The market for radiation oncologists

 Dr. Wes Talcott at Yale points me to some contemporary discussion of the labor force in radiation oncology.  As with a number of other medical specialties, there's a tension between the number of staff needed to prep a patient for treatment and the number of new board certified specialists needed to supervise such treatment. Residents fill the first kind of position, and time and training transforms them into the second.

The contemporary discussion seems to focus on proposals that individual residency programs should reduce the number of residency positions they need to fill, in a decentralized manner, either by offering fewer positions in the Match, or declining to fill positions that aren't filled in the main Match. There is a concern that a coordinated reduction in positions would invite antitrust scrutiny, although other specialties (such as gastroenterology*) have managed that.

Here's an article from the International Journal of Radiation Oncology*Biology*Physics:

Chicken Little or Goose-is-Cooked? The State of the US Radiation Oncology Workforce: Workforce Concerns in US Radiation Oncology by Chirag Shah, MD and Trevor J. Royce, MD, MS, MPH, Published:March 11, 2021 DOI: https://doi.org/10.1016/j.ijrobp.2020.11.056  

"oversupply worries have reached a fever pitch among trainees, with the job market being the primary concern and 52% perceiving an increasingly competitive market10; these concerns have manifested in a precipitous decline in student interest, with 14% of RO residency positions unmatched in the 2020 Match (compared with previous rates of near 0%) and worse numbers expected for the 2021 match."

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Here's a reply, suggesting that the current situation presents an opportunity for the RO profession to remake itself in various ways:

When in a Hole, Stop Digging: In Reply, Workforce Concerns in US Radiation Oncology  Louis Potters, MD, FASTRO, FACR,  Published:March 11, 2021, International Journal of Radiation Oncology*Biology*Physics, DOI: https://doi.org/10.1016/j.ijrobp.2020.12.024

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A different kind of reply is that fewer U.S. medical graduates are applying for RO residency positions in the Match:

No Longer a Match: Trends in Radiation Oncology National Resident Matching Program (NRMP) Data from 2010-2020 and Comparison Across Specialties  by Chelain R.GoodmanM.D., Ph.D.aAustinSimM.D., J.D.hElizabeth B.JeansM.Ed, M.D.dJustin D.AndersonM.D.bSarahDooleyM.D.cAnkitAgarwalM.D., M.B.A.gKarenTyeM.D., M.S.eAshleyAlbertM.D.fErin F.GillespieM.D.iRahul D.TendulkarM.D.kClifton D.FullerM.D., Ph.D.aBrian D.KavanaghM.D.jShauna R.CampbellD.O. Available online 11 March 2021,In Press, Journal Pre-proof International Journal of Radiation Oncology*Biology*Physics https://doi.org/10.1016/j.ijrobp.2021.03.006

"In the 2020 NRMP, 122 US MD senior graduates preferentially ranked radiation oncology, a significant decrease from 2010-2019 (Median [Interquartile Range],187 [170-192], p<0.001). Across all specialties, radiation oncology experienced the greatest declines in the 2020 NRMP cycle relative to 2010-2019 in both the number of ERAS applicants from the US and Canada (-31%) as well as the percentage of positions filled by US MD or DO senior graduates (-28%). Of 189 available positions, 65% (n=122) were filled by US MD senior graduates who preferentially ranked radiation oncology as their top choice of specialty, a significant decrease from 2010-2019 (Median=92% [IQR, 88-94%], p=0.002). The percentage of radiation oncology programs and positions unfilled prior to the SOAP was significantly increased in 2020 compared to 2010-2019 (Programs: 29% versus 8% [5-8%], p<0.001; Positions: 19% versus 4% [2-4%], p<0.001). Despite >99% (n=127 of 128) of US senior applicants successfully matching in the 2020 NRMP, 16 of 24 remaining unfilled positions were filled via the SOAP. Radiation oncology was the top utilizer of the 2020 SOAP, filling 15% of total positions versus a median of 0.9% [0.3-2.3%] across all specialties (p<0.001).

Conclusions

Supply of radiation oncology residency positions now far exceeds demand by graduating US medical students. Efforts to nullify a market correction revealed by medical student behavior via continued reliance on the SOAP to fill historical levels of training positions may not be in the best of interest of trainees, individual programs, or the specialty as a whole."

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*The reduction in gastroenterology residency positions was combined with an increase of a year in required training, and this combination contributed to the unraveling of the gastro Match, which has since been restored. See the background discussion in

McKinney, C. Nicholas, Niederle, Muriel and Alvin E. Roth, "The collapse of a medical labor clearinghouse (and why such failures are rare)," American Economic Review, 95, 3, June, 2005, 878-889.

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Update: here's a discussion of the RadOnc situation by the Rad Onc Virtual Visiting Professor Network

Discovering Auctions: Contributions of Paul Milgrom and Robert Wilson by Teytelboym, Li, Kominars, Akbarpour and Dworczak

 Here's a celebratory account of the Nobel winning work of Milgrom and Wilson. The authors have used the new AEA symbol for random ordering of authors, which I can't reproduce here (it's an r in a circle..)

Discovering Auctions: Contributions of Paul Milgrom and Robert Wilson

by (in random order) Alexander Teytelboym  Shengwu Li  Scott Duke Kominers Mohammad Akbarpour Piotr Dworczak,  March 13, 2021

Abstract: The 2020 Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel was awarded to Paul R. Milgrom and Robert B. Wilson for “improvements to auction theory and inventions of new auction formats.” In this survey article, we review the contributions of the laureates, emphasizing the subtle interplay between deep theoretical questions and practical design challenges that resulted in one of the most successful fields of economics.

Kim Krawiec to UVA

 Controversial markets are coming to Virginia:

Here's the announcement from the U. of Virginia:

Kimberly Krawiec, Expert in Controversial Markets, To Join Faculty

"Kimberly D. Krawiec, a leading expert in market regulation, will join the University of Virginia School of Law faculty in the fall.

...

“Kim is a major contemporary voice on misconduct and trade within forbidden or contested markets,” Dean Risa Goluboff said in welcoming Krawiec to the faculty.

...

"Krawiec, who visited at UVA Law in 2004, has taught both large lecture classes and smaller ones, including her recent favorites Taboo Trades and Forbidden Markets, and Advanced Contracts. “Taboo Trades” is also the name of the podcast she launched in August, which so far has covered topics ranging from marijuana legalization to blood and other “repugnant transactions.”

Ethical payment for research participation

 Discussions of ethical questions turn out to have less math or data than other discussions, but more, well, discussion...  Here's our reply to issues raised in the prior discussion in the preceding issues of the American Journal of Bioethics.

