Removing financial disincentives to kidney donation in the U.S.

A forthcoming article in the American Journal of Transplantation, by authors who are firmly opposed to creating incentives for donation, show increasing acceptance of reimbursing donor expenses...but there is as yet too little action towards making that happen.


Providing coverage for the unique life-long health care needs of living kidney donors within the framework of financial neutrality

John S. Gill, Francis Delmonico, Scott Klarenbach and Alexander Morgan Capron

Accepted manuscript online: 26 NOV 2016

Abstract

Organ donation should neither enrich nor impose financial burdens on donors. We describe the scope of health care required for all living kidney donors that reflects contemporary understanding of long-term donor health outcomes, propose an approach to identify donor health conditions which should be covered within the framework of financial neutrality, and propose strategies to pay for this care. Despite the Affordable Care Act in the United States, donors continue to have inadequate coverage for important health conditions that are either donation related or may compromise post-donation kidney function. Amendment of Medicare regulations is needed to clarify that surveillance and treatment of conditions that may compromise post-donation kidney function following donor nephrectomy will be covered without expense to the donor. In other countries lacking health insurance for all residents, sufficient data exist to allow creation of a compensation fund or donor insurance policies to ensure appropriate care. Providing coverage for donation-related sequelae as well as care to preserve post-donation kidney function ensures protection against the financial burdens of health care encountered by donors throughout their lifetime. Providing coverage for this care should thus be cost-effective even without considering the health care cost savings that occur in living donor transplant recipients. T 

Conclusion

It is now widely accepted that to remove economic barriers to donation and achieve a fair and successful program of living organ donation, the gift of an organ must be “financially neutral” for the donor. Financial neutrality requires that donors be protected against health care costs arising from post-surgical events, and medical complications that manifest in the weeks or months after the donation, as well as the long-term care of conditions that may compromise residual kidney function.

Strategies to provide for the particular lifelong health care needs of living donors will vary among countries. Limiting coverage to the costs arising from the donation and its potential sequelae including loss of post donation kidney function will avoid creating an inducement to donate—and the consequent violation of financial neutrality—that would arise were countries to offer living donors comprehensive medical insurance as a means of covering donors’ future health-care costs.

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

and here's an earlier related paper...

Am J Transplant. 2015 May;15(5):1187-91. doi: 10.1111/ajt.13232. Epub 2015 Mar 31.

Living and deceased organ donation should be financially neutral acts.

Delmonico FL¹, Martin D, Domínguez-Gil B, Muller E, Jha V, Levin A, Danovitch GM, Capron AM

Abstract

The supply of organs—particularly kidneys—donated by living and deceased donors falls short of the number of patients added annually to transplant waiting lists in the United States. To remedy this problem, a number of prominent physicians, ethicists, economists and others have mounted a campaign to suspend the prohibitions in the National Organ Transplant Act of 1984 (NOTA) on the buying and selling of organs. The argument that providing financial benefits would incentivize enough people to part with a kidney (or a portion of a liver) to clear the waiting lists is flawed. This commentary marshals arguments against the claim that the shortage of donor organs would best be overcome by providing financial incentives for donation. We can increase the number of organs available for transplantation by removing all financial disincentives that deter unpaid living or deceased kidney donation. These disincentives include a range of burdens, such as the costs of travel and lodging for medical evaluation and surgery, lost wages, and the expense of dependent care during the period of organ removal and recuperation. Organ donation should remain an act that is financially neutral for donors, neither imposing financial burdens nor enriching them monetarily.

The politics (and incentives) of liver transplants

From the LA Times: California has long wait lists for liver transplants, but not for the reasons you think

"About 7,000 people get a liver transplant each year in the United States, while 17,000 remain on waiting lists at transplant centers. Who should get a lifesaving transplant has always been a complex calculation. But it has blown up into a vicious political struggle that played out most recently at a meeting of the organization governing the nation’s transplant network.

