Allocating vaccines while they're still scarce--I'm interviewed by Stacy Vanek Smith on the Indicator from Planet Money

 Here's a podcast in which I'm interviewed by Stacey Vanek Smith about how vaccines might be allocated while still scarce:

Who Gets A Vaccine? A Conversation With Alvin Roth

The Indicator from Planet Money, December 15, 2020

("9-Minute Listen")

And here's the transcript.

Below is the latter part of the interview, about vaccines (edited by me to take out excess "you know's," you know?):

SMITH: What are - when you're looking at the vaccine situation now, there are a limited number of COVID vaccines available, at least at this moment. What do you see when you look at that market right now? Not that it's a market per se but you know what I mean.

ROTH: Any time we're allocating scarce resources,  I think it's fair to talk about that as the marketplace. It's waiting for a scarce resource to become available. So what we do with [deceased donor] organs is we form waiting lists and each organ has a different kind of waiting list. So that's a little bit like what we're going to see with a vaccine. Different states are going to have different rules of how to get vaccines. They also have different supply and demand. It might be that lots of people in New York will want to have a vaccine. And it's possible - and I'm purely speculating - that a smaller percentage of people in Tennessee will want it, right? We have a lot of vaccine hesitancy in the United States.

SMITH: Yeah.

ROTH: So one thing that reminds me of kidney exchange a little bit is exchange. Supposing it turns out that we allocate to the states proportional to population, which I think we may be doing this morning. And suppose it turns out that in New York, there's a giant shortage, that there are lots of health care workers, and they're eager to get it. And then after that, there are lots of old people and vulnerable people of various sorts. And New York will develop a priority list.

At the same time, they might discover that in Tennessee, they've gotten more vaccines than they can get rid of on the first day because of vaccine hesitancy or maybe people aren't eager to try it out so early. So you could imagine an exchange, that we'll send you 100,000 doses today and call them in two months when we think we'll need them.

SMITH: What would - like, what do you think is sort of an ideal way for states and I guess - and countries to start approaching this? Because it is complicated, and everybody wants this vaccine, right? A lot of people want this vaccine right now. The demand is greater than the supply. Like, what would you I guess like to see happen or like to see start happening for countries and states kind of making this decision?

ROTH: One thing that people have said is, health care workers are important because they help us contain the disease. But they're also vulnerable to it  - especially if we talk about the health care workers who are treating people who are ill with COVID. So it might make sense to prioritize them so that the hospitals don't shut down, things like that.

But then you might also say, people who are at risk in various ways should get a high priority because getting a vaccine might save their life. But then we might want to go in a different direction. We might want to say - who is likely to be a superspreader? Who  is exposed by the nature of their work? Maybe the essential workers who drive the trucks and deliver the goods and coming to your door and maybe getting your signature.

SMITH: Right, right 'cause this is a little different than a kidney because we're talking about a virus that can spread. So that's in there, too. Like, people who are more likely to - 'cause if we can vaccinate, let's say, like, people who do deliveries, then that could pay sort of exponential dividends.

ROTH: Right. And then we could also think about what's costly to us about the precautions we're taking. One of those things, of course, is child care. If you have school-age children and they're now at home and especially if they're quite young, so they can't even really do Zoom classes without your help, well, then someone in your household is not working very hard 'cause they're providing a service that teachers used to provide. So we might think about what set of vaccinations would be required to open up schools again 'cause that would be a big weight lifted off the economy.

SMITH: Oh, right. That would be - that would help in, like, other ways because then it could help people go back to work, yeah.

ROTH: You'd like there to be the biggest multiplier effect you can get for each vaccine that not only does good for the person getting the jab, you know, the needle in his upper arm but that jab should also do the most good for the most other people.

SMITH: Dr. Alvin Roth is a professor of economics at Stanford University and winner of the 2012 Nobel Prize in Economics.

This episode of THE INDICATOR was produced by Nick Fountain, fact-checked by Sean Saldana. THE INDICATOR is edited by Paddy Hirsch and is a production of NPR.

Copyright © 2020 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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A quick note on interviews.  These 9 minutes came from a one hour interview, so lots of decisions about what to include were made by NPR. (That’s why I come off as a solitary hero in the initial discussion of kidney exchange.)  But, aside from that, the editors did a pretty good job on this one, imho...)

More on the shortage of transplantable kidneys

Here are some snips from the transcript of the Undark podcast,
Solving the Deadly Transplantable Kidney Shortage
This month: A penetrating look at the trials of patients with kidney failure, and the doctors working to make more lifesaving transplants possible.

