Tuesday, June 30, 2009
Behavioral game theory on the MA Turnpike
Some still slow to make the move to Fast Lane: 1 in 3 tollpayers paying at booth
"The Massachusetts Turnpike Authority has made strides in signing people up to use Fast Lane, with 66 percent of tolls now paid electronically, up from 62 percent in January. But the 34 percent who use cash, and pay higher tolls at booths inside Greater Boston to do so, remain a bit of a mystery."
...
"The survey LeBovidge conducted found that the biggest hurdle to signing up more people used to be cost, accounting for about 75 percent of the abstainers. About 7 percent worried about handing personal data to the Turnpike Authority or having their movements tracked. Some remaining drivers - not reflected in the survey - come from out of state and might not have an E-Z Pass account usable in Massachusetts. Other commuters do not have a checking account or credit card.
...
"If they wait in cash lanes enough times, most technophobes get converted. Fast Lane usage at the Allston-Brighton booths rises to 86 percent during morning rush hour into Boston. Massive traffic jams also do the trick: The Easter backup helped drive signups to 45,905 in May, compared with 10,875 during the same month last year."
One reason this is an interesting problem is that it's not just about individual choice, there's an element of behavioral game theory in this kind of slow learning. Cash payers produce congestion--negative reinforcement--for other cash payers. When lines at the toll booths get really long, even the EZ Pass users have to wait on line to get to the toll booths. So slower payers provide a negative externality to everyone on the busiest days.
In a forthcoming paper in the QJE, Amy Finkelstein raises the possibility that those cash payers may also provide a small positive externality by being more politically sensitive to changes in the tolls: EZ-Tax: Tax Salience and Tax Rates.
"Abstract: This paper examines whether the salience of a tax system affects equilibrium tax rates. I analyze how tolls change after toll facilities adopt electronic toll collection (ETC); drivers are substantially less aware of tolls paid electronically. I estimate that, in steady state, tolls are 20 to 40 percent higher than they would have been without ETC. Consistent with a salience-based explanation for this toll increase, I find that under ETC, driving becomes less elastic with respect to the toll and toll setting becomes less sensitive to the electoral calendar. Alternative explanations appear unlikely to be able to explain the findings."
So the next time you are stuck on the Mass Pike behind a long line of drivers waiting to pay their tolls, try to remember that there may be a small benefit to having the toll be so salient.
Monday, June 29, 2009
Where the wait for a parking permit is 8 to 10 years
The NY Times reports that the recession has resulted in fewer commuters and empty parking spaces, but has not shortened the wait for a parking permit, since commuters are reluctant to give up their right to park (and cannot sublet them to those still working): Slump Opens Spaces at the Station
"From Ronkonkoma on Long Island to Darien, Conn., riders are doing double takes at the vacancies in the station lot, and the empty spots, in turn, have sparked efforts to free them up for parkers without permits. In Connecticut, there is even a push to let permit holders “rent” their permits.
...
But these empty spaces may be chimerical. It’s “look but don’t touch” for people like Mr. Blake because many permit holders, even if they have lost their jobs and no longer commute regularly, still hold tightly onto their permits. Jeanette DeLeo, an assistant in the city clerk’s office in Rye, said there has been no whittling of the waiting list in her town, and the reason is not hard to fathom.
“With a waiting list of 8 to 10 years, people will not give up their permits,” Ms. DeLeo said."
Sunday, June 28, 2009
You can be too rich or too thin: Repugnance and fashion
Now even Vogue thinks you can be too thin.
"A brave editor has exposed fashion's dark secret - that it is the designers themselves who demand ultra-skinny models"
"Alexandra Shulman, the editor of British Vogue, has written to international fashion designers complaining that their sample garments - displayed on catwalks or sent to magazines for photo shoots - have in recent years gradually shrunk. Now they are so small, the only models who can fit into them are flat-chested, hipless, and so emaciated that Vogue is fearful of readers' horror if they put them on the cover. Even the superwaif Kate Moss struggles. Post-motherhood, post-30, she has newly acquired breasts.
Shulman's letter is brave: in taking on her own industry she risks scorn, snubs and precious advertising revenue. But she is also clever to cut to the heart of the long-raging size-0 debate. Before, the glossy magazines or model agencies were blamed or the models themselves made scapegoats. In 2006 the Spanish Government decreed that any girl with a body mass index of less than 18 should be banned from fashion shows. Many balked at the notion of gazelle-like teens being publicly weighed like livestock. Designers insisted that these were just naturally slender young women and that they sized their samples accordingly.
Shulman's letter exposes the dark truth, that the pressure to use überskinny models emanates from the designers themselves. In gradually shaving millimetres off sample sizes they force a model, who already has only a few ounces of body fat, to starve herself. To choose, perhaps, between Prada and her periods. (Italian and French designers are the most didactic body fascists.) And if a glossy magazine wishes to publish the latest collections by, for example, Dior these are the girls they must use. Indeed some newspapers - with less “edgy” values and older readers - now resort to retouching catwalk shots to make the models look bigger, less scary."
Understanding repugnance to some transactions is so tricky because it so often involves many things other than pure repugnance, such as the incentives that competition in certain professions may give members of those professions, and how such competition might therefore be regulated for the public good (e.g. no life-shortening steroids for athletes). The repugnance involving ultrathin young models may be akin to the repugnance that society feels to prostitution.
Saturday, June 27, 2009
Price gouging
Here are some of the earlier posts in that discussion:
Price gouging policy as rendered in everyday politics
Price gouging and behavioral economics – more work needed
Price gouging: Is it wrong? Should it be against the law?
Price gouging seems to me to be a special class of repugnant transactions, repugnant not because money is involved, but because too much money is involved. (Special, but not unique. Recall the $10,000 upper limit in yesterday's post.)
Friday, June 26, 2009
Money for eggs for stem cell research
Rob Stein has a great story in the Washington Post: New York to Pay Women to Give Eggs for Stem Cell Research. I'm going to quote at length from it below, because the controversy in many ways parallels that about whether or not there should be a market for kidneys.
Both controversies revolve around whether compensation for donors is a repugnant transaction, involving coercion, or exploitation, or the objectification* of people, or the encroachment of markets into areas that should be outside of market influence, or whether these are transactions that willing adults were until now unreasonably prevented from participating in. Quotes follow, emphasis added.
"New York has become the first state to allow taxpayer-funded researchers to pay women for giving their eggs for embryonic stem cell research, a move welcomed by many scientists but condemned by critics who fear it will lead to the exploitation of vulnerable women.
The Empire State Stem Cell Board, which decides how to spend $600 million in state funding for stem cell studies, will allow researchers to compensate women up to $10,000 for the time, discomfort and expenses associated with donating eggs for experiments. "
...
"The little-noted decision two weeks ago puts New York at odds with policies in every other state that provides funding for human embryonic stem cell research and with prevailing guidelines from scientific organizations, including the National Academy of Sciences.
The move was welcomed, however, by proponents of stem cell research, stem cell scientists and some bioethicists, who said it would remove a major obstacle to pursuing some of the most exciting goals of the research -- including producing replacement tissues tailored to individual patients. " ...
"But the decision was questioned by others, including opponents and some proponents of stem cell research.
"In a field that's already the object of a great deal of controversy, the question is, are we at the point where we really need to go that route in order to do the science?" said Jonathan D. Moreno, a professor of bioethics at the University of Pennsylvania. "I'm not convinced." "
...
""The lack of compensation has meant it's been nearly impossible to get enough eggs," said Douglas A. Melton, co-director of the Harvard Stem Cell Institute in Boston. "
...
But proponents of reimbursing women have argued that fertility clinics routinely pay women thousands of dollars to donate eggs to help infertile women have children.
In making its decision on June 11, the New York board argued that there was no reason that stem cell researchers should be precluded from offering women equivalent sums, although they stressed that researchers should follow the same guidelines as fertility clinics: Anything over $5,000 must be justified, and anything over $10,000 would be excessive.
