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Showing posts sorted by date for query credit. Sort by relevance Show all posts

Thursday, September 19, 2024

Getting more transplants,, two recent articles

 Frank McCormick, and Martha Gershon point me to two articles about increasing kidney transplants.

The first one is by Dylan Matthews in Vox Future Perfect. Here are its first paragraphs and last sentence (the middle is well worth reading too if you're new to this debate..)

The moral case for paying kidney donors.
Kidney donors save lives. Why aren’t we compensated for it?

"A few months ago, I wrote about a proposal called the End Kidney Deaths Act, which seeks to make sure that every one of the more than 135,000 Americans who get diagnosed with kidney failure every year has access to a kidney transplant.

"Its method is simple: a federal tax credit worth $10,000 a year for five years, paid to anyone who donates a kidney to a stranger. It’s the kind of thing that would’ve helped a lot when I donated a kidney back in 2016. Elaine Perlman, a fellow kidney donor who leads the Coalition to Modify NOTA, which is advocating for the act, estimates the measure will save 100,000 lives over the first decade it’s enacted, based on conversations with transplant centers on how many surgeries they can perform with their current resources. Polling has shown this kind of measure has overwhelming public support, with at least 64 percent of Americans supporting a system where a government agency compensates donors.

...

"Not enough nurses? Pay nurses more. Not enough waiters? Pay your waiters more. Not enough kidney donors? Here’s a crazy idea: Pay us."

##########

And here's an article in Healthcare Brew, by Caroline Catherman:

From pigs to payouts, weighing solutions for the US kidney shortage.  About one out of every 20 people waiting for a kidney transplant die each year, according to the United Network for Organ Sharing. Scientists, policymakers, and other experts are scrambling to find a solution.

It also talks about the End Kidney Deaths Act, and pig kidneys and more effective deceased donation as well.

Tuesday, August 13, 2024

End Kidney Deaths Act intoduced in Congress

 Here's the press release from the Congressional sponsors:

Malliotakis Introduces Bipartisan End Kidney Deaths Act, August 12, 2024

"(WASHINGTON, DC) - Today Congresswoman Nicole Malliotakis (NY-11) joined Reps. Don Bacon (NE-02), Josh Harder (CA-09) and Joe Neguse (CO-02) in introducing the End Kidney Deaths Act, bipartisan legislation that would provide a refundable tax credit to living kidney donors who donate kidneys to strangers, specifically those waiting the longest on the kidney waitlist.

"Specifically, the End Kidney Deaths Act will provide a $10,000 refundable tax credit per year for five years ($50,000 total) to living kidney donors who donate kidneys. If enacted, this legislation is expected to save up to 100,000 Americans currently on the waitlist and save taxpayers an estimated $10 to $37 billion."

...

VIEW THE BILL TEXT HERE

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And here's the Coalition to Modify NOTA 's press release(which includes quotes from some of their long list of supporters...)

LIFE-SAVING END KIDNEY DEATHS ACT INTRODUCED TO CONGRESS; PROJECTED TO SAVE 100K LIVES AND $37 BILLION OVER 10 YEARS

Washington DC – The End Kidney Deaths Act (H.R. 9275) has just been introduced by Congressional Representative Malliotakis (R-NY) and Representative Harder (D-CA). This bill will save up to 100,000 American lives and $37 billion tax dollars over the next decade by offering refundable tax credits to encourage living kidney donation in this ten-year pilot program. The End Kidney Deaths Act will provide all Americans who donate kidneys to strangers at the top of the kidney waitlist with a refundable tax credit of $10,000 each year for five years, totaling $50,000."

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Earlier:

Saturday, July 22, 2023

Wednesday, July 24, 2024

The End Kidneys Death Act has growing support

I've earlier blogged about the Coalition to Modify NOTA (the National Organ Transplant Act of 1984).

Here is a summary of their proposed legislation

The End Kidney Deaths Act Summary

It begins this way:

"The End Kidney Deaths Act is a ten year pilot program to provide a refundable tax credit of $10,000 each year for five years ($50,000 total) to living kidney donors who donate a kidney to a stranger, which will go to those who have been waiting longest on the kidney waitlist. By the 10th year after the passage of the End Kidney Deaths Act, up to 100,000 Americans who were dying on the waitlist will instead have healthy kidneys, and taxpayers will have saved $10-$37 billion. Deceased donor kidneys last half as long as living donor kidneys, the gold standard of kidney care.

"One author of the National Organ Transplant Act, Representative Al Gore, said 40 years ago in 1984 that if transplant centers conclude efforts to improve voluntary donation are unsuccessful, incentives including tax credits, should be provided to donors."  

Their list of supporters is growing, and includes many transplant professionals as well as many people who have already donated or received kidneys.

Saturday, June 22, 2024

Experimental Economics sessions at Stanford (SITE) this summer

Here's the preliminary program for this summer's experimental economics at Stanford. 

Session 13: Experimental Economics

Thu, Aug 22 2024, 8:00am - Fri, Aug 23 2024, 5:00pm PDT

John A. and Cynthia Fry Gunn Building, 366 Galvez Street, Stanford, CA 94035

ORGANIZED BY

Christine Exley, University of Michigan

Judd Kessler, University of Pennsylvania

Muriel Niederle, Stanford University

Alvin Roth, Stanford University

Lise Vesterlund, University of Pittsburgh

This workshop will be dedicated to advances in experimental economics combining laboratory and field-experimental methodologies with theoretical and psychological insights on decision-making, strategic interaction and policy. We would invite papers in lab experiments, field experiments and their combination that test theory, demonstrate the importance of psychological phenomena, and explore social and policy issues. In addition to senior faculty members, invited presenters will include junior faculty as well as graduate students.