"The benefits of liver transplants are astounding. Patients just weeks from death can have their lives extended significantly, even indefinitely. Given the limited number of donor livers, in 2000 Congress established what’s called “the Final Rule” to guide the medical community in how to allocate them fairly. The Final Rule compels the transplant community to allocate donor organs based on best medical judgment, best use of the organs and avoidance of futile transplants. It also notes that a patient’s chance of getting a transplant should not be affected by where he or she lives.

"Balancing these various guidelines has always been tricky. But what has emerged — and is now the point of contention — is a marked geographic disparity in how sick a patient must be before rising to the top of a transplant list. For example, waiting lists at California transplant centers are significantly longer (and therefore patients in California get a lot sicker before possibly receiving transplants) compared with waiting lists in Oregon. That’s unfair to the Californians who need liver transplants, right?

"Acting on this assumption, the national board of the Organ Procurement and Transplantation Network / United Network for Organ Sharing, or OPTN/UNOS, proposed new boundaries for the nation’s transplant regions. The aim was to have regions with shorter, less-sick waiting lists share the limited supply of donor livers with regions that have longer, more-sick waiting lists. The new map was recently offered for public comment and a regional advisory vote.

"Eight of the 11 regions came out against it — because longer waitlists aren’t necessarily a sign of greater need.

The divide is deep. Antagonists have split into camps (“Liver Alliance” versus “Coalition for Organ Distribution Equity”), hired lobbyists and collected their congressional representatives. Given the uproar, it was not surprising that the OPTN/UNOS board of directors declined to vote on the controversial proposal at its national meeting in St. Louis last week. Nevertheleess, there’s a feeling of urgency that something must be done, so it’s entirely possible the board will soon enact the redistribution proposal — perhaps with minor modifications — despite present objections.
...
"Transplant waiting lists also get distorted by intense competition in populous regions where there are more liver transplant centers — a largely ignored issue. With money and prestige at stake, centers are motivated to perform more liver transplants. The simplest way to accomplish that is to put very ill patients on the transplant list, because when a donor organ becomes available, the center with the sickest listed patient in that region gets the organ.

Unfortunately, this encourages centers to list sicker patients over those who have the best chance of long, high-quality lives post-transplant.
...
"Rates of organ donation, by the way, do not explain the wait-list problem: California has some of the highest donation rates in the country, while New York persistently ranks at the bottom. Everyone agrees on the need to increase donations — but just redistributing livers will not significantly change the number of transplants or lives saved.

"Still, the disparity between the wait lists causes endless teeth-grinding in the transplant community.

"There is no question that wait lists are abhorrently long in some places, but OPTN/UNOS’ redistribution proposal misses the larger point: What is it about our transplant system that has created this situation? How can we make changes to keep the wait lists at more reasonable levels?

"Matters of healthcare access, while important, are beyond the control of OPTN/UNOS and the transplant community. Within grasp, however, is a simple solution: Lower the number of patients on transplant lists. Such a move would not affect the number of transplants (every available liver would still be transplanted), but it would reduce the delay and degree of illness for those on the wait lists. This is, of course, simple to say, but difficult to implement given how our current system incentivizes transplant centers to get as many patients on their lists as possible.

"To create a fairer balance between the haves and have-nots, though, both factions in the liver debate need to understand (and agree on) who the haves and have-nots actually are. Without consensus on that, we risk missing the big picture: increasing the health, happiness and well-being of more people with liver disease."

Dr. Willscott E. Naugler is an associate professor and medical director of liver transplantation at Oregon Health & Science University in Portland. He also serves as the Region 6 (Pacific Northwest) regional representative to the UNOS Liver and Intestine Committee."

Genos seeks to make a market for personal genetic (whole exome) information

Genos is a new company that seeks to make a market for personal genetic information--it wants to both sell sequencing services to individuals, and then serve as a broker between the individuals who will still own their own data, and research projects that wish to use those data.