In the U.S., there are 58 local organ procurement organizations, more commonly known as OPOs. When someone is dying in the hospital with no chance of recovery, doctors will call their local OPO and set the organ procurement process into motion. The donor will go into surgery, their organs will be collected and the OPO will work to distribute the organs to people on the local waitlist. But for years, journalists and independent researchers have said these OPOs are not getting as many organs as they should be. Numerous studies and investigations have claimed OPOS could be recovering more than twice as many organs as they do now, if they were to opt for organs that were less-than-perfect, but likely still good enough.

Just a few weeks ago, a study published in the journal JAMA Internal Medicine looked at discard rates in France and in the United States. It found that OPOS in the U.S. discard at least 3,500 kidneys a year, nearly 20 percent of all deceased donor kidneys, as compared to 9 percent in France. These discarded kidneys are often from donors over 50 years old, or with curable diseases. But it’s hard to tell just how many organs we are missing out on because OPOS self-report their own numbers. And, according to a 2017 study published by the American Society of Transplantation and the American Society of Transplant Surgeons, some OPOS have even manipulated their numbers to appear better than they are.

In July, President Trump signed an executive order to launch an initiative called “Advancing American Kidney Health.” One of the plans is to order Secretary of Health and Human Services Alex Azar to reform the organ procurement process to increase the supply of transplantable kidneys

...

Kaitlin Benz: Highly complex because the transplant surgeons who decide whether or not to accept a less-than-perfect kidney have a lot to consider. The government evaluates the 261 transplant centers in the U.S. by their one-year post-op success rate, which generally ranges between 90 to 95 percent. Ideally, all of a program’s transplanted patients are still alive and well after a year, but that’s just not always going to happen. For their program to be considered successful, doctors need to have a high success rate, which means they have to closely consider how much risk they’re able to take on donor organs. What if they accept a less-than-perfect kidney and the patient dies six months later? Here’s Ron Gill.

Ron Gill: And so, ok, if I’m being measured on a one-year survival, I don’t want to take a kidney that has a greater risk of not working in a year. However, what’s dawning on us all is the comparator can’t be them not working as well. The comparator is the waiting list.

Kaitlin Benz: He says measuring success by one-year survival rates can disincentivize surgeons from even trying on those borderline, suboptimal kidneys that may not be perfect, but might give their patient a few more years of health and freedom than dialysis would.

Ron Gill: It kind of puts a stranglehold on innovation in my view. And many of us in the field feel that if you’re going to hold people to a very high standard and we keep losing so many people on the waiting list every year, what is it going to take to make that change? There are groups that are probably being punished for some of their lesser outcomes because they’ve taken greater risks. And again, we all probably made a mistake if we’re comparing their outcomes with other centers rather than comparing their outcomes with the waiting list.

Podcast on non-directed kidney donation as an act of effective altruism

Here's a very personal discussion  about becoming a non-directed donor.

The Neoliberal Podcast

Donating a Kidney with Dylan Matthews

"Jeremiah sits down with Dylan Matthews of Vox.com to discuss his decision to donate a kidney to a stranger, and Jeremiah's plans to do the same.  While our previous episode with Nobel prize winner Alvin Roth explored the economics of kidney markets and the details of kidney policy, this episode dives more deeply into the medical and personal side of deciding to donate a kidney."
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Dylan Matthews has his own podcast, called Future Perfect.

Repugnant transactions on NPR's Hidden Brain (podcast)

I discuss repugnant transactions with Shankar Vedantam, who intersperses our conversation with audio clips of illustrative examples... He's an effective interviewer and editor.

For Sale, By Owner: The Psychology Of Repugnant Transactions

March 4, 2019 • You own your body. So should you be able to sell parts of it? This week, we explore the concept of "repugnant transactions" with the man who coined the term, Nobel Prize- winning economist Al Roth. He says repugnant transactions can range from selling organs to poorly-planned gift exchanges — and what's repugnant in one place and time is often not repugnant in another.

Matching story for Valentine's day--BBC

Valentine's Day sparks a demand not just for love, but also for stories about marriage as a matching market.  This year I was among those interviewed by the BBC.  Below are two links:  you can listen to the interviews, or read a summary.

First, the interviews: They go for 18 minutes, and are easy listening.  I'm interviewed third, beginning just before minute 10 and going to about minute 14.   (I didn't see a way to embed it) :

Rational Partner Choice: "Should your head trump your heart when seeking lifelong love? We ask an economist, a romantic novelist and a hyper-rationalist businessman this Valentine's Day challenge."