Holly Fernandez Lynch, Thomas C. Darton, Jae Levy, Frank McCormick, Ubaka Ogbogu, Ruth O. Payne, Alvin E. Roth, Akilah Jefferson Shah, Thomas Smiley & Emily A. Largent (2021) Plumbing the Depths of Ethical Payment for Research Participation, The American Journal of Bioethics, DOI: 10.1080/15265161.2021.1895364

"In closing, we’ll respond to Savulescu’s lamentation that our article did not offer “a full economic evaluation of a proposed HIC study such as the UK, with a proposal for a specific amount” (2021). Although we understand this criticism, and considered it ourselves, we were hesitant to make this final move, as there are several different amounts and rationales that could be ethically justified under our framework. Nonetheless, analyzing a particular protocol and the range of payment offers that might be justifiable would be a compelling next step."

Debating deaccessioning

 The museum world is divided about deaccessioning--i.e. selling art to finance things other than the purchase of more art, such as museum operations.

The NY Times has the story:

Selling Art to Pay the Bills Divides the Nation’s Museum Directors. Bitter debate has ensued as museum leaders around the country discuss whether to permanently embrace a pandemic-spurred policy that allows the sale of art to cover some operating costs.  By Robin Pogrebin and Zachary Small

"It started as a stopgap measure to respond to the pandemic, a temporary two-year loosening of an Association of Art Museum Directors’ policy that has long prohibited American institutions from selling art from their collections to help pay the bills.

"But more and more museums are taking advantage of the policy and the association began discussing making it permanent, an idea that, depending on which institution you talk to, either makes perfect sense or undermines the very rationale for their existence.

...

"The longstanding policy — enforced by the museum director’s association and widely embraced by its members — has been that the art owned by institutions was held for the public benefit and, as such, should be mostly retained.

"Some items could be sold — known as deaccessioning — but they were supposed to be artworks that were duplicative or no longer in line with the museum’s mission, and the proceeds were to be dedicated to the acquisition of other art, not to underwriting staff salaries or other operating costs.

...

"The stark differences of opinion among museum leaders were evident last week when the association convened two unusual, mandatory sessions to gather feedback from members about the rules for such sales.

...

"It’s difficult to say what would happen if the association pushed through a policy that was unpopular with half of its membership since issues that have divided museum directors at this level have been rare.

"Many have already lined up on either side of the debate. Campbell, who is now the director and chief executive of the Fine Arts Museums of San Francisco, in an Instagram post warned that “Deaccessioning will be like crack cocaine to the addict — a rapid hit, that becomes a dependency.”

...

"Nonetheless, more than 25,000 people have signed a petition urging the Met to reconsider. “We call on the Met’s board to do the job they signed up for: to give, to support the institution,” says the petition, started by the art critic Tyler Green. “We call upon the Met’s senior staff leadership to resist any attempts to sell off the art the Met holds in the public trust.”

"Some museum leaders worry that donors will be less likely to contribute art if they fear it would be sold, or that formerly generous trustees, seeing the cash available from art sales, may become less likely to donate money."

Negotiating climate change, by Schmidt and Ockenfels in PNAS

 Now that there's light at the end of the Covid tunnel, we can turn our attention back to big problems:

Focusing climate negotiations on a uniform common commitment can promote cooperation  by Klaus M. Schmidt and  Axel Ockenfels, PNAS March 16, 2021 118 (11) e2013070118; https://doi.org/10.1073/pnas.2013070118

Edited by Lise Vesterlund, University of Pittsburgh, and accepted by Editorial Board Member Paul R. Milgrom

Abstract: International cooperation on the reduction of greenhouse gas emissions, disarmament, or free trade needs to be negotiated. The success of such negotiations depends on how they are designed. In the context of international climate change policy, it has been proposed [e.g., M. L. Weitzman J. Assoc. Environ. Resour. Econ. 1, 29–49 (2014)] that shifting the negotiation focus to a uniform common commitment (such as a uniform minimum carbon price) would lead to more ambitious cooperation. Yet, a proof-of-concept for this important claim is lacking. Based on game theoretical analyses, we present experimental evidence that strongly supports this conjecture. In our study, human subjects negotiate contributions to a public good. Subjects differ in their benefits and costs of cooperation. Participation in the negotiations and all commitments are voluntary. We consider treatments in which agreements are enforceable, and treatments in which they have to be self-enforcing. In both situations, negotiating a uniform common commitment is more successful in promoting cooperation than negotiating individual commitments (as in the Paris Agreement) and complex common commitments that tailor the commitment to the specific situation of each party (as attempted with the Kyoto Protocol). Furthermore, as suggested by our model, a uniform common commitment benefits most from being enforced.

College admissions, exam optional

 The WSJ has a report focusing on post-covid, exam optional college admissions:

College Admission Season Is Crazier Than Ever. That Could Change Who Gets In.  By waiving SATs and ACTs, highly selective schools invited an unprecedented wave of applications, upending the traditional decision process.  By Melissa Korn and Douglas Belkin

"Ivy League schools and a host of other highly selective institutions waived SAT and ACT requirements for the class of 2025, resulting in an unprecedented flood of applications and what may prove the most chaotic selection experiment in American higher education since the end of World War II.

...

"Harvard University received more than 57,000 freshman applications for next fall’s entering class, a 42% year-over-year jump. Yale, Columbia and Stanford universities were so overwhelmed they also pushed back the date to announce admission decisions. The University of Southern California’s applications pool beat the prior record by 7%. And New York University topped 100,000 applications, up 17% from last year.

...

"Testing isn’t the only conundrum admissions officials are confronting. Grade-point averages—normally a key data point—were complicated by last year’s spring semester, when many high schools offered pass-fail options to students who were suddenly finishing junior year online. Sports and other extracurricular activities were canceled in pockets of the country, stripping teens of leadership opportunities to boast about on applications.

"Still, tests are the biggest single X-factor this year. Test administrations for the SAT and ACT across much of the country were canceled because of public-health concerns about crowding teens into auditoriums. More than 1,600 four-year colleges didn’t require that applicants submit standardized test scores this admissions cycle, since so many students couldn’t take the exams as scheduled. The movement behind test-optional policies had gained some high-profile backers over the past decade, but the trickle turned to a tsunami when 600 more joined the roster since last March.

...

"With the gates to many more selective schools no longer guarded by standardized tests, tens of thousands of additional students applied. In a year when nothing was certain, anything seemed possible—so what the heck, seniors thought, why not apply to Harvard?

...

"Data from the Common App, a standard application used by more than 900 schools, show that applications through March 1 were up 11% nationwide. But the number of applicants rose by just 2.4%, meaning roughly the same number of students are just sending out more applications. The flurry of applications was concentrated at more selective colleges."

Elite public schools move away from exams

 Covid cancelled exams for many exam schools: will they stay exam free in the future?  Several cities are moving in that direction.

Here's NBC, on Boston Latin:

A golden ticket: Efforts to diversify Boston's elite high schools spur hope and outrage. Exam schools loom large as symbols of opportunity and inequality in American public schools. Now, the nation's twin crises are shaking them to their core.  By Melissa Bailey, The Hechinger Report

Here's SF Chronicle on Lowell High School:

S.F. school board strips Lowell High of its merit-based admissions system  by Jill Tucker

"the San Francisco Board of Education voted 5-2 to use the same lottery-based system to assign students to Lowell High as other district high schools instead of maintaining the previous system that used test scores and grades."

