At least that's the conclusion of a recent NY Times article, Who’s No. 1?, written before the Thanksgiving weekend games were played. It begins by noting
"This is the 13th year of the Bowl Championship Series, the byzantine and unpopular system that is supposed to guarantee that the college-football season ends with a championship game between the sport’s two best teams. Comparing teams that usually do not play one another — there are 120 major college-football programs, and each one competes in just 12 games each season — was never going to be easy. Like three egg rolls served to a party of four at a Chinese restaurant, the portions never seem to divide up quite as neatly as they should. This year, for instance, four programs — Oregon, Auburn, Boise State and Texas Christian — have spent much of the season in contention for the two positions in the championship."
...
"In addition to the championship game, the B.C.S. involves four beauty-contest games: the Fiesta, Orange, Rose and Sugar bowls. In the last four years, the teams ranked lower than their opponents by the B.C.S. formula have won 12 of the 20 games established by the system. The putative underdog has also won 6 of the last 8 title games: last year’s championship, in which the higher-rated Alabama defeated Texas, was something of a novelty. If the No. 2 team routinely beats the No. 1 team, it’s worth asking whether the B.C.S. rankings are valid.
...
"Without high-quality out-of-conference games, every major conference is in essence an island unto itself. We can identify the best team in the Pac 10, or the best team in the S.E.C. But we don’t have any good way of comparing the Pac 10 against the S.E.C., or against any other conference. It doesn’t matter how smart your computer rankings are, or how wizened the participants in your poll: there simply isn’t enough worthwhile data to work with."
I've written earlier posts about college football bowls, and how the present system arose in part out of an effort to roll back the unraveling of dates at which teams and bowls were matched...
Saturday, December 4, 2010
Friday, December 3, 2010
School choice in NY and Chicago
In NYC, the high school choice process seems to be working smoothly: High School Applications are due back to counselors Friday, December 3, 2010.
In Chicago, priorities at various schools are still being adjusted: Chicago parents scramble with new rules for best schools, Moms and dads schmooze at open houses and pay for expert advice as many applicants go after a few coveted spots
HT: Parag Pathak
In Chicago, priorities at various schools are still being adjusted: Chicago parents scramble with new rules for best schools, Moms and dads schmooze at open houses and pay for expert advice as many applicants go after a few coveted spots
HT: Parag Pathak
Thursday, December 2, 2010
Transplant budget cuts in Arizona
Arizona Cuts Financing for Transplant Patients
"Even physicians with decades of experience telling patients that their lives are nearing an end are having difficulty discussing a potentially fatal condition that has arisen in Arizona: Death by budget cut.
"Effective at the beginning of October, Arizona stopped financing certain transplant operations under the state’s version of Medicaid. Many doctors say the decision amounts to a death sentence for some low-income patients, who have little chance of survival without transplants and lack the hundreds of thousands of dollars needed to pay for them.
“The most difficult discussions are those that involve patients who had been on the donor list for a year or more and now we have to tell them they’re not on the list anymore,” said Dr. Rainer Gruessner, a transplant specialist at the University of Arizona College of Medicine. “The frustration is tremendous. It’s more than frustration.”
"Organ transplants are already the subject of a web of regulations, which do not guarantee that everyone in need of a life-saving organ will receive one. But Arizona’s transplant specialists are alarmed that patients who were in line to receive transplants one day were, after the state’s budget cuts to its Medicaid program, ruled ineligible the next — unless they raised the money themselves.
"Francisco Felix, 32, a father of four who has hepatitis C and is in need of a liver, received news a few weeks ago that a family friend was dying and wanted to donate her liver to him. But the budget cuts meant he no longer qualified for a state-financed transplant.
"He was prepared anyway at Banner Good Samaritan Medical Center as his relatives scrambled to raise the needed $200,000. When the money did not come through, the liver went to someone else on the transplant list."
Update: here's an article in Slate by Sally Satel: Cutting Human Lives: What should we make of Arizona's new law for rationing organ transplants?
"Even physicians with decades of experience telling patients that their lives are nearing an end are having difficulty discussing a potentially fatal condition that has arisen in Arizona: Death by budget cut.
"Effective at the beginning of October, Arizona stopped financing certain transplant operations under the state’s version of Medicaid. Many doctors say the decision amounts to a death sentence for some low-income patients, who have little chance of survival without transplants and lack the hundreds of thousands of dollars needed to pay for them.
“The most difficult discussions are those that involve patients who had been on the donor list for a year or more and now we have to tell them they’re not on the list anymore,” said Dr. Rainer Gruessner, a transplant specialist at the University of Arizona College of Medicine. “The frustration is tremendous. It’s more than frustration.”
"Organ transplants are already the subject of a web of regulations, which do not guarantee that everyone in need of a life-saving organ will receive one. But Arizona’s transplant specialists are alarmed that patients who were in line to receive transplants one day were, after the state’s budget cuts to its Medicaid program, ruled ineligible the next — unless they raised the money themselves.
"Francisco Felix, 32, a father of four who has hepatitis C and is in need of a liver, received news a few weeks ago that a family friend was dying and wanted to donate her liver to him. But the budget cuts meant he no longer qualified for a state-financed transplant.
"He was prepared anyway at Banner Good Samaritan Medical Center as his relatives scrambled to raise the needed $200,000. When the money did not come through, the liver went to someone else on the transplant list."
Update: here's an article in Slate by Sally Satel: Cutting Human Lives: What should we make of Arizona's new law for rationing organ transplants?
Pentagon report calls for repeal of "don't ask, don't tell"
Pentagon calls for repeal of ‘don’t ask’
"Ending a ban on gays serving openly in the armed services would not harm long-term military effectiveness, the Pentagon said yesterday in a long-awaited report that is expected to speed a vote on the repeal of the “don’t ask, don’t tell’’ policy."
...
"That call shifted the focus to moderate members of the Senate, including Scott Brown of Massachusetts, who had said they wanted to read the report before voting on whether to end the policy. The House has passed a bill overturning the policy, but a Republican-led threat of a filibuster halted a similar effort in the Senate in the fall.
...
"There were few clues yesterday about whether Republicans would embrace the findings of the report. “I haven’t looked at it,’’ Brown said. “As soon as I get back to the office and get a free minute, I’ll start digesting it.’’
...
"The study, conducted over nine months, found that 70 percent of troops surveyed believed that allowing gays and lesbians to serve openly in the military would have mixed, positive, or no impact. The other 30 percent thought there would be negative consequences, with opposition strongest among combat troops.
"The survey was based on responses from about 115,000 troops and 44,300 military spouses.
“We are both convinced that our military can do this, even during this time of war,’’ concluded the cochairs of the report, Pentagon general counsel Jeh Johnson and Army General Carter Ham.
"Overall, nearly seven out of 10 respondents in the Pentagon’s survey said they believe that they have already served with someone who is gay. Of those, only 8 percent cited a negative impact on their unit.
“We have a gay guy. He’s big, he’s mean, and he kills lots of bad guys,’’ one member of the special operations force is quoted as saying. “No one cared that he was gay.’’
Update: Dec 9, Senate Stalls Bill to Repeal Gay Policy in Military
"Ending a ban on gays serving openly in the armed services would not harm long-term military effectiveness, the Pentagon said yesterday in a long-awaited report that is expected to speed a vote on the repeal of the “don’t ask, don’t tell’’ policy."
...
"That call shifted the focus to moderate members of the Senate, including Scott Brown of Massachusetts, who had said they wanted to read the report before voting on whether to end the policy. The House has passed a bill overturning the policy, but a Republican-led threat of a filibuster halted a similar effort in the Senate in the fall.
...
"There were few clues yesterday about whether Republicans would embrace the findings of the report. “I haven’t looked at it,’’ Brown said. “As soon as I get back to the office and get a free minute, I’ll start digesting it.’’
...
"The study, conducted over nine months, found that 70 percent of troops surveyed believed that allowing gays and lesbians to serve openly in the military would have mixed, positive, or no impact. The other 30 percent thought there would be negative consequences, with opposition strongest among combat troops.
"The survey was based on responses from about 115,000 troops and 44,300 military spouses.
“We are both convinced that our military can do this, even during this time of war,’’ concluded the cochairs of the report, Pentagon general counsel Jeh Johnson and Army General Carter Ham.
"Overall, nearly seven out of 10 respondents in the Pentagon’s survey said they believe that they have already served with someone who is gay. Of those, only 8 percent cited a negative impact on their unit.
“We have a gay guy. He’s big, he’s mean, and he kills lots of bad guys,’’ one member of the special operations force is quoted as saying. “No one cared that he was gay.’’
Update: Dec 9, Senate Stalls Bill to Repeal Gay Policy in Military
Wednesday, December 1, 2010
Harvard reviewing its decision to abolish early admissions
The Crimson reports: Harvard Examining Early Admissions--College reviews decision to eliminate early admissions
"The College is reevaluating its three-year-old decision to eliminate early admissions, Harvard’s top admissions official acknowledged yesterday.
...
"Fitzsimmons’ comments came in response to an announcement by the University of Virginia that it plans to offer a new Early Action option to students applying next year.
"In Sept. 2006, Harvard announced that it would no longer offer its Early Action program, which allowed high-school seniors to receive an admissions decision in December but did not mandate that they attend if accepted. Within the month, Princeton and Virginia followed suit, cancelling their Early Decision programs, which had similar timing but bound accepted students to attend, in favor of a single admissions notification date.
"The three schools have jointly conducted 18-city recruiting tours since the announcement of the decision, and some officials acknowledged at the time that they hoped other top universities would follow suit in eliminating early admissions programs.