(There actually are 4 interviews, the fourth is with the wife of the businessman, Ed Conard: they've been happily married for 20 years.)
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The written summary has me as the middle of three views on the subject (the headline below reflects the first of the views they considered, with marriage modeled as an optimal stopping problem).

Forget love: This is how to find your perfect partner  By Justin Rowlatt

Here's what they say about their conversation with me:

"Mr Conard's approach to choosing a wife is a well-established method for buying things like a new place to live but, says Nobel Prize winning economist Alvin Roth, spouses aren't like houses: marriage is a market without prices.
...
"He agrees that it is important to meet quite a few possible partners before you take the plunge - "don't marry the first person you meet", he warns.

"You've also got to have realistic expectations: "the first thing a matrimonial agency has to do is persuade clients they aren't a 10."

"But, he says, you can do too much calibrating and evaluating. Choosing a partner is a two-way thing: it is only when you are serious about marriage that potential partners will take you seriously.

"Part of being well matched is the history you share and this starts when you first meet", Prof Roth says, "so investing in that history improves the quality of that match."
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And here are my Valentine's Day blog posts to date.

Kidney matching podcast: Jeremiah Johnson interviews me and Josh Morrison

On the Neoliberal Podcast (49 minutes):
Kidney Matching featuring Dr Alvin Roth & Josh Morrison

Josh Morrison, who donated one of his kidneys as a non-directed donor, is a founder of Waitlist Zero.
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The audio connection seemed to change my voice a bit: here's an unusual comment, forwarded to me by a twitter-literate colleague:

Replying to @ne0liberal @JoshMorrison @waitlistzero

Dr Roth has the velvetiest voice I’ve ever heard

(if you find voices entertaining, you can compare it to the audio in yesterday's post, where I thought I sounded more like myself.)

Feeding America: Podcast on HBS case study of Canice Prendergast and Feeding America

Here's an audio interview of Canice Prendergast and Scott Kominers (who wrote the HBS case study) about the work that Prendergast and colleagues did with a team from Feeding America, which manages a network of more than 200 food banks nationwide.

The podcast is here: Building a Nonprofit Marketplace to Feed America

Prendergast says at one point: "The dynamic of the group was wonderful. I think one of the amazing things about this committee was essentially the length of time we got to listen to each other. I think if it has turned out to be a success, the reason was largely because of the willingness not of the academics to listen to the practitioners, but actually the practitioners to listen to the academics. This was a long way removed from anything that they imagined they would do when we started."


You can read the whole transcript by clicking on "Read More" at the bottom of the page linked above.

Capitalisn't conversation on kidneys and repugnance with Luigi Zingales and Kate Waldock

Here's a podcast and transcript of a conversation I had recently  with Kate Waldock and Luigi Zingales on the Chicago Booth Capitalisn't show, about kidney exchange, repugnant transactions and more:  Capitalisn’t: Abdomenable Transactions





The closing interaction between Luigi and Kate seemed to me to capture something important about compensation for donors, and maybe about repugnance:

Luigi: Al is a great guy. His contribution is extremely important for economics but more importantly, is also very important for humankind. However, listening to his discussion and listening to how complicated it is to do these matches even with his algorithm and how many people are left out, the question arises: Why don’t we pay for people to donate an organ? Of course, not your heart because it means that you are killing yourself, but what about a kidney? People can very happily live without a kidney. If they’re willing to donate a kidney for money, why is it so wrong?

Kate: Luigi, how much money would you have to be paid to sell your kidney?

Luigi: Wow, that’s a good question because I would give a kidney to my wife and my kids, but I don’t think I would sell it for money.

Kate: All right. Fair enough. I’m not sure there’s a price that I would accept either. "

Podcast on matching markets and more from Social Science Bites

David Edmonds interviewed me in London for Social Science Bites, mostly about matching markets, but also about interdisciplinarity, and whether it's fun to win a Nobel prize:

The system that runs the ride-sharing company Uber doesn’t just link up passengers and drivers based on price. It also has to connect the two based largely on where they are geographically. It is, says Nobel laureate Stanford economist Alvin E. “Al”  Roth, a matching market.

In this Social Science Bites podcast, Roth explains to interviewer David Edmonds some of the ins and outs of market matching, starting with a quick and surprisingly simple definition.

