Allocating and reallocating scarce medical supplies

An op-ed in USA today points out that shortages of critical hospital supplies are occurring and will continue to occur at different times in different states, allowing for increased efficiencies in sharing (which is hampered by a vacuum in leadership at the Federal level).

One of the authors, Dr. Deborah Proctor, is in fact an experienced market designer, who led the (re-)adoption of a fellowship match for gastroenterology fellows.*

National redistribution of hospital supplies could save lives
Taking supplies from less stressed hospitals and sharing them with overwhelmed ones, we could maximize the use of equipment and save more lives.
Diane R. M. Somlo, Dr. Howard P. Forman and Dr. Deborah D. Proctor

"Since we now know more about the predicted peaks in COVID-19 across the U.S., we can see that peak demand will likely occur at different times in different states and cities, starting in early April and extending through May. While some hospitals are already starting to drown, other hospitals that are further from their peak demand have stockpiles of unused equipment lying in wait. 

"What if there was a nation-wide system that allowed hospitals that have equipment but have lower present and predicted demand to lend some reusable (ventilator) and non-reusable equipment (PPE, testing kits) to hospitals that are currently being overwhelmed? Then, as demand in one area rises and the other falls, freed up ventilators could be re-distributed, and manufacturers will have had more time to generate non-reusable equipment for hospitals that lent their equipment. By taking from stockpiles of less stressed hospitals and sharing it with currently overwhelmed ones, we could maximize the use of our national inventory of equipment and save more lives.
...
" redistribution approaches in other settings have enabled vast functional expansions of limited supplies, including kidney transplants and donated food for food pantries across the U.S. Bottom line: Redistribution has the potential to improve the trajectory of COVID-19 mortality in the U.S. Our country is already on track to employ these measures at a state level or voluntarily, so delaying set up of cross-state exchange only means missing out on the maximal benefit of redistribution. In fact, as of this writing, New York’s Governor Andrew Cuomo has just signed an executive order enabling redistribution of medical supplies to struggling hospitals within New York state and Oregon has sent ventilators to New York.

"In these coming trying times, our healthcare system is facing an unprecedented, deadly burden, and we need to make supplies available where they are needed most —independent of state lines. Now is the time to start making the changes, to call on the federal government, national leaders, and private partnerships to coordinate our efforts as a nation, so we can provide the best care possible with our limited supplies. Lives depend on it."

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

* Niederle, Muriel, Deborah D. Proctor and Alvin E. Roth, ''The Gastroenterology Fellowship Match: The First Two Years,'' Gastroenterology , 135, 2 (August), 344-346, 2008.

Transplantation slows in Canada, too...

Ventilators in short supply may be part of the problem (since most deceased donations involve ventilators), but there's also a general risk aversion at play...

Donated organs not being used as hospitals scale back transplants for COVID-19

"OTTAWA — Transplant centres across the country have massively scaled back organ transplants as hospitals try to make sure they are able to accommodate COVID-19 cases.

"Living-donor surgeries have largely shut down across the country, and deceased-donor transplants are happening only when the case is urgent.

"Dr. Atul Humar, past president of the Canadian Society of Transplantation, said that means many organs are not going to good use.

“There’s some donors, deceased organ donors, and we’re not sending teams to procure those organs,” said Humar, who is also the director of the transplant program at Toronto General Hospital.

“It’s quite tragic.”

"Patients who go through certain types of organ donation often require time in the intensive care unit on a ventilator — resources desperately needed by patients with serious cases of COVID-19.

"At Humar’s hospital, organ transplant surgeries have decreased by about 80 per cent, though the numbers vary from province to province."

Eating cats and dogs banned in Shenzhen

The distinction between pets and pet food just became a little clearer in Shenzhen.

The BBC has the story:

Shenzhen becomes first Chinese city to ban eating cats and dogs  

"The new law will come into force on 1 May.

"Thirty million dogs a year are killed across Asia for meat, says Humane Society International (HSI).

"However, the practice of eating dog meat in China is not that common - the majority of Chinese people have never done so and say they don't want to.

"Dogs and cats as pets have established a much closer relationship with humans than all other animals, and banning the consumption of dogs and cats and other pets is a common practice in developed countries and in Hong Kong and Taiwan," the Shenzhen city government said, according to a Reuters report."

Sheltering in place (or maybe someplace else), repugnantly

Many fewer things would be regarded as repugnant were it not for underlying inequality. So it shouldn't surprise us to see new repugnances emerge as  we are all--rich and poor and in between-- asked to shelter in place to halt the spread of the COVID-19 corona virus.

Here's an example from the Guardian:

Coronavirus retreat for wealthy to wait out pandemic cancelled

The Harbor offered a two-month retreat in a villa where guests could ‘meet and mingle and collaborate – no facemask required’

"A luxurious southern California retreat for wealthy participants to wait out the coronavirus pandemic has folded before the program could even open its doors.

"As millions of Americans face strict social distancing orders amid the pandemic, the “Harbor” proposed the opposite for those who could afford it: a two-month retreat in an exclusive villa where guests could “meet, mingle and collaborate with some of the brightest, forward-thinking individuals – no facemask required”.

*********

Frankly, it sounded like a cruise ship to me...

Choosing who to interview in the sports medicine fellowship match

Little is known about what goes on between application to fellowship (or residency) programs, and rank-ordering for the relevant medical Match.  Here's an attempt at looking into the black box of choosing who to interview, and combining interview information with other information to determine rank order lists:

Factors Used by Program Directors in the Orthopedic Sports Medicine Fellowship Match
Travis Menge, Ashley Nord, Kendall Hamilton, Monica LaPointe and Peter J.L. Jebson
Journal of Surgery [Jurnalul de chirurgie], Volume 16:2, 2020

Abstract
Background: Obtaining an orthopedic sports medicine fellowship position is becoming more difficult, as the number of residents seeking post-graduate training continues to increase.
Objective: To identify factors that orthopedic surgery sports medicine fellowship program directors deem valuable in selecting applicants.
Methods: A web-based questionnaire was sent to all ACGME accredited sports medicine fellowship program directors in the United States in 2016. The questionnaire was designed to identify the most important criteria in selecting applicants for an interview, and ranking candidates to match into their program.
Results: Thirty-five of ninety-one program directors responded. The criteria for offering an applicant an interview were quality of recommendation letter, technical competence, and residency program reputation. Letters of recommendation that held the highest value were from the chief of sports medicine and another sports medicine surgeon in the department. The most important features of the interview were the applicant’s ability to articulate thoughts, the maturity of the applicant, and the ability of the applicant to listen well. The attributes deemed most important in high ranking a candidate included the applicant’s commitment to hard work, quality of the interview, and quality of letters of recommendation.