Thursday, August 22, 2024

9:30 AM - 10:00 AM PDT

Check-In & Breakfast

10:00 AM - 10:30 AM PDT

Flexible Pay and Labor Supply: Evidence from Uber’s Instant Pay

Presented by: Keith Chen (University of California, Los Angeles)

Co-author(s): Katherine Feinerman (University of California, Los Angeles) and Kareem Haggag (University of California, Los Angeles)

Modern tech platforms provide workers real-time control over when they work, and increasingly, flexible pay: the option to be paid immediately after work. We investigate the labor supply effects of pay flexibility and the implications of present-biased preferences among gig-economy workers. Using granular data from a nationwide randomized controlled trial at Uber, we estimate the effects of switching from a fixed weekly pay schedule to Instant Pay, a system that allows on-demand, within-day withdrawals. We find that flexible pay substantially increased both drivers’ work time and earnings (ITT 2%; TOT: 18-37%). Furthermore, the response is significantly higher when drivers are further away from the end of their counterfactual weekly pay cycle, aligning with predictions of hyperbolic discounting models. We discuss welfare and broader implications in contexts in which workers have the ability to flexibly supply labor.


10:30 AM - 10:45 AM PDT

Eviction as Bargaining Failure: Hostility and Misperceptions in the Rental Housing Market

Presented by: Charlie Rafkin (Massachusetts Institute of Technology)

Co-author(s): Evan Soltas (Massachusetts Institute of Technology)

Court evictions from rental housing are common but could be avoided if landlords and tenants bargained instead. Such evictions are inefficient if they are costlier than bargaining. We test for two potential causes of inefficient eviction — hostile social preferences and misperceptions — by conducting lab-in-the-field experiments in Memphis, Tennessee with 1,808 tenants at risk of eviction and 371 landlords of at-risk tenants. We detect heterogeneous social preferences: 24% of tenants and 15% of landlords exhibit hostility, giving up money to hurt the other in real-stakes Dictator Games, yet more than 50% of both are highly altruistic. Both parties misperceive court or bargaining payoffs in ways that undermine bargaining. Motivated by the possibility of inefficient eviction, we evaluate the Emergency Rental Assistance Program, a prominent policy intervention, and find small impacts on eviction in an event-study design. To quantify the share of evictions that are inefficient, we estimate a bargaining model using the lab-in-the-field and event-study evidence. Due to hostile social preferences and misperceptions, one in four evictions results from inefficient bargaining failure. More than half would be inefficient without altruism. Social preferences weaken policy: participation in emergency rental assistance is selected on social preferences, which attenuates the program’s impacts despite the presence of inefficiency.


10:45 AM - 11:00 AM PDT

Workplace Hostility

Presented by: Manuela Collis (University of Toronto)

Co-author(s): Clémentine Van Effenterre (University of Toronto)

We conduct a choice experiment with 2,048 participants, recruited among upper-year students, recent graduates, and alums from a large public university, to understand how much individuals value a workplace free of hostility and whether this can be offset with hybrid or solo work arrangements. In the experiment, we ask respondents to choose between two job offers for thirteen distinct and realistic scenarios. Our experiment shows that people are willing to forgo a significant portion of their earnings to avoid hostile work environments—15 to 30 percent of their wage. Women report a stronger preference for inclusive workplaces and environments free of sexual harassment. We also find that women value hybrid work twice as much in the presence of sexual harassment and value teamwork more in non-inclusive environments. Based on these findings, we introduce a model of compensating differentials to understand how the presence of hostility shapes the demand for alternative work arrangements and to implement policy counterfactuals.


11:00 AM - 11:30 AM PDT  Coffee Break

11:30 AM - 12:00 PM PDT

Why Exclude Test Scores from Admission Decisions?

Presented by: Yucheng Liang (Carnegie Mellon University)

Co-author(s): Wenzhuo Xu (Carnegie Mellon University)

One major argument in support of test-optional and test-blind college admission policies is that standardized test scores inaccurately reflect students’ abilities and are biased against those with fewer resources. This argument goes against standard economic reasoning as information, even if noisy or biased, never has negative value. In an experiment, we show that participants responsible for admitting students for an educational opportunity are indeed willing to exclude invalid or biased test scores from their admission criteria. This result is primarily driven by procedural fairness concerns and an underestimation of the scores’ usefulness. However, this underestimation can be mitigated through experience in making admission decisions both with and without these test scores.


12:00 PM - 12:30 PM PDT

Mechanism Design for Personalized Policy: A Field Experiment Incentivizing Exercise

Presented by: Rebecca Dizon-Ross (University of Chicago)

Co-author(s): Ariel Zucker(University of California, Santa Cruz)

Personalizing policies can theoretically increase their effectiveness. However, personalization is difficult when individual types are unobservable and the preferences of policymakers and individuals are not aligned, which could cause individuals to mis-report their type. Mechanism design offers a strategy to overcome this issue: offer a menu of policy choices, and make it incentive-compatible for participants to choose the “right” variant. Using a field experiment that personalized incentives for exercise among 6,800 adults with diabetes and hypertension in urban India, we show that personalizing with an incentive-compatible choice menu substantially improves program performance, increasing the treatment e↵ect of incentives on exercise by 80% with-out increasing program costs relative to a one-size-fits-all benchmark. Personalizing with mechanism design also performs well relative to another potential strategy for personalization: assigning policy variants based on observables.


2:00 PM - 2:30 PM PDT

What Money Shouldn’t Buy: Aversion to Monetary Incentives for Health Behaviors

Presented by: Florian H. Schneider (University of Copenhagen)

Co-author(s): Pol Campos-Mercade (Lund University and Institute for Future Studies), Armando Meier (University of Basel) and Roberto A. Weber (University of Zurich)

We study attitudes towards offering monetary payments for health behaviors, aiming to understand how such attitudes may influence the use of monetary incentives as a policy instrument. We develop the Policy Lab, an experimental paradigm in which participants decide whether to provide a set of others with monetary incentives for vaccination. In two studies with representative samples of the Swedish population (N=2,010) and one with Swedish policymakers (N=2,008), a majority of participants oppose using direct financial incentives. Despite the widespread perception that such incentives are an effective policy instrument, opposition to their use is driven by perceptions that they are coercive and unethical. Policymakers are, if anything, slightly more opposed to the use of direct financial incentives. We also document that opposition to incentives extends beyond vaccination to other health domains. Our findings suggest that public opposition to the use of monetary incentives as a policy instrument may create barriers to their adoption.