“A matching market is a market in which prices don’t so all the work,” Roth details, “So matching markets are markets in which you can’t just choose what you want even if you can afford it – you also have to be chosen.” But while the definition is simple, creating a model for these markets is a tad more complex, as Roth shows in offering a few more examples and contrasting them with commodity markets.

“Labor markets are matching markets. You can’t just decide to work for Google – you have to be hired. And Google can’t just decide that you’ll work for them – they have to make you an offer.” And like say university admission, matching markets require something to intervene, whether it be institutions or technology, to make this exchange succeed. In turn Roth himself helped engineer some high profile matches in areas where the term ‘market might not traditionally have been used: kidney donors with the sick, doctors with their first jobs, refugees with asylum, or students and teachers with schools. Or even the classic idea of ‘matchmaking’ – marriage.

Roth turned to game theory to help explain and understand these markets, and his work won he and Lloyd Shapley the 2012 Nobel Memorial Prize in Economic Sciences. Roth has always had an eye on the real world implications as he pioneered market design, and as the Nobel Committee outlined:

Lloyd Shapley studied different matching methods theoretically and, beginning in the 1980s, Alvin Roth used Lloyd Shapley’s theoretical results to explain how markets function in practice. Through empirical studies and lab experiments, Alvin Roth demonstrated that stability was critical to successful matching methods.

Roth is currently president of the American Economics Association, and sits as the Craig and Susan McCaw professor of economics at Stanford University. He is also the Gund professor of economics and business administration emeritus at Harvard University.

To download an MP3 of this podcast, right-click HERE and save.

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Listen to my Morishima Lecture: Marketplaces and Market Design (audio only)

Below you can listen to a podcast of my lecture in honor of Michio Morishima at the LSE last Thursday. (Update: I've also added links to video below.)

I showed slides in my lecture, but I think you can actually follow the talk without them.  The introduction is by Professor Nava Ashraf.  My talk ends at minute 60, and then you can hear a half hour of questions and answers, many raised by my discussion of repugnant transactions.
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Update:
Here are two videos of the event; the first mostly follows me and not the slides, the second is audio plus slides.

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School choice in Indianapolis: podcast of my talk at the Economic Club of Indianapolis

Here's a link to the broadcast of my talk on radio WYFI in Indianapolis, on markets, marketplaces, Who Gets What, and school choice with unified enrollment which is coming to Indianapolis next year.

Economic Club of Indiana / Dr. Alvin Roth

Interview on Who Gets What and Why: American Monetary Association, Jason Hartman

This interview was conducted some time ago, but I just now saw the link...and listening to it just now, it seems to me that we had a pretty interesting discussion.
(the link at the title below will take you to the podcast...)

AMA 126 – Who Gets What and Why, The New Economics of Matchmaking & Market Design with Alvin Roth

Jason Hartman talks with Alvin Roth, Craig & Susan McGaw Professor of Economics at Stanford and author of “Who Gets What and Why”

Key Takeaways

[5:28] – what aspect of the real estate market surprises him the most

[11:45] – The market of organ donation

[16:24] Repugnant Transactions

[20:51] Government’s role in contracts

[24:56] Signals and two kinds of messages we send

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Conversations about Who Gets What and Why (now in paperback)

After my book Who Gets What and Why came out in paperback, I did several radio interviews about it. Three of them have shown up on the web:

6/16/16: Alvin E. Roth – Economist – “Who Gets What – and Why” (14 minutes)
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This youtube is another audio conversation, on June 20 (about 20 minutes)

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Monday, June 27, station WISR in Pittsburgh (starts right before minute 1:02, and with a brief break for ads around 1:13, continues until 1:22)

http://wisr680.com/turn-guests-mon-627/

Podcast about Who Gets What and Why (now in paperback)

Here's an interview about Who Gets What and Why, now in paperback.

Curious Minds interviews me about matching, market design, and a phone call that set me on my path (podcast)

CM 014: Alvin Roth on the Secrets of Market Design

By Gayle | December 14, 2015 | 0 

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Nobel-prize-winning economist Alvin Roth explores the markets that shape our lives, particularly our work, our health care and our schools. He also explains how key technologies enable companies like Uber, Airbnb, and Google to thrive. His insights extend beyond products, services, and features to include how successful companies attract and hire the most talented employees.