Bikes and guns while sheltering in place in Santa Clara County (bikes are essential, guns are not)

From the Santa Clara County Department of Public Health, a new shelter in place order that defines, among other things, "essential businesses" which are those that can keep operating from their traditional premises (as opposed to only making home deliveries):


Coronavirus Frequently Asked Questions
MARCH 31, 2020 SUPERSEDING SHELTER-IN-PLACE ORDER 

"This new Order requires that most people continue sheltering in their place of residence until May 3, 2020.  This new Order replaces the prior Shelter-in-Place Order, which was set to expire on April 7, 2020.  It also adds to the list of restrictions to slow the spread of the COVID-19 disease.

"You are still allowed to participate in “essential activities” or to work for an “essential business” if it is not possible for you to work from home."

There follows a long list of essential businesses, and a long set of Q's and A's to guide the perplexed.

Among the Essential businesses:

"Bicycle repair and supply shops"
********************

and there's this Q&A:

"Can gun shops selling firearms and ammunition continue to keep their storefronts open? 

"No.  Gun shops are not essential businesses under the Order.  The Order allows delivery of inventory directly to customers at their residences in compliance with applicable laws and regulations, but gun shops may not make sales from their storefronts. "
*********
I imagine the situation is different in Texas.

Expect a case to reach the Supreme Court in a few years...

Headlines that could be dated April 1

Something was in the air this year: many headlines in serious outlets struck me as appropriate for April Fools Day.

Non-political ones come first:

Coffee beans not vital for human survival, Switzerland decides

Dairy Queen burgers are not made of human flesh, county coroner is forced to confirm

The Ohio State University wants to trademark its favorite word: ‘The’

"officials filed Application No. 88571984 with the U.S. Patent and Trademark Office last week, seeking a trademark for the word “THE” to use it on items including T-shirts, caps and hats."



Bodyguard to Saudi king reportedly shot dead by friend
...with friends like these...

A Prisoner Who Briefly Died Argues That He’s Served His Life Sentence

A court in Iowa found that a murderer who was revived “is either still alive, in which case he must remain in prison, or he is actually dead, in which case this appeal is moot.”

Investors who lost $190m demand exhumation of cryptocurrency mogul
Canadian company founder took crucial password to the grave

Are vegetables vegan?

Wisconsin town to legalize snowball fights after 50-year ban

Judge blocks California’s alligator ban after Louisiana sues

Why is Gwyneth Paltrow selling a candle that smells like her vagina?

‘Mad’ Mike Hughes, who vowed to prove the flat-Earth theory, dies in homemade-rocket disaster

Alabama bill may lift yoga ban in public schools but prohibit 'namaste' greeting

Nevada Brothels Requiring Customers To Wear Masks

Astrophysicist gets magnets stuck up nose while inventing coronavirus device

Turkmenistan Has Banned Use Of The Word 'Coronavirus'


And a special section of (American) politics, if you can call it that:

Donald Trump’s interest in buying Greenland stuns Denmark
‘Greenland is not for sale, and can’t be sold,’ says island’s government

Trump cancels Denmark trip after PM says Greenland is not for sale
President says he is postponing meeting with Mette Frederiksen because she was not interested in discussing transaction

Trump blasts report claiming he wanted to nuke hurricanes

Trump border wall between US and Mexico blows over in high winds

Trump’s border wall, vulnerable to flash floods, needs large storm gates left open for months

Sarah Palin stuns TV viewers by rapping Baby Got Back dressed as a bear

Complacency, Not Panic, Is the Real Danger: Ido Erev in the NYT

A timely article points out that many of us are more likely to underestimate dangers (like corona virus) than overestimate them.

Complacency, Not Panic, Is the Real Danger
Only a small minority of people panic under threat, research shows. Far more don’t take the threat seriously enough.

How to efficiently (re)distribute ventilators (and masks, gowns, test kits...)?

How to allocate scarce medical goods, when all signals indicate shortages of everything, everywhere (but some needs are more immediate and urgent than others)?

Market mechanisms that work well when the situation evolves slowly are struggling under big swings in demand and supply.

I've received many emails on this and related subjects in the last week. (If the predictions of future need were precise, things would be easier...).  Here are two thoughts on providing market-wide information that isn't emerging naturally from the functioning of existing markets.

From the WSJ:

Manufacturers Seek U.S. Help in Deciding Where to Ship Scarce Medical Goods
To address coronavirus-related shortages, companies want the federal government to provide strategic guidance
By Rebecca Ballhaus and Andrew Restuccia, March 29, 2020

"Producers and distributors of medical supplies across the country are raising red flags about what they say is a lack of guidance from the federal government about where to send their products, as hospitals compete for desperately needed masks and ventilators to combat the spread of the novel coronavirus.
...
"Company executives say they are ill-equipped to make decisions about which hospitals and states should first receive their medical supplies and are calling on the government to step in.

“It’s really the allocation piece that’s most important to us right now because we just cannot and never will have a window into what the most urgent need is,” said Scott Whitaker, chief executive of the Advanced Medical Technology Association, a trade association that represents producers of medical devices.

"Charlie Mills, chief executive of Medline Industries Inc., a large privately held manufacturer and distributor of medical supplies, said as the company works to ramp up its production of supplies, it is being inundated with orders. He said he would welcome the government having a “strong say” in how to respond.