Here's an article in WIRED:

Genos Will Sequence Your Genes—And Help You Sell Them to Science

"The latest contender is Genos, a genetic sequencing startup that is unveiling its whole exome-sequencing service today. The hot, shiny object of the industry, this type of next-generation sequencing offers a complete profile of all the expressed genes (the ones that code for proteins) in your genome. While a growing number of targeted genetic testing kits are currently on the market (Color, Myriad, and 23andMe, to name a few), whole exome sequencing produces 50 to 100 times more data.
...
"In a first for the personal genomics movement, the company is creating a research pipeline with academic and commercial partners, and paying customers to donate their data. The incentives range between $50 and $200 per project; the first four include a vaccine for breast cancer, a clinical trial for treating lymphoma, and research into prion diseases and common neurological disorders."
**********

A market for information will have some interesting design issues, and a market for genetic information will have to navigate issues of repugnance as well. I'm on their advisory board.

Here's a press release.

Marijuana becomes legal in Massachusetts today

Here's a story that ran yesterday in the Boston Globe:
It’s official: Marijuana legal at midnight in Massachusetts

"Marijuana will be legal for possession, use, and home-growing Thursday for adults 21 and over.
...
"The initiative passed last month with 1.8 million people voting for the measure, despite the opposition of top politicians, the Catholic Church, doctors and business groups, and an array of other civic leaders. About 1.5 million people voted against it.
...
"For legalization advocates, the strike of midnight Thursday will represent the culmination of a long twilight struggle that was met with dismissal for decades, but increasing acceptance in recent years. Massachusetts voters decriminalized the drug in 2008, replacing the criminal penalties for possession of one ounce or less with a new system of civil penalties. And, in 2012, voters approved a ballot question legalizing marijuana for medical use.
...
"The law allows adults to grow up to six plants per person, with a maximum of 12 per household. It mandates the state treasurer appoint a three-person Cannabis Control Commission to regulate the new industry. And it sets a January 2018 timeframe for when retail pot shops can open.

"But the framework is likely to be tinkered with by politicians who believe it does not sufficiently protect public health and safety. Top leaders have discussed the prospect of delaying the opening of stores to give policymakers more time.

"For law enforcement the journey ahead may be the most rocky, especially in the next year.

"They will be forced to navigate a legal gray zone in which marijuana is legal for purchase, possession, and use, but the drug remains illegal to sell. (Sales are legal only through the regulated market, which won’t start until 2018.)"

Non-market surrogacy (the urge to have children is strong...)

Here's a moving story from England (where  paid surrogacy is illegal) about within-family surrogacy that also involves a number of other reproductive technologies that have sometimes met with opposition in some quarters:
Woman gives birth to own grandson as surrogate for her cancer survivor daughter

 "Ms Jenkins said: "They managed to take 21 eggs before I started chemo but only 10 survived. They were made into embryos and grown for two weeks, then frozen.

"Then in May this year we had an embryo defrosted and implanted into my mother's womb..."

Tom Schelling (1921-2016)

Tom Schelling has passed away. Here's an obit in the Washington Post:
Thomas Schelling has died. His ideas shaped the Cold War and the world.

His 1960 book The Strategy of Conflict is one of the first books I read about game theory. It was both an introduction to game theory, and a critique of some of its conventional formulations. I still sometimes teach some of the experiments he wrote about there.

He shared the 2005 Nobel Prize in Economics with Bob Aumann

John Dickerson speaks on Kidney Exchange in DC

If you're in DC today...

Swapping Kidneys: Better Matching Market Design via Optimization

 Tuesday, December 13, 2016

• 6:30 PM
• GWU, Funger Hall, Room 108

  2201 G St. NW, Washington, DC (map)
• For our last Data Science DC Meetup of 2016, we are excited to have John Dickerson join us to talk about Matching Market Design -- where techniques from computer science and operations research are combined with massive data to optimize kidney exchange between donors and patients. John is an Assistant Professor in the Department of Computer Science at the University of Maryland working at the intersection of computer science, AI, and economics, with a focus on solving practical problems using stochastic optimization and machine learning.