Alvin Roth is a Stanford University Professor, and bestselling author of Who Gets What – and Why: The New Economics of Matchmaking and Market Design. In this episode you will learn:

• how one phone call and a pivotal decision ultimately led to a Nobel Prize
• the important differences between markets
• the role of markets when it comes to marriage, loans, and more
• the role of social support in markets
• the ways the Internet and mobile technology shape market possibilities
• the three key factors that influence the success of companies like Airbnb and Uber
• the ways Smartphones are influencing markets
• how labor market findings influenced the market designs of today
• what game theory can teach us about getting into college and getting a job
• how market designers are applying their skills to the growing global refugee crisis

Alvin also shares what got him interested in the economics of market design and the potential this new field holds for helping us rethink what markets are and can do.

Climate change agreement, on Bloomberg Surveillance this morning

I discussed this weekend's climate change agreement on Bloomberg Surveillance from minute 33 to 41, which you can listen to hereDownload
or here: http://media.bloomberg.com/bb/avfile/News/Surveillance/vDuJ6SlgV5gs.mp3

More or less I said that the Paris deal, which may be all that was politically available, is complex and aspirational—it will be hard for each country to devise ways to cut emissions, it will be hard to measure what was cut, it will be hard to decide what it cost (and so to determine rich to poor country subsidies).

A simpler plan, but not politically feasible (not in the US and not in the world at large) would have been to agree to, say, double the price of carbon over the next few years, by taxing it, and giving back the money to individuals (by reducing other taxes, or by lump sum tax deductions), so that they would still have reason to economize on how much they drive, how they heat their houses, etc.  This would also give a boost to companies that want to produce clean energy and energy saving tech

Refugee resettlement, on Bloomberg Surveillance

Early yesterday morning, I was interviewd for 5 minutes about refugee resettlement on
Bloomberg Surveillance: Yergin, Alloway and Roth

Nov 13, 2015

Bloomberg Surveillance with Tom Keene and Michael McKee. GUESTS: Dan Yergin Vice Chairman IHS Inc joins Surveillance to discuss oil and commodities Tracy Alloway Executive Editor:Media Markets Bloomberg Editorial on What’s Moving Markets Alvin Roth Professor:Economics Stanford University Roth on matching markets and refugee resettlement.

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or here: http://media.bloomberg.com/bb/avfile/News/Surveillance/vwGKliX5qMZY.mp3

My five minutes are from minute 34:15 to 39:30.

All this happened hours before the terrorist attacks in Paris, which I fear will have a very chilling effect on refugee resettlment in Europe.

Economic Rockstar podcast: Alvin Roth on Match-Making, Repugnant Markets and Market Design

You can find the interview here:
Economic Rockstar Connecting Brilliant Minds in Economics and Finance
057: Alvin Roth on Match-Making, Repugnant Markets and Market Design November 5, 2015

Who Gets What and Why: podcast at Ideas Books

Craig Barfoot at IdeasBooks interviews me about Who Gets What and Why: our conversation ranges over repugnant transactions, kidney exchange, and my treadmill desk.  You can find the podcast (about 20 minutes) here: http://www.ideasbooks.org/news/2015/10/1/episode-9-alvin-roth-who-gets-what-and-why
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It looks like you can find it here too:
http://podacademy.org/bookpods/matching-markets-who-gets-what-and-why/

Roger Doooley interviews me about Who Gets What and Why

Ep #68: Disrupting Markets with Nobel Winner Al Roth

07-23-2015 | 0 COMMENTS | ROGER DOOLEY

My guest today on The Brainfluence Podcast is quite a unique scholar. Al Roth is the Craig and Susan McCaw Professor of Economics at Stanford University, as well as the Gund Professor of Economics and Business Administration Emeritus at Harvard University. He is the author ofWho Gets What And Why: The New Economics of Matchmaking and Market Design. He also happens to have been awarded the Nobel Prize for Economics in 2012.

While winning a Nobel Prize makes Al unique, what sets him apart is his application of his knowledge of economics in solving seemingly intractable real-world problems. His insights have resulted in market creation in areas like city-wide school admissions, hospital internship negotiations, and kidney transplants that save thousands of lives each year.

Today, we’re going to hear how an economics professor turned into a lifesaver and how you can apply some of Al’s insights to your business ventures. The principles that Al has brought to the medical field, and that have been used in some of the great entrepreneurial successes in recent history, are readily accessible to you. These same principles can be used to understand and identify novel business opportunities, reshape the way you view your business and help you experience incredible success.

If you enjoy the show, please drop by iTunes and leave a review while you are still feeling the love! Reviews help others discover this podcast, and I greatly appreciate them!

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