“All of our customers are wanting more,” Mr. Mills said. “The federal government might be in a better position to decide where it would go.”
**************

And here's an op-ed in The Hill by Loertscher and Marx:

A national ventilator exchange could address critical shortages
BY SIMON LOERTSCHER AND LESLIE M. MARX

"With elective procedures on hold indefinitely, we know there are ventilators sitting unused across the country right now — we just don’t know where and how many, so we need a nationwide registry. Every hospital in the country can document the quantity, makes and models of their machines, how many are available to treat COVID-19, and which are reserved to treat other conditions.

"There is ample evidence, for example, from reallocating land or spectrum licenses, that such registries improve the efficiency and volume of transactions.
...
"Of course, if there are not enough ventilators to go around, we face terrible ethical dilemmas, either with or without a rental market. But if we have enough, and they are just in the wrong places, then a short-term rental market is exactly the thing that could get us out of such dilemmas.

"For this model to be effective, it’s imperative to act now. If our government moves quickly to pool our resources and combine the best ideas of health care professionals, market design economists, and logistics specialists, we could do a lot of good in this time of unprecedented challenges."

Family legacies in Operations Research (and related fields)

ORMS Today has an article on multi-generations of operations researchers, broadly defined.

Like father, like son and daughter
All in the family tree: INFORMS rich with O.R. legacies

I know only some of the folks they interviewed: here's the full list.

The Wikums
Erick and his son Anders

The Weintraubs
Andres and his son Gabriel 

The Weins
Lawrence, his son Alex and daughter Nicole

The Roths
Al and his son Aaron

The Elmaghrabys
Wedad and her father Salah

The Bixbys
Robert and his daughter Ann

The Armacosts
Robert and his son Andrew

The Camms
Jeff and his daughter Allison

The Hilliers
Fred and his son Mark (and almost his granddaughter Sarah)

Repugnant Behavior, a conference in Montpellier in February 2021

Here's the announcement and call for papers:

WINIR Workshop on

Repugnant Behaviours

24-25 February 2021

University of Montpellier, Montpellier, France

Organiser: Alain Marciano

"Formally introduced in economics by Nobel laureate Alvin Roth, the concept of "repugnance" arises in the debate among philosophers (e.g., Elizabeth Anderson, Michael Sandel, Debra Satz) and other social scientists (e.g., Kristie Blevins, Amitai Etzioni, Kimberly Krawiec, Amartya Sen, Philip Tetlock) about how and why moral concerns, taboos and sacred values place, or ought to place, limits on market transactions. (A set of representative references is provided in the call for papers.)

Important dates

15 June 2020 – Abstract submission deadline

15 July 2020 – Notification of acceptance

15 December 2020 – Full paper submission deadline

Keynote speaker

Kimberly D. Krawiec

Kathrine Robinson Everett Professor of Law

Duke Law School, USA

REFERENCES

Anderson, E. (1990) “The Ethical Limitations of the Market” Economics and Philosophy 6(2): 179-205.

Anderson, E. (1993) Value in Ethics and Economics (Cambridge, MA: Harvard University Press).

Blevins, B., Ramirez, R. & Wight, J. B. (2010) “Ethics in the Mayan Marketplace” in M. D. White (ed.) Accepting the Invisible Hand: Market-Based Approaches to Solving Social-Economic Problems (New York: Palgrave Macmillan).

Cook, P J. & Krawiec, K. D. (2018) “If We Allow Football Players and Boxers to Be Paid for Entertaining the Public, Why Don’t We Allow Kidney Donors to Be Paid for Saving Lives?” Law and Contemporary Problems 81(3): 9-35.

Elias, J. J., Lacetera, N. & Macis, M. (2015) “Sacred Values? The Effect of Information on Attitudes toward Payments for Human Organs” American Economic Review 105(5): 361-365.

Elias, J. J., Lacetera, N. & Macis, M. (2016) “Efficiency-Morality Trade-Offs In Repugnant Transactions: A Choice Experiment” NBER, Working Paper No 22632.

Etzioni, A. (1986) “The Case for a Multiple-Preference Conception” Economics and Philosophy 2: 159-183.

Etzioni, A. (1988) The Moral Dimension: Toward a New Economics (New York: Free Press).

Healy, K. & Krawiec, K. D. (2017) “Repugnance Management and Transactions in the Body” American Economic Review 107(5): 86-90.

Held, P. J., McCormick, F., Ojo, A & Roberts, J. P. (2016) “A Cost‐Benefit Analysis of Government Compensation of Kidney Donors” American Journal of Transplantation 16(3): 877–885.

Kass L. R. (1997) “The Wisdom of Repugnance: Why We Should Ban the Cloning of Humans” New Republic 216(22):17-26.

Kekes J. (1998) A Case for Conservatism (Ithaca, NY: Cornell University Press).

Khalil, E. L. & Marciano, A. (2018) “A Theory of Tasteful and Distasteful Transactions” Kyklos 71(1): 110-131.

Krawiec, K. D. (2015) “Markets, Morals and Limits in the Exchange of Human Eggs” Georgetown Journal of Law & Public Policy 13(1): 349-365.

Krawiec, K. D. (2016) “Lessons from Law About Incomplete Commodification in the Egg Market” Journal of Applied Philosophy 33(2): 160-177.

Krawiec, K. D., Liu, W. & Melcher, M. (2017) “Contract Development in a Matching Market: The Case of Kidney Exchange” Law and Contemporary Problems 80(1): 11-35.

Kray, L. J., George, L. G., Liljenquist, K. A., Galinsky, A. D., Tetlock, P. E. & Roese, N. J. (2010) “From What Might Have Been to What Must Have Been: Counterfactual Thinking Creates Meaning” Journal of Personality and Social Psychology 98(1): 106-118.

Leider, S. & Roth, A. E. (2010) “Kidneys for Sale: Who Disapproves, and Why?” American Journal of Transplantation 10(5): 1221-1227.

McGraw, P. & Tetlock, P. E. (2005) “Taboo Trade-Offs, Relational Framing And The Acceptability Of Exchanges” Journal of Consumer Psychology 15(1): 35-38.

McGraw, P., Schwartz, J. & Tetlock, P. E. (2012) “From the Commercial to the Communal: Reframing Taboo Trade-Offs in Religious and Pharmaceutical Marketing” Journal of Consumer Research 39(1): 157-173.