Here's the NY Times on gifted programs for the youngest children:

N.Y.C. schools will replace the gifted and talented admissions exam with a lottery this year. By Eliza Shapiro

Same sex marriage in Japan takes a step forward

In The U.S., court decisions paved the way for same sex marriage.  Now there's a court decision in Japan. The NY Times has the story:

Landmark Ruling Cracks Door Open for Same-Sex Marriage in Japan. A court found that it was unconstitutional for the country not to recognize the unions. But change would come only if Parliament passes legislation. By Ben Dooley and Hisako Ueno

"A Japanese court on Wednesday ruled that the country’s failure to recognize same-sex marriages was unconstitutional, a landmark decision that could be an important step toward legalizing the unions across the nation.

"The ruling, handed down by a district court in the northern city of Sapporo, came in a civil suit against the Japanese government by three same-sex couples. 

...

"The ruling will not, however, change the law. Same-sex marriages will be recognized in Japan only if Parliament enacts legislation, Mr. Dmitrenko said. Lawmakers have repeatedly declined to take up such a bill.

"Still, activists saw the court’s decision as an important step in tearing down barriers to normalizing gay marriage in Japan, the only country in the Group of 7 nations that has not legalized same-sex unions.

"The unions are not explicitly banned in Japan, but they are not recognized by the national government or most localities. In recent years, some local governments have moved to provide gay couples with certificates acknowledging their marriage, but the documents have little legal or practical value.

"National authorities have long argued that their position is supported by a provision in the country’s constitution that stipulates marriage can occur only with the consent of both sexes, a provision that was intended to stop Japan’s once common practice of arranged marriages."

Match Day 2021 for medical residents

 Yesterday was Match Day, during Covid Year, and the aggregate data are reassuring that virtual (instead of in-person) interviews left the Match, in aggregate, much as before. The NRMP reports on match results, and Thalamus reports on interviews among the largest specialties.

Here's the NRMP press release:

Press Release: NRMP Delivers Strong Residency Match During Uncertain Times

"The 2021 Main Residency Match was the largest in NRMP history. There were 38,106 total positions offered, the most ever, and 35,194 first-year (PGY-1) positions offered, an increase of 928 (2.7%) over 2020. The growth in positions was supported by continued growth in the number of Match-participating programs. A record-high 5,915 programs were part of the Match, 88 more than 2020. In five years, the number of Match-participating programs has increased by 845 (16.7%), spurred in part by the completion of the transition to the single accreditation system for allopathic and osteopathic programs.

"Rather than faltering in these uncertain times, program fill rates increased across the board. Of the 38,106 total positions available, 36,179 filled, representing a 2.6 percent increase of filled positions over 2020. Of the 35,194 first-year positions available, 33,535 filled, representing a 2.9 percent increase of first-year filled positions. Those fill rates drove the percent of all positions filled from 94.6 to 94.9 percent and the percent of PGY-1 positions filled from 94.6 to 94.8 percent in 2021. There were 1,927 unfilled positions after the matching algorithm was processed, a decline of 71 (3.6%) compared to 2020.

...

"Percent of Applicants Matched to PGY-1 Positions Declines Slightly for Seniors; Rates Remain High. With all applicant groups demonstrating increases in the number of applicants submitting rank ordered lists of programs and ultimately matching to first-year PGY-1 positions, the overall percent matched declined modestly for some groups. Specifically, the percent of U.S. MD seniors matched to PGY-1 positions declined from 93.7 to 92.8, and the percent of U.S. DO seniors matched to PGY-1 positions declined from 90.7 to 89.1 percent. Non-U.S. citizen IMGs saw the largest decline, from 61.1 percent in 2020 to 54.8 percent in 2021. The unavailability of medical licensure examinations in the early stages of the pandemic coupled with permanent changes to the scoring and administration of those examinations by the end of 2020 created significant challenges for IMGs this year and likely contributed to the decline. Additionally, changes in clinical rotations may have affected match rates. The overall percent of applicants matched to PGY-1 positions declined from 80.8 to 78.5 percent."

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And here's a post from Thalamus, the interview managing service whose motto is "connecting the docs."

Explaining COVID’s Impact on the 2020-2021 Virtual Recruitment Season and NRMP Match Outcomes  March 19, 2021 by Team Thalamus

Here are their concluding remarks:

"1. The number of interview invitations stayed the same.

"2. The number of interviews completed by both applicants and programs went up. 

"3. The rate of interview cancellations decreased. 

"4. And while the candidates receiving the top 20% of interview offers completed more interviews than other candidates, overall applicants and programs both completed more interviews, thereby lengthening rank lists and providing each greater opportunity to match.

"While the slight decrease in match rates is due to a disproportionally larger number of applicants entering the match in comparison to the growth rates of the number of available residency positions, more candidates matched than ever before, because significantly more unique applicants received opportunities to interview.

"And therefore, overall, the match rate held steady as it has had in recent years, driven by its Nobel Prize winning application of the stable marriage algorithm.  

"Of course, there are several factors at play here including where applicants and programs enter preferences of where or whom they would like to match, respectively.  Similarly, given visa restrictions "IMGs were particularly disadvantaged this year more than usual, which lead to their larger resultant drop in their match rate.  There are continued challenges here including increasing the number of positions of available training positions to match a continued acceleration and growth of the applicant pool, and data can help expand upon this work. "

"Overall, the challenges of over-interviewing in GME was not greatly affected by the virtual interview process, and the greatly hypothesized “match crisis” appears to have been avoided.  Yet, this process shed significantly light on a continued systemic problem: Due to a lack of transparency, applicants continue to overapply, and residency programs continue to over-interview, creating a costly and anxiety-ridden process for all.  Data and technology can help change this for the future as COVID leaves its recognizable mark on the medical residency recruitment and match process."

Matching theorist wins high school science talent search

 Yunseo Choi will attend Harvard next year, planning to study math and econ (see video below).

Teen Scientists Win $1.8 Million at Virtual Regeneron Science Talent Search 2021 for Remarkable Research on Infinite Matching Algorithms, Machine Learning to Evaluate New Medicines and Water Filtration   $250,000 top award goes to Yunseo Choi in nation’s oldest and most prestigious STEM competition for high school seniors

"TARRYTOWN, N.Y. and WASHINGTON, D.C.  – Regeneron Pharmaceuticals, Inc. (NASDAQ: REGN) and Society for Science (the Society) announced that Yunseo Choi, 18, of Exeter, New Hampshire, won the $250,000 top award in the 2021 Regeneron Science Talent Search, the nation’s oldest and most prestigious science and math competition for high school seniors. Historically held in person in Washington, D.C., this is the second year in its 80-year history that the competition took place virtually to keep the finalists and their families safe during the ongoing pandemic. Forty finalists, including Yunseo, were honored tonight during a virtual winners’ award ceremony. More than $1.8 million was awarded to the finalists, who were evaluated based on their projects’ scientific rigor, their exceptional problem-solving abilities and their potential to become scientific leaders.

