Thursday, April 22, 2021

Lawsuits to overturn bans on repugnant transactions: kidney sales and incest

 What to do if a transaction you would like to engage in is banned?  You could sue to overturn the ban.  Here are two recent news stories, both from the NY Post:

NJ man suing federal government for rights to sell his own organs  By Priscilla DeGregory

"John Bellocchio, 37, of Oakland filed the suit against United States Attorney General Merrick Garland in Manhattan federal court Thursday.

"He says in the suit that he struggled financially and looked into offloading some of his organs — perhaps a kidney — only to find out it’s illegal to make a buck on your body parts.

"Bellocchio, a career academic who now owns a business that helps connect people with service dogs, argues that the law contravenes his constitutional right to freedom of contract in determining what can be done with his own personal property — or, more specifically, his own body.

"There “is a broad misunderstanding among so many people that a well-regulated government-managed market for organs is something out of a bad Dickens novel, like Sweeney Todd-type stuff and it’s just not the case,” Bellocchio told The Post."
**********


"A New Yorker who wants to marry their own adult offspring is suing to overturn laws barring the incestuous practice, calling it a matter of “individual autonomy.”

"The pining parent seeks to remain anonymous because their request is “an action that a large segment of society views as morally, socially and biologically repugnant,” according to court papers.

...
"Legal papers give only the barest picture of the would-be newlyweds, failing to identify their gender, ages, hometowns or the nature of their relationship.

“The proposed spouses are adults,” the filing says. “The proposed spouses are biological parent and child. The proposed spouses are unable to procreate together.”

"Incest is a third-degree felony under New York law, punishable by up to four years behind bars, and incestuous marriages are considered void, with the spouses facing a fine and up to six months in jail.
...
"In 2014, a state appeals court unanimously approved a case involving a woman married to her mother’s half-brother, noting the genetic relationship was the equivalent of first cousins. But even that ruling cited “the almost universal horror” with which a parent-child marriage is viewed."

HT: Kim Krawiec

Wednesday, April 21, 2021

Signals and interviews in the transition from medical school to residency

Late last year I was interviewed by Dr. Seth Leopold, who is a Professor in the Department of Orthopaedics and Sports Medicine at the University of Washington School of Medicine, and Editor-in-Chief of the journal Clinical Orthopaedics and Related Research.   That interview has just appeared ahead of print on the journal's website: 

A Conversation with … Alvin E. Roth PhD, Economist, Game Theorist, and Nobel Laureate Who Improved the Modern Residency Match  by Leopold, Seth S. MD, Clinical Orthopaedics and Related Research: April 7, 2021 - Publish Ahead of Print - doi: 10.1097/CORR.0000000000001758

Here's one part of our Q&A:

Dr. Leopold:You once commented in a Not the Last Word column in CORR® that the Match might be improved if a bit more room could be made for candidates to send “signals” to programs that indicate particular interest[5]; if you could make one change to the Match right now to make it fairer all around, what would that change be?

Dr. Roth: I don’t yet know enough about the whole pre-Match process of applications and interviews to answer that confidently. I’m hoping to gain access to data that will illuminate more clearly how applications lead to interviews, and how interviews interact with other kinds of information to influence what rank-order lists are submitted by applicants and programs. Some of that process is surely in flux, between the pandemic causing interviews to be conducted remotely and the United States Medical Licensing Examination Step 1 going pass/fail. Signaling is a way to address miscoordination in interviewing (such as whether too many interviews are concentrating on too few candidates), but there are other ways the interview process might be broken that might better be addressed by other tweaks in how interviews are organized.

Dr. Leopold:I believe the study you’re proposing here would find a very attentive audience, both in medical schools and residency programs across the country, especially competitive ones like orthopaedic surgery. Based on other kinds of markets you’ve evaluated—I recognize I’m asking you to speculate—what do you think you might find here?

Dr. Roth: Presently, in at least some specialties, many interviews are conducted for each residency and fellowship position. It could be that interviews play a critical role in allowing programs and applicants to assess each other, regardless of the other information they may have. But it could also be that at least some interviews are being conducted “defensively,” because all the interviews that others are participating in make it hard for each program or applicant to predict how likely any interview will lead to a position being offered and accepted in the Match. So, it is possible that there is “too much” interviewing, in the sense that in perhaps predictable ways, some programs are interviewing some candidates they can virtually never hire, and some candidates they would never want to hire. Conversely, applicants are interviewing for some jobs they have hardly any chance of being offered, and some they sensibly think they won’t need to take. Of course, some things can be predictable even if they can’t be predicted by individual applicants and programs with the information they now have available. It might therefore be possible to suggest institutional reforms that would help reduce the uncertainty in deciding which interviews to offer. That might also reduce the number (and costs) of interviews. (In just such a way, the Match helped solve the problem of uncertainty involved in offers and acceptances, back when offers were exploding.) And there’s a possibility that fewer interviews could make everyone better off in terms of expectations, particularly if participants on both sides of the market will feel a reduced need to do so many interviews if everyone else reduces the number they do. But as you say, until we can look into this carefully, I’m just speculating.