"We could not distinguish ethically between the payment for in vitro fertilization, which is very well precedented, and the compensation for donation for research," Hohn said.
Ronald M. Green, a Dartmouth College bioethicist, agreed.
"It is discriminatory against women to ban them from receiving payment," Green said. "We pay for participation in research that has risks associated with it for other procedures. So why not this? The idea that women cannot make that decision on their own strikes me as sexist.
But Moreno, at the University of Pennsylvania, questioned whether enough effort had been made to persuade women to donate eggs without compensation. "I wonder if all the expertise that could be brought to be bear on this problem of getting unreimbursed donation have been explored," he said. "
...
"Moreover, critics worry that the move could lead to the exploitation of women, especially poor women, who tend not to be in demand for infertility donation.
"With the economy the way it is, you don't need to be a rocket scientist to know that when a woman is looking at receiving up to $10,000 to sign up for research project, that's an undue inducement," said Thomas Berg, a Catholic priest who directs the Westchester Institute for Ethics & the Human Person and serves on the Empire State Stem Cell Board's ethics committee. He opposed the decision. "I think it manipulates women. I think it creates a trafficking in human body parts."
Others agreed, calling it an unnerving precedent.
"Whenever society starts to pay for relationships that are traditionally done with altruism and generosity within families, it raises the issue of whether there is anything that is not for sale," said Laurie Zoloth, a Northwestern University bioethicist. "
*On arguments involving objectification and such, see here, starting on p.45
Thursday, June 25, 2009
Kidney exchange in Canada
HT: Duncan Gilchrist
Testing companies as (nonprofit) gate keepers
Slate follows the money, and the nonprofit status of the main testing companies: Taking the $ATs
"Last year, the SAT cost $45 for the basic test, which 1.5 million U.S. students took. The College Board does not comment on how much revenue each test brings in, but once you factor in the nearly 222,000 students who received fee waivers from the College Board, you can roughly estimate that SAT revenue was at least $58,360,365. I say at least because many students take the test over and over again, trying to refine their scores to get into better colleges. That's not to mention the litany of extra fees the College Board charges if you get your scores by phone ($12.50), rush the results ($36.50), or ask for a refund ($7). The real revenue is likely to be millions more than $58,360,365, and that's before you factor in the foreigners who want a piece of an American education ($26 international processing fee; $23 more if you're taking it in India or Pakistan).
That's only the beginning. Many colleges also demand that students take SAT Subject Tests, which are more focused than the broad-ranging SAT. The majority of students who take Subject Tests, which are at least $29 each, sit for three or more. In all, 752,854 Subject Tests were taken, leading to at least $21.8 million in revenue but certainly far more because of the flexible pricing structure.
The PSAT, which serves little purpose besides being a warm-up act for the SAT? $13 per test. In 2006, 2.7 million students took the PSAT for an estimated $35.3 million in revenue, less whatever costs the College Board waived for low-income students.
Then there are the AP exams, which assess whether students have college-level mastery of a subject, usually after taking a corresponding honors course in high school. Having an AP course on your transcript is highly attractive for your college application, just as scoring well on an AP test is highly beneficial once you get to college. So for the elite students in the country, the AP test is a necessary evil, one that costs them $86. In 2008, more than 2.7 million AP tests were taken worldwide. That's more than $232 million of revenue.
In 2006—the most recent year for which the College Board's tax returns are available—the College Board brought in a total of $582.9 million of revenue. Meanwhile, it spent only $527.8 million. That leaves it with a $55.1 million surplus.
In most cases we'd call that $55.1 million a pretty good profit margin. But here's the thing: It's not profit; it's "excess." The College Board is a nonprofit, so by law that $55.1 million has to be rolled over to the next year's budget. In exchange, the College Board gets a host of tax breaks and the cultural benefit of seeming like a cuddly, crunchy organization meant to promote educational ideals. But it's not; it's just as money-hungry and market-share-driven as any other organization. It needs to be to survive an increasingly crowded marketplace. But at what cost?
Some history for context: The College Board was started back in 1900 to help streamline the college-application process. A bunch of colleges had a confab and realized it would be easier if there were a general entrance exam that would qualify you for all the schools at once. Thus, the SAT. These days, the College Board is still a member organization, and it costs a paltry $325 a year to be in the ranks. Those dues grant you a small voice in an unwieldy representative democracy. There are more than 5,000 members, and the real decisions are made by the employees and trustees of the board."
...
"Of course, the College Board is not alone in its drive for revenue. Its main rival, ACT Inc., is a nonprofit out of Iowa City, Iowa, that administers the ACT test, the SAT's main competition. It had a $36 million surplus in 2007, which it says it reinvests in its programs and services, just as the College Board says it does. ACT charges 31 cents each time a college pulls a student's home address from its database, which allows the college to send a promotional brochure to a student's home. Those kind of micropayments add up. (Asked via e-mail whether the College Board had a similar fee, the College Board's spokeswoman offered no response. Test watchdogs suggest that it does, though the fee is unknown. The Big Money was not granted any interviews with the College Board or ACT officials for this story.) The Educational Testing Service, the organization that the College Board uses to actually design, score, and transport the SATs (and to a lesser degree the AP tests), had a $94 million surplus and paid its president $931,605 in 2007.
Is all of this kosher? Nonprofits in this country are generally broken down into two categories: private foundations and public charities. Private foundations are organizations that give money out. Clearly, the College Board and its brethren do not fall under that lot. Most everybody else is classified as a public charity. It's a clumsy label for a whole host of outfits that we don't think of as charities—hospitals, colleges, advocacy groups. Usually, we associate contributions to these nonprofits as being tax-deductible; it's an incentive to give money to charity that makes the nonprofit status so tempting to companies with a social mission. But checks written for the SAT and all the other standardized tests aren't tax-deductible because a service is being offered in exchange for the money. Hence, it's a transaction. A transaction that, according to the tax code, isn't nonprofit in its nature. Yet it counts toward all that revenue for the College Board, which filled out a nonprofit tax return, reaping all the benefits that go along with that. (Again, this all applies to ACT as well.)
To keep its nonprofit status, an organization must pass an IRS review every five years, which means it needs to execute its charitable mission appropriately. The College Board's charitable mission was summed up by its president in 2006: "to connect students to access and opportunity, to prepare more and more students to be ready to go to college and succeed." The quote's logic is circular. In order "to go to college and succeed," you have to get into college. And to do that, you have to prepare for and take the SAT. Certainly, the College Board can help you do that. But if the College Board didn't exist, there would be no need for it to happen in the first place."
Wednesday, June 24, 2009
Breast feeding
Unraveling and uncertainty: The NBA draft
"Instead he chose to play in Italy, where he will earn $1.2 million this season in salary and endorsements, including a shoe contract with Under Armour. Roma signed Jennings to a three-year deal but has little at risk because his contract must be bought out if he leaves for the National Basketball Association.
If Jennings has a strong season with Roma and is among the top 10 selected in next June’s N.B.A. draft, as expected, more players may follow his route. "
As the June 25 draft approaches, here's another story about Jennings, for whom not everything has worked out as hoped: After a Year in Europe, Brandon Jennings Wants to Be Drafted by the Knicks.
"Now, he has his eye on the Knicks.
“I really want to come here, I’m not going to lie,” Jennings said Monday after working out for the Knicks and expressing his appreciation for Coach Mike D’Antoni’s run-and-gun offense. ...The Knicks have the eighth selection in next week’s draft but seem unlikely to pick Jennings if Davidson’s Stephen Curry is available. ...Ricky Rubio, an 18-year-old from Spain whom Jennings called “all hype” last week, is more likely to be the first point guard chosen."
...