Roth, A. E. (2007) “Repugnance as a Constraint on Markets” Journal of Economic Perspectives 21(3): 37-58.

Sandel, M. J. (2012) What Money Can't Buy: The Moral Limits of Markets (New York: Farrar, Straus & Giroux).

Sandel, M. J. (2013) “Market Reasoning as Moral Reasoning: Why Economists Should Re-Engage With Political Philosophy” Journal of Economic Perspectives 27(4): 121-140.

Satz, D. (1995) “Markets in Women's Sexual Labor” Ethics 106(1): 63-85.

Satz, D. (2008) “The Moral Limits of Markets: The Case of Human Kidneys” Proceedings of the Aristotelian Society 108(1/pt3): 269-288.

Satz, D. (2012) Why Some Things Should Not Be For Sale: The Moral Limits of Markets (New York: Oxford University Press).

Schoemaker, P. & Tetlock, P.E. (2011) “Taboo Scenarios: How To Think about The Unthinkable” California Management Review 54(2): 5-24.

Sen, A. (1987) On Ethics and Economics (Oxford: Blackwell).

Sheehan, M. (2016) “The Role of Emotion in Ethics and Bioethics: Dealing with Repugnance and Disgust” Journal of Medical Ethics 42(1): 1-2

Death with dignity, in Germany

Medically assisted suicide, controversial everywhere, has come to Germany.

The Lancet reports:
Germany overturns ban on assisted suicide
Rob Hyde
Published:March 07, 2020DOI:https://doi.org/10.1016/S0140-6736(20)30533-X

"Germany's supreme court has lifted a ban on professionally assisted suicide in a landmark ruling. ...

"Following a campaign by doctors and terminally ill patients, Germany's supreme court has lifted a law which outlawed the provision of assisted-suicide services. These services could range from signing a prescription for a lethal overdose of sedatives, to providing consultation to terminally ill patients on how they could travel outside of Germany to end their lives legally.

"Speaking from Germany's Federal Constitutional Court in Karlsruhe, Judge Andreas Voßkuhle said the 2015 law—paragraph 217 of the German Criminal Code—did not allow a person either “the right to a self-determined death” or “the freedom to take one's life and seek help doing so”. This law, he said, therefore violated the German constitution, and was now void.

"The association Sterbehilfe Deutschland e.V. (Assisted Suicide Germany) was among those campaigning against paragraph 217. Roger Kusch, head of the organisation and Hamburg's former senator for justice, said that the ruling by the supreme court marked “…a wonderful day for our association, for the association members and also for all interested citizens.” He said the ruling meant that no-one now has to suffer the pressure “…from churches and from other people, who believe they have to influence the entire population and the whole of society.”

"Others, however, are less jubilant. Frank Ulrich Montgomery is president of the Standing Committee of European Doctors, which represents national medical associations across Europe. He fears that the supreme court's ruling will mean the principle of doctors preserving life could be rendered obsolete.
...
"“Euthanasia” comes from the Greek word euthanatos (which means easy death), and means taking steps to end an individual's life to relieve suffering. In a medical context, euthanasia refers to a doctor using painless means to end a person's life, providing the patient and the patient's family agree. Assisted suicide, by contrast, refers to when a person is helped to kill themselves. Switzerland has eight right-to-die clinics and is the European country most often associated with euthanasia. However, euthanasia and assisted suicide are legal not only in Switzerland, but also in Belgium, Luxembourg, and the Netherlands, although each country varies on how it defines both terms. In Germany, the issue of the state legalising euthanasia is highly sensitive, especially given that the Nazis used the same term to describe the murder of hundreds of thousands of disabled people."

NSF report on Doctorate Recipients in the Social, Behavioral, and Economic Sciences (SBE): 2017

Here's the Doctorate Recipients in the Social, Behavioral, and Economic Sciences (SBE): 2017
NSF 20-310   |   March 16, 2020

There were almost 1,000 more doctorates awarded in Psychology in 2017 than the total in Economics plus Political Science plus Sociology.

I was surprised to note that the gender ratio of Economics doctorates is less extreme than that of Psychology doctorates, although in the opposite direction, and that Poli Sci doctorates are more evenly distributed between women and men (and the gender imbalance in Sociology is very close to Economics, also in the opposite direction.)


Here's a figure and a table from the pdf file.

Litigation financing revisited

It looks like litigation financing--i.e. the financing of legal suits for a share of the proceeds--is here to stay, and the New York City Bar Association is trying to come to terms with it.   Here is their

REPORT TO THE PRESIDENT
BY THE NEW YORK CITY BAR ASSOCIATION
WORKING GROUP ON LITIGATION FUNDING

"Maintenance is defined as “helping another prosecute a suit,”18 and champerty is defined as “maintaining a suit in return for a financial interest in the outcome.”19 Prohibitions against maintenance and champerty arose in medieval England.20
...
"Many U.S. states are beginning to relax prohibitions on maintenance and champerty.  Twenty-eight jurisdictions permit maintenance with varying limitations,31 and sixteen explicitly allow champerty.32 However, other states have refused to “abandon the champerty doctrine ...

"New York’s prohibition of champerty remains in force, although its breadth is uncertain.
**************
Earlier:
Sunday, November 8, 2015

More on (third party) litigation financing, including a medieval word, "champerty"

Saturday, July 13, 2019

Litigation financing is no longer so repugnant

Celebrating Hervé Moulin's 70th Birthday, in Mexico City, in June (maybe)

Not many scholars are as worthy of celebration as Hervé Moulin, so I was glad to see this announcement (from before corona virus achieved pandemic status...)

Workshop on Fairness, Incentives and Algorithms in Celebration of Hervé Moulin 70th Birthday  June 22-23, 2020, CIDE, Mexico City, Mexico

"Topics addressed in this interdisciplinary workshop include, but are not limited to: Fair division, Cost-sharing, Computational Social Choice, Mechanism design on Networks, Price of Anarchy, Matching.