"All three schools said at the time that early admissions programs were unfavorable to less affluent students, who sometimes forgo the programs in order to apply to many universities during the regular decision cycle and compare financial aid offers from different schools.
"Virginia Dean of Admission Gregory W. Roberts said yesterday that the elimination of Early Decision has indeed increased diversity at his university.
“Socioeconomically and racially, the enrolling classes for the past three years have been significantly more diverse,” Roberts said. But he added that the school’s new Early Action program—which allows applicants to apply to other schools’ early admissions programs concurrently and does not compel them to attend Virginia if admitted—will not discourage underprivileged students from applying.
“From a university institutional self-interest perspective, we felt like there were students we were missing who were interested in applying and receiving early notification,” Roberts said. “We felt like we will be able to enroll the same type of class...and also respond to student interest.”
A subsequent Crimson editorial supports early action if it promotes diversity, and seems a bit obtuse about the relationship between Harvard's admissions policies and those of other schools:
HT: Rezwan Haque
update: a Feb 10, 2011 Crimson article updates the story (no decision has been reached yet) and focuses on the signaling aspect of early decision:
"Amy Sack, president of college counseling firm Admissions Accomplished, said that Harvard’s lack of an early admissions program has not discouraged her students from applying to the College. According to Sack, students who want to attend Harvard usually apply early to comparable schools such as Stanford University or Yale University, both of which offer non-binding early action admissions programs.
"The College is reevaluating its three-year-old decision to eliminate early admissions, Harvard’s top admissions official acknowledged yesterday.
...
"Fitzsimmons’ comments came in response to an announcement by the University of Virginia that it plans to offer a new Early Action option to students applying next year.
"In Sept. 2006, Harvard announced that it would no longer offer its Early Action program, which allowed high-school seniors to receive an admissions decision in December but did not mandate that they attend if accepted. Within the month, Princeton and Virginia followed suit, cancelling their Early Decision programs, which had similar timing but bound accepted students to attend, in favor of a single admissions notification date.
"The three schools have jointly conducted 18-city recruiting tours since the announcement of the decision, and some officials acknowledged at the time that they hoped other top universities would follow suit in eliminating early admissions programs.
"All three schools said at the time that early admissions programs were unfavorable to less affluent students, who sometimes forgo the programs in order to apply to many universities during the regular decision cycle and compare financial aid offers from different schools.
"Virginia Dean of Admission Gregory W. Roberts said yesterday that the elimination of Early Decision has indeed increased diversity at his university.
“Socioeconomically and racially, the enrolling classes for the past three years have been significantly more diverse,” Roberts said. But he added that the school’s new Early Action program—which allows applicants to apply to other schools’ early admissions programs concurrently and does not compel them to attend Virginia if admitted—will not discourage underprivileged students from applying.
“From a university institutional self-interest perspective, we felt like there were students we were missing who were interested in applying and receiving early notification,” Roberts said. “We felt like we will be able to enroll the same type of class...and also respond to student interest.”
A subsequent Crimson editorial supports early action if it promotes diversity, and seems a bit obtuse about the relationship between Harvard's admissions policies and those of other schools:
Prioritize Socioeconomic Diversity
If Early Action negatively impacts the applicant pool, it should not return
"Harvard Dean of Admissions and Financial Aid William R. Fitzsimmons ’67 announced last week that the College is in the process of re-evaluating its decision to eliminate early admissions. The program, known as Early Action, allowed applicants to receive a non-binding admissions notification in the winter. The college removed this option four years ago because top officials felt it gave an unfair edge to candidates from more affluent backgrounds. Such a groundbreaking decision deserves the critical reconsideration Harvard is currently undergoing, but administrators must stay true to their commitment to socioeconomic diversity. If such an evaluation reveals that a return to Early Action would compromise this priority, the program must not be reinstated.This news comes on the heels of the University of Virginia’s announcement that it will reinstate early admissions; UVA had followed Harvard’s lead in eliminating its Early Decision option in 2006 and now exemplifies a growing trend of restoring related programs in competitive universities across the country. Whatever Harvard decides to do at the end of its evaluation, such actions should not be influenced by other schools’ choices. We hope that the admissions office acts solely according to what best serves Harvard and its goals."
HT: Rezwan Haque
update: a Feb 10, 2011 Crimson article updates the story (no decision has been reached yet) and focuses on the signaling aspect of early decision:
"Amy Sack, president of college counseling firm Admissions Accomplished, said that Harvard’s lack of an early admissions program has not discouraged her students from applying to the College. According to Sack, students who want to attend Harvard usually apply early to comparable schools such as Stanford University or Yale University, both of which offer non-binding early action admissions programs.
“I think it would be nice for them to be able to indicate that Harvard is their first choice. It would let them not have to play the game as much,” she said. “I think my students would be happy if Harvard brings it back.”
"In 2006, the last year early admission was offered, Harvard received 4,008 early action applications.
"The early acceptance rate was 21.5 percent compared to below nine percent overall."
Tuesday, November 30, 2010
More on economists at hi tech firms
John Horton (who is interested in online labor markets) writes in response to my post about economists at Amazon to let me know about this recent story in the San Jose Mercury News:
Google, Yahoo, other Silicon Valley tech giants add economists to arsenal
"In the wake of the example of UC Berkeley economist Hal Varian, who helped Google perfect the auction process behind its multibillion-dollar search advertising revenue stream, big Internet companies are competing to woo economists away from universities or work with them on specific projects. Yahoo has been among the most aggressive, but eBay, Amazon.com, Facebook and other companies also are recruiting practitioners of what used to be called "the dismal science." Illustrating how crucial companies think those skills are, Microsoft CEO Steve Ballmer personally recruited economist Susan Athey from Harvard.
"Other companies have recognized that economists really have a lot to contribute," said Varian, who joined Mountain View-based Google full time in 2007 after having worked as a consultant for the search giant since 2002. Google has 10 economists, statisticians and other quantitative analysts on Varian's staff, and is looking to hire more.
"Internet companies see the economists as critical in their efforts to fine-tune advertising networks that serve millions of online ad impressions a day, and to better understand e-commerce platforms with tens of millions of buyers and sellers. Economists can also help determine whether new businesses or approaches will be effective."
...
"Yahoo chief economist Preston McAfee, who joined the Sunnyvale company from the California Institute of Technology in 2007, has long believed that economics could be a practical discipline, like engineering. McAfee now heads a team of seven Ph.D. economists and five game-theory/algorithmic scientists who work with software engineers to create products that aren't just smart but are also savvy.
"Engineers are pretty nice people, and they assume the rest of the world is pretty nice like them," said McAfee. "But that's not the way most people are. And if you build (software) assuming that's the way people are, it will get heavily spammed. So one of the roles that economics plays at Yahoo and other tech companies is to be just a little more suspicious about human nature."
...
"One of Varian's first jobs was to polish Google's nascent search advertising, in which advertisers bid for keywords that bring up their text ad when someone Googles that term. Search advertising has since transformed Google into a corporate colossus.
"Eric Schmidt said, 'Take a look at this ad auction,' " said Varian, "and I sat down to try to model the behavior of that auction, and wrote the first model ever of what I call a position auction.
"At that time, I talked to my fellow economists and said, 'You know, there really are some interesting things going on here,' and they would say, 'Is that economics?' And now, of course, years later, people say, 'Wow, how did you know that was going to be so big?' And the answer is, I didn't. I just thought it was really interesting and it turned out to be big."
Google, Yahoo, other Silicon Valley tech giants add economists to arsenal
"In the wake of the example of UC Berkeley economist Hal Varian, who helped Google perfect the auction process behind its multibillion-dollar search advertising revenue stream, big Internet companies are competing to woo economists away from universities or work with them on specific projects. Yahoo has been among the most aggressive, but eBay, Amazon.com, Facebook and other companies also are recruiting practitioners of what used to be called "the dismal science." Illustrating how crucial companies think those skills are, Microsoft CEO Steve Ballmer personally recruited economist Susan Athey from Harvard.
"Other companies have recognized that economists really have a lot to contribute," said Varian, who joined Mountain View-based Google full time in 2007 after having worked as a consultant for the search giant since 2002. Google has 10 economists, statisticians and other quantitative analysts on Varian's staff, and is looking to hire more.
"Internet companies see the economists as critical in their efforts to fine-tune advertising networks that serve millions of online ad impressions a day, and to better understand e-commerce platforms with tens of millions of buyers and sellers. Economists can also help determine whether new businesses or approaches will be effective."
...
"Yahoo chief economist Preston McAfee, who joined the Sunnyvale company from the California Institute of Technology in 2007, has long believed that economics could be a practical discipline, like engineering. McAfee now heads a team of seven Ph.D. economists and five game-theory/algorithmic scientists who work with software engineers to create products that aren't just smart but are also savvy.
"Engineers are pretty nice people, and they assume the rest of the world is pretty nice like them," said McAfee. "But that's not the way most people are. And if you build (software) assuming that's the way people are, it will get heavily spammed. So one of the roles that economics plays at Yahoo and other tech companies is to be just a little more suspicious about human nature."
...
"One of Varian's first jobs was to polish Google's nascent search advertising, in which advertisers bid for keywords that bring up their text ad when someone Googles that term. Search advertising has since transformed Google into a corporate colossus.
"Eric Schmidt said, 'Take a look at this ad auction,' " said Varian, "and I sat down to try to model the behavior of that auction, and wrote the first model ever of what I call a position auction.
"At that time, I talked to my fellow economists and said, 'You know, there really are some interesting things going on here,' and they would say, 'Is that economics?' And now, of course, years later, people say, 'Wow, how did you know that was going to be so big?' And the answer is, I didn't. I just thought it was really interesting and it turned out to be big."