"The biggest strikes against the 6-foot-2, 169-pound Jennings are his underwhelming numbers for his Italian club team, Lottomatica Virtus Roma. He averaged 5.5 points, 1.6 rebounds and 2.3 assists in 17 minutes. But he is hoping N.B.A. general managers will see a player with more experience than nearly everyone else in the pool.
“I had to go out there and earn my spot,” he said of his experience in Italy. “It was a job. And I was playing against bigger and stronger guys every day.”
Jennings spoke maturely about his time in Europe, highlighting the character-building value of testing his mettle abroad. But he conceded that at times, it was frustrating. As a freshman at Arizona, the college he committed to before changing plans, he could have been at the center of a successful team that made a run in the N.C.A.A. tournament.
In Italy, Jennings spent most of his time on the bench, trying to make sense of his coaches’ decisions to use him primarily as a defensive player. He said he worried about his draft stock and remembered the critics who told him to go to college.
“It was a humbling experience for me,” Jennings said. “If I would have went to college, I would have played 30 minutes and I would have got whatever I wanted, but I had to go earn my spot.” "
Despite the risk, if Jennings does well in the draft tomorrow, others are likely to follow him to Europe, and soon.
Because of One-and-Done Rule, Others May Follow Jennings's Path:
Talented Recruit Chose European Payday Instead of Mandated College Season
"One year after Jennings's decision to play in Italy, there are signs that his success in the draft could trigger a small but significant movement. Jeremy Tyler, a talented forward from San Diego, already has decided to skip his senior year of high school to play overseas, and several others are now also considering following Jennings's unconventional route to the NBA.
Sonny Vaccaro, the former shoe company executive who helped orchestrate Jennings's move, said he has had in-depth discussions with the parents of seven elite players still in high school about playing overseas instead of going to college.
...
"Because players need to be 19 years old and a year out of high school before entering the NBA draft, they have had few options other than to attend college for at least a year. They view Jennings as a trailblazer because he chose a creative -- if not risky -- route, signing a professional contract instead of adhering to NCAA rules that forbid compensation. "
Update 6/25/09: Jennings chosen 10th, by Milwaukee Bucks. (But the uncertainty lasted right until he was chosen:
"Brandon Jennings' first decision was to not attend the NBA draft. When he was taken 10th by the Milwaukee Bucks, he suddenly showed up.
About a half hour before the draft got under way on Thursday night, Jennings' agent released a statement that his client, who decided to play in Europe last season rather than attend college, would be with his family rather than at the draft with many of the other future NBA players.
There had been media speculation that the 6-foot-1 Jennings, who averaged 5.5 points and 2.3 assists for Lottomatica Virtus Roma of the Italian League, would fall out of the lottery.
"Because we do not have strong grasp of Brandon's draft position, I've advised that he and his family enjoy this day in a more private setting with the people he loves the most,'' Bill Duffy, president and CEO of BDA Sports Management, said in the statement."
Tuesday, June 23, 2009
Even adoption is sometimes viewed as repugnant
The Ethicist column in the NY Times describes the issue: Madonna and Child "There is a creepy evocation of colonialism when a rich American or European swoops into a poor African nation and grabs a child, as if the country were a baby plantation. Critics charge that the adoptive parents benefit from the persistence of poverty. They do, but in much the same way as Lenny Bruce described the modus operandi of Jonas Salk, J. Edgar Hoover and himself: “These men thrive upon the continuance of disease, segregation and violence.” That is, they respond to but do not promote human misery. (O.K., except for Hoover.) "
In the end, a court approved the adoption, reversing a lower court.
Malawi court approves Madonna's adoption of Mercy
"Madonna has succeeded in her attempt to adopt a second child from Malawi after an appeal court overrode residency demands and ruled that “every child has the right to love”.
The decision by the African state’s highest court means the singer could take four-year-old Chifundo “Mercy” James to New York within days.
But it will do nothing to silence complaints that Madonna has used her wealth and celebrity to bypass the country’s laws."
...
"Madonna’s application to adopt Chifundo was initially rejected by a lower court in April because the singer is not resident in Malawi, and because a judge decided that the young girl would fare perfectly well in the orphanage where she has lived. " (emphasis added)
...
"But at Malawi’s Supreme Court of Appeal yesterday a panel of three judges said that the singer’s commitment to helping disadvantaged children should have been taken into account. Madonna has founded a charity, Raising Malawi, for orphans there.
They also argued that the residency disqualification was a narrow interpretation of largely outdated laws.
...
"The Human Rights Consultative Committee said it fears that the ruling has opened up the country’s vulnerable children to trafficking. "
Notice that the initial Malawi judge found the adoption so repugnant that he preferred to leave the child in an orphanage. (I doubt that even in Malawi the judge thought the child would be better off in the orphanage than in a family; rather his feeling must have been that something about the adoption was so repugnant that Malawians should be willing to have the child bear this cost.)
This kind of repugnance, with children bearing the cost, is found not only in the developing world. In the US, the National Association of Black Social Workers is also well known for its opposition to transracial adoption. (Here's an updated link to their September 1972 Position Statement on Trans-Racial Adoptions.) Until relatively recently, this opposition led to adoption practices in the U.S. that discouraged interracial adoption, and often prevented minority children from finding permanent adoptive families. This began to change only with legislation in the 1990's: see
A Guide to The Multiethnic Placement Act of 1994 As Amended by the Interethnic Adoption Provisions of 1996
"The Multiethnic Placement Act (MEPA) was enacted in 1994 amid spirited and sometimes contentious debate about transracial adoption and same-race placement policies. At the heart of this debate is a desire to promote the best interests of children by ensuring that they have permanent, safe, stable, and loving homes that will meet their individual needs. This desire is thwarted by the persistent increases in the number of children within the child protective system waiting for, but often not being placed in, adoptive families. Of particular concern are the African American and other minority children who are dramatically over-represented at all stages of this system, wait far longer than Caucasian children for adoption, and are at far greater risk of never experiencing a permanent home. Among the many factors that contribute to placement delays and denials, Congress found that the most salient are racial and ethnic matching policies and the practices of public agencies which have historically discouraged individuals from minority communities from becoming foster or adoptive parents. MEPA addressed these concerns by prohibiting the use of a child's or a prospective parent's race, color, or national origin to delay or deny the child's placement and by requiring diligent efforts to expand the number of racially and ethnically diverse foster and adoptive parents."
Monday, June 22, 2009
Why did books replace scrolls? Random access and the market for texts
That is, why did the modern form of the book, the codex, with pages bound together on a spine, replace pages sewn together and rolled up in a scroll? (Today, the term codex is mostly used for old, hand-written books that predate the printing press.)
It isn't that scrolls are no longer produced. Every week in synagogues around the world, as a new portion of the Torah is read , the parchment scroll is advanced, from right to left, until it is time to start the annual cycle again.
But if you want to browse, you don't use the scroll, you look in a book. It's easier to flip back and forth in a book, to compare passages, to read ahead and find out what is coming, to look back and remember what came before, to share with another reader who may be at a different place. In computerese, books (in codex form) are random access devices, while scrolls are sequential access machines.
And, except for the Torah, there basically aren't any more scrolls. Books have completely replaced scrolls, since books are so much easier to use.
Technologies like the printing press also made it cheap to produce texts as books, but if we didn't find books superior, it would still be possible to buy versions of your favorite novels or math texts (or dictionaries!) in scroll form. While a kosher Torah scroll to be used in public prayer in a synagogue is hand written by a scribe, there are printed Torah scrolls for non-ritual use: the technology for attaching single-sided printed pages together in a scroll isn't any obstacle. (Remember how early computer printers used to work on a continuous stream of accordian-folded paper?)
Search, which is easier in books than in scrolls, is even easier in digital texts such as we find online: e.g. here you can search not only the Five Books whose contents make up the Torah scroll, but the entire Hebrew Bible (and here is a link to the weekly portion).
So computers and the internet and the Kindle and other ways to handle texts electronically are just the latest chapters in the ancient, ongoing story of the market for texts.