2:30 PM - 3:00 PM PDT

Goals, Expectations, and Performance

Presented by: Alexandra Steiny Wellsjo (University of California, San Diego)

Co-author(s): Avner Strulov-Shlain (University of Chicago)

People and organizations often set goals to self-motivate and achieve better outcomes in challenging tasks. But goals, and their effectiveness, might depend on what people expect to happen. Do goals reflect expectations or do goals set expectations? How do goals and expectations affect performance? We run an online real-effort task to answer these two questions by introducing exogenous variation in goals and expectations. First, we find that goals mostly reflect expectations rather than affect them. Second, practicing an easier version of a task leads to higher expectations and higher performance. Eliciting a goal leads to higher performance as well. However, controlling for expectations, changing the difficulty of the goal has no discernible effect. These results suggest that people should come in optimistic and set a goal, but they cannot fool themselves into expecting and doing more simply by choosing a higher goal.


3:00 PM - 3:30 PM PDT

Coffee Break

3:30 PM - 4:00 PM PDT

Understanding Expert Choices Using Decision Time

Presented by: Stefano DellaVigna (University of California, Berkeley)

Co-author(s): David Card (University of California, Berkeley), Chenxi Jiang (University of California, Berkeley), and Dmitry Taubinsky (University of California, Berkeley)

Laboratory experiments find a robust relationship between decision times and perceived values of alternatives. This paper investigates how these findings translate to experts’ decision making and information acquisition in the field. In a stylized model of expert choice between two alternatives, we show that (i) less-commonly chosen al- ternatives are more likely to be chosen later than earlier; (ii) decision time is higher when the likelihood of choosing each alternative is closer to fifty percent; and (iii) the ultimate quality of the chosen alternative may increase or decrease with decision time, depending on whether earlier or later signals are more informative. We test these pre-dictions in the editorial setting, where we observe proxies for paper quality and signals available to editors. We document that (i) the probability of a positive decision rises with decision time; (ii) average decision time is higher when our estimated probability of a positive decision is closer to fifty percent; and (iii) paper quality is positively (negatively) related to decision time for papers with Reject (R&R) decisions. Structural estimates show that the additional information acquired in editorial delays is modest, and has little impact on the quality of decisions.


4:00 PM - 4:15 PM PDT

Choosing Between Information Bundles

Presented by: Menglong Guan (Penn State University)

This paper presents an experimental study on how people choose sets of information sources (referred to as information bundles). The findings reveal that subjects frequently fail to choose the more instrumentally valuable bundle in binary choices, largely due to the challenge of integrating the information sources within a bundle to identify their joint information content. The mistakes in choices can not be attributed to an inability to use information bundles. Instead, these mistakes are strongly ex-plained by subjects’ tendency to follow a simple but imperfect heuristic when valuing them, which I call “common source cancellation (CSC)”. The heuristic causes subjects to mistakenly disregard the common information source in two bundles and focus solely on the comparison of the sources that the two bundles do not share. As a result, choices between information bundles are made without adequately considering the joint information content of each bundle. Notably, CSC emerges as a robust explanation for the information bundle choices for all subjects, including those who make perfect use of information bundles to make inferences.


4:15 PM - 4:30 PM PDT

Persuasion through Simulation

Presented by: John J. Conlon (Stanford University)

Co-author(s): Spencer Y. Kwon (Brown University)

We describe and experimentally test a model where an agent facing a complex decision forms beliefs by sampling or “simulating” relevant scenarios. Crucially, simulation is subject to cuing: scenarios similar to the agent’s current context are more easily simulated, and a persuader can manipulate the agents’ beliefs by altering this context. Even objectively uninformative messages simply highlighting known scenarios can be persuasive if they facilitate simulation of otherwise neglected scenarios. Experimentally, participants’ beliefs (about a lottery outcome and about others’ actions in a dictator game) are highly susceptible to such persuasion through simulation. We then study a consumer choice setting where a firm can cue its potential customers with particular scenarios and designs products with such “advertising” in mind. The firm chooses to highlight a single most compelling scenario and produces excessively “specialized” goods, with utility concentrated in scenarios its ads target. When the firm produces multiple goods, it additionally needs to consider how their ads cue each other. This force generates endogenous brands: products that the firm chooses to associate or dissociate depending on which scenarios it wants its consumers to simulate.


Friday, August 23, 2024

10:00 AM - 10:30 AM PDT

Who You Gonna Call? Gender Inequality in External Demand For Parental Involvement

Presented by: Olga Stoddard (Brigham Young University)

Co-author(s): Kristy Buzard (Syracuse University) and Laura K. Gee (Tufts University)

Gender imbalance in time spent on children causes labor market gender inequalities. We investigate a novel source of this inequality: external demands for parental involvement. We pair a theoretical model with a large-scale field experiment with a near-universe of US schools. Schools receive an email from a two-parent household and are asked to contact one parent. Mothers are 1.4 times more likely than fathers to be contacted. We decompose this inequality into discrimination stemming from differential beliefs about parents’ responsiveness versus other factors, including gender norms. Our findings underscore how agents outside the household contribute to gender inequalities.


10:30 AM - 11:00 AM PDT

Precautionary Debt Capacity

Presented by: Olivia Kim (Harvard University)

Co-author(s): Deniz Aydin (Washington University in St. Louis)

Firms with ample financial slack are unconstrained... or are they? In a field experiment that randomly expands debt capacity on business credit lines, treated small-and-medium enterprises (SMEs) draw down 35 cents on the dollar of expanded debt capacity in the short-run and 55 cents in the long-run despite having debt levels far below their borrowing limit before the intervention. SMEs direct new borrowing to financing investment gradually over time and do not exhibit a measurable impact on delinquencies. Heterogeneity analysis by the risk of being at the credit line limit supports the SME motive to preserve financial flexibility.


11:00 AM - 11:30 AM PDT

Coffee Break

11:30 AM - 12:00 PM PDT

Pushing the Envelope: The Effects of Negotiating

Presented by: Zoë Cullen (Harvard University)

12:00 PM - 12:30 PM PDT

Gender Diversity Improves Academic Performance

Presented by: Xiaoyue Shan (National University of Singapore)

This paper uses a field experiment in a first-semester course at a Swiss university to examine the impact of gender diversity on academic performance. 2,580 students across six cohorts are randomly assigned into 645 study groups with varying gender composition. Results show that group gender diversity significantly raises students’ course performance, especially for men. Moving from homogeneous to gender-balanced groups increases course grade by about 15% standard deviations. Analyses of mechanisms reveal that diversity enhances peer-to-peer interaction and students’ mental health, self-esteem, self-confidence, and group satisfaction. Diversity appears to lower women’s study effort and leads them to hold significantly more traditional gender attitudes, which may have limited diversity’s impact on their performance. The findings of this paper highlight the value of gender diversity in improving student performance and well-being in higher education.


