Over and over again, Habitat's designers ran into the limits of their own knowledge. The range of tastes and knowledge its many users brought to Habitat quickly overwhelmed the ability of designers to foresee how users would react. A treasure hunt that took weeks to build lasted less than a day, after a single Habitat resident quickly discovered a critical clue; the winner had a great time, but most of the other players barely got started. The system's operators soon realized the value of letting users create their own games. "It's not that they could necessarily do things that were as good as some of the things that we had the facilities to do," says Morningstar. "But the things which they did were much more directly in tune with what people immediately wanted--because they were much more directly in contact with themselves."

I was pleased to discover that Chip Morningstar and Randy Farmer now have a blog extending their insights to the present day. It's full of good stuff.

And, in the "I am so old" department, my "7-year-old niece" mentioned in the chapter's lead is now a 16-year-old rising senior at the South Carolina Governor's School for the Arts & Humanities, specializing in visual arts. She'll doing some college shopping while visiting us later this summer.

I met Anthony Pigliacampo, who founded the company with his sister, when he came to a talk I gave at IDEO. A few months ago, he kindly lent me a couple of prototype bags to test. They're pretty and well-made--but the company's real appeal is the design-your-own angle. It's good for entertainment, even if you don't buy anything. But if you do, use the code DYNAMIST and get 20% off.

"We used to care only that people weren't alienated by the look of our appliances," said Paul Klein, general manager of brand and advertising for GE Consumer & Industrial. "But we've realized that affluent people think of their kitchen as décor, even if a caterer is doing the cooking."

Financial results are great, Deutsch reports--quite a contrast to the days when GE wanted to sell the division, only to find that no one wanted to buy it.

One result is that G.E.'s appliance sales were up 16 percent in the first quarter of 2006, and analysts expect them to keep growing. The unit's return on total capital was 60 percent last year, compared with 16.4 percent for the company as a whole. And the appliance business generated $700 million in cash.

As I often point out in speeches, usually by playing the "Interrogation" commercial, GE has realized the importance of aesthetics in one division after another--a striking, bottom-up strategy from a hard-nosed engineering- and finance-oriented company. That's why I used GE Plastics as the lead example in chapter one of The Substance of Style.

As the ad says, you can have beauty and brains.

Every midnight, construction crews of his Fort Worth-based RightWay Facility Services move into a dozen or so restaurants around the country like commandoes. These eight- to 10-man teams lay carpet, put down tile, install kitchen equipment, replace sewer lines, knock out and rebuild walls.

Eight hours later, they fold drop cloths, gather tools and clean up so that the eateries can serve food in a few hours without missing a beat.

"What we do isn't glamorous, but it is amazing," says the 51-year-old owner of RightWay, which lists many of America's leading chains as clients. "We get no timeouts or do-overs."

His company routinely updates restrooms at Olive Gardens and Red Lobsters for Darden Restaurants Inc. and has overhauled nearly 100 TGI Friday's for Carlson Restaurants Worldwide Inc.

Chick-fil-A, Bennigan's, Chili's, Denny's, On the Border, Outback Steakhouse, Kentucky Fried Chicken, Jack in the Box, Applebee's and Tony Roma's also depend on RightWay to keep their buildings up to corporate snuff.

"Restaurants expect miracles. If you have to close down to get a job done, they want you to close down and reopen like that," Mr. Robertson says, snapping his fingers.

Hall pulls out some good details about the business, from wages (significantly higher than run-of-the-mill construction jobs) to specialized problem-solving (how do you lay down new kitchen tile without closing the place for two days while it dries?). RightWay represents the kind of specialization and innovation that rarely get press coverage--there's no news peg--yet contribute enormously to the cumulative process of economic growth.

On a related issue, the AARP Bulletin has published this excellent article on living donors. (The one flaw is that the mention of Lifesharers at the end doesn't make clear that the organization is made up of people who've agreed to be deceased donors.)

UPDATE: And here's some good news. In a show of good sense, the American Medical Association's annual meeting has adopted a new policy that "Public solicitation of organs from living donors that increase the quantity of available organs and do not unreasonably disadvantage others on the organ waiting list are ethically acceptable."