Black market for babies in Malaysia

Al Jazeera files this report: BABIES FOR SALE:  Malaysia's underground baby trade

"The babies offered for sale come from a variety of women. Some are poor migrant workers who, by law, are not allowed to have children in the country. Others come from Malaysian women, including some who are forced to give up their babies to avoid the stigma associated with having a child out of wedlock.

"The buyers are often childless couples desperate to start a family and frustrated with the country's convoluted adoption procedures. But activists say some babies are bought for more sinister purposes, sometimes by syndicates who groom children for paedophiles.
...
"During our investigation into Malaysia's baby trade, it was easy to find a woman who wanted to sell her unborn child.

One Filipino who was six months pregnant offered her baby boy for $2,000, plus the cost of her monthly check-ups and the baby's delivery fee.

"The baby is healthy and actually the baby is starting to move now," the expectant mother told our undercover reporters who were posing as a couple who were unable to have children.

The woman said she had been working in Kuala Lumpur, but her work visa had expired. Migrant workers are not allowed to bear children in Malaysia, and her child would be stateless if born in the country."

Festival of Economics in Trento, June 1-4, on health inequality

The initial announcements for the 12th Festival of Economics in Trento in June 2017 have appeared: the theme will be health inequality.
I expect to speak about kidney exchange, and in particular global kidney exchange between rich and poor countries.

A Trento dall’1 al 4 giugno 
Il Festival dell’Economia 2017 dedicato al tema: “La salute disuguale”

Festival economia 2017: protagonista 'La salute disuguale'
Boeri, tra i partecipanti Nobel Roth e epidemiologo Marmot

Repugnant money in England

I've written a lot about repugnance and money, but never quite like this. Here's the Telegraph story on some new banknotes:
New £5 notes contain animal fat, says Bank of England, drawing anger from vegans and vegetarians

"Vegans and vegetarians have voiced outrage after it emerged the new £5 notes contain tallow, a substance made from animal fat...
...
"More than 1,700 people so far have signed a petitiondemanding that the substance is no longer used in the production of the currency. 

"The new £5 notes contain animal fat in the form of tallow. This is unacceptable to millions of vegans & vegetarians in the UK. We demand that you cease to use animal products in the production of currency that we have to use," the petition read."

Dutch hospital director becomes anonymous kidney donor

Joris van de Klundert points me to the following story:
Voorzitter AMC geeft het goede voorbeeld als anonieme donor--
Ziekenhuisbestuurder schenkt een nier aan een onbekende
(Google translate: "Chairman AMC sets a good example as anonymous donor--
Hospital Director donates a kidney to a stranger")

"Levi (52) was operated on in his own hospital. When that happened, he would not say, because the recipient could then figure out his identity. This is undesirable, for an anonymous donation in order to protect the privacy.

"He tells his story because he wants to encourage others to think about undertaking organ donation.
...
"Thanks to a donor kidney dialysis patients do not have more weekly. Dialysis takes time, has serious side effects and worsens the health of patients.

"Levi is one of the seven people who have donated a kidney in the hospital this year an unknown. The Dutch Transplant Foundation (NTS) is no national records of the numbers of so-called altruistic donations, but thinks that it is a few dozen per year."

Opposition to kidney sales in Iran

Afshin Nikzad points me to the following story in Farsi, and provides the translation below. He writes:

http://donya-e-eqtesad.com/SiteKhan/1136026/

"I edit/copy parts of the article from google translate (since it didn't give a great translation) : 

The 78 years old residing in America in an interview with US media said he had been in America for a kidney transplant and doctors had told him he should stay on the waiting list for a kidney transplant from brain death or that of one of his two children. All catch. But he found a third way through his Iranian birth certificate: buying a kidney in Iran. In his interview he talked about the youth in Iran who from the poverty and desperation were lined up to speak to him for selling their kidney.

Doctor, "Ali Husseini,” the head of the Transplantation Society of the Middle East in response to the letter, said: "Buying and selling kidney with strangers is dirty and inhumane and is banned even in countries like India and Pakistan" He also said “among all the thousands seller in the country there is not a single a rich person, all were poor and sold the kidney from poverty and desperation; undoubtedly they  have not donated their kidney.”