12:30 PM - 2:00 PM PDT  Lunch

2:00 PM - 2:30 PM PDT

Over- and Underreaction to Information

Presented by: Cuimin Ba (University of Pittsburgh)

Co-author(s): J. Aislinn Bohren (University of Pennslyvania) and Alex Imas (University of Chicago)

This paper explores the impact of the learning environment on how people react to information. We develop a model of belief-updating where people respond to complexity by forming a representation of the environment that channels attention to states that are most salient given the observed information. They then use this distorted representation to process the information using Bayes’ rule, subject to cognitive imprecision. The model predicts overreaction when environments are complex, signals are noisy, or priors are concentrated on less salient states; it predicts underreaction when environments are simple, signals are precise, or priors concentrated on salient states. Results from a series of pre-registered experiments provide support for these predictions and demonstrate their robustness across different learning environments and decision domains. We then provide evidence for the specific cognitive mechanisms by manipulating attention and salience directly. We also show that the proposed model is highly complete in capturing explainable variation in belief-updating; moreover, the interaction between psychological mechanisms is critical to explaining belief data in more complex settings. These results connect disparate findings in prior work: underreaction is typically found in laboratory studies, which feature simple learning settings, while overreaction is prevalent in financial markets, which feature more complex environments.


2:30 PM - 3:00 PM PDT

Numbers Tell, Words Sell

Presented by: Michael Thaler (University College London)

Co-author(s): Mattie Toma (University of Warwick) and Victor Yaneng Wang (University of Oxford)

3:00 PM - 3:30 PM PDT

Coffee Break

3:30 PM - 4:00 PM PDT

A competitive world

Presented by: Bertil Tungodden (NHH Norwegian School of Economics)

Co-author(s): Thomas Buser (University of Amsterdam), Alexander W. Cappelen (NHH Norwegian School of Economics), and Uri Gneezy (University of California, San Diego)

We elicit willingness to compete in large and representative samples in 62 countries covering all continents. We also shed light on the socialization of boys and girls around the globe by eliciting the importance adults attach to boys’ and girls’ willingness to compete. Globally, a clear majority of people are willing to compete against others and find it important that children are willing to compete. Nevertheless, the shares vary strongly across countries and we show that this variation is correlated with inequality: people in more unequal countries are more competitive and find it more important that children are willing to compete. We also document some near-universal patterns that replicate the main findings of the competitiveness literature at a global scale: in all but one country, men are more competitive than women, and in the vast majority of countries willingness to compete is positively associated with income and level of education. Despite the near-universal gender gap in competitiveness among adults, people in many – mostly Western – countries place greater importance on girls’ than boys’ willingness to compete.


4:00 PM - 4:15 PM PDT

Breaking the Spiral of Silence

Presented by: Yihong Huang (Harvard University)

Co-author(s): Yuen Ho (University of California, Berkeley)

The Spiral of Silence theory plays a crucial role in contemporary political discourse. According to this idea, people who hold views perceived as socially inappropriate tend to self-censor, generating a distribution of expressed views that is skewed towards appropriate opinions. If the attention paid to silence is limited, this can exacerbate self-censorship and create an equilibrium where only socially appropriate views are expressed and considered dominant. We experimentally test this hypothesis based on a simple model in which self-censorship and limited attention to silence interact to jointly establish equilibrium norms. In our experiment, UC Berkeley undergraduates discuss controversial political and socioeconomic issues. Students with socially inappropriate views self-censor to a significant degree. Given the limited attention students pay to silence, self-censorship amplifies over time. We experimentally increase the salience of silence, and show that this affects both beliefs about others’ views and public expression decisions. Because inference and expression amplify each other, different levels of attention to silence can produce divergent perceived social norms in equilibrium.


4:15 PM - 4:30 PM PDT

Social Media and Job Market Success: A Field Experiment on Twitter

Presented by: Jingyi Qiu (University of Michigan)

Co-author(s): Yan Chen (University of Michigan), Alain Cohn (University of Michigan), and Alvin Roth (Stanford University)

We conducted a field experiment on Twitter to examine how social media promotion affects job market outcomes in economics. We tweeted 519 candidates’ job market papers from our research account and randomly assigned half of these tweets to be quote-tweeted by prominent economists in their fields. We find that the quote-tweeted papers received 442% more views and 303% more likes on Twitter. Further- more, treatment group candidates received one more flyout, whereas treatment group women received 0.9 more job offers. Our results suggest that social media promotion can improve the visibility and success of job market candidates, especially women.

Sunday, June 9, 2024

Recent kidney transplant papers

 Here are two new papers on kidney exchange that caught my eye, and one on incentivizing deceased donation by prioritizing registered donors on the deceased donor waiting list.


This one concerns organizing international kidney exchanges between countries while making sure that each one gets their fair share. (All exchanges are between 2 pairs.)

Benedek, Márton, Péter Biró, Daniel Paulusma, and Xin Ye. "Computing balanced solutions for large international kidney exchange schemes." Autonomous Agents and Multi-Agent Systems 38, no. 1 (2024): 1-41.

Abstract: To overcome incompatibility issues, kidney patients may swap their donors. In international kidney exchange programmes (IKEPs), countries merge their national patient–donor pools. We consider a recently introduced credit system. In each round, countries are given an initial “fair” allocation of the total number of kidney transplants. This allocation is adjusted by a credit function yielding a target allocation. The goal is to find a solution that approaches the target allocation as closely as possible, to ensure long-term stability of the international pool. As solutions, we use maximum matchings that lexicographically minimize the country deviations from the target allocation. We perform, for the first time, a computational study for a large number of countries. For the initial allocations we use two easy-to-compute solution concepts, the benefit value and the contribution value, and four classical but hard-to-compute concepts, the Shapley value, nucleolus, Banzhaf value and tau value. By using state-of-the-art software we show that the latter four concepts are now within reach for IKEPs of up to fifteen countries. Our experiments show that using lexicographically minimal maximum matchings instead of ones that only minimize the largest deviation from the target allocation (as previously done) may make an IKEP up to 54% more balanced.