"Yunseo Choi won first place and $250,000 for her project where she played theoretical “match maker” for an infinite number of things or people. She studied matching algorithms that work for a finite number of couples and determined which important properties would still work for an infinite number of pairs. Matching theory has numerous real-life applications, including matching organ donors to recipients, assigning medical school applicants to rotations and pairing potential couples in dating apps."

HT: Scott Kominers

Data use agreements, and university research policies regarding restrictions on publication

 Since the beginning of the year, I've been sent several Data Use Agreements from organizations interested in the possibility of sharing some of their data for research purposes.  I've had to decline the opportunity more than once, because of publication restrictions that conflict with Stanford research policies (and those of most other universities, I think, out of concern for academic freedom, and to keep academic publications free from selection bias concerning the research findings).

The relevant Stanford policies are here:   https://doresearch.stanford.edu/policies/research-policy-handbook/conduct-research/openness-research

The most relevant paragraphs are these:

"C. Publication Delays

"In a program of sponsored research, provision may be made in the contractual agreement between Stanford and the sponsor for a delay in the publication of research results, in the following circumstances:

"For a short delay (the period of delay not to exceed 90 days), for patenting purposes or for sponsor review of and comment on manuscripts, providing that no basis exists at the beginning of the project to expect that the sponsor would attempt either to suppress publication or to impose substantive changes in the manuscripts.

"For a longer delay in the case of multi-site clinical research (the period of delay not to exceed 24 months from the completion of research at all sites), where a publication committee receives data from participating sites and makes decisions about joint publications. Such delays are permitted only if the Stanford investigator is assured the ability to publish without restrictions after the specified delay."

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Alex Chan points me to this article in Science by some of our Stanford colleagues:

Waiting for data: Barriers to executing data use agreements  by Michelle M. Mello, George Triantis, Robyn Stanton, Erik Blumenkranz, David M. Studdert,   Science  10 Jan 2020: Vol. 367, Issue 6474, pp. 150-152 DOI: 10.1126/science.aaz7028

Here's a figure from the paper that makes clear that concerns about publication often are serious obstacles (and that concerns about indemnification clauses are frequent obstacles).

"The third set of issues relates to clashes between DUA negotiators over what is and is not acceptable in the contract. Negotiators reported that the most common and serious of these substantive issues related to provisions concerning information privacy and security, indemnification, and the definition of confidential information; provisions concerning publication rights and ownership of academic researchers' work product were less commonly in dispute but serious problems when they were. These are no mere matters of “legalese”; each implicates potentially important risks to the university and faculty member.

...

"Indemnification is another actionable area. At least where low-risk data are involved, university contract negotiators may be spending more time on these provisions than is warranted. If good privacy and security protections are in place, the risk of a data breach is low, and haggling over who pays in the unlikely event of a breach that causes harm should not obstruct timely data transfers for research. Yet, negotiators at 13 of 48 universities had walked away from a negotiation because of indemnification issues.

"When it comes to provisions safeguarding publication rights and ownership of faculty members' work product, on the other hand, universities must remain resolute. These provisions implicate core values of the university and of open science. A potential strategy for minimizing haggling over non-negotiable issues is for universities as a group to more clearly signal their unified position. Existing university policies setting forth institutional commitments to academic freedom and policies concerning IP are helpful in communicating norms, but even more helpful would be a universal DUA template."

Bob Wilson's Nobel lecture, in Econometrica

Here is Bob Wilson, in a very low key account of (what I would have described as) how he saw the future, changed economics, mobilized a generation of scholars, and won the Nobel.

Strategic Analysis of Auctions  by Robert B. Wilson, ECONOMETRICA: MAR 2021, VOLUME 89, ISSUE 2p. 555-561, https://doi.org/10.3982/ECTA19347

Abstract: The diploma for the Sveriges Riksbank Prize in Economics Sciences in Memory of Alfred Nobel that I shared in 2020 with Paul Milgrom cites “improvements in auction theory and inventions of new auction formats”.1 As requested by the Royal Swedish Academy of Sciences, this lecture describes the origin of my work on auctions. It complements the Nobel Lecture by Paul Milgrom (2021) that describes later developments in theory and practice.

Here's footnote 4:

"As an MBA student in 1959 I received a failing grade on a written analysis of a case involving competitive bidding because I invoked a mathematical analysis rather than the mandatory ‘administrative point of view’ "

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Earlier post:

Monday, October 12, 2020

Finally! Paul Milgrom and Bob Wilson win the 2020 Nobel Prize in Economics

A call for capping residency interviews

 One clear symptom that the marketplace for medical residents is in crisis is the persistent drumbeat of suggestions for how to modify it.  The transition from medical school to residency has become congested, with many applications and interviews preceding the centralized clearinghouse known as the Match (which will yield its results on March 19).  

One way to treat a disease is to treat some of its most obvious symptoms. Here's the latest such proposal, to put a cap on the number of interviews. (Readers of this blog will wonder how those will be coordinated, and a number of proposals have been made including signaling, or a centralized interview match.)  

I'm hoping that data will become available to allow these proposals to be better evaluated, and perhaps to allow a market design that will deal with causes as well as symptoms.

Here's the latest, from Medscape.

Fixing the Match Crisis Starts With Capping Interviews  by Helen K. Morgan, MD

"Concern over the so-called "Match crisis" increases every cycle. This year, pandemic-related changes have shined a spotlight on the skewed distribution of interviews. Thanks to the shift from in-person to virtual interviews, applicants were no longer limited by travel and financial concerns. According to some experts, this has resulted in "top" candidates taking additional slots and subsequently reducing opportunities for others.

"Worry about residency interview distribution has surged, with letters of concern posted by the Association of American Medical Colleges and the American College of Surgeons. Before the start of this season, my colleagues and I modeled the potentially dire consequences of ob/gyn applicants "hoarding" too many interviews in an article published in the Journal of Surgical Education.

The residency application problems exposed by the pandemic aren't going anywhere without action. Establishing a cap on interviews is now clearly necessary...."

HT: Mike Rees

Rajk College interviews me and Matt Jackson (pre-pandemic)

 Here's an interview that reminds me of the before (Covid) days, when we could go into the office.

It was conducted January 30, 2020 by students from Rajk College in Budapest, who also interviewed Matt Jackson.  Along with some more familiar things (what are matching markets?) I got to talk about the relationship of market design to mechanism design, and what I like about being an academic.

Here's the interview with me (11 minutes):

 

And here's the one with Matt Jackson, recorded on the same day:

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Here's a link to other interviews by Rajk College, and here's an article in Hungarian.