Monday, November 29, 2010
Wolverines beat Buckeyes in organ donation this year
For you Michigan fans who were disappointed this weekend on the football field, here's some heartening news:U-M beats Ohio State in annual organ donation challenge
"Ann Arbor, Mich. - U-M racked up a victory over Ohio State this week, signing up more people to the state’s organ donor list and winning the annual Wolverine-Buckeye challenge.
"U-M signed up 79,958 donors to Ohio State’s 57,083 in the challenge that ended at midnight on Thanksgiving.
"We all enjoy winning a victory against our rival from Ohio," says Tony Denton, Executive Director of University Hospitals and Chief Operating Officer, U-M Hospitals and Health Centers.
"But the real winners will be the people who rely on these life-saving gifts, organs and tissues that will give thousands of people a second chance at life," Denton says.
"Every day, 19 people die while waiting for an organ transplant and another 138 people are added to the national waiting list. The University of Michigan Health System began a new effort this year, dubbed Wolverines For Life, to encourage organ, tissue, eye, blood, and bone marrow donation by U-M employees, patients, students, alumni, fans and everyone in the state of Michigan.
"To kick off this effort, U-M Football Coach Rich Rodriguez, along with Health System leaders, encouraged people to join in the annual Wolverine-Buckeye challenge. The challenge allowed people to sign up as organ donors upon their death and have their pledge tallied for their favorite school.
HT: Steve Leider
"Ann Arbor, Mich. - U-M racked up a victory over Ohio State this week, signing up more people to the state’s organ donor list and winning the annual Wolverine-Buckeye challenge.
"U-M signed up 79,958 donors to Ohio State’s 57,083 in the challenge that ended at midnight on Thanksgiving.
"We all enjoy winning a victory against our rival from Ohio," says Tony Denton, Executive Director of University Hospitals and Chief Operating Officer, U-M Hospitals and Health Centers.
"But the real winners will be the people who rely on these life-saving gifts, organs and tissues that will give thousands of people a second chance at life," Denton says.
"Every day, 19 people die while waiting for an organ transplant and another 138 people are added to the national waiting list. The University of Michigan Health System began a new effort this year, dubbed Wolverines For Life, to encourage organ, tissue, eye, blood, and bone marrow donation by U-M employees, patients, students, alumni, fans and everyone in the state of Michigan.
"To kick off this effort, U-M Football Coach Rich Rodriguez, along with Health System leaders, encouraged people to join in the annual Wolverine-Buckeye challenge. The challenge allowed people to sign up as organ donors upon their death and have their pledge tallied for their favorite school.
HT: Steve Leider
Market design at Amazon
The following job market ad at Econ-jobs.com for a new economist at Amazon caught my eye, both for what it suggests about the kind of internal research Amazon hopes to do, and about what kind of economists they hope to hire:
"Economists at Amazon will be expected to work directly with chief economist Patrick Bajari and senior management on key business problems faced in retail, international retail, cloud computing, third party merchants, search, Kindle and operations. Amazon economists will apply the frontier of economic thinking to market design, pricing, forecasting, online advertising and other areas. You apply econometric modeling, working with our world class data systems, and economic theory to business problems. In addition, economists at Amazon will be expected to maintain an independent and active research agenda, publishing in leading academic journals."
"Basic Qualifications: PhD in Economics or anticipating completion of a PhD in Economics by Aug 2011
"Preferred Qualifications:
Strong background in econometrics, industrial organization, economic theory and quantitative methods
Ability to work in a fast paced business environment
Strong research track record
Effective verbal and written communication skills
Most companies don't hire researchers who publish. Companies that do often are aiming at people who already have academic jobs, and want to keep the possibility open of returning to academia, and in that case the ability to publish (permission to use company data plus time to write papers) is a perk aimed at attracting the right kind of people.
I don't know how much success Amazon has had in the past at hiring economists with active research agendas, but now that they've hired Bajari they clearly have some prospects, particularly if they will be open to having their economists publish about some of the very interesting design problems that Amazon faces, as a marketplace for goods, for merchants, and for computing services.
Amazon likely has particularly good data--they seem to be able to keep track of the same commodity sold by their various different vendors. And each of their three big marketplaces offers the possibility for conducting very interesting experiments.
So...maybe Amazon will start being a source of new research in market design. We'll have to wait and see.
And incidentally, does anyone remember when only banks had a post called Chief Economist? That title is now a tech title too (e.g. Hal Varian at Google and Susan Athey at Microsoft.) Together with the employment of microeconomists under other job titles (e.g. Preston McAfee, David Reiley and Michael Schwarz at Yahoo!, and Paul Milgrom in various entrepreneurial ventures over the years), it's a sign that market design and experiments and related ideas are coming of age.
"Economists at Amazon will be expected to work directly with chief economist Patrick Bajari and senior management on key business problems faced in retail, international retail, cloud computing, third party merchants, search, Kindle and operations. Amazon economists will apply the frontier of economic thinking to market design, pricing, forecasting, online advertising and other areas. You apply econometric modeling, working with our world class data systems, and economic theory to business problems. In addition, economists at Amazon will be expected to maintain an independent and active research agenda, publishing in leading academic journals."
"Basic Qualifications: PhD in Economics or anticipating completion of a PhD in Economics by Aug 2011
"Preferred Qualifications:
Strong background in econometrics, industrial organization, economic theory and quantitative methods
Ability to work in a fast paced business environment
Strong research track record
Effective verbal and written communication skills
Most companies don't hire researchers who publish. Companies that do often are aiming at people who already have academic jobs, and want to keep the possibility open of returning to academia, and in that case the ability to publish (permission to use company data plus time to write papers) is a perk aimed at attracting the right kind of people.
I don't know how much success Amazon has had in the past at hiring economists with active research agendas, but now that they've hired Bajari they clearly have some prospects, particularly if they will be open to having their economists publish about some of the very interesting design problems that Amazon faces, as a marketplace for goods, for merchants, and for computing services.
Amazon likely has particularly good data--they seem to be able to keep track of the same commodity sold by their various different vendors. And each of their three big marketplaces offers the possibility for conducting very interesting experiments.
So...maybe Amazon will start being a source of new research in market design. We'll have to wait and see.
And incidentally, does anyone remember when only banks had a post called Chief Economist? That title is now a tech title too (e.g. Hal Varian at Google and Susan Athey at Microsoft.) Together with the employment of microeconomists under other job titles (e.g. Preston McAfee, David Reiley and Michael Schwarz at Yahoo!, and Paul Milgrom in various entrepreneurial ventures over the years), it's a sign that market design and experiments and related ideas are coming of age.
Sunday, November 28, 2010
Microfinancial crisis
The NY Times reports India Microcredit Faces Collapse From Defaults
"India’s rapidly growing private microcredit industry faces imminent collapse as almost all borrowers in one of India’s largest states have stopped repaying their loans, egged on by politicians who accuse the industry of earning outsize profits on the backs of the poor.
...
"Initially the work of nonprofit groups, the tiny loans to the poor known as microcredit once seemed a promising path out of poverty for millions. In recent years, foundations, venture capitalists and the World Bank have used India as a petri dish for similar for-profit “social enterprises” that seek to make money while filling a social need. Like-minded industries have sprung up in Africa, Latin America and other parts of Asia.
"But microfinance in pursuit of profits has led some microcredit companies around the world to extend loans to poor villagers at exorbitant interest rates and without enough regard for their ability to repay. Some companies have more than doubled their revenues annually.
"Now some Indian officials fear that microfinance could become India’s version of the United States’ subprime mortgage debacle, in which the seemingly noble idea of extending home ownership to low-income households threatened to collapse the global banking system because of a reckless, grow-at-any-cost strategy. "
"India’s rapidly growing private microcredit industry faces imminent collapse as almost all borrowers in one of India’s largest states have stopped repaying their loans, egged on by politicians who accuse the industry of earning outsize profits on the backs of the poor.
...
"Initially the work of nonprofit groups, the tiny loans to the poor known as microcredit once seemed a promising path out of poverty for millions. In recent years, foundations, venture capitalists and the World Bank have used India as a petri dish for similar for-profit “social enterprises” that seek to make money while filling a social need. Like-minded industries have sprung up in Africa, Latin America and other parts of Asia.
"But microfinance in pursuit of profits has led some microcredit companies around the world to extend loans to poor villagers at exorbitant interest rates and without enough regard for their ability to repay. Some companies have more than doubled their revenues annually.
"Now some Indian officials fear that microfinance could become India’s version of the United States’ subprime mortgage debacle, in which the seemingly noble idea of extending home ownership to low-income households threatened to collapse the global banking system because of a reckless, grow-at-any-cost strategy. "
Saturday, November 27, 2010
The market for guns in the U.S.
That's the subject of this Treasury Dept. report, published in 2000: Commerce in Firearms in the United States
"Each year, about 4-1/2 million new firearms, including approximately 2 million handguns, are sold in the United States. An estimated 2 million secondhand firearms are sold each year as well. A critical part of the mission of the Bureau of Alcohol, Tobacco and Firearms (ATF) is to prevent diversion of these firearms from the legal to the illegal market, and to keep them out of the hands of criminals, unauthorized juveniles and other prohibited persons under the Gun Control Act (GCA). This report presents data on the firearms market and describes ATF’s regulatory enforcement programs to prevent firearms trafficking. Criminal investigation, which is also central to ATF’s anti-trafficking work, is discussed in separate reports."
More on the site Mayors Against Illegal Guns and their 2008 report The Movement of Illegal Guns in America, which uses "trace data" on guns used in crimes to track where they were purchased.