"We consider IKEPs in the setting of European KEPs which are scheduled in rounds, typically once in every three months.

...

"We first note that the search for an optimal exchange scheme can be done in polynomial time for 2-way exchanges (matchings) but becomes NP-hard as soon as 3-way exchanges are permitted."

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Here's a paper that reports simulations on Using deceased donor kidneys to start living donor kidney exchange chains

Verma, Utkarsh, Nayaran Rangaraj, Viswanath Billa, and Deepa Usulumarty. "Long term simulation analysis of deceased donor initiated chains in kidney exchange programs." Health Systems (2023): 1-12.

ABSTRACT: Kidney exchange programs (KEPs) aim to find compatible kidneys for recipients with incompatible donors. Patients without a living donor depend upon deceased donor (DD) donations to get a kidney transplant. In India, a DD donates kidneys directly to a DD wait-list. The idea of initiating an exchange chain starting from a DD kidney is proposed in a few articles (and executed in Italy in 2018), but no mathematical formulation has been given for this merger. We have introduced an integer programming formulation that creates DD-initiated chains, considering both paired exchange registry and DD allocations simultaneously and addressing the overlap issue between the exchange registry and DD wait-list as recipients can register for both registries independently. A long-term simulation study is done to analyse the gain of these DD-initiated chains over time. It suggests that even with small numbers of DDs, these chains can significantly increase potential transplants.

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And here's the paper on incentivizing registration to be a deceased donor.

Li, Mengling, and Yohanes E. Riyanto. "Incentivizing Organ Donation Under Different Priority Rules: The Role of Information." Management Science (2024).

Abstract: This paper examines the incentive to register for deceased organ donation under alternative organ allocation priority rules, which may prioritize registered donors and/or patients with higher valuations for organ transplantation. Specifically, the donor priority rule grants higher priority on the organ waiting list to those who have previously registered as donors. The dual-incentive priority rules allocate organs based on donor status, followed by individual valuations within the same donor status, or vice versa. Both theoretical and experimental results suggest that the efficacy of the donor priority rule and the dual-incentive priority rules critically depends on the information environment. When organ transplantation valuations are unobservable prior to making donation decisions, the hybrid dual-incentive rules generate higher donation rates. In contrast, if valuations are observable, the dual-incentive priority rules create unbalanced incentives between high- and low-value agents, potentially undermining the efficacy of the hybrid dual-incentive rules in increasing overall donation rates.

Thursday, May 16, 2024

Increasing the supply of transplantable organs, in the long term, and sooner.

 Here's an article on the website of The American Council on Science and Health, on technologies that might eventually replace the need for human organ transplants, and on policies to increase their supply while still needed.

We Urgently Need More Organs For Transplantation. Science And Policy Can Come To The Rescue. By Henry I. Miller, MS, MD and Sally Satel, MD

"Both scientific and policy advancements could provide desperately needed organs for transplantation. For example, there have been some promising early studies using kidneys from pigs genetically engineered to prevent rejection, but a policy change – paying human donors for donating organs – could be implemented immediately and would be a game changer.

...

"[A] sector of medicine that desperately needs breakthroughs is the transplantation of solid organs, which are in severely short supply. Currently, more than 100,000 Americans are waiting for transplants, and due to a shortage of hearts, lungs, livers, and kidneys, at least 17 die each day. Donor organs — from a living person or cadaver — must match the rejection recipient’s tissue type and size; they are often not perfect. By one estimate, approximately half of transplanted organs are rejected by recipients’ bodies within 10-12 years, despite a constantly expanding understanding of what causes rejection. Another obstacle is that the organ procurement system in the U.S. is inefficient, inconsistent, and unaccountable – in short, a mess that causes preventable deaths.

"We are making progress, but too slowly. Two new high-tech approaches to providing organs for transplantation might ultimately both eliminate the need for organ donors and reduce the risk of tissue rejection. And there is also a low-tech approach that would require only a tweak in healthcare policy.

"Organs produced by 3D bioprinting"

...

"Organs from genetically modified pigs"


...

"The low-tech policy approach

"Although friends and relatives and even the occasional “good Samaritan” donor can donate kidneys, they must be given without compensation. Under section 301(a) of the National Organ Transplant Act of 1984 (NOTA), it is a federal crime for “any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce.”  Therefore, we propose a federal tax credit for living donors willing to save the life of a stranger. The value of the reward should be between $50,000 and $100,000, which physicians and others who endorse donor compensation believe would be sufficient to address the organ shortage. An economic analysis published in 2022 estimated that a reward of $77,000 could encourage sufficient donations to save 47,000 patients annually.

"The credit would be universally available—refundable in cash for people who do not owe income tax, not phased out at high-income levels, and available under the alternative minimum tax. NOTA’s restriction on payments by organ recipients and other private individuals and organizations would not change—it would still be illegal for recipients to buy organs.

"A qualified organ donation would be subject to stringent safeguards. As all donors are now, prospective compensated donors would be carefully screened for physical and emotional health. A minimum six-month waiting period before the donation would filter out impulsive donors and donations by financially desperate individuals seeking instant cash.

"In addition to saving lives, the credit would save the government money, perhaps as much as $14 billion per year, by reducing expenditures on dialysis. Thus, donors would receive financial compensation from the government for contributing to the public good and bearing the risk of a surgical operation to remove the organ.

"This would be a compassionate and pragmatic policy. Moreover, it could be implemented immediately, rapidly clearing much of the backlog of Americans waiting for organs in advance of the longer-term high-tech approaches.

"The organ shortage kills thousands of Americans every year. We must do all we can to alleviate it now."


HT: Frank McCormick

Wednesday, March 27, 2024

Danny Kahneman (1934-2024)

 Danny Kahneman passed away today.

Here's the Washington Post obituary:

Daniel Kahneman, Nobel-winning economist, dies at 90. He found that people rely on shortcuts that often lead them to make wrongheaded decisions that go against their own best interest  By Chris Powe

"Daniel Kahneman, an Israeli-American psychologist and best-selling author whose Nobel Prize-winning research upended economics — as well as fields ranging from sports to public health — by demonstrating the extent to which people abandon logic and leap to conclusions, died March 27. He was 90.