(I'm not an early adopter myself, but here's a review of the new Kindle from yesterday's Washington Post that makes it sound as if, after maybe a little more progress on the electronic front, trees may soon be able to start sleeping at least a little easier.)
Your grandchildren's houses may not have bookshelves.
Saturday, June 20, 2009
Liver Transplant for Jobs in Tennessee
This reveals something about the regionalized waiting system for deceased donor organs in the United States, picked up in a WSJ article by Laura Meckler: Jobs's Transplant Highlights Differing Wait Times
"Apple Inc. CEO Steve Jobs's decision to travel to Tennessee for a liver highlights the significant disparities in transplant waiting times across the country -- the source of a longstanding controversy over the fairest way to distribute scarce organs.
For liver transplants, the wait is particularly agonizing. Kidney replacements can often be put off for years through dialysis, where a machine does the work of the kidneys. But there is no such treatment for liver disease.
There are 15,771 Americans waiting for a liver today, according to the United Network for Organ Sharing. Last year, 1,481 people died awaiting a donor.
Faced with a sometimes years-long wait, patients typically have only a few options. They can wait their turn at a home-state transplant center, knowing that their chances will improve as they get sicker; look for a friend or family member willing to undergo major surgery to contribute half of his or her liver; or seek out a hospital where the waiting times are typically shorter.
Those who travel out of state must be evaluated at the new hospital, but there is no prohibition to being on the wait list at more than one transplant center. UNOS doesn't keep statistics on how many people choose to travel out of state."
The story, incidentally, seems to be something of a scoop for the WSJ. Other newspapers are reporting the story on an "as reported in the WSJ" basis (apparently the transplant was two months ago). E.g. here is the Washington Post: Jobs, on Leave From Apple, Reportedly Had Liver Transplant
Update (6/23/09): Memphis Hospital Says It Did Jobs’s Liver Surgery.
"Methodist University Hospital in Memphis acknowledged Tuesday that it had performed a liver transplant on Steven P. Jobs, the chief executive of Apple."
...
"Methodist has one of the shortest waiting times of any liver transplant center in the country, according to a transplant registry operated by the Arbor Research Collaborative for Health and the University of Michigan."
...
"A scoring system, known as a MELD score, determines where a patient ranks on a transplant waiting list. The higher the score, the sicker a patient is and the higher the ranking. Any ties are decided by who has had that score the longest.
In its statement, Methodist said that Mr. Jobs had received a liver transplant because he was the patient of his blood type with the highest MELD score and thus “the sickest patient on the waiting list at the time a donor organ became available.” "
Further update (6/24/09): A CNN story discusses the regional allocation system, and how it favors those who are healthy and wealthy enough to be on waiting lists at multiple places around the country, under the provocative headline: Did Steve Jobs' money buy him a faster liver transplant?
Political pressure in Illinois college admissions
Blago-Style Admissions
Clout goes to college
U. of I. admissions: How politicians pressured university to admit students
Governor Appoints Panel to Investigate U. of Illinois Admissions
Federal Investigators Subpoena Admissions Records at 3 Illinois Universities
College admissions is serious stuff in Illinois. (Or, to put it another way, state politics includes everything.)
Update: the Chicago Trib has kept following the story, and now has quite a collection of articles: Clout goes to college.
Further update (7/13/09) from the Chronicle: Backlash Over U. of Illinois 'Clout' Scandal Spreads to Trustees and News Media
(8/3/09): The chairman of the Board of Trustees at the University of Illinois resigned on Monday amid increasingly incendiary accusations that he encouraged an academic version of “pay to play” politics to flourish, allowing students to be admitted based largely on personal and political connections.
Friday, June 19, 2009
Computer assisted markets
I'm thinking here of labor market clearinghouses for doctors, kidney exchange, and school choice mechanisms, as well as the American Economic Association's newish coordination mechanisms for the economics job market, namely early market signaling, and a late market scramble.
I enumerate this list to emphasize that these markets use computers in a variety of different ways. The slide with which I'll begin my talk lists some of these, in increasing order of how "intensely" the market is computationally assisted:
–Markets can be run on computers (making transaction rules very well specified, and performing market operations very quickly, avoiding congestion.)
– Markets can be accessed over the internet (reducing transaction costs and increasing market thickness and scope.)
–Markets can use computers as trusted intermediaries (allowing confidential information to be entered and handled and transmitted in a trustworthy way.)
–Market outcomes can be determined by (computationally intensive) algorithms (e.g. integer programs to find optimal kidney exchanges that couldn't be found any other way).
Some markets make essential use of only some of these forms of computational assistance, and some use them all.
Here is my full set of slides: Computer Assisted Markets.pptx
Thursday, June 18, 2009
Retail market for gold
"If gold is the ultimate sanctuary for small investors who have taken furious flight to quality, then Thomas Geissler may have invented the ultimate vending machine.
"After creating an online platform for trading precious metals this year, his small company has hit on a frontier beyond the Internet: the seemingly endless line of devices at airports and train stations that spit out cigarettes, condoms, toothpaste and candy bars in exchange for a little cash. But his machines will allow customers to buy small chunks of gold."
Of course, there are some special market design problems to address:
"The machines will be tested with explosives to make sure they are resistant to theft, Mr. Geissler said."
HT: Scott Kominers and Andrea Hawksley
Wednesday, June 17, 2009
Queuing to tee up at the Bethpage State Park Black Course
But if you just want the experience of playing on the same course as the top pros, the Black is a public golf course. You could just sign up for a tee time. Or could you? It turns out not to be quite so easy.
Just as markets can unravel, so can queues. A reliable symptom is people waiting on line overnight, especially if they have to wait for more than one night. Getting a tee time at this particular famous public (i.e. not rationed by price) golf course on Long Island seems to qualify: Parking All Night at Bethpage, Hoping to Drive. Note the well developed rules for regulating the queue, which include a rule meant to prevent the substitution of capital for leisure.
"Bethpage has five public golf courses: Black, Red, Blue, Yellow and Green. But the bulk of tee times for the courses, particularly the famed Black, can be hard to get through the phone-reservation system, which has 70,000 registered users. At least one company floods the system each night with hired callers, then resells the times as part of golf packages.
Yet there is one way to ensure a time at Bethpage Black, a major-championship course with $50 fees during the week, $60 on weekends, and double that for non-New Yorkers: get to the parking lot and spend a night. Maybe two. Maybe more."
...
"A sign there explains the complex rules of the “Walk Up Car Line.” Most important is that someone must be at the car for part of every hour. For the Envoy, on this Saturday afternoon, that person was Steve Atieh, 25, from Basking Ridge, N.J., who planned to play the Black course with two brothers and a friend.
They teed off 39 hours after arriving, about 11 hours after their car battery died while the radio broadcast a Yankees game."
...
"Steve Tomasheski was sitting in space No. 3 when someone offered $1,000 for it. He declined, afraid to disappoint his playing partners. Please do not tell his wife."
...
"At 7 p.m., Michael Azzue, an assistant supervisor at Bethpage, arrived in a cart. “Who’s No. 1?” he said, shouting. Azzue attached a plastic bracelet around Atieh’s wrist. At least one person from every car must be present when a supervisor arrives between 6 and 9 p.m. That person must be one of the golfers the next morning, to prevent hiring a nongolfer to do the waiting, which used to happen."
Apparently it is repugnant to pay someone to wait in line for you, although the story suggests that there is some demand for this, and people who arrive a little late (and before the monitoring kicks in) sometimes buy places from early arrivals.
Endnote: "Success has many fathers...", here's a story on a dispute about who really deserves the credit for designing the course. (Credit is a subject worth a discussion in its own right. In my experience, success in complex design projects often does have many fathers, with lots of people contributing in critical ways.)