"Each year, about 4-1/2 million new firearms, including approximately 2 million handguns, are sold in the United States. An estimated 2 million secondhand firearms are sold each year as well. A critical part of the mission of the Bureau of Alcohol, Tobacco and Firearms (ATF) is to prevent diversion of these firearms from the legal to the illegal market, and to keep them out of the hands of criminals, unauthorized juveniles and other prohibited persons under the Gun Control Act (GCA). This report presents data on the firearms market and describes ATF’s regulatory enforcement programs to prevent firearms trafficking. Criminal investigation, which is also central to ATF’s anti-trafficking work, is discussed in separate reports."
More on the site Mayors Against Illegal Guns and their 2008 report The Movement of Illegal Guns in America, which uses "trace data" on guns used in crimes to track where they were purchased.
Friday, November 26, 2010
Irish horses going the way of Celtic tigers
Facing Starvation: The Sad Plight of Ireland's Abandoned Horses
"During Ireland's boom years, thousands of people bought horses as a status symbol. But with the economy in crisis, many owners can't afford to keep them. Some 20,000 abandoned horses are roaming Ireland and could face starvation this winter.
...
"A horse slaughterhouse in Kilkenny processed more than 3,000 horses last year, five times more than in 2005. Most of the horse steaks are exported to France.
"But only well-nourished horses whose health has been comprehensively logged are allowed to be slaughtered. One wrong drug and the meat is labelled as unsellable. Contrary to EU rules, most Irish horses don't carry implanted microchips containing their most important data. So their remains can't even be processed into dog food. The absence of microchips also makes it impossible to track where an abandoned horse came from. That makes it tempting for troubled owners just to dump their horses by the roadside because it would cost €300 to have the animal put down and disposed of by a vet."
For some related previous posts, see
Why can't you eat horse meat in the U.S.? and Abandoned horses not headed for foreign tables
"During Ireland's boom years, thousands of people bought horses as a status symbol. But with the economy in crisis, many owners can't afford to keep them. Some 20,000 abandoned horses are roaming Ireland and could face starvation this winter.
...
"A horse slaughterhouse in Kilkenny processed more than 3,000 horses last year, five times more than in 2005. Most of the horse steaks are exported to France.
"But only well-nourished horses whose health has been comprehensively logged are allowed to be slaughtered. One wrong drug and the meat is labelled as unsellable. Contrary to EU rules, most Irish horses don't carry implanted microchips containing their most important data. So their remains can't even be processed into dog food. The absence of microchips also makes it impossible to track where an abandoned horse came from. That makes it tempting for troubled owners just to dump their horses by the roadside because it would cost €300 to have the animal put down and disposed of by a vet."
For some related previous posts, see
Why can't you eat horse meat in the U.S.? and Abandoned horses not headed for foreign tables
Thursday, November 25, 2010
Misc. kidney chains and exchanges
The UNOS National Kidney Paired Donation Pilot System is cautiously expanding its scope to include non-directed donor chains
"St. Louis: The OPTN/UNOS Board of Directors, meeting Nov. 8-9, approved a proposal to broaden potential participation in the recently established national pilot program for kidney paired donation (KPD) transplantation.
"The pilot program was initially approved for operation to match only two to three pairs of transplant candidates and their intended donors. All of these intended donors had meant to donate to a specific recipient before they were found to be medically incompatible with that person. (For additional resource information about the paired donation process, visit the OPTN website: http://optn.transplant.hrsa.gov/resources/KPDPP.asp.
"Once the newly approved protocol is implemented, pairs can be matched with a "non-directed donor" - a person who chooses to be a living donor but does not come forward to help a specific patient. By including one non-directed donor and a series of other donor/candidate pairs, a chain of transplants can be performed that ends with the transplantation of a candidate who had been awaiting a deceased donor transplant. This is known as "donor chain."
"The pilot program is intended to determine whether having a national base for paired donation can result in more transplants," said OPTN/UNOS President Charles Alexander, RN, M.S.N., M.B.A. The transplant community asked us to take some extra time to study whether and how to add non-directed donors and chains; A number of transplant centers and paired donation organizations have been performing chains for years with good results, and the consensus is that this option should be part of the national pilot."
Here's the Washington Post story about the UNOS pilot: Pilot transplant project aims to spur kidney swaps
In the meantime, kidney exchange is also spreading regionally, as the following stories indicate.
Here's a video about a recent, large non-simultaneous chain at Georgetown, which accomplished 16 transplants.
Transplant exchanges allow more to benefit from donations : Oct 29, 2010: Sanford Health transplant leader once personally touched by donation when daughter received new liver
"Sanford Transplant Services, part of Sanford Health of Fargo, N.D., has been in place since 1989 and has completed more than 580 transplants. Dr. Bhargav Mistry has been an instrumental leader in the program and has completed more than 400 of those transplants. Hospital leaders and others say Mistry's commitment to the excellence and genuine care for his patients has built the program into what it is today - a nationally recognized transplant program offering the latest in surgery and technology.
"An example of that innovation occurred in July 2010, when an anonymous kidney donor set off a sequence of 10 surgeries involving 10 patients and resulting in five people receiving kidney transplants.
"The rare chain of surgeries - the first of its kind in North Dakota - was made possible using a unique paired exchange program involving multiple transplant centers based in Minneapolis. Under a transplant chain, or exchange, a potential recipient and her willing, but incompatible, donor family member, friend or other donor are listed in a waiting "pool," along with other mismatched pairs.
"Then, when any potential donor on the list is determined to be compatible for any potential recipient also on the list, the donor gives their organ anonymously if a donation match will also be made for his partner.
...
"In this case, a Minneapolis non-directed donor, or an anonymous donor who meets strict criteria to donate a kidney, was a match for a potential recipient in Fargo in the paired exchange pool.
"Therefore, the donor's kidney was recovered and flown to Fargo. Two surgeries later, a kidney from Fargo was driven to Minneapolis, extending the chain with four more transplants at Abbott Northwestern Hospital and University of Minnesota Medical Center, Fairview. In total, 10 people produced five successful kidney transplants.
...
"Mistry seems incredibly compassionate about his chosen career; in fact, he has been personally affected by the need for donation. His daughter, Karishma Mistry, was born without a gall bladder, and doctors told the Mistrys years ago that she would eventually need a new liver.
"I decided to go into transplantation a few months before she was born," Mistry said. "I didn't know we would be in this kind of situation. I think it was just fate."
"In October of 2005, Karishma was added to the transplant list, when complications with her condition arose. In May 2006, the Mistrys received a call that a donor had been found. Today, the teenage girl is doing well and lives a full life. "
(See also Transplant surgeon's daughter gets liver transplant after long wait )
Large non-simultaneous chain in San Antonio at Methodist Specialty and Transplant Hospital, includes 16 transplants: here's a video report from CNN.
And here's a paper on the virtual matching process...
Virtual Crossmatch Approach to Maximize Matching in Paired Kidney Donation.
Am J Transplant. 2010 Nov 10;
Authors: Ferrari P, Fidler S, Wright J, Woodroffe C, Slater P, Van Althuis-Jones A, Holdsworth R, Christiansen FT
Abstract: "We developed and tested a new computer program to match maximal sets of incompatible live donor/recipient pairs from a national paired kidney donation (PKD) registry. Data of 32 incompatible pairs included ABO and 4 digit-high-resolution donor and recipient HLA antigens and recipient’s HLA antibodies. Three test runs were compared, in which donors were excluded from matching to recipients with either donor-specific antibodies (DSA) >8000MFI (mean fluorescent intensity) at low-resolution (Run 1) or >8000MFI at high-resolution (Run 2) or >2000MFI and high-resolution (Run 3). Run 1 identified 22 703 possible combinations, with 20 pairs in the top ranked, Run 2 identified 24 113 combinations, with 19 pairs in the top ranked and Run 3 identified 8843 combinations, with 17 pairs in the top ranked. Review of DSA in Run 1 revealed that six recipients had DSA 2000-8000MFI causing a possible positive crossmatch resulting in breakdown of two 3-way and three 2-way chains. In Run 2, four recipients had DSA 2000-8000MFI, also potentially causing breakdown of three 2-way chains. The more prudent approach of excluding from matching recipients with DSA with >2000MFI reduces the probability of matched pairs having a positive crossmatch without significantly decreasing the number of possible transplants."
"St. Louis: The OPTN/UNOS Board of Directors, meeting Nov. 8-9, approved a proposal to broaden potential participation in the recently established national pilot program for kidney paired donation (KPD) transplantation.
"The pilot program was initially approved for operation to match only two to three pairs of transplant candidates and their intended donors. All of these intended donors had meant to donate to a specific recipient before they were found to be medically incompatible with that person. (For additional resource information about the paired donation process, visit the OPTN website: http://optn.transplant.hrsa.gov/resources/KPDPP.asp.
"Once the newly approved protocol is implemented, pairs can be matched with a "non-directed donor" - a person who chooses to be a living donor but does not come forward to help a specific patient. By including one non-directed donor and a series of other donor/candidate pairs, a chain of transplants can be performed that ends with the transplantation of a candidate who had been awaiting a deceased donor transplant. This is known as "donor chain."
"The pilot program is intended to determine whether having a national base for paired donation can result in more transplants," said OPTN/UNOS President Charles Alexander, RN, M.S.N., M.B.A. The transplant community asked us to take some extra time to study whether and how to add non-directed donors and chains; A number of transplant centers and paired donation organizations have been performing chains for years with good results, and the consensus is that this option should be part of the national pilot."