"His death was confirmed by his stepdaughter Deborah Treisman, the fiction editor for the New Yorker. She did not say where or how he died.

...

"Dr. Kahneman took a dim view of people’s ability to think their way through a problem. “Many people are overconfident, prone to place too much faith in their intuitions,” he wrote in his popular 2011 book “Thinking, Fast and Slow.” “They apparently find cognitive effort at least mildly unpleasant and avoid it as much as possible.”

"Dr. Kahneman spent much of his career working alongside psychologist Amos Tversky, who he said deserved much of the credit for their prizewinning work. But Tversky died in 1996, and the Nobel is never awarded posthumously.

"Both men were atheist grandsons of Lithuanian rabbis, and both had studied and lectured at the Hebrew University of Jerusalem. Their three-decade friendship and close collaboration, chronicled in Michael Lewis’s 2016 book “The Undoing Project,” was a study in opposites.

"According to Lewis, Tversky was the life of the party; Dr. Kahneman never even went. Tversky had a mechanical pencil on his desk and nothing else; Dr. Kahneman’s office was full of books and articles he never finished. Still, Dr. Kahneman said, at times it was as if “we were sharing a mind.” They worked so closely together that they tossed a coin to decide whose name would go first on an article or a book.

"Their research helped establish the field of behavioral economics, which applies psychological insights to the study of economic decision-making, but also had a far-reaching effect outside the academy. "

Sunday, March 24, 2024

Conference in Jerusalem, in solidarity with Israeli academics

 I'm expecting to be back in California later today.  I gave three talks while in Israel, and met with many people, but the proximate cause of my trip was the economics conference organized by Effi Benmelech on behalf of Northwestern's Crown Family Israel Center for Innovation. It was organized as an expression of support for Israeli academics.


Here is the program

Wednesday, March 20 | Mishkenot Sha’ananim, Jerusalem

9:00-9:15 Welcome  Effi Benmelech, Northwestern University

9:15-10:00 Amir Yaron, Governor of the Bank of Israel

10:00-10:15 Break

Macro Session

10:15-11:00 Moving to Fluidity: Regional Growth and Labor Market Churn  Eran Hoffman, Hebrew University

11:00-11:45 Policy Design and Rates of Convergence in Learning Models  Martin Eichenbaum, Northwestern University

11:45-12:45 Lunch

Applied Micro Session

12:45-13:30 Fostering Soft Skills in Active Labor Market Programs: Evidence from a Large-Scale RCT  Analia Schlosser, Tel Aviv University

13:30-14:15 Decomposing the Rise of the Populist Radical Right  Roee Levy Tel Aviv University

14:15-14:30 Break

14:30-15:15 Why Has Construction Productivity Stagnated? The Role of Land-Use Regulation  Edward Glaeser, Harvard University

15:15-15:30 Break

Matching Markets Session

15:30-16:15 Organ Allocation for Transplants, Around the World and in Israel: Part I  Al Roth, Stanford University

16:15-17:00 Organ Allocation for Transplants, Around the World and in Israel: Part II  Itai Ashlagi, Stanford University

Thursday, March 21 Mishkenot Sha’ananim, Jerusalem

Industrial Organization Session

9:15-10:00 Selling Subscriptions Liran Einav, Stanford University

10:00-10:15 Break

10:15-11:00 An Empirical Analysis of Merger Efficiencies  Alon Eizenberg, Hebrew University

11:00-11:15 Break

11:15-12:00 Pharmaceutical Advertising in Dynamic Equilibrium  Ariel Pakes, Harvard University

12:00-13:00 Lunch

Economic History Session

13:00-13:45 Land Privatization and Business Credit: The Response of Bankruptcies to Land Enclosures in England 1750-1830  Karine van der Beek, Ben-Gurion University

13:45-14:00 Break

14:00-14:45 Diversity, Pluralism and Tolerance: The Roots of Economic Progress  Joel Mokyr, Northwestern University

14:45-15:00 Break

Experimental Economics

15:00-15:45 Describing Deferred Acceptance to Participants: Experimental Analysis  Yannai Gonczarowski, Harvard University

15:45 Adjourn


Saturday, March 9, 2024

Michael Kremer on market design by economists (and other essays on developments in economics)

 The March issue of the IMF publication Finance and Development (F&D) contains this essay by Michael Kremer.

ECONOMICS AND INNOVATION by MICHAEL KREMER, MARCH 2024

Here are his concluding paragraphs:

"Economists as innovators

"In addition to shedding light on the design of policies and institutions for innovation, economists can also participate directly in the innovation process. For example, economic theorists have used market design principles to design kidney transplant matching systems, and development economists are using experimental methods not just to test innovations, but also to help develop them. An analysis of Development Innovation Ventures (DIV)—the US Agency for International Development’s tiered evidence-based social innovation fund—found that 36 percent of awards went to innovations developed by teams including development economists, scaled to reach over 1 million users, compared with just 6 percent of awards to innovations without such involvement.

"Furthermore, 63 percent of DIV-supported innovations that had previously been tested in randomized controlled trials reached more than 1 million people, compared with only 12 percent of those without such trials. For example, economists helped develop a credit-scoring approach using psychometrics (psychological testing) to assess default risk for potential borrowers without credit histories, which scaled through adoption by commercial lenders.

"Just as biochemists and computer scientists often develop practical innovations in their fields, economists are increasingly developing social innovations in ours."

#########

The March issue also includes

NEW LESSONS FROM BEHAVIORAL ECONOMICS, by ULRIKE MALMENDIER  and CLINT HAMILTON

and

RETHINKING MY ECONOMICS  by ANGUS DEATON

Saturday, February 24, 2024

Foreign surrogacy in Denmark is becoming less restrictive

 Above the Law has the story:

Denmark Passes New Pro-Surrogacy Regulations. The new rules in Denmark focus on two areas of surrogacy.  By ELLEN TRACHMAN  February 14, 2024

 "On February 5, 2024, the Danish government announced new surrogacy-supportive rules scheduled to come into effect on January 1, 2025. The rules address parentage for families formed by surrogacy — including commercial (compensated) surrogacy outside of Denmark — as well as for families formed by altruistic (noncompensated) surrogacy within Denmark.