Dr. Mohammad Reza Ganji, head of the Iranian Society of Nephrology said “… In the past two years  63% of the transplants have been from brain-dead (that is two thousand and six hundred transplants), and this is statistically significant in the world."

Family consent for deceased organ donation in Canada

The National Post has the story:
One in five willing organ donors in Ontario have their wishes vetoed by family — and doctors don’t argue

"Legislation in most provinces and territories outlines legal authority for organ procurement from someone who has died. Written consent, such as an organ donor card or an online registration form, is legally binding. Family members can’t revoke that consent in most Canadian jurisdictions (the law is less clear in the North West Territories) — their refusal is legally meaningless.

"Despite the legal authority to do so, every provincial donation organization in Canada has a policy that the wishes of families will be followed (except Manitoba, where the wording is vague). Alberta legislation clearly prohibits seeking family consent when donor consent was previously provided and yet an Alberta Health Services directive states “your next of kin will be asked by the donation team to sign a consent form.”

"With more than 4,000 Canadians waiting for a lifesaving transplant, the gap between the law and what actually happens is glaring.

“People who register want donation to be part of their legacy,” says Linda Wright, the former director of bioethics of the University Health Network in Toronto, where more organ transplants are performed than anywhere else in Canada.

“As a living person you want to know your wishes will be respected,” she says, but health-care providers “don’t want to further traumatize families” often shocked and devastated over the sudden loss of a loved one.

"To date, no physician in Canada has ever overridden the wishes of the family in favour of the legally binding consent of the potential donor."

Conference on Economic Design: York, United Kingdom, June 14-16, 2017

2017 Conference on Economic Design: York, United Kingdom, June 14-16, 2017

The tenth bi-annual Conference on Economic Design will be held at the University of York, United Kingdom, on three full days June 14-16 (Wed--Fri), 2017. It will be organised by the Economics Department of the University of York and the Centre for Mechanism and Institution Design. The conference welcomes paper submissions from many different fields such as economics, business, finance, politics, computer science, operations research, law, history relevant to mechanism or institution design in a broad sense, regardless of whether contributions are theoretical, empirical, experimental, historical or practical. Subjects include but are not limited to auctions, matching, school choice, college admission, organ exchange, decentralised markets, random market mechanisms, voting, social choice, taxation, tax reform, coalition formation, price formation, ranking and scoring, measurements of power and influence, contest, fair division, contract, bargaining, negotiation, market design implementation, pricing on electricity, pricing on public utilities, pricing on cloud computing services, online allocation mechanisms, online auctions, market design experiments, public goods experiments, behavioural mechanism design, information and incentive, digital sport market for labour, market design in transportation sector, institution and organisation, health care, health policy, health insurance, pension scheme, fiscal policy, monetary policy, growth and development, performance evaluation, arbitration, patent design, governance, etc. York is a beautiful historical city with a rich heritage and a wealth of attractions being one of the most popular tourist destinations in the UK. We would like to advise you to make a hotel reservation as soon as possible if you wish to attend the conference, in order to avoid a shortage of affordable accommodation. The Keynote Speakers are: Sanjeev Goyal (Cambridge) Parag Pathak (MIT) Philip Reny (Chicago) Important Dates: Paper Submission Opens: 20-Nov-2016 Paper Submission Deadline: 16-Feb-2017 Notice of Accepted Papers : 1-Mar-2017 until 6-Apr-2017 Registration Opens: 10-Mar-2017 Early Registration Deadline: 20-Apr-2017 Registration Deadline: 20-May-2017 Conference Fees: Regular participants: Until 20-Apr-2017: £330 (GBP), after 20-Apr-2017: £380 (GBP) Student participants: Until 20-Apr-2017: £190 (GBP), after 20-Apr-2017: £230 (GBP) (Fees include a gala dinner, 3 lunches, drinks, a two-year membership of the Society for Economic Design and a subscription to the Review of Economic Design.) Paper Submission: We start to accept paper submissions from 20th Noverber 2016 until 16th February 2017. Each individual is allowed for only one paper submission. Papers should be submitted in PDF with a cover letter to CED2017york@gmail.com. If the author is a student, it is advised to declare it.