Video interview series presented by Rajk College for Advanced Studies for its 50th birthday. The series covers interviews made by selected awardees of the John von Neumann and Herbert Simon Awards established by Rajk College, Budapest, Hungary. This interview was made with Alvin Roth at the Economics Department of Stanford University CA at January 30, 2020 before any COVID-19 restrictions. Directors: Kornél Hoffmann, Márton Simó, Ádám Vig, Judit Berei, Artúr Velkey, Mátyás Tompa, Dóra Kovács Interviewers: Márton Simó, Ádám Vig Cinematographer: Dániel Bálint Editing: Levente Klára Graphic design: Soma Sebesvári Sponsored by: G7.hu, Oriens, Centrál Média, MTA KRTK KTI About Rajk College for Advanced Studies: homepage: http://rajk.eu/​ facebook: https://www.facebook.com/rajkofficial

The market for chicken parts

 Can the wholesale food market come to resemble the modern retail financial market?  The WSJ has the story.

Trading Chicken Feet Is Going Digital. For giants like Tyson, moving millions of pounds of meat from farmers to vendors still requires phone calls, spreadsheets and middlemen  By Julia-Ambra Verlaine

"For agricultural giants like Tyson Foods Inc., moving millions of pounds daily of meat and poultry products from farmers to vendors world-wide still requires phone calls, spreadsheets and personal relationships with middlemen who take a cut. Brokers fees can add up, and it is hard to get reliable up-to-the-minute pricing information. Unlike other markets, inventory and supply aren’t available on a centralized database.

...

"Scott Spradley, chief technology officer at Tyson, the second-largest processor of chicken, beef and pork in the U.S., said large transactions with some external partners still require a fax machine. To fill a supermarket order for chicken, salespeople need to call warehouses peppered across the country. Improving the technology could ultimately bring down the cost of processing and distributing food across the country.

...

"The more middlemen involved, the higher the cost. Before a steak ends up on an American dinner table, it goes through slaughterhouses that process and package the meat. While large retailers like Costco Wholesale Corp. or food chains like McDonald’s Corp. have direct contracts with producers at fixed rates, small restaurants and local suppliers have to go through protein brokers including Louis Dreyfus Co., or redistributors such as NebraskaLand.

“It’s an archaic industry that relies on an old-boy network, a bit like foreign exchange in the 1980s,” said Mr. Honey. “We are trying to cut the fat out that brings the price up.”

...

"Companies like Nui, populated with former traders, are seeking to build streaming platforms that centralize supply and give access to smaller players at better prices. Industry publisher Urner Barry is like a Bloomberg in the meat, fish poultry industry—providing data, news and market pricing on lamb, pork, turkey, eggs and more.

"Urner Barry, founded in 1858, upgraded its electronic platform called COMTELL over a year ago. It supplies brokers, restaurateurs and supermarkets with prices on over 15,000 products ranging from chuck roll to West Coast chicken drumsticks.

“Unlike the past, people are coming into this industry that have a finance background,” said Russell Barton, a COMTELL director at Urner Barry. “They are treating the meat and poultry markets like analysts treat the stock market. They aren’t content with a static price sheet.”

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One of the companies mentioned in the WSJ story is the New Zealand based Nui (https://www.nuimarkets.com/our-platform/)

Frequent flier miles, infrequent flying, and credit cards

 The WSJ has the story of how frequent flier programs keep airlines afloat even when there is less frequent flying:

American Airlines to Use Frequent-Flier Program to Raise $7.5 Billion. Carrier will use funds to replace a loan from the federal government  By Micah Maidenberg

The airline on Monday said it would issue $5 billion in notes and seek a $2.5 billion term loan backed by AAdvantage, its loyalty initiative for customers, to secure the funds. Both Delta Air Lines Inc. and United Airlines Holdings Inc. also have tapped their respective frequent-flier programs to land financing.

"Carriers have found the relatively stable cash flows that their frequent-flier programs bring in to be a rich source of collateral for financing.

"Airlines mainly earn money from frequent-flier programs by selling miles to banks and retailers that then award them to customers who sign up for credit cards and make purchases. That means airlines stand to benefit from every swipe of a co-branded card, whether customers are buying plane tickets or clothing. Airlines have said this revenue has held up better than ticket sales as travel demand dried up last year."

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Earlier post:

Thursday, October 15, 2020

Frequent flier programs during the pandemic slowdown in air travel

Kidneys for Communities

 A new organization, Kidneys for Communities, plans to advocate for living kidney donation by seeking donors who identify with a particular community.  Their come-on is "Put your kidney where your heart is.  Share your spare with someone in your community"

They say "Kidneys for Communities was founded on the idea that communities inherently take care of each other. If we can save a life, we can save the world.

"When we tap in to the compassion and connection of communities, we can radically increase the number of living kidney donors around the world and save tens of thousands of lives every year. By enlisting one community after another to join our mission, more donors will choose to give, more lives will be saved and more communities will be strengthened."

**********

Here's their press release, which includes the idea of a community member starting a kidney exchange chain that would end with a donation to a community member:

Kidneys for Communities' new program aims to increase living kidney donations impacted by COVID. New national community-directed donation program takes center stage for National Kidney Month

"Tackling the living kidney-donor shortage, Kidneys for Communities, a nonprofit, has launched the first-ever national community-directed donation program to increase the pool of living kidney donors in the United States.

"The pandemic has impacted living kidney donations across the U.S. According to the U.S. Organ Procurement and Transplantation Network (OPTN), living kidney donations in 2020 dropped to just 5,237, the lowest number in just over two decades. 

...

"The Kidneys for Communities model addresses the significant shortage of living kidney donations in the U.S., where more than 100,000 people are in immediate need of a kidney transplant, according to the OPTN. Based on OPTN data, of those who receive kidneys from living donors, approximately 95 percent know or are associated with the donor through their community network.

"The community-directed donation model increases living kidney donations by allowing potential donors who belong to membership-based associations to direct their lifesaving donation to someone—even a potential stranger—based on a community they want to support.

...

"To further increase living donor and recipient matches, Kidneys for Communities partners with leaders in the renal transplantation field, including Alliance for Paired Kidney Donation, which matches willing but incompatible kidney donor and recipient pairs through paired donations.

"Through Kidneys for Communities and Alliance for Paired Kidney Donation, a person can donate their kidney on a community member's behalf, similar to a voucher concept; the member in need is then entered into a pool, where they're matched with a viable donor. This creates a chain that allows for at least two people in need to receive a kidney: the member of the respective community and another recipient in need.

**********

The program is loosely motivated by some of the faith-based organiztions that have been so successful in recruiting living donors in the U.S. and Israel.

Related posts

Friday, February 9, 2018

Altruistic kidney donation in Israel: Matnat Chaim (gift of life)

hursday, September 5, 2013

Project Renewal: Kidney donation in faith-based communities

Tuesday, April 21, 2015

Expanding non-directed kidney donation: the Renewal model

Allocating leftover vaccine before it spoils

 The NY Times has the story:

Hunting for a Leftover Vaccine? This Site Will Match You With a Clinic.  More than half a million people have signed up for Dr. B, a service that promises to match them with clinics struggling to equitably dole out extra doses before they expire.   By Katie Thomas

"a New York-based start-up is aiming to add some order to the rush for leftover doses. Dr. B, as the company is known, is matching vaccine providers who find themselves with extra vaccines to people who are willing to get one at a moment’s notice.