...

"In Denmark, compensated surrogacy is illegal, and altruistic surrogacy has traditionally fallen into a legal gray area, pushing most hopeful parents who want to have a genetic connection to their child, but who are unable to carry a pregnancy themselves, to go abroad. The Danish government estimates that about 100 children are born to Danish parents each year by surrogacy outside of Denmark, while about five children each year are born within Denmark in altruistic surrogacy arrangements.

...

"Denmark has a history of denying parental rights to the intended parents of children born by surrogacy abroad. But on December 6, 2022, the European Court of Human Rights ruled against Denmark in K.K. and Others v. Denmark. In that case, a married heterosexual couple had twins with the assistance of a Ukrainian surrogate. Under Ukrainian law, both Danish intended parents were recognized as parents of the child, and the surrogate was not a parent of the child.

...

"The ECHR found that Denmark’s refusal to recognize the parent-child relationship between the mother and child was a human rights violation — not a violation of the mother’s human rights, but of the two children, to have a recognized legal relationship with their mother.


To its credit, Denmark is reacting to the ECHR’s definitive ruling. In the announcement by the Danish government last week, the government made it clear that the country’s new rules are intended to go beyond the minimum requirements of the ECHR to merely not violate the human rights of Danish children.  (The bare minimum requirement would be to just allow stepparent adoptions.) Instead, the Danish government’s new rules go farther to protect children and their parents.

...

"The new rules permit Danish family courts to quickly make a decision on parenthood in the case of a foreign surrogacy agreement, even permitting a court ruling to be made prior to the family’s return to Denmark. The rules also require that the court assess the best interest of the child, but with a presumption that it is, of course, in the child’s best interest to have a timely recognition of their parents.

"Moreover, the court decisions are permitted to be retroactive to the birth of the child, permitting parents to have access to parental leave work benefits, inheritance rights, and all other benefits of that legal relationship. And, in contrast to a stepparent adoption, the new rules will allow recognition of the parent-child relationship with the mother or nongenetic parent even if parents have separated, or if one parent died before they had a chance to apply for parenthood.

...

"In a stated attempt to address the risk of child trafficking, the rules require that at least one intended parent be genetically related to the child. Additionally, the surrogate is required to confirm in a notarized declaration after the birth that she wishes to transfer parenthood of the child to the intended parents."

Thursday, February 8, 2024

Morally contested markets on NPR's Planet Money (including kidneys, revenge and insider trading)

 The NPR show Planet Money discusses kidney sales, revenge, and insider trading. The hosts are enthusiastic about at least thinking about all of these.* 

They start with a discussion of organ transplants, and in the first 9 minutes of the show you can hear some parts of an interview with me, discussing tradeoffs (and possible titles for a book I'm working on).  Then they talk to Siri Isaksson about retaliation, and after that to Chester Spatt about insider trading.

 

They write:

"There are tons of markets that don't exist because people just don't want to allow a market — for whatever reason, people feel icky about putting a price on something. For example: Surrogacy is a legal industry in parts of the United States, but not in much of the rest of the world. Assisted end-of-life is a legal medical transaction in some states, but is illegal in others.

"When we have those knee-jerk reactions and our gut repels us from considering something apparently icky, economics asks us to look a little more closely.

"Today on the show, we have three recommendations of things that may feel kinda wrong but economics suggests may actually be the better way. First: Could the matching process of organ donation be more efficient if people could buy and sell organs? Then: should women seek revenge more often in the workplace? And finally, what if insider trading is actually useful?"

##########

*In their enthusiasm, they mis-state how few kidney exchanges were done before my colleagues and I got involved. (There weren't many, but more than two...)

As it happens, earlier this week I blogged about another interview, in the NYT, by Peter Coy (in print, not audio) that focused on kidney exchange:

Tuesday, February 6, 2024

Update (5pm): now I see that on the Planet Money site there's a transcript.  Here's the part that I participated in:

SYLVIE DOUGLIS, BYLINE: This is PLANET MONEY from NPR.

(SOUNDBITE OF COIN SPINNING)

MARY CHILDS, HOST:

A couple decades ago, Al Roth was working on solving this problem - people who needed kidneys weren't getting matched effectively with people who had kidneys to donate.

AL ROTH: Part of the kind of work I do is called matching theory.

GREG ROSALSKY, HOST:

Al helped create this, like, beautiful, elegant algorithm that would match kidney donors with recipients.

CHILDS: You obviously won a pretty big prize for this work.

ROTH: I did. I recommend it.

CHILDS: OK. Yeah (laughter). You like the prize. It's a good prize.

ROTH: Yeah.

CHILDS: That's good to know.

ROTH: A week long of parties.

CHILDS: The prize he won? - it was the Nobel Prize in economics.

ROSALSKY: As you might know, Al's matching work vastly improved the way people get kidneys and saved literally thousands of lives. Like, in the year 2000, before Al's work, there were only two paired kidney transplants - two. Thanks to Al's algorithm, there are now about a thousand per year.

CHILDS: But, Al says, his Nobel Prize-winning algorithm - it isn't even the best way to get people kidneys. Technically, he says, the best way is to grow kidneys in a lab, so it's not even the second-best way.

I'm just envisioning you doing all this matching work knowing that this is, like, a little goofy. Like...

ROTH: Oh.

CHILDS: ...There's a easier way.

ROTH: I hope it's a lot goofy...

CHILDS: (Laughter).

ROTH: ...The work I'm doing, anyway.

CHILDS: (Laughter).

ROTH: No, no. That's right. So could we figure out a way to have more donors to have fewer deaths? I bet we could.

ROSALSKY: OK, so there is a much easier, more efficient way to get people kidneys. It's the way people get most things - with money. Like, what if we could just buy and sell organs?

ROTH: Oh, we'd have a lot more organs. That's how we get most of our stuff. There's a famous passage quoted from Adam Smith, which I'm going to paraphrase, but it says something like, it's not through the generosity of the butcher and the baker that you get your food. You buy it from them. It's how they - that's how they sustain their families - is by selling you food. And that's how you get food, and that's why there's enough food.

CHILDS: Right. The kidney market already has supply and demand. It just doesn't have prices to balance them because buying and selling kidneys is illegal in basically the entire world. So here we are. We don't have enough kidneys. We desperately need more, and yet, we refuse to pay more than $0 for them.