The human side of kidney exchange: video from NAS (5 minutes)

This short (5 min) video is the first in a series From Research To Reward  by the National Academy of Sciences about the human side of the benefits from science.  It mostly follows a married, incompatible pair through their kidney exchange transplants, as part of a chain organized by the Alliance for Paired Donation (APD). The Matchmaker: An Economist Tackles Kidney Exchange from The National Academies on Vimeo.
"When Fielding Daniel and his wife Amy discovered that it would take five years for him to to be matched with a kidney donor, they were devastated. They launched a desperate search for a life-saving solution that led them to an unexpected savior - a market economist [then] at Harvard University. 

Learn more at www.nasonline.org/r2r.
xx

xx
"This short film is the first in the series From Research To Reward which examines the impact of social science research on our lives. It was created by Redglass Pictures for The National Academy of Sciences.

"A film by Sarah Klein and Tom Mason
Director of Photography Jon Kasbe
Music by  Ryan Sayward Whittier
Motion Graphics by  Kathleen Chee
Special thanks to: Dr. Alvin Roth. Amy and Fielding Daniel, Nobel Media, Dr. Michael Rees"

The Matchmaker: An Economist Tackles Kidney Exchange from The National Academies on Vimeo.

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

The video has an animated artist's impression of the 2004 paper "Kidney Exchange" by Roth, Sonmez and Unver in the Quarterly Journal of Economics.

It also has a shout out to Susan Rees, the transplant coordinator at the APD. I've written before about the importance of the nurses and social workers who act as transplant coordinators.

You can also link to the video at
http://www.redglasspictures.com/the-matchmaker-1/

http://www.theatlantic.com/video/index/509054/harvard-economist-redesigned-kidney-marketplace/

https://www.youtube.com/watch?v=TJio37Fo0BQ

http://www.nasonline.org/publications/from-research-to-reward/

That last link also has a previously published companion story that I blogged about earlier:

The Matchmaker: An Economist Tackles Kidney Exchange from The National Academies on Vimeo.

A NATIONAL ACADEMY OF SCIENCES SERIES
ABOUT SCIENTIFIC DISCOVERY AND HUMAN BENEFIT
Matching Kidney Donors with Those Who Need Them—and Other Explorations in Economics

The chain in which the Daniels participated was featured on the front page of the December 25, 2011 issue of Parade magazine and was started by non-directed donor Deb Shearer.

Here's that story: The Miracle of Life: How One Woman Turned Tragedy into the Ultimate Gift


For kidney exchange history buffs, here's my 2009 post about of the first, pioneering non-simultaneous kidney exchange chain, organized by Dr Mike Rees, who founded the APD: the original paper is here, in the NEJM: Rees, Michael A., Jonathan E. Kopke, Ronald P. Pelletier, Dorry L. Segev, Matthew E. Rutter, Alfredo J. Fabrega, Jeffrey Rogers, Oleh G. Pankewycz, Janet Hiller, Alvin E. Roth, Tuomas Sandholm, Utku Ünver, and Robert A. Montgomery, “A Non-Simultaneous Extended Altruistic Donor Chain,” New England Journal of Medicine, 360;11, March 12, 2009

Matching in Budapest, Dec 14-15

101 years of matching in Hungary will be the subject of two matching conferences are coming up in Budapest.
On Dec 14, 100 years of matching theory in Hungary.  Here is the conference program.

And on Dec 15:

The 12th Matching in Practice workshop, at the Hungarian Academy of Sciences in Budapest.