"Since the service began last month, more than 500,000 people have submitted a host of personal information to sign up for the service, which is free to join and is also free to providers. Two vaccine sites have begun testing the program, and the company said about 200 other providers had applied to participate.

...

"The company’s database sorts people by local rules about vaccine priority, giving providers better odds of administering their leftover shots to those in the greatest need.

"For many providers, that orderly procedure would be a welcome change from the haphazard systems they are using now. At some pharmacies and supermarket chains, workers have resorted to combing the shopping aisles to find people willing to get a last-minute vaccine. At other locations, vaccine hopefuls wait in line at the end of every shift, which could pose an infection risk, particularly to the most vulnerable."

Coordinating vaccine delivery is hard (California/Blue Cross version)

 The Mercury News has the story:

Santa Clara County will not participate in state’s Blue Shield-run vaccine program  by Maggie Angst

"Santa Clara County said late Monday it won’t take part in the state’s new centralized vaccine distribution system run by Blue Shield — a potentially huge blow to Gov. Gavin Newsom’s highly-touted plan.

"County Executive Jeff Smith said the county would not sign a contract with Blue Shield allowing the health insurance company to take over vaccine distribution in the county, claiming the new oversight wouldn’t do anything to improve vaccination speed or efficiency.

...

"According to officials from Blue Shield and the state, only one county of 58 in the entire state — Kern County — has signed a contract with Blue Shield.

“I think everyone sees it as a solution looking for a problem,” Smith said. “We’re talking about adding bureaucracies rather than vaccinating people.”

Swiss voters approve ban on face coverings

Here's a headlne from the NY Times that surprised me, until I realized that the Swiss aren't banning pandemic protective gear, but are expressing a familiar repugnance.

Swiss Voters Narrowly Approve a Ban on Face Coverings.  The referendum forbids veils worn by Muslim women in public places, as well as ski masks donned by protesters.   By Nick Cumming-Bruce

"Switzerland on Sunday became the latest European country to ban the wearing of face coverings in public places, prohibiting the veils worn by Muslim women.

"Official results of the nationwide referendum showed 51.2 percent of voters supported the ban on full facial coverings, which was proposed by the populist, anti-immigrant Swiss People’s Party (S.V.P.), compared with 48.8 percent opposing it, a much narrower margin of victory than pollsters had initially predicted.

"The initiative, started long before the onset of the coronavirus pandemic, makes exceptions for facial coverings worn at religious sites and for security or health purposes, but also bans coverings like the ski masks worn by protesters. Officials have two years to write legislation to put the ban into effect.

...

"France, Denmark, the Netherlands and Austria ban face coverings, and opinion polls at the start of the year showed the Swiss initiative garnering the backing of around 65 percent of voters, but the gap narrowed quickly as liberals and women’s groups pushed back against a ban they condemned as racist, Islamophobic and sexist.

...

"Some liberal-leaning Muslims supported the ban.

“What the full veil represents is unacceptable; it is the cancellation of women from public space,” Saïda Keller-Messahli, president of the Forum for a Progressive Islam, told Swiss media."

How do Zoom interviews change labor markets? Interview Hoarding by Manjunath and Morrill

 Suppose there were a pandemic that caused widespread lockdowns.  How might this influence the outcome of a labor market that was forced to switch from in-person, on-site interviews to remote interviews via Zoom or its equivalents?

Vikram Manjunath and Thayer Morrill take up the challenge, motivated by the case of the National Resident Matching Program, which matches new doctors to hospital residency programs. (Match Day is March 19 this year, so we may know some relevant things about how the pandemic influenced the Match not too long after.)

Interview Hoarding  by Vikram Manjunath and Thayer Morrill, February 22, 2021

Abstract: Many centralized matching markets are preceded by interviews between the participants. We study the impact on the final match of an increase to the number of interviews one side of the market can participate in. Our motivation is the match between residents and hospitals where, due to the COVID-19 pandemic, interviews for the 2020-21 season of the NRMP match have switched to a virtual format. This has drastically reduced the cost to applicants of accepting interview offers. However, the reduction in cost is not symmetric since applicants, not programs, bore most of the costs of in-person interviews. We show that if doctors are willing to accept more interviews but the hospitals do not increase the number of interviews they offer, no doctor will be better off and potentially many doctors will be harmed. This adverse consequence results from a mechanism we describe as interview hoarding. We prove this analytically and characterize optimal mitigation strategies for special cases. We use simulations to extend the insights from our analytical results to more general settings.

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Update: Manjunath, Vikram, and Thayer Morrill. "Interview hoarding." Theoretical Economics 18, no. 2 (2023): 503-527.

Deferred Acceptance with Compensation Chains by Piotr Dworzak

 Here's an interesting look at deferred acceptance algorithms, published online early in Operations Research 

Deferred Acceptance with Compensation Chains  by Piotr Dworczak 

Published Online:18 Feb 2021https://doi.org/10.1287/opre.2020.2042

Abstract: I introduce a class of algorithms called deferred acceptance with compensation chains (DACC). DACC algorithms generalize the Gale–Shapley algorithm by allowing both sides of the market to make offers. The main result is a characterization of the set of stable matchings: a matching is stable if and only if it is the outcome of a DACC algorithm. The proof of convergence of DACC algorithms uses a novel technique based on a construction of a potential function.

Tom Schelling (who passed away in 2016) gets a Memorial Minute at Harvard

 From the Harvard Gazette, March 3, 2021

Thomas Crombie Schelling, 95.  Memorial Minute — Faculty of Arts and Sciences

submitted by Eric S. Maskin, Amartya Sen, Richard J. Zeckhauser, Benjamin M. Friedman

"Thomas C. Schelling taught at Harvard for 32 years, in the Department of Economics and in the Kennedy School. More than any other thinker, Schelling influenced the West’s conceptual approach to the nuclear dangers after World War II. He was an outstanding economist, but ordinary disciplinary boundaries could not contain his fertile mind. Schelling’s contributions interwove theoretical understanding and policy-relevant applications. He laid bare the underpinnings of such problems as nuclear deterrence, racial segregation, smoking, and climate change. Schelling eschewed mathematical expression; he wrote in plain but elegant English. He often developed ideas using examples from everyday life and then applied them to global issues. For instance, he illuminated the architecture of threats and promises first within the family and then in international affairs.

...

"The Nobel Prize committee wrote that Schelling’s insights proved “to be of great relevance for conflict resolution and efforts to avoid war,” and, unsurprisingly, he devoted his Nobel lecture to what he called the “nuclear taboo.”

"As the threat of nuclear war receded, Schelling applied his characteristic approach to other big problems. He analyzed the damage, to both the individual and society, of smoking and other personal addictions. He anticipated future work in behavioral economics and psychology with his working assumption that often what appears to be irrational behavior of an individual is instead a reflection of different aspects of that individual’s self. He probed the problem of racial segregation and showed how easily it can arise even if people have only a tiny preference for their own race. In his final decades, Schelling’s principal focus was climate change. That concern was not new for him; in 1980 he chaired the Ad Hoc Study Panel on Economic and Social Aspects of Carbon Dioxide Increase, under President Carter."