"Program Committee

Anna Bogomolnaia (Glasgow) Justin Leroux (HEC Montreal)

Local committee

Isabel Melguizo (CIDE)

Ruben Juarez (Hawaii) Hervé Moulin (Glasgow)

Antonio Jiménez (CIDE)

Rajnish Kumar (Belfast) Alison Watts (SIU)"


The Moulin celebration was originally planned to coordinate with the 15th Meeting of the Societyfor Social Choice and Welfare [June 24-7], which has now been postponed due to corona virus.  Birthday's are harder to postpone, but there's no telling about celebrations in these complicated times.

Foie gras and NY farm workers

The NY Times ran this story:

A Luxury Dish Is Banned, and a Rural County Reels
The ban protects animals and slaps wealthy gourmands. But upstate, hundreds of low-wage immigrant laborers are bracing for the impact.
By John Leland, Photographs by Desiree Rios

"Last October, when the New York City Council passed a ban on foie gras as inhumane, Mayor Bill de Blasio called foie gras “a luxury item that the vast majority of us would never be able to afford.”
...
"But two hours northwest of the city, in one of New York’s poorest counties, foie gras plays a much different role. There it is not a luxury splurge but a domino in a fragile local economy. Almost all of the foie gras produced in the United States comes from two duck farms in Sullivan County, where about 400 workers, mostly immigrants from Mexico and Central America, rely on it for their livelihood.

"Locals say that New York City’s ban, which is scheduled to go into effect in 2022, threatens all the businesses connected with the two farms, from the neighboring farms that supply feed for the ducks to the machine shops that repair agricultural equipment, from the small truckers to the local markets and restaurants that cater to the Spanish-speaking workers.
...
"Hudson Valley Foie Gras, the larger of the two farms, is a sprawling artifact of an earlier disruption, on the site of three former egg farms, which closed when the advent of interstate highways made it cheaper for city stores to get eggs from industrial farms elsewhere.
...
"Opponents of foie gras call the force-feeding process cruel. It’s already banned in India, Israel and Britain. Whole Foods stopped selling the product in 1997, and Postmates stopped delivering it in 2018. The American Veterinary Medical Association takes a neutral position, citing a lack of evidence that birds are harmed by the process, though many veterinarians disagree.
...
"Already hurting from a ban in California, which they say cut their sales by 20 percent, Hudson Valley hired a politically connected lobbying firm, Bolton-St. Johns, and a publicity firm, Millennial Strategies, which represents Lyft, Juul and Starbucks. 

School choice without the assumption of full-information equilibrium by Kapor, Neilson and Zimmerman

Forthcoming in the AER:

Heterogeneous Beliefs and School Choice Mechanisms By Adam J. Kapor and Christopher A. Neilson and Seth D. Zimmerman

Abstract: This paper studies how welfare outcomes in centralized school choice depend on the assignment mechanism when participants are not fully informed. Using a survey of school choice participants in a strategic setting, we show that beliefs about admissions chances differ from rational expectations values and predict choice behavior. To quantify the welfare costs of belief errors, we estimate a model of school choice that incorporates subjective beliefs. We evaluate the equilibrium effects of switching to a strategy-proof deferred acceptance algorithm, and of improving households’ belief accuracy. We find that a switch to truthful reporting in the DA mechanism offers welfare improvements over the baseline given the belief errors we observe in the data, but that an analyst who assumed families had accurate beliefs would have reached the opposite conclusion.
**********

see my earlier post:

Monday, January 28, 2019

School choice in New Haven: studied by Kapor, Neilson and Zimmerman and switching from immediate to deferred acceptance

The Power of Experiments by Mike Luca and Max Bazerman

New this month from MIT Press, a history and guide to experiments in (mostly) online businesses:

The Power of Experiments

Decision Making in a Data-Driven World

By Michael Luca and Max H. Bazerman

"How organizations—including Google, StubHub, Airbnb, and Facebook—learn from experiments in a data-driven world."

My blurb says: "Luca and Bazerman's The Power of Experiments will open your eyes about how to distill information from data."

Hal Varian's blurb says: "One of the great things about e-commerce is that it is far easier to run experiments online than offline. As more and more companies move online, they need to learn how to use this powerful tool. This book shows how to take advantage of experiments and how this will revolutionize business, both online and off."

Susan Athey's says: "This accessible and engaging book provides an excellent introduction to a subject that every young person entering the business world today should understand—experimentation. The case studies draw the reader into the challenges that arise in practice, highlighting issues ranging from bias to ethics to unintended consequences."

And the draft I read was fun and easy to read.  This might be the book to spend time with while you're sheltering in place.

NRMP Match Day (and corona virus precautions)

Today, Friday, is Match Day, the day when new American medical school graduates and others find out the residency programs to which they have been matched by the National Resident Matching Program (NRMP).

In a usual Match Day, the graduates of most American med schools would gather together, to learn all together where they would be heading later this summer.  However this year, many of us are working from home, with large gatherings discouraged if not banned, to prevent the spread of corona virus.

The AAMC put out this announcement earlier this week:

The Match®: 10 things to know as the day draws nigh
...

"A two-stage reveal: On Monday, students learned if they have been matched to a residency via emails that were sent out at 11 a.m. ET. On Friday, they learn specifically where their residencies will be during the Match Day ceremonies (either in-person or online), which start at noon ET across the country, or by emails from the National Resident Matching Program® that go out at 1 p.m. ET. Students can also learn about both results through a mobile device.

"Coronavirus impact: Many schools have made or are weighing changes to Match Day celebrations as the status of the virus outbreak changes in various regions of the country."

The labor force that is the Army

The Army Times has this story:

Choose your job: Army offers soldiers career agency to bolster retention
Kyle Rempfer

"Assignment Interactive Module 2.0 offers a virtual conduit through which units can advertise jobs; soldiers can attract hiring units by highlighting their life experiences, degrees and extracurricular pursuits; and the Army can gather large amounts of data on all of it.

"The marketplace has been open for the past four assignment cycles, but the latest iteration that closed this winter was the first where all positions were viewable to the entire moving population and the process was guided by the Army Talent Alignment Process rules, which more heavily weigh a soldier’s personal desires.

“This is the first time that we allowed complete transparency and also had set it up so the decisions that came out of this process were going to have the preference of the individual officer prioritized over any other consideration,” said Maj. Gen. J.P. McGee, director of the Army’s Talent Management Task Force.