Unfortunately, our laws and culture discourage healthy people from donating organs, as I learned this spring when I gave a kidney to a friend.

My parents were appalled. My doctor told me, "You know you can change your mind." Many people couldn't understand why I didn't at least wait until my friend had been on dialysis for a while.

This pervasive attitude not only pressures donors to back out, it shapes policies that deter them. Some transplant centers require intrusive, demeaning psychological probes that scare people off. Some bioethicists suspect that donors suffer from a mental disorder, as opposed to being motivated by benevolence or religious conviction.

The scrutiny is particularly nasty when healthy people want to give their organs to strangers — not truly unknown people, mind you, but patients they have gotten to know through Internet sites or press coverage.

Many transplant centers flatly refuse "directed donations" to specific strangers. Some argue that it's "unfair" for patients to jump the queue with personal initiative and an appealing story; others insist that such donors aren't to be trusted (they must be either criminal or crazy). Posters at livingdonorsonline.org warn givers to never even mention the Internet, lest their good intentions be thwarted.

Sandra Grijalva, a San Francisco woman with polycystic kidney disease, asked Kaiser officials if she could find a donor online — after having one of her friends disqualified because of high blood pressure. "They said absolutely not," she says. The donor, Kaiser maintained, might someday try to extort money. (So might your cousin, but at least you'd be alive.)

Instead of dire possibilities, consider a cold reality: Without tens of thousands of new living donors, most of the people on that very long waiting list are going to suffer and die on dialysis. The transplant community's top priority should be increasing the supply of willing donors.

I also take aim at the National Kidney Foundation's shocking attitude toward discussing incentives.

But even talking about incentives is taboo to some self-styled patient advocates. On Monday, the American Enterprise Institute will hold a conference in Washington on incentive-based transplant reforms. (It's organized by my kidney recipient, a physician and health-policy scholar at the institute.) When the National Kidney Foundation heard about the conference, its chief executive, John Davis, complained to the institute's president, "We don't see how an AEI forum would contribute substantively to debate on this issue."

Davis' group adamantly opposes donor compensation, lobbying against even experimental programs and small tax credits. It's as though the National Parkinson Foundation opposed stem cell research, or thought researchers should work for free.

The AEI conference, which is open to the public, will be aired live on C-Span2, beginning at 10:00 a.m. Eastern on Monday. I will moderate the first panel and speak on the second. After the conference, AEI will probably also post video.

In addition to container shipping, advances in polymers also fueled the increase in container shipping of produce. In the ~late eighties, a polymer was created that allowed the cheap (in energy and $) separation of nitrogen and oxygen. Produce would be shipped in nitrogen-filled containers that did not require refrigeration.

As a working scientist, I always like to point out the ways in which science research leads to far-reaching consequences.

When you step off a plane in Indianapolis, one of the first things you see—right next to the directions to baggage claim and ground transport—is a sign advertising massages, from the fifteen-minute “Fast Track” for $18 to the half-hour “Extended Stay” for $33. Travelers can find similar services at airports in Providence, Anchorage, Cedar Rapids, and Baltimore. The Seattle-based Massage Bar has expanded from Sea-Tac to airports serving Nashville, Newark, and Washington, D.C.

And you don’t have to go to the airport. Car washes in Dallas and Austin offer chair massages while you wait. Tired shoppers can get them at the Fashion Show mall on the Vegas Strip, at Whole Foods Markets, and at many large bookstores. Massage breaks are regular features at business conventions and sporting events.

Once a specialized therapy for injured athletes, an indulgence for the idle rich, or a cover for prostitution, massage has become a legitimate and seemingly ubiquitous enterprise. Between August 2004 and July 2005, about 47 million American adults got at least one massage, up 2 million from the previous year, according to the American Massage Therapy Association’s annual consumer survey.