Programme  (also here)

8:30-9:00	Registration
9:00-10:00	Keynote presentation: Utku Unver (Boston College)
	Efficient and Incentive Compatible Liver Exchange
10:00-10:30	Coffee break
10:30-12:30	Session 1
	First Choice-Maximizing School Choice Mechanisms, by Timo Mennle (University of Zurich)
	School Choice with Voucher, by Mustafa Afacan (Sabanci University)
	Iterative Versus Standard Deferred Acceptance: Experimental Evidence, by Rustam Hakimov (WZB Berlin)
12:30-14:00	Lunch
14:00-15:00	Session 2
	Testing different cardinal matching mechanisms in the field, by  Alexander Nesterov (Higher School of Economics, St. Petersburg)
	Hungarian secondary school and higher education admissions data in the Databank, by Zoltán Hermann (Hungarian Academy of Sciences)
15:00-16:00	Policy roundtable: Course allocation
	Estelle Cantillon (Université Libre de Bruxelles) and Utku Unver (Boston College)
16:00-16:30	Coffee break
16:30-18:30	Session 3
	Team Formation as an Incentive Device, by Xiaocheng Hu (University of Southampton)
	Assignment maximisation, by Inacio Bo (WZB Berlin)
	Refugee resettlement, by Alex Teytelboym (University of Oxford)

******************
In November, the Hungarian Academy of Sciences also hosted a
Workshop on Future Directions in Computational Social Choice, which contained papers on stable matching by Ágnes Cseh: Popular Matchings and Zsuzsanna Jankó: Various Stable Matching Concepts.

Program for the recent Montreal conference on matching

Here's the program for the conference on matching held in Montreal earlier this month.

Colloque CIREQ Montréal de théorie microéconomique

Samedi et dimanche, les 19 et 20 novembre 2016
Organisateur(s)Lars Ehlers (Université de Montréal, CIREQ), Sean Horan (Université de Montréal, CIREQ)

New Zealand's new Compensation for Live Organ Donors Bill

Here's the link to the new New Zealand legislation on removing disincentives from kidney donation, sent by  Frank McCormick.

Compensation for Live Organ Donors Bill (formerly titled Financial Assistance for Live Organ Donors Bill)

3.Purpose

The purpose of this Act is to remove a financial deterrent to the donation of organs by live donors.

...

9Who are qualifying donors

(1)

A person is a qualifying donor in relation to a donor surgery if, on application under Part 3, the Director-General is satisfied that—

(a)

the person will forgo earnings as a result of taking unpaid leave or otherwise ceasing employment to allow for his or her recuperation from the surgery; and

(b)

both the donor surgery and the surgery to implant the organ will be carried out in New Zealand; and

(c)

the recipient of the organ is eligible to receive services funded under the New Zealand Public Health and Disability Act 2000; and

(d)

the organ will be collected, implanted, and dealt with lawfully.

(2)

For the purposes of subsection (1)(d), the Director-General may assume the organ will be collected, implanted, and dealt with lawfully in the absence of information to the contrary.

Entitlement to earnings compensation while recuperating

10Qualifying donors entitled to earnings compensation for up to 12 weeks while recuperating

******

Public lecture at Rice University, Dec 2

I'll be giving the RISE Lecture at Rice (RISE = The Rice Initiative for the Study of Economics).

Here are some other links with logistics (the event is free, but they want to know who is coming...):
http://news.rice.edu/2016/11/21/nobel-laureate-alvin-roth-to-discuss-the-new-economics-of-matchmaking-and-market-design-dec-2/

https://www.eventbrite.com/e/rice-university-presents-nobel-laureate-alvin-roth-tickets-29130669617

Removing financial dis-incentives from kidney donation in New Zealand

Frank McCormick points out this encouraging story from New Zealand, about removing financial disincentives from donating a kidney:

'Recognising the heroes' - MP's bill will give organ donors full compo while they recover

"Mr Bishop has steered a Member's Bill into law that will pay donors 100 per cent of their income for up to eight weeks plus childcare costs if needed.

In 2015 there were 78 live donors who donated a kidney or part of their liver, and "while the rate of live and deceased donors is slowly increasing, New Zealand still has one of the lowest organ donation rates in the world.