"Officers participating in the first assignment cycle had roughly two months to contact the unit and ask questions, such as about the command climate and the training calendar. Officers could also speak directly to unit leadership, make a value proposition to them and learn what the unit offers in return.

"And while the Assignment Interactive Module 2.0 is currently only available for officers, an enlisted virtual marketplace is expected to deploy in January 2021.
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The Armed Forces News has this one:
Army Tests New Enlisted Assignment System
Published: March 12, 2020
"Spurred by the success of a similar program for officers, the Army will begin a pilot plan to implement a marketplace-style assignment system for enlisted soldiers, the Association of the U.S. Army reported. Beginning this summer, soldiers and non-commissioned officers in armor, military intelligence and quartermaster military occupational specialties (MOSs) will take part in testing of the Assignment Satisfaction Key-Enlisted Marketplace, AUSA reported, citing an Army press release. By the beginning of next year, the Army expects to have the system in place for the entire force.

"The plan calls for soldiers to be able to view a complete list of available positions from which to choose. They would then be able to rank their preference for new assignments based on personal and family needs, AUSA reported."

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and the WSJ has this one:

In Generational Shift, Army Uses a New System to Promote Hundreds of Officers
The Army is revamping its process and adapting private-sector techniques to choose new battalion commanders, a keystone position

"The U.S. Army has initiated the biggest shift since the Vietnam War era in how it selects a key class of officers, drawing on the hiring practices of private-sector organizations and corporations such as the Boston Symphony Orchestra and Google.

"The aim is to move away from techniques used for over 50 years that rely on past military jobs, physical fitness scores and the recommendations of generals to promote officers to the job of battalion commander.

"The new system includes surveys by subordinates, writing tests, psychological assessments, cognitive evaluations and a series of simulated militarylike scenarios in a wooded area on base to gauge leadership and problem-solving abilities.

"It stresses anonymity to eliminate any possible bias. As soon as candidates arrive, they are assigned a number and aren’t known by their names. At an interview, candidates are seated behind a black curtain, and a five-member selection panel is unable to see a candidate’s uniform, with its career-defining ribbons and patches."

Essential and inessential services under corona virus lockdown (guess before reading--coffee, cannabis, etc?)

We're under "shelter in place" orders in Santa Clara County, with everyone hunkering down, except for essential services:

Bay Area orders ‘shelter in place,’ only essential businesses open in 6 counties

"Six Bay Area counties announced “shelter in place” orders for all residents on Monday — the strictest measure of its kind yet in the continental United States — directing everyone to stay inside their homes and away from others as much as possible for the next three weeks in a desperate move to curb the rapid spread of coronavirus across the region.

"The directive was set to begin at 12:01 a.m. Tuesday and involves San Francisco, Santa Clara, San Mateo, Marin, Contra Costa and Alameda counties — a combined population of more than 6.7 million. It is to stay in place until at least April 7.
...
"Businesses that do not provide “essential” services must send workers home. Among those remaining open are grocery stores, pharmacies, restaurants for delivery only and hardware stores. "
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So I was glad to get this email from our local Stanford campus coffeehouse (which I agree is an essential service):

These Coupa Locations are still Open For Take-Out, Curbside-Pickup & Delivery
Today 9:00am - 3:00pm
 Green Library
571 Escondido Mall in Stanford
(nevertheless, our Wednesday morning market design coffee will meet by Zoom, while we shelter in place...)
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Schools are closed (I guess they might be both essential and sources of contagion).  This being California, there are other essential services:
San Francisco: Cannabis deemed as an essential medicine, dispensaries to remain open
"The San Francisco Department of Public Health released a statement on Tuesday letting San Francisco residents know dispensaries will remain open despite having a shelter in place order.

"The Department states cannabis is an essential medicine."

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Nevada is different:  Nevada Brothels Requiring Customers To Wear Masks

Germany (where prostitution is also legal) is different in a different way, Stephanie Wang forwarded this shelter in place announcement from Germany:
https://www.land.nrw/de/pressemitteilung/landesregierung-beschliesst-weitere-massnahmen-zur-eindaemmung-der-corona-virus
via Google translate, a list of what is inessential:
"Already on Sunday, the Ministry of Labor, Health and Social Affairs decrees that almost all leisure, sport, entertainment and educational offers in the country will be discontinued. As of Monday, all so-called "entertainment companies" such as bars, clubs, discotheques, arcades, theaters, cinemas and museums have to close. The same regulation applies to prostitution companies."

Intermediation in the wholesale pharmaceutical market, by Alex Chan and Kevin Schulman

Intermediaries called Pharmacy benefit managers (PBMs) play an important, but complicated role in the market for pharmaceutical drugs. Here's an article by Chan and Schulman, explaining why the role of PBM's is so opaque (quick summary: the industry is very concentrated, and is paid by both sides of the transactions that are being intermediated...)

Examining Pharmaceutical Benefits in the United States
Alex Chan,  Kevin Schulman

"...consolidation has resulted in a situation in which the 3 largest PBMs have approximately 80% market share.
...
"One of the largest criticisms of PBMs is the lack of transparency surrounding the structure and scale of payments from manufacturers to the PBM. The current PBM business model is shrouded in secrecy. Descriptions of PBM audits by payers and employers entail visits to PBM sites and examination of paper records under conditions of confidentiality, usually performed by a set of consultants that specialize in this role.5 Only the PBM knows the actual scope of payments from drug manufacturers to the PBM (for example, rebates and other payments, such as service fees). In 2016, for 13 pharmaceutical companies, payments to PBMs and other intermediaries were $100 billion, or 50% of gross sales.2 Without transparency, a PBM might develop formularies that maximize payments to the PBM rather than maximize value to patients. Anthem sued its PBM for $15 billion in 2016 for overpayments on drug pricing.6

"Finally, the issue of who is negotiating on whose behalf in drug markets remains contentious. In other words, the agency of PBMs is not clear. When PBMs depended on service fees from health plans and employers as their main source of revenue, it was clear that they served the payer (ie, the employer or the health plan). Under the rebate model, the role of the PBM has evolved to serving as an agent of both the payer and the manufacturer. In fact, as the prescription drug market has evolved, PBM profits appear to have grown with the growth of rebate dollars and manufacturer payments rather than with the growth of payer fees. It is increasingly hard to disentangle the multiple roles of the PBM and to clarify who PBMs serve as intermediaries."