One of the most important factors in the spread of massages was the invention of the portable massage chair. I tracked down the inventor David Palmer, shown here. Here, from the article, is how he got started:

In 1982, he was running a San Francisco massage school and worried that not enough graduates were finding jobs. If massage was so great, why didn’t more people want it?

The answer was pretty obvious: everything about the experience scared off potential clients. “If you want to make sure massage didn’t make it into the mainstream,” Palmer says, “make it as expensive, inconvenient, and scary as possible. Force people to go into a private room behind closed doors, take off all their clothes with a stranger, lie down on a table, get slathered with oil for an hour, and pay $70, $80, $90 for the privilege.”

Massage needed a form that was cheap, quick, convenient, and fully clothed. Palmer developed an acupressure-based routine, or kata, that took just fifteen minutes and was done while the client sat on a drummer’s stool. [Like the one Palmer is sittig on in the photo above--vp.] Although a chair massage might cost more per minute than a table massage, the price for the experience was much lower. The next step was to create a special chair to support the client’s head, arms, and legs.

The first massage chairs were made of wooden pieces that fit into a wooden carrying case and were assembled, often with some fanfare, onsite, as Palmer is demonstrating in the photo. The case and chair weighed 27 pounds, so it's not surprising that they were eventually replaced by lightweight, collapsible models.

My columns will be available to magazine subscribers in the archive on The Atlantic's great website. The Atlantic online archive is incredible, stretching back to the 19th century, and it alone is worth the price of a subscription.

The fake bills are the same size as U.S. currency. They have the distinctive peach and green coloring of new $20 bills and appear to carry the Department of the Treasury and U.S. Federal Reserve seals. But the Treasury seal reads, "Thou shalt not steal."

The back of the bill also looks like the $20 bill, but around the edges are admonitions against looking at a woman with lust and other sins, and repentance is urged.

According to federal Web sites, the largest bill printed is a $100,000 bill, but it circulates only among Federal Reserve banks. Grover Cleveland's picture, which appears on the $1 million religious tracts, actually appears on the $1,000 bill.

Nobody has been arrested, but the counterfeiting cops did seize the group's inventory and may issue a formal "cease and desist" order later this week.

The objections to incentives fail to adequately consider a) the range of incentives that might be considered or b) the way organ markets, if such things existed, would in fact operate within a system of insurance (including federal programs) and transplant centers. Incentives, for instance, might include tax advantages of interest primarily to the wealthy. One, proposed by my economist husband, would be a one-year exemption from federal income tax. That would result in organs going from the rich to the poor.

If there were a fully open market, organ acquisition would become just another cost of the transplant, like immunosuppressant drugs or transplant surgeons' fees, to be covered through the normal channels. The problem is when you don’t make payment an above-board part of the medical system. That’s when you get the many problems we currently observe in black markets, ranging from inadequate care and contract/financial protections for those who sell organs to the availability of organs only to those who are willing to break the law and have the means to travel abroad.

I don't believe that permitting payments, whether for organs outright, through tax incentives, or simply to make up for lost wages (which isn’t illegal but doesn’t happen today in large part because people think it's illegal), would make unpaid donations disappear. Blood donations coexist with blood banks that pay for blood. Volunteer fire fighters work alongside professionals. I would have donated a kidney without compensation even if it were legal. But I am a relatively affluent person who can afford to take such risks, and miss a certain amount of income, without compensation.

Expecting people to take risks and give up something of value without compensation strikes me as far more blatant exploitation than paying them. I don’t expect soldiers or police officers to work for free, and I don’t think we should base our entire organ donation system on the idea that everyone but the donor should get paid. Like all price controls, that creates a shortage--in this case, a deadly one.

While giving up a kidney has risks, it is no more risky and far less emotionally fraught than being a surrogate mother, something many women receive both money and personal gratifications from doing. I suspect that if, like the people who use surrogates (or egg donors), kidney patients were affluent professionals with political clout, markets in kidneys would also be legal. Unfortunately, the typical kidney patient tends to be a relatively low-income wage earner without the time, education, or social capital it takes to get policies changed.