Here's the Washington Post story about the UNOS pilot: Pilot transplant project aims to spur kidney swaps
Here's a press release from Carnegie Mellon University highlighting the role of software in that effort: Organ Network Uses Carnegie Mellon Algorithm To Match Live Kidney Donors With Recipients, National Pilot Program Facilitates Kidney Paired-Donation Transplants (no chains were allowed in this initial pilot...)
In the meantime, kidney exchange is also spreading regionally, as the following stories indicate.
Here's a video about a recent, large non-simultaneous chain at Georgetown, which accomplished 16 transplants.
Transplant exchanges allow more to benefit from donations : Oct 29, 2010: Sanford Health transplant leader once personally touched by donation when daughter received new liver
"Sanford Transplant Services, part of Sanford Health of Fargo, N.D., has been in place since 1989 and has completed more than 580 transplants. Dr. Bhargav Mistry has been an instrumental leader in the program and has completed more than 400 of those transplants. Hospital leaders and others say Mistry's commitment to the excellence and genuine care for his patients has built the program into what it is today - a nationally recognized transplant program offering the latest in surgery and technology.
"An example of that innovation occurred in July 2010, when an anonymous kidney donor set off a sequence of 10 surgeries involving 10 patients and resulting in five people receiving kidney transplants.
"The rare chain of surgeries - the first of its kind in North Dakota - was made possible using a unique paired exchange program involving multiple transplant centers based in Minneapolis. Under a transplant chain, or exchange, a potential recipient and her willing, but incompatible, donor family member, friend or other donor are listed in a waiting "pool," along with other mismatched pairs.
"Then, when any potential donor on the list is determined to be compatible for any potential recipient also on the list, the donor gives their organ anonymously if a donation match will also be made for his partner.
...
"In this case, a Minneapolis non-directed donor, or an anonymous donor who meets strict criteria to donate a kidney, was a match for a potential recipient in Fargo in the paired exchange pool.
"Therefore, the donor's kidney was recovered and flown to Fargo. Two surgeries later, a kidney from Fargo was driven to Minneapolis, extending the chain with four more transplants at Abbott Northwestern Hospital and University of Minnesota Medical Center, Fairview. In total, 10 people produced five successful kidney transplants.
...
"Mistry seems incredibly compassionate about his chosen career; in fact, he has been personally affected by the need for donation. His daughter, Karishma Mistry, was born without a gall bladder, and doctors told the Mistrys years ago that she would eventually need a new liver.
"I decided to go into transplantation a few months before she was born," Mistry said. "I didn't know we would be in this kind of situation. I think it was just fate."
"In October of 2005, Karishma was added to the transplant list, when complications with her condition arose. In May 2006, the Mistrys received a call that a donor had been found. Today, the teenage girl is doing well and lives a full life. "
(See also Transplant surgeon's daughter gets liver transplant after long wait )
Large non-simultaneous chain in San Antonio at Methodist Specialty and Transplant Hospital, includes 16 transplants: here's a video report from CNN.
And here's a paper on the virtual matching process...
Virtual Crossmatch Approach to Maximize Matching in Paired Kidney Donation.
Am J Transplant. 2010 Nov 10;
Authors: Ferrari P, Fidler S, Wright J, Woodroffe C, Slater P, Van Althuis-Jones A, Holdsworth R, Christiansen FT
Abstract: "We developed and tested a new computer program to match maximal sets of incompatible live donor/recipient pairs from a national paired kidney donation (PKD) registry. Data of 32 incompatible pairs included ABO and 4 digit-high-resolution donor and recipient HLA antigens and recipient’s HLA antibodies. Three test runs were compared, in which donors were excluded from matching to recipients with either donor-specific antibodies (DSA) >8000MFI (mean fluorescent intensity) at low-resolution (Run 1) or >8000MFI at high-resolution (Run 2) or >2000MFI and high-resolution (Run 3). Run 1 identified 22 703 possible combinations, with 20 pairs in the top ranked, Run 2 identified 24 113 combinations, with 19 pairs in the top ranked and Run 3 identified 8843 combinations, with 17 pairs in the top ranked. Review of DSA in Run 1 revealed that six recipients had DSA 2000-8000MFI causing a possible positive crossmatch resulting in breakdown of two 3-way and three 2-way chains. In Run 2, four recipients had DSA 2000-8000MFI, also potentially causing breakdown of three 2-way chains. The more prudent approach of excluding from matching recipients with DSA with >2000MFI reduces the probability of matched pairs having a positive crossmatch without significantly decreasing the number of possible transplants."
Wednesday, November 24, 2010
The (duopolistic, Federally funded) market for dialysis
Robin Fields in The Atlantic discusses dialysis: “God Help You. You're on Dialysis.”
It begins:
"In October 1972, after a month of deliberation, Congress launched the nation’s most ambitious experiment in universal health care: a change to the Social Security Act that granted comprehensive coverage under Medicare to virtually anyone diagnosed with kidney failure, regardless of age or income..."
But most of the story focuses on the dire situation of those in dialysis.
"Dialysis entered the American consciousness in the early 1960s as the country’s signature example of medical rationing. In those days, kidney disease killed about 100,000 people a year. Chronic dialysis was possible, thanks to two inventions: the artificial-kidney machine developed by the Dutch doctor Willem Kolff during World War II and a vascular-access device designed by Belding Scribner, a pioneering Seattle physician who opened the first outpatient dialysis center in the United States. But treatments were expensive, and most private insurers would not pay for them. At Scribner’s medical center, the Life or Death Committee parceled out the few slots, weighing not only the health of patients and their income, but also their perceived social worth.
"News reports about the committee’s work sparked one of the earliest national debates over the right to care and put pressure on the government to step in. A turning point came when Shep Glazer, vice president of the largest patient group, made an emotional appeal to the House Ways and Means Committee, as he underwent dialysis on the hearing-room floor. “If your kidneys failed tomorrow, wouldn’t you want the opportunity to live?” asked the 43-year-old father of two. “Wouldn’t you want to see your children grow up?”
"The measure establishing taxpayer funding for treatment of end-stage renal disease, signed into law by President Nixon, was expansive, and its lopsided, bipartisan approval reflected the times. Many lawmakers—even conservatives—thought the United States would adopt a European-style national health-care system. Also, the program that took effect in July 1973 was expected to have about 35,000 patients and cost about $1 billion in its 10th year.
"Those estimates came to seem almost laughable. The number of dialysis patients surpassed 35,000 by 1977 and has gone up from there. The growth reflected not only lower-than-expected transplant rates and the spread of diabetes, but also positive trends, like better cardiac care. With Americans living long enough for their kidneys to fail and no disqualifying conditions for the program, even the oldest and sickest patients increasingly were prescribed dialysis. Upwards of 100,000 now start treatment each year. “It’s been a perfect example of that line, ‘Build it and they will come,’” said Dr. Jay Wish, director of dialysis services for University Hospitals Case Medical Center in Cleveland.
"Because the kidney program absorbed that unforeseen wave—and thus, prolonged so many lives—some call it one of the great success stories of modern medicine. Still, the annual bill for the program quickly outpaced early projections, surging past $1 billion within six years. Per-patient expenditures were expected to drop as technology advanced. Instead they have risen steadily, as drug and hospitalization costs grew for the program’s increasingly frail clientele."
...
"Problems like those that regulators found in McMurry’s clinic are partly rooted in economics. The government’s payment policies for dialysis have created financial incentives that, in some ways, have worked against better patient care, while enabling for-profit corporations to dominate the business.
When the end-stage-renal-disease program began, hospitals provided most of the care on a nonprofit basis. But spurred by the guarantee of Medicare money, the marketplace met the growing demand for services through the expansion of for-profit companies. Today, more than 80 percent of the nation’s 5,000 clinics are for-profit. Almost two-thirds of all clinics are operated by two chains: Colorado-based DaVita and Fresenius, a subsidiary of a German corporation that is the leading maker of dialysis machines and supplies.
From the start, the government’s payment rules rewarded efficiency. Medicare set a rate for dialysis treatments, originally $138 per session, and covered a maximum of three treatments a week for most patients. Providers could keep whatever they didn’t spend on care. There were no penalties for poor results and no bonuses for good ones. Unlike other Medicare rates, the payment wasn’t adjusted upward for inflation.
Lawmakers cut the base rate to about $123 per treatment in 1983, after the program’s cost came in higher than expected and audits showed providers averaging profits of more than 20 percent. Dialysis companies responded like any other business facing a drop in prices, said Philip J. Held, a nationally recognized researcher on kidney disease and an economist by training. They chopped expenses by shortening treatments, thinning staff, and assigning tasks once done by nurses to unlicensed technicians. Some reused dialyzers, the filters that clean the patient’s blood. “It changed the nature of the service,” Held said of the rate cut. “You get what you pay for. The price was lower, but the product was dramatically different.”
The government created another perverse incentive by allowing clinics to bill Medicare separately for certain medications, reimbursing them at a markup over what they paid drug makers. Dialysis companies embraced the opportunity: doses of Epogen, prescribed to treat anemia, and similar medications tripled between 1989 and 2005, becoming Medicare’s single largest pharmaceutical expense. “Their core business became giving patients injectable drugs,” said Richard A. Hirth, a professor of health management and policy at the University of Michigan School of Public Health. “Dialysis was just the loss leader that got [patients] in the door.”
It begins:
"In October 1972, after a month of deliberation, Congress launched the nation’s most ambitious experiment in universal health care: a change to the Social Security Act that granted comprehensive coverage under Medicare to virtually anyone diagnosed with kidney failure, regardless of age or income..."
But most of the story focuses on the dire situation of those in dialysis.