Tuesday, April 20, 2021

The surge in exam-optional applications for college admissions

 Covid forced lots of colleges to make standardized tests optional in admissions, and that seems to have jolted the growth in college applications to new highs.  The Chronicle of Higher Education has the story:

The Endless Sensation of Application Inflation  By Eric Hoover

"consider a big-deal development: the suspension of standardized-testing requirements. After most of the nation’s big-name colleges adopted test-optional policies for the 2020-21 cycle, they all but guaranteed a surge in applications from students who otherwise wouldn’t have applied. When that surge came, some admissions deans publicly expressed surprise that their testing requirements apparently had been suppressing applications from underrepresented students all along, just as critics of ACT and SAT requirements have been saying for decades.

...

"there are some drawbacks to having an overwhelming number of choices, Brennan says: “In admissions, you don’t get a 20-percent increase in staff to account for a 20-percent increase in applications.”

Monday, April 19, 2021

Controversial Markets: Public lecture at the Zurich Center for Market Design (video)

 A video of my April 13 lecture on Controversial Markets is now available at the Zurich Center for Market Design. (The talk proper is about an hour, and then includes some Q&A about compensation for donors, among other things, starting at around minute 56.)

Here's a direct link:


Sunday, April 18, 2021

Texas gas and electricity

 The electric power system failure in Texas following severe winter weather continues to draw commentary (and may eventually draw politically actionable conclusions).  The supply chain of electricity proved complex: e.g. some electric generation depended on natural gas supplies that themselves required electricity.

Here are some recent entries.

From the Federal Reserve Bank of Dallas:

Cost of Texas’ 2021 Deep Freeze Justifies Weatherization. by Garrett Golding, Anil Kumar and Karel Mertens

"Though the cost of annual preparations for extreme and relatively infrequent weather events has proven difficult for policymakers and industry to justify, the shocking aftermath of the February freeze and the resulting widespread power outage demand a careful re-examination. Our analysis indicates winterizing for extreme winter weather events appears financially reasonable.

...

"Temperatures dipped into the single digits and lower across much of Texas overnight on Feb. 14. Electricity demand surged as critical equipment failed at several power plants. Wind-farm output—already low due to diminished wind speeds—declined further as ice accumulated on turbine blades. Electricity generation declined yet again when gas-fired power plants were unable to procure needed gas supplies. Nearly 4 million Texas customers—representing more than 11 million people—lost power during the Arctic blast (Chart 1).


"While industry sources report gas production difficulties occurred because of wells and other such installations freezing, the bigger disruption began when power was cut to the wells, processing plants and compressor stations that move the gas into and along major pipelines serving power plants. During the storm, 38 of Texas’ 176 gas processing plants shut down due to weather conditions and electricity service disruption. Texas natural gas production dropped 45 percent Feb 13–17.

"This created a death spiral for electricity generation."

*************

Here's Peter Cramton in the Dallas News:

Natural gas producers hit the jackpot during the power outages, but they failed Texas The electrical grid is only as reliable as its fuel supply.  by Peter Cramton

"starting on Feb. 11, the storm exposed every Texas county and much of the Midwest to frigid temperatures. Gas field equipment froze, and gas production began falling on Feb. 12, according to the Energy Information Administration, ultimately dropping 45%. Outages from gas-fueled power plants were double what planning models forecasted in the extreme-storm scenario. (Renewable resources, wind plus solar, performed better than expected during the storm.)

"With a deep drop in electricity supply and a sharp increase in demand, the system operator, the Electric Reliability Council of Texas, could not balance supply and demand without ordering controlled outages of about one-third of the system to prevent a catastrophic blackout. Those power cuts exacerbated gas delivery failures to many power plants.

"The failure of gas-fueled power was the proximate cause of the Texas electricity crisis. Had the gas supply been reliable, the electricity shortage would have been far less severe. 

...