As for the idea [from an earlier commmenter] that "Most people view the body/life/health as a sacred matter much like religion is," I certainly agree. When people hear that you are going to donate a kidney, they tend to be repulsed, though after the fact they dole out lots of praise. But we don't need everyone to think it's OK to give or sell kidneys. A tiny minority will do. The rest of the world can simply tolerate their odd behavior.

When I write about "organ donors," I am referring to live donors, primarily of kidneys, but many of the same arguments would apply to incentives for families considering donation of a deceased loved one's organs.

The issue of lost wages is a significant one, especially since kidney patients and their friends and families are disproportionately likely to be of lower socioeconomic status. In many cases, people who might be willing to serve as living donors simply cannot take the chance of financial ruin posed by losing a few weeks of pay (and that's assuming their understanding bosses would give them leave).

Addressing this problem does not require changing federal law--or any government policy. It can be done on a local level by voluntary donations. A philanthropic fund at a major transplant center like Washington Hospital Center, where our surgeries took place, could be established to cover documented lost wages of living donors, presumably with some income cap. Churches could do something similar for members who serve as living donors, presumably for relatives or other church members. This would be particularly valuable in the African-American community; black Americans make up about a third of the people who need kidney transplants.

You may not know this, but in 2004 the state legislature of South Carolina passed a bill authorizing tax credits for [cadaver] organ donors. (The $1000 credit was to have been redeemed by the family.)

The Governor of the state, Mark Sanford, vetoed the bill. His veto message is here.

I found this veto ironic, tragic, and mysterious given that Sanford is ostensibly one of the most libertarian governors in the country. This isn't just my opinion--The State newspaper uses the 'L word' regularly to describe Sanford.

As examples of Sanford's libertarians bona fides, you might note that he was self-limited U.S. Congressman; as Governor he proposed statewide universal school choice (through tax credits); and he has vetoed such measures as increased fines for failure to use child safety seats and an unconstitutional ban on protesting within 1000 yards of a funeral.

Yet given a solution that could possibly save thousands of lives while coercing no one--and costing zero political capital--Sanford punted. My mind boggles.

Sanford may be correct that a state tax credit would violate federal law--a test case would be needed--but there is no reason to deem it immoral, except that the National Kidney Foundation says so. Sanford cites the NKF's opposition in his veto message, on the false assumption that they speak for the interest of people with kidney disease. I'm not sure how big a difference a tax credit would make, but it is worth a try, especially since the very existence of the credit could encourage more people to sign organ donor cards.

So determined is the NKF that kidney donors should never, ever, in any way be compensated for their organs--no matter how many kidney patients current policy kills--that the organization is now trying to stamp out public discussion of the idea. When they heard that AEI is planning a conference on the subject for June 12, they wrote a letter to AEI president Chris DeMuth suggesting that the conference shouldn't be held. The letter from NKF chief Davis (PDF available here) opens:

The officers and staff of the National Kidney Foundation (NKF) were surprised to learn that AEI has scheduled a forum entitled "Buy or Die: Market Mechanisms to Reduce the National Organ Shortage" that will be held on June 12, 2006. We agree that there should be open discussion of all reasonable approaches to increase organ donation, and that the shortage of organs for transplantation deserves greater attention by policy makers. Nevertheless, we believe that the concept of financial incentives has been adequately debated for 15 years, begining with the National Kidney Foundation's 1991 workshop on "Controversies in Organ Donation," and culminating in the definitive Institute of Medicine (IOM) report that was issued late in April 2006. We don't see how an AEI forum would contribute substantively to debate on this issue. [Emphasis added.]

In other words, "We'd like to maintain our monopoly on the policy debate, so please shut up."

Keep in mind by way of context that there are 66,000 Americans on the waiting list for kidneys and that if every single person in the country agreed to be a post-mortem kidney donor, that would only double the supply of cadaver kidneys to about 13,000 a year, since a relatively few causes of death allow for organ transplants.

For more background on the policy debate, see previous posts here, here, and here. Marginal Revolution blogger and GMU economist Alex Tabarok takes a detailed look at incentives here.