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Previous posts:

Saturday, March 7, 2009

Microstructure of Macro Behavior

Tuesday, December 13, 2016

Tom Schelling (1921-2016)

The costs of applying for financial aid for college

 The Chronicle of Higher Education has a surprisingly moving long story about the fact that applying for financial aid is not only time consuming, difficult and even expensive for the people who need it most, but can also be emotionally costly, especially for students from broken families, since the form requires input from both parents.

The Most Onerous Form in College Admissions. The Fafsa is tough, but the CSS Profile is grueling. There’s a human cost.   By Eric Hoover

"The most onerous form in admissions bores into the bones of your existence. Each year it sows confusion and multiplies misery among those seeking financial aid from many of the nation’s wealthiest colleges. It’s called the College Scholarship Service Profile, or CSS Profile, for short. Some students call it burdensome, invasive, evil.

...

"The CSS Profile is more detailed than the Free Application for Federal Student Aid, or Fafsa. The latter form, which families use to get government grants and loans, has long been seen as a barrier to college access. But if the Fafsa is a 100 yards of difficulty, the CSS Profile is a mile.

"And unlike the federal form, it’s not free for everyone. The College Board provides fee waivers for some low-income students; otherwise families pay $25 to submit the form to one college, then $16 a pop for each additional one.

...

"Just so we’re clear, the application — used by more than 400,000 students annually — isn’t evil or ill-intentioned. It helps colleges and scholarship organizations allot more than $9 billion a year to students, often unlocking doors to a new life.

...

"This is perhaps the most important thing to know about the CSS Profile: Teenagers, especially in lower-income families, are often the ones who fill out the form. They’re the ones digging up tax forms and asking reluctant parents for their Social Security number. They’re the ones being asked to list “Social Security benefits received for all family members, except any who will be enrolled in college in 2021-22, that were not reported on a tax return,” and “Alimony Received (including, but not limited to, amounts reported on a tax return),” and to answer this: “Is any person in your family the beneficiary of a trust?”

...

"The heaviest weight falls on students who don’t live in a nuclear family. Students from single-parent homes. Students whose parents had ugly separations. Students with a parent who’s abusive or imprisoned or nowhere to be found. Whose parents are dead. Who live with siblings or grandparents or legal guardians or foster parents — or with no one.

"There are many reasons you might need to request a waiver for the CSS Profile’s noncustodial-parent requirement. One college counselor calls the process “the worst and most demeaning thing I’ve ever seen.”

...

"Though a majority of institutions that use the CSS Profile require noncustodial parents to complete their own form, students who have no contact with that parent can ask colleges to waive the requirement. They do so by completing the College Board’s official waiver-request form, which says that institutions typically consider the requests in cases of “documented abuse,” legal orders limiting the parent’s contact with the child, or “no contact or support ever received from the noncustodial parent.” Colleges might ask for documentation, such as court documents or legal orders.

...

"Each year, 22 percent of first-time domestic students using the CSS Profile get fee waivers, according to the College Board. Orphans and wards of the court under 24 get them, as do students receiving SAT fee waivers. Others qualify based on their parental income and family size (a family of four would qualify with an income of $45,000 or less). An applicant’s eligibility is determined automatically by his or her responses on the CSS Profile — meaning they don’t know if they will get a waiver until they complete the form.

"Let’s do some quick math. If 22 percent of CSS Profile users get fee waivers, that means 78 percent don’t. That’s approximately 312,000 students who pay the College Board about $7.8 million a year just by completing the $25 form and sending it to one college."

Vaccine supply and delivery in Germany: I'm interviewed in Zeit

 Here's an interview in the German newspaper Zeit, in which I was asked in early February about the vaccine rollout here and there. (Google translate is pretty readable, although some of the Q&A is a bit garbled by the translation from English to German and re-translation back into English...)

"Die Welt kann es sich leisten, einiges zu bezahlen" Alvin Roth weiß, wie man begehrte Güter effizient verteilt. Er hat den Nobelpreis dafür bekommen. Ein Gespräch über knappen Impfstoff und wie er vermehrt werden kann.  Interview: Lisa Nienhaus

Google Translate: "The world can afford to pay a lot" Alvin Roth knows how to efficiently distribute desirable goods. He got the Nobel Prize for it. A conversation about scarce vaccine and how it can be propagated. Interview: Lisa Nienhaus February 15, 2021,

The interview starts off talking about congestion, and line jumping, and the tradeoffs between speed and fairness (and how it's really costly to allow some vaccine to expire unused in the name of fairness).  It then turns to shortages of vaccine in the near term:

ZEIT ONLINE: Attempts are being made to build new production facilities. But in Germany we are - to be honest - pretty late.

Roth: But now is not the time to give up. Everything we build now may help us in August. Even if Germany is running late, there is still time to expand production facilities. Especially since these systems would certainly not have to be destroyed after Covid. Being able to produce mRNA vaccines oneself is also a good thing in the future. Vaccine production is not that complicated. You can build production facilities anywhere. And you should too.

ZEIT ONLINE: It's not happening on a large scale yet. What to do?

Roth: Laws are really useful for that. Pfizer / BioNTech and Moderna could be forced to license the production technology to other German pharmaceutical companies.

ZEIT ONLINE: That sounds radical.

Roth: I only think it's logical. If you had a pharmaceutical company, you'd think, "I'm paid by the dose. I've got enough capacity to ship to the whole world in the next year and a half. Why should I hurry?" There is no need to set up production facilities just to supply the world in six months instead of 18. It doesn't make any difference from a business perspective. But for the German or American government, these two options are by no means equivalent. It is important that we vaccinate quickly. We need a lot more production capacity than the pharmaceutical companies think it makes sense.

ZEIT ONLINE: Economists rarely suggest such a strong market intervention. And that also applies to companies that we must first be grateful to because they show us a way out of lockdown.

Roth: It's a global pandemic. It is economically necessary to think about how to avert the damage to the economy. But of course you have to pay the manufacturers. Many forget that.

ZEIT ONLINE: How fair the companies think that probably depends on how much you pay them.

Roth: Yes. But the world can afford to pay a lot. Because the world economy is currently largely at a standstill. We have a multi-trillion dollar economy. Paying a billion to save a trillion is good business.

ZEIT ONLINE: Why is that not happening so far?

Roth: The pharmaceutical companies themselves don't think that way at the moment. But we need the vaccine now. And it's very expensive for the world to shut down its economy like that. If you lose a few percentage points of GDP growth in Germany, that's a huge number. And there is almost no amount to pay to license the vaccine that is not worth it.

Anger at vaccine line jumping

 There is some tension between getting populations vaccinated quickly and ensuring that priorities for who gets vaccinated first are carefully followed.  In some places we have seen the costs of adhering too strictly to priorities when enough high priority people are hard to find quickly.  In other places we see the costs of ignoring priorities.

