Tuesday, August 21, 2018

An egregious repugnant transaction

When I speak about repugnant transactions--transactions which some people voluntarily engage in, but other people think they shouldn't, or perhaps shouldn't even be allowed to--I sometimes run into some skepticism from economists who point out that voluntary transactions generally increase welfare, and that to restrict them is paternalistic.

Nevertheless, many people have that (paternalistic) impulse at least sometimes.
Test yourself on this one, from the Guardian:

British stag group in Spain 'paid homeless man to get face tattoo'
Anger in Benidorm as Polish national given £90 to have groom’s name on forehead

"British tourists on a stag party in Benidorm have provoked outrage by paying a homeless man to have the name of the groom tattooed on his forehead, a local business leader has said.

Karen Maling Cowles, the president of the Benidorm British Business Association, said the group gave 34-year-old Tomek, originally from Poland, €100 (£89) to have “Jamie Blake, North Shields, NE28” inked on his head...
...
"Residents of the Spanish resort criticised the stag group after the tattoo parlour posted a photo on Facebook, since taken down, of Tomek getting the tattoo."
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HT: Muriel Niederle

Monday, August 20, 2018

Medically assisted death debated in Australia

A bill is under consideration in Australia regarding medically assisted suicide, aka death with dignity.  (The politics are complicated by the fact that Australia has both states and territories.) Here's the story from the Guardian:

David Leyonhjelm confident voluntary euthanasia bill will pass Senate
Liberal Democrat pressures Malcolm Turnbull to permit vote in lower house

"The bill to allow the Northern Territory and Australian Capital Territory to legislate for euthanasia – reversing a ban imposed by the commonwealth in 1997 – has support from at least 18 Labor senators, the nine Greens, eight crossbench senators and a small but growing group of Coalition senators. It needs 39 to pass the Senate.
...
"“Australians with a terminal illness should have a right to die with dignity, ideally with effective palliative care, but with sufficient safeguards, that right, in extreme cases, should also extend to voluntary euthanasia.”
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An earlier, related post:

Friday, May 4, 2018

Saturday, August 18, 2018

Diversity isn't just about role models: Alsan, Garrick and Graziani on black male doctors and patients

Medical compliance--following the doctor's "orders,"--is a big issue in medical care, and here's an article that reports a novel field experiment suggesting that black male doctors treating black men may have more success than non-black docs.

Does Diversity Matter for Health? Experimental Evidence from Oakland
Marcella Alsan, Owen Garrick, Grant C. Graziani
NBER Working Paper No. 24787

"We study the effect of diversity in the physician workforce on the demand for preventive care among African-American men. Black men have the lowest life expectancy of any major demographic group in the U.S., and much of the disadvantage is due to chronic diseases which are amenable to primary and secondary prevention. In a field experiment in Oakland, California, we randomize black men to black or non-black male medical doctors and to incentives for one of the five offered preventives — the flu vaccine. We use a two-stage design, measuring decisions about cardiovascular screening and the flu vaccine before (ex ante) and after (ex post) meeting their assigned doctor. Black men select a similar number of preventives in the ex-ante stage, but are much more likely to select every preventive service, particularly invasive services, once meeting with a doctor who is the same race. The effects are most pronounced for men who mistrust the medical system and for those who experienced greater hassle costs associated with their visit. Subjects are more likely to talk with a black doctor about their health problems and black doctors are more likely to write additional notes about the subjects. The results are most consistent with better patient-doctor communication during the encounter rather than differential quality of doctors or discrimination. Our findings suggest black doctors could help reduce cardiovascular mortality by 16 deaths per 100,000 per year — leading to a 19% reduction in the black-white male gap in cardiovascular mortality.
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While there's no substitute for the kind of serious science reported in the paper above, below is a very believable anecdotal account in an interview published in Stat that suggests that companies seeking to solve medical problems afflicting women may have more success with venture capital firms that have women partners:

A women’s health startup tried to drum up interest for a much-needed drug. Many men didn’t get it


Friday, August 17, 2018

Kidney exchange on NPR

Two friends told me that they'd heard me on NPR yesterday, and so I searched and found this program on kidney exchange. (At the link below you can read the transcript, and also see a 9 minute video that apparently played on tv.) They interview patients, donors, and kidney docs, and feature two economists, me and Nikhil Agarwal.  (My part seems to be pieced together from footage from a talk I gave at a Google conference, and a video made by the National Academy of Sciences, but it looks like they actually interviewed Nikhil...)

The economic principle that powers this kidney donor market
Aug 16, 2018 6:20 PM EDT

I can't figure out how to embed the video in this post, but here's a picture that's just a screen shot, not a link:

Thursday, August 16, 2018

An open marketplace for reinsurance

Tremor Technologies Inc. has announced its new online marketplace for reinsurance.  Here's the press release:

Tremor Technologies, Inc., a venture-backed startup based in Greenwich, CT, has announced that its programmatic risk placement marketplace is fully operational with significant buyers and sellers of reinsurance protection in place.


And here's an article with a little more detail:

Tremor opens programmatic marketplace for reinsurance risk placement
by ARTEMIS on AUGUST 14, 2018

"The company has venture capital backing and has been developing its technology platform and building a team of marketplace design experts* for two years now, with the resulting smart market now available.
...
"Peter Cramton, Tremor’s Chief Economist and a recognised international expert on auction theory and practice, as well as market design, commented, “We maximize value for both sides of the market and then fairly share that value among participants with competitive clearing prices.”

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*full disclosure--I'm on Tremor's advisory board.

Wednesday, August 15, 2018

Why aren't clearinghouses used in college admissions?

I recently had an email from  Professor Deepak Hegde, at NYU's Stern School who asked me a question that led to the following exchange (edited for brevity and reproduced with his permission):

"Why are admission decisions in a broader set of settings (e.g., Phd applicants-programs, MBA applicants-to-business schools and so on)  not cleared through matching programs as is done with medical schools and residency applicants (or in some cases public schools matching)?   Are there a general set of conditions that one could develop to understand the contexts in which the matching algorithm that have helped advance could be implemented effectively?"

I replied as follows:

"I certainly don’t have a complete answer, but one obvious piece is that setting up a centralized clearinghouse for a whole market involves getting a lot of parties to coordinate and cooperate.  So I would guess that MBA admissions have a better chance of getting organized than, say Ph.D. admissions, since MBA programs are more alike one another than are Ph.D. programs (e.g. in Physics and Philosophy, or Chemistry and Chinese).

"And since wide scale cooperation is hard, I think it mostly happens in market in which people are very dis-satisfied with the existing system, and not just somewhat irritated.

"Is it your sense that MBA admissions is in a crisis of some sort?"

His reply: "In my assessment ... MBA admissions is not facing such a crisis, yet."

So...I think the MBA Match isn't something we'll hear about in the near future.