Tuesday, June 16, 2009
Michael Sandel on Markets and Morals
My Harvard colleague, the political scientist Michael Sandel, lectures on the BBC on Markets and Morals The Reith Lectures. Here is the transcript: MARKETS & MORALS LECTURE TRANSCRIPT (I don't know how long the BBC will keep these links live...).
Sandel begins by noting that he thinks that Economics is "a spurious science."
"It’s a spurious science in so far as it is used to tell us what we ought to do because questions of what we ought to do in politics or as a society are unavoidably moral and political, not merely economic questions, and so they require democratic debate about fundamental values. Economists can inform us about possible implications of policy choices, but they can’t tell us - and they don’t really claim to tell us - what’s right and wrong, what’s just and unjust. "
The gist of his argument is here:
"Looking back over three decades of market triumphalism, the most fateful change was not an increase in the incidence of greed. It was the expansion of markets and of market values into spheres of life traditionally governed by non-market norms. We’ve seen, for example, the proliferation of for profit schools, hospitals and prisons; the outsourcing of war to private military contractors. We’ve seen the eclipse of public police forces by private security firms, especially in the US and the UK where the number of private guards is more than twice the number of public police officers. Or consider the aggressive marketing of prescription drugs to consumers in the United States. If you’ve ever seen the television commercials in America on the evening news, you could be forgiven for thinking that the greatest health crisis in the world is not malaria or river blindness or sleeping sickness, but a rampant epidemic of erectile dysfunction. (LAUGHTER) Or consider some recent proposals to use market incentives to solve social problems. Some New York City schools are trying to improve academic performance by paying children 50 dollars if they get good scores on standardised tests. In Dallas, they’re trying to encourage reading by paying children 2 dollars for each book they read.
Or consider the vexed issue of immigration policy. Gary Becker, the Nobel Prize winning free market economist at the University of Chicago, has a solution: to resolve the contentious debate over whom to admit, the US, he says, should simply set a price and sell American citizenship for 50,000 dollars, or perhaps 100,000. Immigrants willing to pay a large entrance fee, Becker reasons, would automatically have desirable characteristics. (LAUGHTER) They are likely to be young, skilled, ambitious, hardworking; and, better still, unlikely to make use of welfare or unemployment benefits. (LAUGHTER) Becker also suggests that charging admission would make it easier to decide which refugees to accept - namely those sufficiently motivated to pay the price. Now you might say that asking a refugee fleeing persecution to hand over 50,000 dollars is callous. So consider another market proposal to solve the refugee problem, one that doesn’t make the refugees themselves pay out of their own pockets. An American law professor proposed the following: that an international body assign each country a yearly refugee quota based on national wealth. Then let nations buy and sell these obligations among themselves. So, for example, if Japan is allocated 20,000 refugees per year but doesn’t want to take them, it could pay Poland or Uganda to take them in. According to standard market logic, everyone benefits: Poland or Uganda gains a new source of national income; Japan meets its refugee obligations by outsourcing them; and more refugees are rescued than would otherwise find asylum. What could be better?
There is something distasteful about a market in refugees, even if it’s for their own good, but what exactly is objectionable about it? It has something to do with the fact that a market in refugees changes our view of who refugees are and how they should be treated. It encourages the participants - the buyers, the sellers and also those whose asylum is being haggled over - to think of refugees as burdens to be unloaded or as revenue sources rather than as human beings in peril. What this worry shows is that markets are not mere mechanisms. They embody certain norms. They presuppose, and also promote, certain ways of valuing the goods being exchanged. Economists often assume that markets are inert, that they do not touch or taint the goods they regulate. But this is a mistake. Markets leave their mark. Often market incentives erode or crowd out non-market incentives. "
He then speaks briefly about Gneezy and Rustichini on childcare late fines (Gneezy, U., and A. Rustichini “A Fine is a Price,” Journal of Legal Studies, vol. XXIX, 1, part 1, 2000, 1-18.), about Titmuss on paid versus unpaid blood banks, and on his own reservations about tradeable pollution permits. He sums this up as follows:
"My general point is this. Some of the good things in life are corrupted or degraded if turned into commodities, so to decide when to use markets, it’s not enough to think about efficiency; we have also to decide how to value the goods in question. Health, education, national defence, criminal justice, environmental protection and so on - these are moral and political questions, not merely economic ones. To decide them democratically, we have to debate case by case the moral meaning of these goods in the proper way of valuing. This is the debate we didn’t have during the age of market triumphalism. As a result, without quite realising it, without ever deciding to do so, we drifted from having a market economy to being a market society. The hope for moral and civic renewal depends on having that debate now. It is not a debate that is likely to produce quick or easy agreement. To argue about the right way of valuing goods is to bring moral and even spiritual questions into public discourse. Is it possible to bring moral and religious disagreements into public life without descending into intolerance and coercion? That is the question I’ll turn to in the next lecture. Thank you very much."
Update: In his second lecture, Morality in Politics, Sandel discusses why he thinks paying surrogate mothers is a bad idea (apparently in Britain it is illegal, and so there's a thriving market in which British couples hire surrogate mothers in India). He also discusses arguments for and against same sex marriage. Here is the Programme transcript of the second lecture from the BBC.
HT: Tim Harford
Monday, June 15, 2009
Children can't get organ donations in Japan, because they can't be deceased donors
CNN reports on a Boy not allowed to get life-saving transplant in Japan.
""We were told by his doctor at the end of last year that the heart transplant operation was the only way for him to survive," Ando said.
But the law in Japan prohibits anyone under the age of 15 from donating organs -- meaning Hiroki can't get a new heart in his home country.
According to the web site for Japan Transplant Network, a non-governmental group that supports changing Japan's transplant law, "this stipulation has greatly reduced the possibility of transplants to small children; heart transplants to small children have become impossible."
Lawmaker Taro Kono is spearheading efforts to change the law, which was enacted in 1997. Japan's parliament is now debating four proposed amendments-- including one that would scrap the age limit. "
It appears that the thought of a child dying and having his or her organs transplanted is so distressing that it's against the law; it's considered a repugnant transaction. But because small children can't receive adult hearts, which are too big, this repugnance leads to the deaths of other children.
The boy in question still has a chance:
"Hiroki is now at Columbia University Medical Center in New York, awaiting a new heart. His father says he knows that the transplant issue is a difficult one for families.
"The honest wish from the recipient's side is to have a donor show up as soon as possible," he said, pausing. "I still do not know whether I can make a decision to give my child's heart to someone else if I am faced with such a situation. But unless the people face the issue and think about it seriously, I do not think the time will come soon to see more people volunteering to donate organs."
That last quote is worth re-reading, as it captures a lot of the pathos on both sides of the transplantation transaction, in which one tragic death can sometimes save other lives.
If you aren't already registered as a deceased organ donor (i.e. as someone who is willing to have your organs donated if they can be used after your death), please think about registering now. If you live in the United States, you can often find the form on the website of your State Department of Motor Vehicles, since registration as an organ donor is often done when you get your driver's license.
Sunday, June 14, 2009
Education for matching
"The most important decision any of us make is who we marry. Yet there are no courses on how to choose a spouse. There’s no graduate department in spouse selection studies. Institutions of higher learning devote more resources to semiotics than love.
The most important talent any person can possess is the ability to make and keep friends. And yet here too there is no curriculum for this."
In addition to thinking about how to educate young people how to navigate these life skills better, we can also think about how to design institutions to better facilitate them. Many high school graduates will find they have no problem making friends and even identifying potential mates while they are in college, where the market is thick. Once they disperse to the work force, both of those things may become harder, as the opportunities become less thick. Many of our customs and institutions related to marriage arose when more people married their high school and college sweethearts.
Saturday, June 13, 2009
"Yield" in college admissions
"As usual, some colleges had to do much more than others to fill their classes, a fact that complicates interpretations of yield.
For instance, two colleges may have ended up with identical yield rates. College A did not admit a single applicant early, but College B enrolled a third of its class through early decision, which guarantees a yield of virtually 100 percent for students in that pool.