Here's a NY Times story on corruption in South America (followed by a Guardian story about the difficulty of stopping tech-savvy Californians from grabbing appointments meant for underserved minorities):

‘V.I.P. Immunization’ for the Powerful and Their Cronies Rattles South America. A wave of corruption scandals is exposing how the powerful and well-connected in South America jumped the line to get vaccines early. Public dismay is turning into anger.   By Mitra Taj, Anatoly Kurmanaev, Manuela Andreoni and Daniel Politi

"The hope brought by the arrival of the first vaccines in South America is hardening into anger as inoculation campaigns have spiraled into scandal, cronyism and corruption, rocking national governments and sapping trust in the political establishment.

"Four ministers in Peru, Argentina and Ecuador have resigned this month or are being investigated on suspicion of receiving or providing preferential access to scarce coronavirus shots. Prosecutors in those countries, and in Brazil, are examining thousands more accusations of irregularities in inoculation drives, most of them involving local politicians and their families cutting in line.

...

“People find it much more difficult to tolerate corruption when health is at stake,” said Mariel Fornoni, a pollster in Buenos Aires.

The brazen nature of some of the scandals — which mirror similar affairs in Lebanon, Spain and the Philippines — has outraged the region.

...

"Earlier this month, the doctor conducting Peru’s first vaccine trial acknowledged inoculating nearly 250 politicians, notables and their relatives, as well as university administrators, interns and others, with undeclared extra doses. Some had received three doses, according to the trial’s director, Dr. Germán Málaga, in an attempt to maximize their immunity."

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And here's the Guardian, on California:

California vaccine sites see misuse of codes meant to prioritize Black and Latino residents  by Vivian Ho

"Access codes meant to give Californians of color priority access to Covid-19 vaccine slots have been getting passed around among other residents in the state, allowing some to cut the line and get appointments meant for underserved Black and Latino residents.

Misuse of these codes was reported at vaccine sites in Los Angeles and the Bay Area, said Brian Ferguson, spokesperson for the California office of emergency services, to the Guardian.

"The codes were one of the tools devised by California leaders to address inequities in vaccine distribution in the state. They were given out to leaders and non-profits in the Black and Latino communities in LA and the Bay Area to administer to eligible individuals...

"Instead, the codes ended up passed on by text message and email, oftentimes with misinformation. “My daughter says that the Oakland Coliseum needs to fill up appointment slots in the next few days to prevent spoilage of excess vaccines!” read an email that Oakland resident Jhumpa Bhattacharya received from a friend on Monday. “If you are interested in getting a vaccine before this Wednesday, the link and access code are pasted below."

...

"State officials thought that by handing out vaccine access codes through community leaders, they would bridge any cultural or language barriers while also addressing the issue of the digital divide by giving these eligible individuals special access to the website, Ferguson said. “We don’t want people to be able to get appointments based on who has the fastest internet connection,” he said.

"Since learning of the misuse, the state will begin issuing individualized codes rather than group codes next week. In addition to these codes, the state has been setting up mobile vaccination clinics in these specific communities in hopes of reaching these underserved residents."

Electricity supply and electricity politics in Texas--an interview with Peter Cramton

 The veteran market designer Peter Cramton was among the members of the Board of Directors of the Electric Reliability Council of Texas (ERCOT) who live outside of Texas and were asked to resign last week, following the winter storm that left many Texans without power, or with unexpected, very high electricity bills. ERCOT is the independent system operator, charged with running the network minute to minute.  

He's interviewed by Texas Public Radio:

Former ERCOT Board Member Says ‘Toxic Politics’ Spurred Resignations After Texas Grid Failure  Texas Public Radio | By Dominic Anthony Walsh

"Peter Cramton is an economics professor at the University of Cologne and the University of Maryland. He has expertise and experience in complex market designs, including electricity and radio spectrum markets. He served as an “independent director” on the board of the Electric Reliability Council of Texas (ERCOT) from 2015 until last week.

"At his final board meeting, he said, “ERCOT was flying a 747. It had not one, but two engines experience catastrophic failure. (ERCOT) then flew the damaged plane for 103 hours before safely landing in the Hudson. In my mind, the men and women in the ERCOT control room are heroes.”

Here are some bits of the interview:

Dominic Walsh: Could you help me understand your role as an “independent director?” And does it make sense for some of the independent directors to live out of state? There's a lot of controversy around that.

Peter Cramton: What’s unusual is that we have a hybrid board that consists of “affiliated directors” that are affiliated with a particular stakeholder group. There's complete transparency on that, who they're affiliated with. And it is completely balanced. There are four affiliated directors representing the supply side, and there are four affiliated directors representing the demand side. So those are the two sides of almost every market — supply and demand, production and consumption — and there is a perfect balance. Then there's the “independent directors.” There's five independent directors, and the independent directors can have no association with either side of the market. The challenge with independent directors is: It's hard to find people that have the technical expertise, and (are) independent of the market participants. Now, here's the problem: So, one natural thing is you could say, "Well, you know, it's important that the directors live in Texas." Well, then you’d just be imposing another constraint. So, if we say, "OK, now you have to be independent from all market participants. You have to live in Texas. And you have to be an expert in a highly technical industry…" The reality is it's going to be very difficult to find people that fill all of these.

Walsh: So far, you've described a bunch of advocates for various sectors, and a bunch of experts. It sounds slightly more technocratic than democratic. So, where is the accountability to the public — the democratic element of the board?

Cramton: Absolutely. So, it's critically important. And that is the Public Utility Commission of Texas. So, there's a Public Utility Commission that consists of three commissioners, and they provide that oversight. And in fact, that oversight is incredibly important. So, for example, it's the Public Utility Commission that is responsible for the more delicate decisions that are made in the market. And the Public Utility Commission has oversight over all the market rules. What about a renegade Public Utility Commission? You know, who's watching them? Well, who's watching them: that's the legislature and the governor. The commissioners serve largely for the governor and legislature. And if they're doing something that the governor, the legislature does not like, then the governor and legislature can take action to replace the commissioners or whatever other action they want. So that's the continued hierarchy in this governance structure, and that's all within Texas.

Walsh: Why did you resign? It sounds like you're a big fan of ERCOT and their mission. It sounds like you think ERCOT performed well throughout this. Why did you and other members of the board ultimately resign?

Crampton: We resigned, in short, because the politics are toxic right now. The governor and legislature suggested that we resign. And we basically took him up on that. And so that is the reason that we resigned. So, I think the best way to put it is: We were on the boat. And we were — we didn't leave the sinking ship. We were thrown off the boat. But we're all good swimmers, so I'm sure we'll all do just fine. And quite frankly, because of the toxic politics, we're not the ones that are — for me, I'm a professor. I'm an expert in electricity market design. And I'm not an expert in delicate politics.

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Here's a story from the Texas Monthly on the Texas power grid that also discusses some of the political players:

The Texas Blackout Is the Story of a Disaster Foretold.  Those in charge of Texas’s deregulated power sector were warned again and again that the electric grid was vulnerable.  by Jeffrey Ball