"The evidence is pretty clear that financial barriers is one thing that people do think about," Mr Bishop said."

Game theoretic questions and the Trump transition, on Bloomberg Surveillance

Early yesterday morning I was interviewed on Bloomberg Surveillance, about what I thought were some game theoretic questions facing the Trump transition and administration. We talked about cabinet choices as commitments, and trade and climate agreements as collective action problems...

My contribution starts at minute 7:30 and goes until 12:35.

Play episode 
 

Fairness for Digital Infrastructure conference, January 19-20, 2017, at Penn

Fairness for Digital Infrastructure, January 19-20, 2017, UPenn, Philadelphia PA

"A large part of our digital infrastructure is designed to automate decision making, and ideally should improve economic efficiency. Automated decisions now govern, among many other things, whether we are approved for credit cards, what advertisements we are shown, and what search results we see. Algorithms determine the government’s perception of an individual’s risk (e.g. at airport security) or trustworthiness (e.g. in evaluating recidivism risk for parole decisions). The aim of the workshop is to better understand issues surrounding “unfairness” associated with the use of machine learning and automated decision making. This includes the frictions that are the cause of such inadvertent unfairness, and novel technical solutions to solve these problems.
This workshop will take place at the University of Pennsylvania in Philadelphia on January 19th and 20th 2017.
Co-organizers: Sampath Kannan, Jamie Morgenstern, Mallesh Pai, Aaron Roth, Rakesh Vohra"

An interview with computer scientist Cynthia Dwork

Quanta Magazine, a publication of the Simons foundation, has an interview with Cynthia Dwork on differential privacy and fairness among other things.

How to Force Our Machines to Play Fair
The computer scientist Cynthia Dwork takes abstract concepts like privacy and fairness and adapts them into machine code for the algorithmic age.

Here are some earlier news stories about Apple's introduction of differential privacy to the iPhone,  which I've been following for a number of reasons.

From TechCrunch: What Apple’s differential privacy means for your data and the future of machine learning

From Wired: Apple’s ‘Differential Privacy’ Is About Collecting Your Data—But Not ​Your Data

Apple's differential privacy analyzes the group, protects the individual
Posted on June 21, 2016 

Organ donation in Singapore: not rocking the boat

The Singapore Medical Journal publishes an extremely cautious article on Policy options for increasing the supply of transplantable kidneys in Singapore

It concludes with these
"Recommendations:
In order to increase the number of LDs within the existing regulatory framework, non-repugnant incentives can be considered, such as an organ donation award that not only recognises the significance of the donor’s act but also creates meaningful conversation on the importance of organ donation in saving lives. In addition, local online platforms can be created to help ESRD patients appeal to the public for directed kidney donations.

Meanwhile, in order to increase the number of DDs, it is critically important to establish administrative incentives for healthcare professionals to take responsibility for improving the organ transplantation process through QI programmes. Therefore, measures that can be considered include stronger incentives and training for personnel involved in donor-identification, coupled with greater transparency for both individual hospital DD actualisation rates and DCD statistics. Finally, potential donors and their immediate families can be further incentivised through a transplant priority system which favours donors’ families.

In conclusion, greater measures to encourage and facilitate donation can be implemented at all levels to meet society’s transplantation needs. Moving forward, all relevant institutions in Singapore are encouraged to contribute their insights and experience in increasing the supply of kidneys for transplantation so that a meaningful national conversation can commence and best practices adopted to address this urgent shortage."

An interview in the Buenas Aires Herald (in English): "All market design is political"

I went to Argentina hopeful that I could get some insight there into our new president-elect, since they have had a lot of experience with populist politicians. The consensus there seemed to be that we shouldn't expect campaign promises to be taken too seriously, since populist voters quickly forget them and can be mollified with new promises. And maybe we should expect inflation...

While I was there, newspaper reporters couldn't resist asking me about the election results, together with market design...

Here's an interview (in English) in the Buenos Aires Herald.

‘All market design is political’