"Fixing the Texas gas market is no easy task. Its regulator, the Texas Railroad Commission, is a textbook example of regulatory capture. For decades, the commission has operated as an advocate for the oil and gas industry. This cozy relationship contributed to the Texas disaster because the lack of gas field and pipeline preparation for cold was a major cause of the electricity outages — and one that better regulation would have avoided.

*******

And here's the WSJ:

A Failure of Texas-Size Proportions’—State Debates How to Overhaul Its Power Market. February storm exposed flaws in laissez-faire electricity system; fixes promise to be complex and costly. by Katherine Blunt and Russell Gold

"Fixing the market promises to be as complex as it is costly. The challenge facing Texas Gov. Greg Abbott and state lawmakers is how to make the state’s deregulated power market more reliable, while limiting added costs that would make its electricity more expensive.

"Texas operates the nation’s only pure “energy only” electricity market, one in which producers are paid just for the power they sell, not the ability to deliver whenever watts are needed. All other deregulated electricity markets in the U.S. offer power generators some form of payment for being ready to produce power, to ensure the market has sufficient capacity to reliably provide an essential resource.

"For most of the past two decades, the Texas approach worked. It helped the Lone Star State keep wholesale power prices for much of the past two years at less than $30 per megawatt-hour on average, well below most other regional power markets.

"But a Texas grid that valued inexpensive power over reliability failed spectacularly during February’s winter storm and frigid temperatures, leading not only to crushingly high electricity prices, but power and water shortages that virtually shut down the state’s economy, and frozen pipes that caused widespread property damage."

Net capacity of generators, minute-by-minute



Saturday, April 17, 2021

The Leading Causes of Death in the US for 2020

 In the preliminary data for 2020, COVID is the number 3 cause of death in the US, after only heart disease and cancer.  (Kidney disease moves to number 10, from it's usual rank of 9...)

The Leading Causes of Death in the US for 2020  by Farida B. Ahmad, MPH; Robert N. Anderson, PhD JAMA. Published online March 31, 2021. doi:10.1001/jama.2021.5469



Friday, April 16, 2021

Foster care: professionalism vs. altruism, and related matters

 Foster care in families is one of the areas in which there is in many places considerable repugnance to paying the caregivers, partly out of fear that payment will attract the wrong kind of caregivers.  Partly as a consequence, there is a shortage of foster families for children in need.  Here's a 2008 survey that touches on these issues.

The Recruitment and Retention of Family Foster-Carers: An International and Cross-Cultural Analysis by Matthew Colton, Susan Roberts and Margaret Williams, The British Journal of Social Work, Vol. 38, No. 5 (July 2008), pp. 865-884  (pdf at JSTOR)

Abstract: Fostering services across the globe encounter difficulties in recruiting and retaining family foster-carers. Yet, we know little of the international and cross-cultural issues which impact on recruitment and retention. In this article, we draw on previous empirical research, and also on information collected during a recent study of global trends in family foster-care, to present an international comparative analysis of those issues. Three key themes emerged from the study: motivation and capacity to foster; professionalism versus altruism; and criteria for kinship and unrelated carers. Each of these presents a considerable challenge to foster-care services. Here, we explore these key themes further, and reflect on the implications for policy and practice.


" The recruitment and retention of family foster-carers are key to the delivery of  effective fostering services (Sellick and Howell, 2003). However, difficulties are  experienced on a global level with regard to recruiting and retaining sufficient  numbers of carers.

...

"Although many countries have seen an increase in the use of foster-care as  the placement of choice in recent years, there is a worldwide shortage of placements. In the UK, the shortfall has meant that in many cases, placements are  simply not available and, when a placement can be found, it is not the placement of choice (Sellick, 2006; Sellick and Thoburn, 2002; Pithouse et al., 2000).  The majority of placements are made in emergencies...

"Professionalism versus altruism:  The lack of adequate remuneration for unrelated as well as kinship carers has  had a detrimental impact on recruitment and retention. In the UK, much  research has focused on foster-carer payment (see, e.g. Kirton, 2001; Pithouse  et al., 1994; Sellick, 1992; Bebbington and Miles, 1990), with some commentators highlighting the 'confused and confusing' systems of payment associated  with foster-carers' status as employees, volunteers or professionals (Pithouse  et al., 1994, p. 45). It is clear that, in some cases, although payment did not  motivate foster-carers to care, the adequacy and efficiency of payment systems  sustained them when they were faced with children's challenging behaviour or  lack of progress (Kirton, 2001).

...