“Any meaning that yield ever had is now gone, because the number can be manipulated,” says Daniel M. Lundquist, vice president for marketing and enrollment management at the Sage Colleges, in New York. “It’s a circus, and colleges all do admissions differently.”
How many applicants did a college have? How many did it admit? Did it use a waiting list? How big was its tuition-discount rate? And did its football team win the conference title last year?
The answers to such questions are necessary to put yield in context. Some universities, such as large flagships in the Midwest, have high yields because they face relatively little competition for students.
Other colleges see their yield rates drop as their appeal rises and they become more competitive with higher-ranked institutions. Take Dickinson College, whose yield was 26 percent this year, much lower than some of its highly selective competitors. “We could have a higher yield if we competed against lower-tier institutions,” says Robert J. Massa, vice president for enrollment and college relations. “I would rather have a lower yield and compete against top-tier institutions.”
"In some circles, yield is entangled with measures of prestige. U.S. News & World Report once factored yield rates into its rankings of colleges, but it stopped doing so in 2004 amid the debate over the growth of early decision. The magazine now publishes a list of the “most popular colleges,” based solely on yield rates. In the most recent list, Harvard was first, followed by Brigham Young University and the University of Nebraska at Lincoln."
Friday, June 12, 2009
The Economic Logic of Anonymity and Pseudonymity
So I replied to the email asking "Are you blogging anonymously, incidentally? (May I ask why?)"
I received the following reply: "Yes, I remain anonymous. This allows me more liberty in my writing, and I hope the blog will gather reputation on its own merit, instead of being attached to a name."
This got me thinking about the market design aspects of anonymity , and its not so close relative pseudonymity. When I asked EL about his/her anonymity, I was referring of course to the fact that I don't know who he/she is, what his/her day job is, which personal pronoun is appropriate, etc. But when EL speaks of the blog developing a reputation, he/she is referring to the fact that the posts are under the repeated-use pseudonym Economic Logician (with respect to which the name of the blog is an eponym), so that each post can both rely on and help establish the reputation of the same unidentified/pseudonymous person who wrote the previous posts.
Lots of internet markeplaces allow pseudonymous usernames, and still manage to foster reputation building and trust. (In an earlier post I wrote about the redesign of eBay's reputation system from one in which feedback could only be identified or pseudonymous to one in which it can also be anonymous: "ENGINEERING TRUST - RECIPROCITY IN THE PRODUCTION OF REPUTATION INFORMATION," - by Gary Bolton, Ben Greiner, and Axel Ockenfels. ) That paper notes how being able to identify who left feedback led to reciprocal feedback, either jointly positive or jointly negative, which reduced the informativeness of certain kinds of feedback.
There are other contexts in which anonymity is encouraged or allowed (and not just in comments to blogs). The refereeing of academic papers for publication is an example in which we seem to believe that the benefits (increased frankness) of anonymity may overcome the costs (e.g. an increase in self-serving reviews).
Some journals have double-blind refereeing, in which the authors as well as the referees may choose to remain anonymous during the review process (e.g. by deleting their names from the cover sheet, and also not posting the paper where Google can find it). Google now essentially prevents journals from enforcing anonymity on authors, since it gives authors a way to identify themselves if they wish, despite the requirement that their names and affiliations may not appear on the submitted paper. I think that preventing referees from knowing who the authors are would be a mixed blessing; it would level the playing field in certain desirable ways, but it might also remove information that would be valuable in evaluating the paper. (For example, if you read a paper saying that, on balance, the conclusions of Roth (1977) need to be revisited, it might be useful for you to know if Roth is one of the authors.)
Of course, marketplace rules may allow participants to be anonymous from some parties and not from others, and internet privacy rules are concerned with who can choose how individuals are identified. (See this nice take on the famous New Yorker cartoon about anonymity on the internet.)
So, anonymity has its uses, as does identity, and pseudonymity has some of the advantages and disadvantages of each. I'll keep blogging under my natural name for the time being, since, especially when my posts are unclear or incomplete, they may get some helpful context from the fact that they are linked to me and the work I do .
Thursday, June 11, 2009
Unraveling
Why do transactions in some markets happen inefficiently early? Here are the concluding paragraphs from our recent NBER working paper Unraveling Results from Comparable Demand and Supply: An Experimental Investigation
by Muriel Niederle, Alvin E. Roth, M. Utku Unver - #15006 (LS)
" It has been known at least since Roth and Xing (1994) that many markets unravel, so that offers become progressively earlier as participants seek to make strategic use of the timing of transactions. It is clear that unraveling can have many causes, because markets are highly multidimensional and time is only one dimensional (and so transactions can only move in two directions in time, earlier or later). So there can be many different reasons that make it advantageous to make transactions earlier. There can also be strategic reasons to delay transactions; see e.g. Roth and Ockenfels (2002) on late bidding in internet auctions.
Thus the study of factors that promote unraveling is a large one, and a number of distinct causes have been identified in different markets or in theory, including instability of late outcomes (which gives blocking pairs an incentive to identify each other early), congestion of late markets (which makes it difficult to make transactions if they are left until too late), and the desire to mutually insure against late-resolving uncertainty. There has also been some study of market practices that may facilitate or impede the making of early offers, such as the rules and customs surrounding "exploding" offers, which expire if not accepted immediately.
In this paper we take a somewhat different tack, and consider conditions related to supply and demand that will tend to work against unraveling, or to facilitate it. There seems to be a widespread perception, in markets that have experienced it, that unraveling is sparked by a shortage of workers.
But for inefficient unraveling to occur, firms have to be willing to make early offers and workers have to be willing to accept them. Our experiment supports the hypothesis that a shortage of workers is not itself conducive to unraveling, since workers who know that they are in short supply need not hurry to accept offers by lower quality firms. Instead, in the model and in the experiment, it is comparable supply and demand that leads to unraveling, in which attention must be paid not only to the overall demand and supply, but to the supply and demand of workers and firms of the highest quality. This seems to reflect what we see in many unraveled markets, in which competition for the elite firms and workers is fierce, but the quality of workers may not be reliably revealed until after a good deal of hiring has already been completed."
http://papers.nber.org/papers/W15006
Postscript: Skip Sauer over at The Sports Economist has a post about a 9th grader offered a college football scholarship in what is becoming a seriously unraveled market.
Wednesday, June 10, 2009
The market for beauty queens
"Wednesday brought another breathtaking twist to the saga of Carrie Prejean, the now-former Miss California USA who got the ax from the pageant's boss Donald Trump ...for not honoring her pageant commitments.
Trump told TMZ.com that Prejean refused to appear at roughly 30 events to which she was contractually bound. ...
Pageant officials say Tami Farrell, first runner-up to Prejean, will take over those responsibilities. Which, to be honest, nobody really understands. But they sound very important."
Theft and armed robbery
So for a very long time, at least for some kinds of items, part of marketplace design includes ways to thwart thieves, or catch them. But security is costly in many ways, not least being that if you make your marketplace hard for thieves to enter, you may also discourage customers. So losses from theft (and payment of theft insurance premia) are often a cost of doing business, leading to the occasional story that could be a movie: Well-dressed thief steals €6 million worth of Chopard jewels in Paris.
"Suspicion has fallen on the Pink Panthers, the name given to a diffuse international gang with origins in the Balkans. French police describe the group’s crimes as lightning-fast hold-ups: daring, but planned down to smallest detail.
In December thieves staged a €74 million jewel theft at the Harry Winston boutique in the Avenue Montaigne, near the Place Vendôme, off the Champs-Elysees. Four robbers, two disguised as women, calmly emptied the store as staff and customers lay on the floor.
The Harry Winston raid came a year after the same store was attacked by robbers who forced staff to empty its safes, taking at least €10 million worth of jewels.