"Dialysis entered the American consciousness in the early 1960s as the country’s signature example of medical rationing. In those days, kidney disease killed about 100,000 people a year. Chronic dialysis was possible, thanks to two inventions: the artificial-kidney machine developed by the Dutch doctor Willem Kolff during World War II and a vascular-access device designed by Belding Scribner, a pioneering Seattle physician who opened the first outpatient dialysis center in the United States. But treatments were expensive, and most private insurers would not pay for them. At Scribner’s medical center, the Life or Death Committee parceled out the few slots, weighing not only the health of patients and their income, but also their perceived social worth.
"News reports about the committee’s work sparked one of the earliest national debates over the right to care and put pressure on the government to step in. A turning point came when Shep Glazer, vice president of the largest patient group, made an emotional appeal to the House Ways and Means Committee, as he underwent dialysis on the hearing-room floor. “If your kidneys failed tomorrow, wouldn’t you want the opportunity to live?” asked the 43-year-old father of two. “Wouldn’t you want to see your children grow up?”
"The measure establishing taxpayer funding for treatment of end-stage renal disease, signed into law by President Nixon, was expansive, and its lopsided, bipartisan approval reflected the times. Many lawmakers—even conservatives—thought the United States would adopt a European-style national health-care system. Also, the program that took effect in July 1973 was expected to have about 35,000 patients and cost about $1 billion in its 10th year.
"Those estimates came to seem almost laughable. The number of dialysis patients surpassed 35,000 by 1977 and has gone up from there. The growth reflected not only lower-than-expected transplant rates and the spread of diabetes, but also positive trends, like better cardiac care. With Americans living long enough for their kidneys to fail and no disqualifying conditions for the program, even the oldest and sickest patients increasingly were prescribed dialysis. Upwards of 100,000 now start treatment each year. “It’s been a perfect example of that line, ‘Build it and they will come,’” said Dr. Jay Wish, director of dialysis services for University Hospitals Case Medical Center in Cleveland.
"Because the kidney program absorbed that unforeseen wave—and thus, prolonged so many lives—some call it one of the great success stories of modern medicine. Still, the annual bill for the program quickly outpaced early projections, surging past $1 billion within six years. Per-patient expenditures were expected to drop as technology advanced. Instead they have risen steadily, as drug and hospitalization costs grew for the program’s increasingly frail clientele."
...
"Problems like those that regulators found in McMurry’s clinic are partly rooted in economics. The government’s payment policies for dialysis have created financial incentives that, in some ways, have worked against better patient care, while enabling for-profit corporations to dominate the business.
When the end-stage-renal-disease program began, hospitals provided most of the care on a nonprofit basis. But spurred by the guarantee of Medicare money, the marketplace met the growing demand for services through the expansion of for-profit companies. Today, more than 80 percent of the nation’s 5,000 clinics are for-profit. Almost two-thirds of all clinics are operated by two chains: Colorado-based DaVita and Fresenius, a subsidiary of a German corporation that is the leading maker of dialysis machines and supplies.
From the start, the government’s payment rules rewarded efficiency. Medicare set a rate for dialysis treatments, originally $138 per session, and covered a maximum of three treatments a week for most patients. Providers could keep whatever they didn’t spend on care. There were no penalties for poor results and no bonuses for good ones. Unlike other Medicare rates, the payment wasn’t adjusted upward for inflation.
Lawmakers cut the base rate to about $123 per treatment in 1983, after the program’s cost came in higher than expected and audits showed providers averaging profits of more than 20 percent. Dialysis companies responded like any other business facing a drop in prices, said Philip J. Held, a nationally recognized researcher on kidney disease and an economist by training. They chopped expenses by shortening treatments, thinning staff, and assigning tasks once done by nurses to unlicensed technicians. Some reused dialyzers, the filters that clean the patient’s blood. “It changed the nature of the service,” Held said of the rate cut. “You get what you pay for. The price was lower, but the product was dramatically different.”
The government created another perverse incentive by allowing clinics to bill Medicare separately for certain medications, reimbursing them at a markup over what they paid drug makers. Dialysis companies embraced the opportunity: doses of Epogen, prescribed to treat anemia, and similar medications tripled between 1989 and 2005, becoming Medicare’s single largest pharmaceutical expense. “Their core business became giving patients injectable drugs,” said Richard A. Hirth, a professor of health management and policy at the University of Michigan School of Public Health. “Dialysis was just the loss leader that got [patients] in the door.”
Tuesday, November 23, 2010
Signaling (by candidates) and advertising (by employers) on the Economics job market
John Cawley has been carefully reading the ads in Job Openings for Economists, and he notices that advertisers have been taking explicit note of the signaling mechanism in the economics job market.
He notes:
"University College London writes in their JOE ad that: "We will pay particular attention to the applications of candidates who have signalled their interest in UCL through the AEA signalling system."
and the JOE ad for U Mass - Amherst states: Candidates will be interviewed at ASSA (Denver) and are encouraged to use AEA signaling.
(Here's a direct link to our recent paper:
The Job Market for New Economists: A Market Design Perspective, by Peter Coles, John Cawley, Phillip B. Levine, Muriel Niederle, Alvin E. Roth, and John J. Siegfried (Journal of Economic Perspectives—Volume 24, Number 4—Fall 2010—Pages 187–206) )
He notes:
"University College London writes in their JOE ad that: "We will pay particular attention to the applications of candidates who have signalled their interest in UCL through the AEA signalling system."
and the JOE ad for U Mass - Amherst states: Candidates will be interviewed at ASSA (Denver) and are encouraged to use AEA signaling.
(Here's a direct link to our recent paper:
The Job Market for New Economists: A Market Design Perspective, by Peter Coles, John Cawley, Phillip B. Levine, Muriel Niederle, Alvin E. Roth, and John J. Siegfried (Journal of Economic Perspectives—Volume 24, Number 4—Fall 2010—Pages 187–206) )
Monday, November 22, 2010
Entrepreneurial market design in old New York
My colleague Ed Glaeser has penned an economist's love letter to New York City that focuses on its entrepreneurial history: Start-Up City: Entrepreneurs are the heroes of New York’s past and the key to its future.
You should read the whole thing, but here's a part that caught my eye as focusing particularly on an entrepreneurial act of market design.
"Entrepreneurs have played a key role in every stage of New York’s development. During the early nineteenth century, when waterways were the lifelines of commerce, New York owed its expanding sea trade partly to natural advantages: a safe, centrally located harbor and a deep river that cut far into the American hinterland. But those advantages became important because of the vision and energy of entrepreneurs like Jeremiah Thompson, the gambling Quaker. Thompson immigrated to New York at 17 to work in the American branch of his family’s wool business. By the 1820s, he had established himself as America’s largest importer of English clothing, its largest exporter of raw cotton, and its third-largest issuer of bills of exchange.
"As a global trader, Thompson was acutely aware of the shortcomings of the transatlantic ships of the time, which would stay in port until their hulls were filled with goods. (Imagine showing up at LaGuardia and having to sit around until the airline sold enough tickets to fill the entire flight to Frankfurt.) Thompson saw an opening and created the Black Ball packet line, whose ships set sail on a scheduled day every month, no matter how light their cargoes were. His innovation was a gamble, since sometimes his ships sailed with relatively empty hulls, which meant less income from the merchants who bought the space. But a virtuous circle developed: fixed schedules attracted more cargo, and more cargo made ships sailing on fixed schedules more profitable. Once Thompson was turning a profit, other packet lines, like the Yellow Ball and Swallowtail lines, entered the market. An 1827 letter to the New England Palladium described the significance of Thompson’s invention: “I consider Commerce by lines of ships, on fixed days, an invention of the age nearly as important as Steam Navigation and in its results as beneficial to New York, which has chiefly adopted it, as the Grand [Erie] Canal.”
"Thanks to such innovation, the city grew great during the first half of the nineteenth century, its population rising from 33,000 in 1790 to 814,000 on the eve of the Civil War. In 1821, New York’s exports, measured in dollars, were less than 10 percent higher than Boston’s. By 1860, New York was exporting over 700 percent more than the city on the Charles."
You should read the whole thing, but here's a part that caught my eye as focusing particularly on an entrepreneurial act of market design.
"Entrepreneurs have played a key role in every stage of New York’s development. During the early nineteenth century, when waterways were the lifelines of commerce, New York owed its expanding sea trade partly to natural advantages: a safe, centrally located harbor and a deep river that cut far into the American hinterland. But those advantages became important because of the vision and energy of entrepreneurs like Jeremiah Thompson, the gambling Quaker. Thompson immigrated to New York at 17 to work in the American branch of his family’s wool business. By the 1820s, he had established himself as America’s largest importer of English clothing, its largest exporter of raw cotton, and its third-largest issuer of bills of exchange.
"As a global trader, Thompson was acutely aware of the shortcomings of the transatlantic ships of the time, which would stay in port until their hulls were filled with goods. (Imagine showing up at LaGuardia and having to sit around until the airline sold enough tickets to fill the entire flight to Frankfurt.) Thompson saw an opening and created the Black Ball packet line, whose ships set sail on a scheduled day every month, no matter how light their cargoes were. His innovation was a gamble, since sometimes his ships sailed with relatively empty hulls, which meant less income from the merchants who bought the space. But a virtuous circle developed: fixed schedules attracted more cargo, and more cargo made ships sailing on fixed schedules more profitable. Once Thompson was turning a profit, other packet lines, like the Yellow Ball and Swallowtail lines, entered the market. An 1827 letter to the New England Palladium described the significance of Thompson’s invention: “I consider Commerce by lines of ships, on fixed days, an invention of the age nearly as important as Steam Navigation and in its results as beneficial to New York, which has chiefly adopted it, as the Grand [Erie] Canal.”