"In Sweden, foster-carers are remunerated for the child's board and lodging, and receive payment for their work  which is taxable, and deemed pensionable income (Hojer, 2006). Half the  foster-carers surveyed by Hojer (2001), however, felt that the payment they  received was too low. Further, some expressed fears that they would be perceived as greedy and that their foster-children would feel they were being looked after for financial reasons rather than personal commitment. As is the  case elsewhere, foster-carers in private agencies in Sweden generally receive  higher fees than those in the public sector. They receive a 'paid commission' as  opposed to being 'paid employees' of social services and are, therefore, not eligible to receive unemployment benefits when placements cease. There is thus a  degree of financial insecurity attached to the foster-carer role in Sweden—a  situation acknowledged by the government and subject to investigation (Hojer, 2006).

...

"Although the foster-care service in Fife, Scotland, had been  'fully professional' (Ramsay, 1996, p. 44) since 1990, carers' socio-demographic  characteristics were found to be similar to those of foster-carers in other studies  (see, e.g. Bebbington and Miles, 1990). Some financial reward, together with  the support provided by link social workers and foster-carer groups, proved  key to recruitment and retention. Indeed, payment of a professional fee to carers resulted, to some extent, in 'financial freedom', thus enabling them to care  (Ramsay, 1996, p. 46).

"The conflict between professionalism and altruism presents as a real issue for  fostering services today, and recruitment may become even more difficult if  foster-carers continue to be inadequately paid. In some countries, for example,  the rate of pay for a foster-family providing full care to a child aged four to  eleven years amounts to less than it costs to keep a dog in a kennel. One of the  justifications for this is that a higher rate of pay will attract those who want to  foster for financial as opposed to altruistic reasons (Martin et al., 2006)."

*********

Stanford GSB Ph.D. student Cameron Taylor has a working paper modeling the decision of families to provide foster care:

Fostering Children, by Cameron Taylor, November 13, 2019 

"Foster care is an important social service. In the US, hundreds of thousands of children enter the foster care system every year due to substantiated reports of abuse or neglect. Foster children tend to have lower educational attainment, and significantly higher rates of incarceration and homelessness than the general population (Gypen et al., 2017). They represent some of the most disadvantaged children in society.

"The foster care market is organized so that children are removed from their birth homes and then placed either in institutional settings or with volunteer families. The driving motivation behind placing children with families is that keeping children in family environments can stimulate higher quality childcare through “normal childhood experiences” (Welfare and Institutions Code 16000).

"While previous work has focused on the effects of different margins of foster care on child welfare outcomes, very little is understood about how or why families choose to be foster parents. This paper studies how families choose to be foster parents through the lens of a simple price theoretic household model"

**********

Here's a paper presented yesterday at the 2021 NBER Decentralization Conference on Mechanism Design for Vulnerable Populations  

Abstract: This paper presents an empirical framework to study the assignment of children into foster homes and its implications on placement outcomes. The empirical application uses a novel dataset of confidential foster care records from Los Angeles County, CA. The estimates of the empirical model are used to examine policy interventions aimed at improving placement outcomes. In general, it is observed that market thickness tends to improve expected placement outcomes. If placements were assigned across all the administrative regions of the county, the model predicts that (i) the average number of foster homes children go through before exiting foster care would decrease by 8% and (ii) the distance between foster homes and children’s schools would be reduced by 54%.

**********

And here's a working paper that models the matching of children to foster families:

Search and Matching for Adoption from Foster Care  by Nils Olberg, Ludwig Dierks, Sven Seuken, Vincent W. Slaugh, M. Utku Ünver

"More than 100,000 children in the US foster care system are currently waiting for an adoptive placement. Adoption agencies differ significantly in what systems they use to identify matches between families and children. We consider two prominent alternatives: (1) family-driven search, where families respond to announcements made by the caseworker responsible for a child, and (2) caseworker-driven search, where caseworkers utilize a software tool to perform a targeted search for families. In this work, we compare these two systems via a game-theoretic analysis. We introduce a dynamic search-and-matching model that captures the heterogeneous preferences of families and children. This allows us to study their incentives during the search process, and we can compare the resulting welfare of the two systems in equilibrium. We first show that, in general, no system dominates the other, neither in terms of family welfare nor in terms of child welfare. This result maybe surprising, given that the caseworker-driven approach employs a less wasteful search process. However, we do identify various advantages of the caseworker-driven approach. Our main theoretical result establishes that the equilibrium outcomes in caseworker-driven search can Pareto-dominate the outcomes in family-driven search, but not the other way around. We illustrate our results numerically to demonstrate the effect different model parameters (e.g., search costs and discount factors) have on welfare."