The Pink Panthers have accumulated loot worth up to €200 million in an estimated 120 attacks on stores in around 20 countries since their first robbery in Mayfair in London in 2003.
Two weeks ago Paris police arrested two Serbians, alleged to be Panthers, and charged them with carrying out armed raids on stores in Monaco, Switzerland and Germany.
Last Thursday a former soldier from Montenegro, also said to be a Panther, was sentenced to 15 years in jail for a 2005 jewel robbery in the Riviera resort of Saint-Tropez. The court in Draguignan also fined Dusko Martinovic €130,000 for the raid, which he carried out in 90 seconds with two accomplices who have not been caught. The trio escaped into the Mediterranean aboard a speed boat before the police reached the boutique that they had emptied.
The world record for a jewellery theft remains the $100 million (£62 million) robbery of diamonds in Antwerp, Belgium, in 2003. "
While diamonds can presumably be resold easily, some items, like an iconic artwork or a thoroughbred race horse are too identifiable. But that doesn't always protect them from theft: sometimes thieves steal them and try to ransom them back to the original owners, and sometimes they may be destined to be enjoyed privately by wealthy criminals in distant places. Here's one list of The 10 Most Infamous Heists, some of them still unsolved.
Update: The Times of London reports on a modern form of theft: Criminal gang bought own music on iTunes and Amazon using stolen cards.
A gang of criminal musicians bought their own music online with stolen credit cards, and received royalties...
Tuesday, June 9, 2009
Market for wedding guests
Japanese company does thriving trade in 'fake friends'
"Along with choosing a dress and booking a honeymoon, there is one other item to add to the wedding checklist in Japan: hiring fake friends.
Office Agents, a Tokyo-based company, rents out friends, work colleagues and even relatives to pad out the guest list.
Brides or grooms who want to impress their prospective partners with their sheer volume of friends are among those secretly padding the guest list with fakes.
The recession has also boosted the popularity of the service. With unemployment rising and a growing number of Japanese in part time jobs, people rent fake bosses or colleagues."
Are paperless tickets scalp proof?
"Ticketmaster is going to try issuing paperless tickets to reduce scalping. Resale companies are not amused.
http://marketplace.publicradio.org/display/web/2009/06/08/pm_ticketmaster/
"JILL BARSHAY: Miley Cyrus hopes she can cut out scalpers from her next tour by selling only paperless tickets. Ones you can't give or sell to someone else. Ones you buy online and pick up at the concert gate by showing your driver's license and a credit card.
Sean Pate is the spokesman for StubHub, the big ticket resale site, owned by eBay. He's predicting paperless tickets will mean long lines on concert night.
SEAN PATE: You know, we're going to see a lot of inconveniences for the fans, especially of Miley Cyrus's demographic. Her fans more than likely don't own credit cards.
That means mom or dad may have to listen to the concert too. Not to mention how mortifying it is for a 12-year-old to be seen with her parents.
Critics say some concerts will still sell out quickly. And prices will be jacked up. The question is by whom. Don Vaccaro is the CEO of TicketNetwork, another resale site. He points out that Miley Cyrus's management company, which is owned by Ticketmaster, is selling prime seats on its Web site starting tomorrow for $295."
Update: Here's the (June 16, 2009) take of the NY Times Ethicist column: Miley Cyrus Takes on the Scalpers.
HT: Steve Leider
Monday, June 8, 2009
Anesthesia was once repugnant
Here is the beginning of Jay's story, and the end (emphasis added):
"The date of the first operation under anesthetic, Oct. 16, 1846, ranks among the most iconic in the history of medicine. It was the moment when Boston, and indeed the United States, first emerged as a world-class center of medical innovation. The room at the heart of Massachusetts General Hospital where the operation took place has been known ever since as the Ether Dome, and the word "anesthesia" itself was coined by the Boston physician and poet Oliver Wendell Holmes to denote the strange new state of suspended consciousness that the city's physicians had witnessed. The news from Boston swept around the world, and it was recognized within weeks as a moment that had changed medicine forever.
But what precisely was invented that day? Not a chemical - the mysterious substance used by William Morton, the local dentist who performed the procedure, turned out to be simply ether, a volatile solvent that had been in common use for decades. And not the idea of anesthesia - ether, and the anesthetic gas nitrous oxide, had both been thoroughly inhaled and explored. As far back as 1525, the Renaissance physician Paracelsus had recorded that it made chickens "fall asleep, but wake up again after some time without any bad effect," and that it "extinguishes pain" for the duration.
What the great moment in the Ether Dome really marked was something less tangible but far more significant: a huge cultural shift in the idea of pain. Operating under anesthetic would transform medicine, dramatically expanding the scope of what doctors were able to accomplish. What needed to change first wasn't the technology - that was long since established - but medicine's readiness to use it.
Before 1846, the vast majority of religious and medical opinion held that pain was inseparable from sensation in general, and thus from life itself. Though the idea of pain as necessary may seem primitive and brutal to us today, it lingers in certain corners of healthcare, such as obstetrics and childbirth, where epidurals and caesarean sections still carry the taint of moral opprobrium. In the early 19th century, doctors interested in the pain-relieving properties of ether and nitrous oxide were characterized as cranks and profiteers. The case against them was not merely practical, but moral: They were seen as seeking to exploit their patients' base and cowardly instincts. Furthermore, by whipping up the fear of operations, they were frightening others away from surgery and damaging public health.
The "eureka moment" of anesthesia, like the seemingly sudden arrival of many new technologies, was not so much a moment of discovery as a moment of recognition: a tipping point when society decided that old attitudes needed to be overthrown. It was a social revolution as much as a medical one: a crucial breakthrough not only for modern medicine, but for modernity itself. It required not simply new science, but a radical change in how we saw ourselves."
...
"Once Morton had successfully demonstrated his technique of ether anesthesia, it was quickly seen that its implications reached considerably beyond the dental business. Before 1846 was out, it had been successfully tried by the most celebrated surgeon in Britain, Robert Liston, who pronounced that the new "Yankee dodge" had "the most perfect and satisfactory results" and was "a fine thing for operating surgeons." It was enthusiastically championed by an emerging generation of medical humanitarians, and the new buzzword "anesthesia" crystallized the sense of novelty and medical miracle. Chemistry had, as Thomas Beddoes had prophesied, come to rule over pain.
Despite its successes, resistance to the idea didn't vanish overnight. Until the end of the century, some doctors would maintain that pain had a necessary role in the preservation of life, but from 1846 onward they were outnumbered by those who insisted that it was the job of a physician to inflict as little of it as possible. Some religious voices would hold out for a good deal longer: Pope Pius XII would confirm that "the Christian's duty of renunciation and of interior purification is not an obstacle to the use of anaesthetics" only in February 1957.
Despite the long resistance, that demonstration in the Ether Dome marked a transition that was as irreversible as it was historic. The practice of medicine finally achieved a goal that it had, until that moment, never truly been able to imagine: loosening pain's age-old stranglehold on humanity. And in a sense, the invention was the least of it. The real milestone witnessed in Boston that day was the moment when culture had finally caught up with chemistry."
The article comes from Jay's new book The Atmosphere of Heaven.
Update: Dubner at Freakonomics follows up on this post and draws some interesting comments, including this one:
“So discredited had narcotic drugs become by the middle of the seventeenth century that when Nicolas Bailly, a barber-surgeon of Troys, administered a narcotic potion to a patient before an operation, the venture aroused widespread condemnation. Bailly was arrested and fined for practicing witchcraft. The stupefaction of patients by administration of herbal remedies was then forbidden in France under heavy penalty.”
(Victor Robinson, M.D.: Victory Over Pain. A History of Anesthesia, London: Sigma, 1947. p.40)— kaloniki "
Sunday, June 7, 2009
Matchmaking in Gaza, and Bollywood
Militant Hamas Gets Into Matchmaking Business
"The applicants, who pay a fee of $10-$70, are divided into categories according to their eligibility. Women under 25 are easiest to marry off; more challenging are women over 30 and divorcees.