"Thanks to such innovation, the city grew great during the first half of the nineteenth century, its population rising from 33,000 in 1790 to 814,000 on the eve of the Civil War. In 1821, New York’s exports, measured in dollars, were less than 10 percent higher than Boston’s. By 1860, New York was exporting over 700 percent more than the city on the Charles."
Sunday, November 21, 2010
Strategy-proofness and strategy sets: residency fraud in school choice
When we speak of strategy-proofness in the context of school choice, we are most often speaking about whether it is safe for parents to reveal their true preferences when asked to submit a rank ordering of possible school assignments. Of course, parents have other private information as well, and they may have incentives to misprepresent that also.
I'm reminded of this by the fact that the San Francisco Unified School District has recently sent a letter to the address of record to each student regarding an Amnesty Period for Residency Fraud.
(It includes the line "This letter is directed to families that have committed residency fraud. Parents/Guardians who have never submitted false residency information to the District may disregard this letter.")
I'm reminded of this by the fact that the San Francisco Unified School District has recently sent a letter to the address of record to each student regarding an Amnesty Period for Residency Fraud.
(It includes the line "This letter is directed to families that have committed residency fraud. Parents/Guardians who have never submitted false residency information to the District may disregard this letter.")
Saturday, November 20, 2010
Research misconduct in the marketplace for science
Lately there have been a number of news stories about research misconduct of the "conventional" sort, involving scientists falsifying the scientific record by fabricating or misrepresenting data. When federal granting agencies find that someone has committed this kind of fraud they have procedures for denying them future grants, etc.
Here's a story about a kind of egregious scientific misconduct that is not covered by such procedures, although the criminal law addresses a small part of it. The story is about a scientist who sabotoged another scientist's experiments: Research integrity: Sabotage!
"Bhrigu, over the course of several months at Michigan, had meticulously and systematically sabotaged the work of Heather Ames, a graduate student in his lab, by tampering with her experiments and poisoning her cell-culture media. Captured on hidden camera, Bhrigu confessed to university police in April and pleaded guilty to malicious destruction of personal property, a misdemeanour that apparently usually involves cars: in the spaces for make and model on the police report, the arresting officer wrote "lab research" and "cells".
...
"Bhrigu's actions are surprising, but probably not unique. There are few firm numbers showing the prevalence of research sabotage, but conversations with graduate students, postdocs and research-misconduct experts suggest that such misdeeds occur elsewhere, and that most go unreported or unpoliced. In this case, the episode set back research, wasted potentially tens of thousands of dollars and terrorized a young student. More broadly, acts such as Bhrigu's — along with more subtle actions to hold back or derail colleagues' work — have a toxic effect on science and scientists. They are an affront to the implicit trust between scientists that is necessary for research endeavours to exist and thrive.
"Despite all this, there is little to prevent perpetrators re-entering science. In the United States, federal bodies that provide research funding have limited ability and inclination to take action in sabotage cases because they aren't interpreted as fitting the federal definition of research misconduct, which is limited to plagiarism, fabrication and falsification of research data. In Bhrigu's case, administrators at the University of Michigan worked with police to investigate, thanks in part to the persistence of Ames and her supervisor, Theo Ross.
...
"At Washtenaw County Courthouse in July, having reviewed the case files, Pollard Hines delivered Bhrigu's sentence. She ordered him to pay around US$8,800 for reagents and experimental materials, plus $600 in court fees and fines — and to serve six months' probation, perform 40 hours of community service and undergo a psychiatric evaluation.
"But the threat of a worse sentence hung over Bhrigu's head. At the request of the prosecutor, Ross had prepared a more detailed list of damages, including Bhrigu's entire salary, half of Ames's, six months' salary for a technician to help Ames get back up to speed, and a quarter of the lab's reagents. The court arrived at a possible figure of $72,000, with the final amount to be decided upon at a restitution hearing in September.
"Before that hearing could take place, however, Bhrigu and his wife left the country for India...
"Now that Bhrigu is in India, there is little to prevent him from getting back into science. And even if he were in the United States, there wouldn't be much to stop him. The National Institutes of Health in Bethesda, Maryland, through its Office of Research Integrity, will sometimes bar an individual from receiving federal research funds for a time if they are found guilty of misconduct. But Bhigru probably won't face that prospect because his actions don't fit the federal definition of misconduct, a situation Ross finds strange. "All scientists will tell you that it's scientific misconduct because it's tampering with data," she says."
HT: Muriel Niederle
Here's a story about a kind of egregious scientific misconduct that is not covered by such procedures, although the criminal law addresses a small part of it. The story is about a scientist who sabotoged another scientist's experiments: Research integrity: Sabotage!
"Bhrigu, over the course of several months at Michigan, had meticulously and systematically sabotaged the work of Heather Ames, a graduate student in his lab, by tampering with her experiments and poisoning her cell-culture media. Captured on hidden camera, Bhrigu confessed to university police in April and pleaded guilty to malicious destruction of personal property, a misdemeanour that apparently usually involves cars: in the spaces for make and model on the police report, the arresting officer wrote "lab research" and "cells".
...
"Bhrigu's actions are surprising, but probably not unique. There are few firm numbers showing the prevalence of research sabotage, but conversations with graduate students, postdocs and research-misconduct experts suggest that such misdeeds occur elsewhere, and that most go unreported or unpoliced. In this case, the episode set back research, wasted potentially tens of thousands of dollars and terrorized a young student. More broadly, acts such as Bhrigu's — along with more subtle actions to hold back or derail colleagues' work — have a toxic effect on science and scientists. They are an affront to the implicit trust between scientists that is necessary for research endeavours to exist and thrive.
"Despite all this, there is little to prevent perpetrators re-entering science. In the United States, federal bodies that provide research funding have limited ability and inclination to take action in sabotage cases because they aren't interpreted as fitting the federal definition of research misconduct, which is limited to plagiarism, fabrication and falsification of research data. In Bhrigu's case, administrators at the University of Michigan worked with police to investigate, thanks in part to the persistence of Ames and her supervisor, Theo Ross.
...
"At Washtenaw County Courthouse in July, having reviewed the case files, Pollard Hines delivered Bhrigu's sentence. She ordered him to pay around US$8,800 for reagents and experimental materials, plus $600 in court fees and fines — and to serve six months' probation, perform 40 hours of community service and undergo a psychiatric evaluation.
"But the threat of a worse sentence hung over Bhrigu's head. At the request of the prosecutor, Ross had prepared a more detailed list of damages, including Bhrigu's entire salary, half of Ames's, six months' salary for a technician to help Ames get back up to speed, and a quarter of the lab's reagents. The court arrived at a possible figure of $72,000, with the final amount to be decided upon at a restitution hearing in September.
"Before that hearing could take place, however, Bhrigu and his wife left the country for India...
"Now that Bhrigu is in India, there is little to prevent him from getting back into science. And even if he were in the United States, there wouldn't be much to stop him. The National Institutes of Health in Bethesda, Maryland, through its Office of Research Integrity, will sometimes bar an individual from receiving federal research funds for a time if they are found guilty of misconduct. But Bhigru probably won't face that prospect because his actions don't fit the federal definition of misconduct, a situation Ross finds strange. "All scientists will tell you that it's scientific misconduct because it's tampering with data," she says."
HT: Muriel Niederle
Friday, November 19, 2010
Selling blood plasma as a part time job
In the Chronicle, Lawrence Biemiller writes, At Central Michigan U., It’s a Matter of Money
“For a lot of college students, it’s just a little extra spending money,” Mr. Canze said when I asked about the plasma trade. “I probably know nine to a dozen people who will go regularly. They screen you, hook you up, pump you, and get you on your way.” Each visit to the local BioLife Plasma Services facility takes about an hour, during which you can read, listen to music, or get on Facebook through the company’s Wifi network. The facility even offers day care.
“Donating” is a euphemism the company uses. The frequently-asked-questions section of the company’s Web site includes the question: “Why do plasma donors receive money for donating?” The answer: “Plasma donors spend up to two hours, as often as twice a week, in our centers to help save someone’s life or improve the quality of it. We merely offer compensation to our donors for their commitment to the program. For more compensation information, contact your local center directly.”
You make $20 per BioLife visit, Mr. Canze told me. You can go as often as twice a week, and if you go at least once a week for a month, you get a $20 bonus. The math is easy enough—you can make $180 a month. That’s real money, especially for college students, especially in Michigan.
Thursday, November 18, 2010
More on compensation for marrow donors
Representatives of the major world marrow donation clearinghouses come out against compensation for donors:
Remuneration of hematopoietic stem cell donors: principles and perspective of the World Marrow Donor Association byMichael Boo , Suzanna M. van Walraven* , Jeremy Chapman , Brian Lindberg , Alexander H. Schmidt , Bronwen E. Shaw , Galen E. Switzer , Edward Yang and Torstein Egeland , Blood, 2010 Oct 4. [Epub ahead of print]
Abstract: Hematopoietic stem cell transplantation (HSCT) is a curative procedure for life threatening hematological diseases. Donation of hematopoietic stem cells (HSC) from an unrelated donor, frequently residing in another country, may be the only option for 70% of those in need of unrelated HSCT. To maximize the opportunity to find the best available donor, individual donor registries collaborate internationally. To provide homogeneity of practice among registries, the World Marrow Donor Association (WMDA) sets standards against which registries are accredited, and provides guidance and regulations concerning unrelated donor safety and care. A basic tenet of the donor registries is that unrelated HSC donation is an altruistic act; non-payment of donors is entrenched in the WMDA standards and in international practice. In the United States, the prohibition against remuneration of donors has recently been challenged. In this document we describe the reasons that the WMDA continues to believe that HSC donors should not be paid due to ethical concerns raised by remuneration, potential to damage the public will to act altruistically, the potential for coercion and exploitation of donors, increased risk to patients, harm to local transplantation programs and international stem cell exchange, and the possibility of benefiting some patients while disadvantaging others."