The Advance Market Commitment for pneumonia vaccine, by Kremer, Levin, and Snyder

Advance Market Commitments: Insights from Theory and Experience
Michael Kremer, Jonathan D. Levin, Christopher M. Snyder
NBER Working Paper No. 26775
Issued in February 2020


Abstract: Ten years ago, donors committed $1.5 billion to a pilot Advance Market Commitment (AMC) to help purchase pneumococcal vaccine for low-income countries. The AMC aimed to encourage the development of such vaccines, ensure distribution to children in low-income countries, and pilot the AMC mechanism for possible future use. Three vaccines have been developed and more than 150 million children immunized, saving an estimated 700,000 lives. This paper reviews the economic logic behind AMCs, the experience with the pilot, and key issues for future AMCs.

And here's their concluding paragraph:

"The AMC moved from theory to practice in its first decade, and we now have a decade of learning from the pneumococcal pilot. While aspects of program evaluation are complicated, the best estimates suggest that the introduction of PCV saved 700,000 lives at a highly favorable cost. Iterations likely could improve AMC design, just as market designs have been refined in settings such as school choice and radio spectrum allocation. Policymakers may wish to consider offering a set of AMCs, perhaps each smaller in scale than the pilot pneumococcus AMC, where potential targets could range beyond health to address agricultural or sustainability problems specific to developing countries."

Hoarding, price gouging, and backlash in the time of corona virus--updated

The NY Times has the story (followed by an update):

He Has 17,700 Bottles of Hand Sanitizer and Nowhere to Sell Them
Amazon cracked down on coronavirus price gouging. Now, some sellers are holding stockpiles of sanitizer and masks.
By Jack Nicas

"On March 1, the day after the first coronavirus death in the United States was announced, brothers Matt and Noah Colvin set out in a silver S.U.V. to pick up some hand sanitizer. Driving around Chattanooga, Tenn., they hit a Dollar Tree, then a Walmart, a Staples and a Home Depot. At each store, they cleaned out the shelves.

"Over the next three days, Noah Colvin took a 1,300-mile road trip across Tennessee and into Kentucky, filling a U-Haul truck with thousands of bottles of hand sanitizer and thousands of packs of antibacterial wipes, mostly from “little hole-in-the-wall dollar stores in the backwoods,” his brother said. “The major metro areas were cleaned out.”

...

"Mr. Colvin said he had posted 300 bottles of hand sanitizer and immediately sold them all for between $8 and $70 each, multiples higher than what he had bought them for. To him, “it was crazy money.” To many others, it was profiteering from a pandemic.

"The next day, Amazon pulled his items and thousands of other listings for sanitizer, wipes and face masks. The company suspended some of the sellers behind the listings and warned many others that if they kept running up prices, they’d lose their accounts. EBay soon followed with even stricter measures, prohibiting any U.S. sales of masks or sanitizer.
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And here's the update:

The Man With 17,700 Bottles of Hand Sanitizer Just Donated Them
A Tennessee man had planned to sell his stockpile at marked-up prices online. Now he is under investigation for price gouging.

"On Sunday, Amazon and eBay suspended him as a seller, which is how he has made his living for years. The company where he rented a storage unit kicked him out. And the Tennessee attorney general’s office sent him a cease-and-desist letter and opened an investigation.

“We will not tolerate price gouging in this time of exceptional need, and we will take aggressive action to stop it,” Attorney General Herbert H. Slatery III of Tennessee said in a news release.

"Tennessee’s price-gouging law prohibits charging “grossly excessive” prices for a variety of items, including food, gas and medical supplies, after the governor declares a state of emergency. The state can fine people up to $1,000 a violation."
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Here are all my posts on price gouging

Organizations' security policies in the news

Organizations that deal with large amounts of data have to consider issues of data security involving their own employees, and these issues sometimes conflict with issues of transparency and collegiality.  Here are a few stories about data, data leaks, and data policies.


The NY Times Magazine writes about Google:
The Great Google Revolt
Some of its employees tried to stop their company from doing work they saw as unethical. It blew up in their faces.

Buzzfeed news:
How Saudi Arabia Infiltrated Twitter

The Guardian:
Donald Trump 'offered Julian Assange a pardon if he denied Russia link to hack'
WikiLeaks published emails damaging to Hillary Clinton in 2016
Ex-congressman denies being middleman for US president

The organ as a fictitious commodity, by Nicolas Brisset

Here, in French (and in English via Google Translate) an effort to understand, from writings on the subject, what underlies the widespread repugnance towards compensation for kidney donors, but mostly does not cause objections to kidney exchange.


L’organe comme marchandise fictive, Nicolas Brisset, Dans Actuel Marx 2020/1 (n° 67), pages 167 à 184
The organ as a fictitious commodity, Nicolas Brisset, In Actuel Marx 2020/1 (n ° 67) , pages 167 to 184

From the introduction:

"Finding out in the name of what individuals resist is an inexhaustible source of intuitions and reflections. Not that everything must be accepted as a whole, but understanding these moral systems is a necessary step from the perspective of both a social theory and a normative point of view on societal organization. We find in the history of social sciences several types of proposals in this regard  [5].
Our work will consist in starting from a social choice between two systems proposed to manage the distribution of a specific entity (the organ taken from living donors) in order to infer the moral foundations. In fact, in a 2007 issue of the Journal of Economic Perspective , two purely economic articles proposed very different ways of organizing the distribution of kidneys taken from living donors. On the one hand, Gary Becker and Julio Jorge Elìas proposed what seems at first sight (we will come back to this) to a trading system  On the other, Alvin Roth favored a system centered on organ donation  [7].
However, it turns out that one of these two proposals has been implemented in several countries, while the other seems for the moment to face a strong social rejection. Briefly, the trading system was rejected, while the donation-based system was retained. In this work, we will begin by analyzing the moral system that could have led to the rejection of the market solution in the context of the distribution of organs for the benefit of a system putting donation at the center. What is this rejection based on? We will try to decide between three hypotheses commonly put forward to explain the border between the merchant and the non-merchant. In turn, the use of money, the institution of the market and the problem of coercion were put forward as possible reasons for a refusal to market the organism."