ROSALSKY: And as Al saw while working on kidneys, people had moral objections to the idea of paying for organs. They had concerns that just didn't really make sense to him as an economist.

ROTH: But when I started to look, it turns out there are lots of markets like that.

CHILDS: Lots of markets where people just don't want to allow a market. They feel icky about putting a price on something. Al has a list - for example, surrogacy - a legal and flourishing industry in much of the U.S., not in much of the rest of the world; assisted end of life - perfectly fine medical transaction in Oregon, illegal where I am in Virginia.

ROSALSKY: Al is actually working on a book about all of this.

ROTH: Its working title is "Repugnant Transactions And Controversial Markets." And the idea is that sometimes economists have perfectly good ideas that other people don't think are perfectly good.

ROSALSKY: Al has sort of made his own little subdiscipline in economics about this.

ROTH: "Ickonomics" (ph), "Yuckonomics" (ph) - you know, I trade in book titles. I'm open to suggestions.

CHILDS: You can email Al with your book title suggestions, though honestly, that's kind of hard to beat. In the meantime, when we have those knee-jerk reactions and our gut repels us from considering the icky thing, economics would like to humbly submit that maybe we should.

(SOUNDBITE OF JORDACHE V. GRANT AND SKINNY WILLIAMS' "OLDER HEADS")

CHILDS: Hello, and welcome to PLANET MONEY. I'm Mary Childs.

ROSALSKY: And I'm Greg Rosalsky. Today on the show, we apply an elegant economic framework to Al's market, the trading of human organs, to whether or not we should exact revenge on our enemies, and to whether or not we should trade on inside information.

(SOUNDBITE OF JORDACHE V. GRANT AND SKINNY WILLIAMS' "OLDER HEADS")

CHILDS: When we face difficult situations that don't have an absolutely clear right answer, economist Al Roth says borrowing tools from economics can be useful.

ROTH: Economists deal in trade-offs, and one of the things about trade-offs is you have to say to yourself, supposing there's something we really don't like, what will happen if we ban it? And if the answer is it won't go away, but it'll go underground or become criminalized or become very irregular, then you might prefer to regulate it rather than ban it.

ROSALSKY: And there are real problems with banning things. For example, remember that time we tried to ban alcohol, like, in the 1920s and 1930s?

ROTH: We discovered that it gave rise to a big criminal economy and didn't completely wipe out alcohol at all. So we legalized it. And the legal market for alcohol, with all its problems, is a lot nicer in many ways, a lot more socially useful than the criminal market - you know, Al Capone and the Saint Valentine's Day massacre and, you know, Eliot Ness.

CHILDS: Alcohol, as you may know, is legal today. Selling kidneys - no, not legal - with kidneys, we are in our Prohibition era.

ROTH: There is a black market for kidneys. And often it's pretty terrible because the almost-universal laws against compensating kidney donors have driven that market underground. And what underground often means is out of the hospitals and into hotel suites and apartments...

CHILDS: Eugh (ph).

ROTH: ...And - yes, so medically very bad, as well as, you know, not just illegal but dealing with criminals - medically very bad, bad for the donors, bad for the recipients.

CHILDS: And that's what we have today. That's the market we have chosen. We have the black market with money and the legal market with no money.

ROSALSKY: So Al has been thinking about solutions to this. Like, what can we do realistically to incentivize more kidney donations? How else could we go about creating a market for kidneys to be, as Al likes to put it, more generous to kidney donors?

CHILDS: And when Al thinks about how to design a market, he prioritizes investigating what exactly it is that we're objecting to so he can build a market that fixes or avoids those problems. And in the case of kidneys...

ROTH: There are metaphysical objections. You know, it's just wrong. But the objections that seem to touch on the world seem to say that you can't do this without exploiting poor people because poor people are so vulnerable that just offering them money takes away their agency.

CHILDS: The first reaction is just a gut reaction, which doesn't help inform Al on design. The second reaction is that money can be coercive, that if people have no money and you offer them money to participate in a study, they might have to do the study, especially if you offer a huge amount, like a life-changing amount of money. It's just too compelling. They wouldn't have a choice.

ROSALSKY: This argument does strike Al as unreasonable.

ROTH: There's lots of jobs that we pay people to do because otherwise no one would do them. And you can earn a decent living being a meatpacker. But that's one of the things that bothers people. They say, why should we allow a market that will be mostly - most of the participants will be in the lower parts of the income range? And of course, that isn't very sympathetic to people who are lower income, right? In other words...

CHILDS: Right.

ROTH: ...We need jobs that people with lower income can get. That's why they have some income - is that there are jobs.

CHILDS: Luckily, there is a really obvious, easy solution to this objection - just solve poverty.

ROTH: There'd be a lot less repugnance to monetary transactions if there was no income inequality.

CHILDS: (Laughter).

ROTH: If you wanted to sell me your kidney, but we all had the same income and the same prospects, it just might not be a big thing.

CHILDS: OK, failing that, Al mentioned another way to create a kidney market, a way to get kidneys only from people who aren't that poor - a tax break.

ROTH: People who are wealthy enough to benefit from tax credits on income tax aren't the poorest of the poor. So it might be that the way to start paying kidney donors is to say, we will give you a tax break on everything after the first $10 million of income in the year that you - you know, and then only hedge fund managers would donate kidneys, and that would be repugnant.

CHILDS: But there's a twisted logic to it because at least they could - like, should something go awry in the surgery or in the...

ROTH: Yeah, they'd be fine. They'd be fine. Yeah.

ROSALSKY: Perfect. Like, now we have a few ideas of how to make this happen without paying people for kidneys. We could resolve income inequality, or we could just, you know, do a tax credit and receive only hedge fund manager kidneys. And - right? - there's something a little goofy about all this because these solutions are trying to account for objections that are just hard to design around 'cause those objections are at least partly stemming from some messy human feeling or intuition that just won't let us exchange things in the normal way.

CHILDS: So do you think there'll ever be a U.S. market for kidneys?

ROTH: Well, I think we're not doing a good job yet and that we ought to find a way to be more generous to donors so that we have more of them.

CHILDS: And what that looks like - you're open to suggestion?

ROTH: I'm open to suggestions.