But in a nod to Gaza's grinding poverty triumphing over its conservative culture, there is a special file for women with jobs. Bringing home a salary in Gaza can trump any other category, matchmakers say.
In the women's application, they describe their ideal man. Most ask for a devout Muslim with a job and his own apartment, a top find in crowded Gaza.
Women also must describe their appearance and answer a killer question: ''Do you consider yourself pretty according to Gaza standards?''
The ideal of beauty in Gaza means tall and fair-skinned with blue or green eyes and light-colored hair -- and that's what men usually ask for. But most Gaza women have dark hair and bronze skin.
''If we see a girl that appears to match (a man), but she's not physically what he wants, I'll call him and say, 'Well, she's pretty, but she's dark.' Or 'she's short, but she's white.' We encourage them to be a bit more realistic,'' Khalil said."
...
"Around 40 men a month turn to Tayseer in search of a wife. When association employees think there's a match, they quietly organize a meeting, with employees acting as chaperones in compliance with Islamic law. If the couple like each other, Gaza's traditional courtship kicks in.
The man's relatives visit the woman's family, saying that a well-meaning stranger told them of a girl wanting to marry. The matchmakers are not mentioned, because their role is still taboo, said Khalil."
Meanwhile, in another part of the world, there is a different challenge to a different tradition of arranged marriage (the photo of the prospective bride suggests some other differences between India and Gaza also):
Bollywood's Rakhi Sawant takes search for a husband to prime time TV
"Rakhi Sawant, a Bollywood dancer, actress and television host, has refused a union brokered by her parents. Instead, she has promised to find the perfect man herself — with the aid of a prime time TV series.
Rakhi Ka Swayamvar (Rakhi’s Search for a Husband) has attracted more than 12,500 aspirant grooms from across the subcontinent. The show is due to begin later this month but the outspoken celebrity’s promise to marry on air has already whipped up controversy in what remains a rigidly conservative country."
...
"A recent survey by the International Institute for Population Sciences found that 95 per cent of marriages in India today are arranged by the families of the bride and groom. More than 70 per cent of married women between the ages of 15 and 24 said that they were never asked their views on their future husband before their wedding. About a quarter said that their first sexual experience within marriage was forced."
Related recent posts:
Marriage and dating online in Korea, Marriage and dating online (in the U.S.), Marriage market in India
Saturday, June 6, 2009
University admissions in the UK: admissions formulae
The article discusses first Durham University, and then Cambridge and Oxford. Some controversy attaches to these universities' weighted ranking systems that now give extra points to students who come from low achieving schools.
Friday, June 5, 2009
Digital Economy Symposium at HBS
The organizers are John Deighton, Karim Lakhani, and Misiek Piskorski.
I plan to talk about "Computationally Assisted Markets."
Fertility and religion
Some of the particular issues that arise with in vitro fertilization involve how to be sure, in a legal sense, who the parents are. (This is presumably also one of the reasons behind the restriction of sex to marriage in so many cultures, when sex was the only reproductive option.)
The problem of how to integrate new technological and commercial possibilities with ancient customs, rules, and practices is very clear when those are religious in nature. But similar problems also present themselves in secular society, in dealing e.g. with issues like surrogacy, or compensation for sperm and egg donors in ways that navigate around repugnance.
In only slightly related news (but still on the subject of being fruitful, and making sure your children have the right parents), the cost of arranged marriages is going up among Israel's most orthodox Jews: Haredi matchmaking rates skyrocketing
Thursday, June 4, 2009
Protecting the commons with 'altruistic punishment': scam baiting
An example of altruistic punishment in practice is the internet sport of scam baiting: Baiting Nigerian scammers for fun (not so much for profit).
"When your hobby is baiting 419 scammers (also known as Nigerian scammers or advance-fee fraudsters), a death threat isn't cause for concern—it's a trophy worth bragging about to your friends.
Scam baiters are the vigilante enforcers who come together to waste hours, weeks, or months of 419 scammers' lives for nothing more than the satisfaction of knowing that they are distracting them from real victims. Though the world of 419 scams has existed since long before the Internet, people continue to fall for scammers in droves—certainly, scammers are making millions of dollars every year by promising money, goods, and romance that they never deliver on. That's part of why scam baiting has actually become a somewhat popular pastime online, with thousands of users flocking to scam baiting forums to share stories and ideas on how to string along more scammers. And hey, why not? Most of us end up spending too much time screwing around on the Internet anyway—these folks just use that time to make scammers miserable."
If you want to play (the next time you get an email offering to transfer millions of dollars to your account*), one of the central sites seems to be 419Eater.com.
*For those of you who never look in your junk mail folder, here's a good example from mine:
"Sir / Madam,
I am Barrister Adamu Azeez, an attorney to late Richard Lim a foreigner who is an Engineer with Nigerian National Petroleum Corporation (NNPC) here in Nigeria. Late Mr. Richard Lim has an account with United Bank for Africa Plc, Nigeria.
I received a memo early this year from the Bank Remittance Department for an interview about (US$25.500,000.00) (TWENTY FIVE MILLION FIVE HUNDRED THOUSAND UNITED STATES DOLLARS ONLY) that belongs to my client Late Mr. Richard Lim ,the bank informed me on their policy to freeze the account of Late Richard Lim, I am in a position to redirect the (US$25.500,000.00) to any foreigner's account any where because they was no Next of Kin in his entire file within the bank and his account has been dormant for years which is against the policy of the Bank.
I am contacting you because of the need to involve a foreigner as the foreign beneficiary to that fund and also to stand as the Next of Kin to the deceased. I have resolved to share the money in this ratio.
(1) 65% for me.
(2) 30% for you.
(3) 5% for the Remittance Manager in the bank who has agreed to guide us for the success of our objectives.
(4) 5% for any expenses both party might incur during the processing of this transaction.
I will need your full name and address including telephone and fax number for the internal processing of the fund transfer and the internal processing of the required documents to back you up for the claim of the fund in receipt of all the required information from you which was given above. I will give you further details on the entire process when I receive your positive response."
HT: jeff at Cheap Talk
Wednesday, June 3, 2009
Same sex marriage in New Hampshire
"The New Hampshire legislature approved revisions to a same-sex marriage bill on Wednesday, and Gov. John Lynch promptly signed the legislation, making the state the sixth to let gay couples wed. "
Real estate brokers and the internet
Now that many houses for sale can be viewed on the internet, it is entirely possible to conduct a search for a house without the assistance of a real estate broker. But a peculiarity of the real estate market is that a buyer who does not use a broker may not reduce the fees paid in the transaction. A typical seller's contract with the broker who helps put the house on the market (the "originating broker") is for 6% of the selling price. If the buyer is accompanied by an agent, this fee is split between the two. If the buyer comes without an agent, the 6% is paid entirely to the originating broker.
An internet brokerage firm has seen this as an opportunity. Redfin.com offers to represent buyers and refund 50% of Redfin's half of the fee set by the originating broker and seller. So, if the fee is the conventional 6% of the sales price, Redfin as the buyer's broker would get 3% and refund 1.5%. That is, if you are on the verge of buying a house for a million dollars without a broker, but instead close the deal through Redfin, they will give you $15,000. That's not a bad reason to have an agent.
Obviously this is inefficient from the point of view of the buyer, seller, and originating broker (since if they could negotiate efficiently they could divide among themselves the 15K that Redfin keeps). But the final moments of the negotiations are tense ones, in which the reservation values of all three parties are unknown, so this may not be the kind of 3-way negotiations in which we should expect efficiency. So Redfin may have a good business.
I keep expecting the real estate market to undergo some fundamental change, and maybe this is a sign of pressure building.
HT: Michael Schwarz
p.s. for completeness, I note that Redfin also offers discounted sell-side services, part of which come with a fee that is not contingent on whether or not a sale results.