and the Conclusion:
"The objective of this article has been limited, namely to show how the refusal of a method of matching, the organ market, could be understood as supported by a particular moral economy. The heart of the rejection seems to be that nobody would sell their organ if they weren't there obliged. A representation opposed to the idea according to which the prohibition of the markets to the organs would be inherently paternalistic. Here we find the heart of all debates relating to contested goods or activities. Prostitution, blood, gametes, surrogate mothers, the center of debate can be systematically summed up by the question: would these goods and services be produced and sold in the absence of a situation of loss of autonomy? We have seen that this question was also at the heart of Marxist historiography: to build capitalism is to build the political conditions for market efficiency in orienting work towards industrial activity. It seems that the only coherent explanation for the rejection of the market formulas proposed within the framework of the organs is precisely the rejection of such a construction."
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Professor Brisset has examined kidney exchange before--here's an earlier blog post with links to his work:

Wednesday, June 29, 2016

Repugnance and the social acceptance of kidney exchange (in French)

Repugnance and risk perception in paid clinical trials, by Leuker, Samartzidis, Hertwig and Pleskac

In PLOS One, a new paper on repugnance and risk perception:

When money talks: Judging risk and coercion in high-paying clinical trials
Christina Leuker ,Lasare Samartzidis,Ralph Hertwig,Timothy J. Pleskac
Published: January 31, 2020

Abstract
Millions of volunteers take part in clinical trials every year. This is unsurprising, given that clinical trials are often much more lucrative than other types of unskilled work. When clinical trials offer very high pay, however, some people consider them repugnant. To understand why, we asked 1,428 respondents to evaluate a hypothetical medical trial for a new Ebola vaccine offering three different payment amounts. Some respondents (27%) used very high pay (£10,000) as a cue to infer the potential risks the clinical trial posed. These respondents were also concerned that offering £10,000 was coercive— simply too profitable to pass up. Both perceived risk and coercion in high-paying clinical trials shape how people evaluate these trials. This result was robust within and between respondents. The link between risk and repugnance may generalize to other markets in which parties are partially remunerated for the risk they take and contributes to a more complete understanding of why some market transactions appear repugnant.

Compensation for kidney donors? Opt in or opt out? The BBC and The Rift revisit the debates.(featuring Sally Satel and Frank McCormick)

The BBC covers the shortage of transplantable organs, and reviews the debate about compensating living organ donors, among other possibilities. Of particular interest is their discussion of 'opt-in' versus 'opt-out' systems for registering potential deceased donors, given the recent experience with the change in Wales.

Should organ donors be paid? The heavy toll of US kidney shortage
By Henri Astier


"Many countries, notably in continental Europe, have tried boosting the supply of dead donors through a "presumed consent" approach. Such a system, also known as "opt out", automatically places people on a national register of donors unless they choose not to be.

"All US states, by contrast, have "opt-in" laws. Would switching to "opt out" make a big difference? International studies suggest not. Spain, which has presumed consent, is only slightly ahead of the US in the number of transplants relative to its population; France and Belgium, with similar legislation in place, have fewer transplants.

"Wales is currently the only part of the UK with an opt-out system - England is due to follow suit later this year. But the Welsh did not see an increase in organ donations after it changed its law in 2015.
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And here's another forum for the compensation debate, at The Rift (featuring Sally Satel and Frank McCormick [click on his name next to Sally's] on the pro-compensation side...)
SHOULD ORGAN DONORS RECEIVE FINANCIAL COMPENSATION?

Unraveling of finance internships, and a black market for courses

Mallesh Pai points me to this story in Philadelphia Magazine, from the University of Pennsylvania:

Desperate for High-Paying Wall Street Jobs, Penn Students Try Buying Their Way Into the Right Classes--Out-of-control corporate recruiting — and a new black market  by DAVID MURRELL

"...students had been posting in Penn student group chats saying they’d be willing to pay their way into courses they hadn’t been able to get into. There was a simple workaround: These students would offer money to entice another student to drop the class, then swoop in through the online registration portal to take the newly free seat. The going rate looked to be about $50 to $60 for a class.
...
"Five years ago, sophomores like Current might not have been so desperate. Back then, finance companies hired for their all-important junior-year summer internships just a few months ahead of time. But recently, in an attempt to scoop up the best students before anyone else, companies have moved up the timeline. It’s now standard practice for finance firms to recruit sophomores like Current — who has only completed three semesters of college and hasn’t even declared a major — for those same junior-year summer internships a full 18 months in advance.
...
"As it happened, Current’s scheme to buy his way into Corporate Valuation didn’t quite work as planned. He was foiled by the course registration system. His co-conspirator did indeed drop the class, but a spot never opened up. (Current now thinks he failed to account for a wait-list.) But while he came up empty, other students say they know people who have succeeded.

“This is very common,” says junior Valentina Losada, another vet of the corporate recruiting wars. “It’s not even seen as something bad.”
...
"firms have realized they don’t need the university anymore; they can conduct phone and Skype interviews, then bring candidates to New York City for the final round. When deciding whether to recruit on campus at Penn or bypass the school and face no institutional regulation, guess which option the banks have chosen?

"Having granted themselves free rein, many companies are now acting like monopolistic bullies. They move the recruiting cycles ever earlier in a race to reach job applicants first. (Shout-out to the free market!) They don’t give students time to consider other internships, sometimes requiring job commitments just one or two days after the initial offer. Escudero says she’s had friends who received offers only to be told they had to give their answer on the spot — take it or leave it.
...
"The pressure also produces some peculiar unintended consequences, like the underground course-swap marketplace. Both Losada and Bomba say they have friends who have successfully bought or sold classes. "
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Here's a related story in the Daily Pennsylvanian:

Ilyse Reisman | Penn students, please don’t sell your classes | Classes should not be treated like stocks