Previous posts:
Compensating donors: how about bone marrow? (in connection with which see Flynn v. Holder Challenge to the National Organ Transplant Act
Compensation for bone marrow donors: opposing views
HT: Rod Garratt (whose related papers are
“One Chance in a Million: Altruism and the Bone Marrow Registry” with Ted Bergstrom and Damien Sheehan-Connor, American Economic Review
and
Stem Cell Matching for Patients of Mixed Race” with Ted Bergstrom and Damien Sheehan-Connor
(About this latter paper he writes "Ted Bergstrom and I will be presenting this work at a session on The Economics of Blood, Stem Cell and Organ Donation at this year's winter meeting of the American Economic Association in Denver. If you are interested in attending, the session will take place Jan 08, 2011 10:15 am at the Sheraton, Director's Row H.
Remuneration of hematopoietic stem cell donors: principles and perspective of the World Marrow Donor Association by
Abstract: Hematopoietic stem cell transplantation (HSCT) is a curative procedure for life threatening hematological diseases. Donation of hematopoietic stem cells (HSC) from an unrelated donor, frequently residing in another country, may be the only option for 70% of those in need of unrelated HSCT. To maximize the opportunity to find the best available donor, individual donor registries collaborate internationally. To provide homogeneity of practice among registries, the World Marrow Donor Association (WMDA) sets standards against which registries are accredited, and provides guidance and regulations concerning unrelated donor safety and care. A basic tenet of the donor registries is that unrelated HSC donation is an altruistic act; non-payment of donors is entrenched in the WMDA standards and in international practice. In the United States, the prohibition against remuneration of donors has recently been challenged. In this document we describe the reasons that the WMDA continues to believe that HSC donors should not be paid due to ethical concerns raised by remuneration, potential to damage the public will to act altruistically, the potential for coercion and exploitation of donors, increased risk to patients, harm to local transplantation programs and international stem cell exchange, and the possibility of benefiting some patients while disadvantaging others."
Previous posts:
Compensating donors: how about bone marrow? (in connection with which see Flynn v. Holder Challenge to the National Organ Transplant Act
Compensation for bone marrow donors: opposing views
HT: Rod Garratt (whose related papers are
“One Chance in a Million: Altruism and the Bone Marrow Registry” with Ted Bergstrom and Damien Sheehan-Connor, American Economic Review
and
Stem Cell Matching for Patients of Mixed Race” with Ted Bergstrom and Damien Sheehan-Connor
(About this latter paper he writes "Ted Bergstrom and I will be presenting this work at a session on The Economics of Blood, Stem Cell and Organ Donation at this year's winter meeting of the American Economic Association in Denver. If you are interested in attending, the session will take place Jan 08, 2011 10:15 am at the Sheraton, Director's Row H.
Wednesday, November 17, 2010
Illegal markets for organ transplants: Kosovo trials
Illegal, black markets for kidneys are often cited both by opponents and proponents of legal markets: opponents look at the abuses in illegal markets and fear that legal markets would spread them, and proponents look at illegal markets and hope that legal markets would curb them.
Seven Charged in Kosovo Organ-Trafficking Ring
"At least seven people have been charged with participating in an international organ-trafficking network based in Kosovo that sold kidneys and other organs from impoverished victims for up to $200,000 to patients from as far away as Israel and Canada, police and senior European Union officials said Monday.
"According to the indictment, the traffickers lured people from slums in Istanbul, Moscow, Moldova and Kazakhstan with promises of up to $20,000 for their organs. Law enforcement officials say many never received a cent. The operations were performed at a private clinic in a run-down neighborhood on the outskirts of Pristina, the Kosovar capital.
"While the ring was first discovered two years ago, the global scale of the network and its victims is only now becoming clear.
"Officials said the ringleader was a highly regarded surgeon and professor at Pristina University Hospital, Dr. Lutfi Dervishi. The clinic was run by his son, Arban. Also charged was Ilir Rrecaj, a senior official in Kosovo’s Health Ministry when the ring was broken. They and two others are accused of crimes including trafficking in humans and body parts, unlawful medical activity, participating in organized crime, and abuse of office. All were released on bail.
...
"The trafficking network’s tentacles reached far. Warrants were issued for a Turkish doctor and an Israeli financier, and two other doctors, an Israeli and a Turk, were named as co-conspirators.
"The police said the ring had its roots at a medical conference in 2006 in Istanbul, where Dr. Dervishi met the Turkish doctor being sought, Yusuf Sonmez. Law enforcement officials describe Dr. Sonmez as a notorious international organ trafficker.
"The Medicus clinic had been founded by a European philanthropist who aided ethnic Albanian doctors during the war in Kosovo in 1999. Dr. Dervishi, police officials said, secretly transformed it into a hub for illegal organ transplants, which were performed by Dr. Sonmez.
"The indictment was first reported by The Associated Press. In it, a European Union prosecutor, Jonathan Ratel, said that in 2008, 20 foreign nationals living in “extreme poverty or acute financial distress” were “recruited with the false promises of payments.”
"The police said they broke the ring in November of that year, when a young Turkish man, Yilman Altun, was found at the Pristina airport, weak and frail. Mr. Altun told the police that his kidney had been stolen. When the police raided the Medicus clinic, they discovered an elderly Israeli man who had received Mr. Altun’s kidney.
"European Union officials said that the indictment in the case had been filed in district court in Kosovo and that a preliminary hearing was expected by the end of the year. If a judge confirms the charges, a trial will follow.
...
"Western law enforcement officials said they suspected the ring might be part of a larger criminal network whose nexus was in Israel. In September, five doctors from South Africa were charged with participating in an international kidney-trading syndicate in which dozens of poor Brazilians and Romanians were paid for kidneys for wealthy Israelis. Analysts said the organ-trafficking case was part of a disturbing global trend in which unscrupulous traffickers take advantage of the growing waiting lists of desperate patients and the vulnerability of poor people further buffeted by the international financial crisis."
Update: Dec 15. The Telegraph follows the beginning of the trial: Kosovo physicians accused of organ trafficking racket -- A gang of Kosovan organ traffickers operated an elaborate international network that traded in the organs of people living in extreme poverty, a court heard.
Seven Charged in Kosovo Organ-Trafficking Ring
"At least seven people have been charged with participating in an international organ-trafficking network based in Kosovo that sold kidneys and other organs from impoverished victims for up to $200,000 to patients from as far away as Israel and Canada, police and senior European Union officials said Monday.
"According to the indictment, the traffickers lured people from slums in Istanbul, Moscow, Moldova and Kazakhstan with promises of up to $20,000 for their organs. Law enforcement officials say many never received a cent. The operations were performed at a private clinic in a run-down neighborhood on the outskirts of Pristina, the Kosovar capital.
"While the ring was first discovered two years ago, the global scale of the network and its victims is only now becoming clear.
"Officials said the ringleader was a highly regarded surgeon and professor at Pristina University Hospital, Dr. Lutfi Dervishi. The clinic was run by his son, Arban. Also charged was Ilir Rrecaj, a senior official in Kosovo’s Health Ministry when the ring was broken. They and two others are accused of crimes including trafficking in humans and body parts, unlawful medical activity, participating in organized crime, and abuse of office. All were released on bail.
...
"The trafficking network’s tentacles reached far. Warrants were issued for a Turkish doctor and an Israeli financier, and two other doctors, an Israeli and a Turk, were named as co-conspirators.
"The police said the ring had its roots at a medical conference in 2006 in Istanbul, where Dr. Dervishi met the Turkish doctor being sought, Yusuf Sonmez. Law enforcement officials describe Dr. Sonmez as a notorious international organ trafficker.
"The Medicus clinic had been founded by a European philanthropist who aided ethnic Albanian doctors during the war in Kosovo in 1999. Dr. Dervishi, police officials said, secretly transformed it into a hub for illegal organ transplants, which were performed by Dr. Sonmez.
"The indictment was first reported by The Associated Press. In it, a European Union prosecutor, Jonathan Ratel, said that in 2008, 20 foreign nationals living in “extreme poverty or acute financial distress” were “recruited with the false promises of payments.”
"The police said they broke the ring in November of that year, when a young Turkish man, Yilman Altun, was found at the Pristina airport, weak and frail. Mr. Altun told the police that his kidney had been stolen. When the police raided the Medicus clinic, they discovered an elderly Israeli man who had received Mr. Altun’s kidney.
"European Union officials said that the indictment in the case had been filed in district court in Kosovo and that a preliminary hearing was expected by the end of the year. If a judge confirms the charges, a trial will follow.
...
"Western law enforcement officials said they suspected the ring might be part of a larger criminal network whose nexus was in Israel. In September, five doctors from South Africa were charged with participating in an international kidney-trading syndicate in which dozens of poor Brazilians and Romanians were paid for kidneys for wealthy Israelis. Analysts said the organ-trafficking case was part of a disturbing global trend in which unscrupulous traffickers take advantage of the growing waiting lists of desperate patients and the vulnerability of poor people further buffeted by the international financial crisis."
Update: Dec 15. The Telegraph follows the beginning of the trial: Kosovo physicians accused of organ trafficking racket -- A gang of Kosovan organ traffickers operated an elaborate international network that traded in the organs of people living in extreme poverty, a court heard.
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