The market for kidneys in Iran

The Iranian economist Farshad Fatemi at the Sharif University of Technology sent me this link to his very interesting working paper The Regulated Market for Kidneys in Iran.

Among other things, it is full of institutional detail and comparisons. Here are a few things that caught my eye.

Comparing total (live plus deceased) kidney donation across countries, per million population, the most recent figures (from 2007) are Iran 27.1%; UK 33.5%; Spain 49.5%; US 54.7%. (His source is the Barcelona-based Transplant Procurement Management Organization, whose international database I have yet to fully explore.)

His description of the market for kidneys in Iran includes the following

"After the donor passes the initial tests, the administrators contact the first patient in the same waiting list as the donor’s blood type [and other components of a match]...
If the patient who is on the top of the waiting list at the moment is not ready for the transplant ..., the next patient will be called... until a ready patient will be found. Then a meeting between the two parties is arranged (they are provided with a private area within the foundation building if they want to reach a private agreement) and they will be sent for tissue tests. If the tissue test gives the favourable result, a contract between the patient and the donor will be signed and they will be provided with a list of the transplant centres and doctors who perform surgery.
When the patient and the donor are referred to transplant centre, a cheque from the patient will be kept at the centre to be paid to the donor after the transplant takes place. The guide price has been 25m Rials (≈ $2660) until March 2007 for 3 years and at this time18 it has been raised to 30m Rials (≈ $3190). This decision has been made because the foundation was worried of a decreasing trend in number of donors.

"In some cases, the recipient will agree to make an additional payment to the donor outside the system; it is not certain how common this practice is, but according to the foundation staff the amount of this payment is not usually big and is thought to be about 5m to 10m Rials (≈ $530 to $1060). The recipient also pays for the cost of tests, two operations, after surgery cares, and other associated costs (like accommodation and travel costs if the patient travels from another city). Insurance companies cover the medical costs of the transplant and the operations are also performed free of charge in state-owned hospitals.
"In addition, the government pays a monetary gift to the donor for appreciation of her altruism (currently, 10m Rials), as well as automatic provision of one year free health insurance, and the opportunity to attend the annual appreciation event dedicated to donors...
"The minimum monthly legal wage for 2007 was Rials 1,830k (later raised to 2,200k for 2008). The minimum payment of Rials 45m is around 2 years of minimum wage. "
...
"[T]o prevent international kidney trade, the donor and recipient are required to have the same nationality. That means an Afghan patient, who is referred to the foundation, should wait until an Afghan donor with appropriate characteristics turns up. This is to avoid transplant tourism. "
...
"the donors are mostly men (Table 7). This can be because of the two facts. Firstly, the ages between 22 and 35; when the donation is accepted; is the fertility age; and women are less likely to be considered as potential donors. Secondly, as we mentioned before since men are supposed as the main breadwinner of the family, it is more likely that they sell their kidneys in order to overcome financial difficulties. Female donors count for around 18% of traded kidneys in our data; it is in contrary with the Indian case where 71% of the sold kidneys were from female donors (Goyal et al. 2002)."

In his sample of 598 transplants (Table 6), 539 were "traded kidneys," 10 "non-traded" and 49 "Cadaver", i.e. the vast majority of kidney transplants were live donor transplants with compensation to the donor.

Market for prayers in Iran

It's not just kidneys; selling prayers in Iran isn't repugnant either.

In Islamic Iran prayer sellers' trade is booming
"TEHRAN (Reuters Life!) - In Islamic Iran where clerics rule, unofficial "prayer sellers," who promise to intercede with the divine to solve all manner of life's problems, are seeing their business boom."
...
"Iran's clerics also believe in the power of prayer but they advise people against using prayers that lack a religious basis. Magic and superstition are both illegal under Islamic law.

"Writing prayers quoting Shia's immaculate Imams and receiving money for that has no legal obstacle," said Grand Ayatollah Lotfollah Safi Golpaygani when asked about the religious legitimacy of the prayer sellers. "

"But referring to prayers written by hustlers without reliable sources is not permitted, and getting money for those kinds of prayers is (religiously) forbidden," he told news website hawzah.net.

"Despite what Iranian clerics say, none of YaAli's customers ask him about the basis of his knowledge, which he says is founded on the Koran.

"It is not important where his knowledge comes from, I just want my problems to be solved," said Marjan, 24, who complains it is getting harder to see YaAli as customer demand increases."

A degree is a degree

"A degree is a degree! Whether fake or genuine, it's a degree! It makes no difference!" Baluchistan province chief minister Nawab Aslam Raisani, who claims a master's in political science, shouted at a gaggle of reporters Tuesday.

This insight is from the news report Fake degree scandal roils Pakistani politics.

(See my earlier post on the Market for bogus colleges.)

Espionage: the market for secret information

The newspapers this morning are full of stories about the arrest of eleven accused Russian spies, e.g. the NY Times reports In Ordinary Lives, U.S. Sees the Work of Russian Agents.
"They had lived for more than a decade in American cities and suburbs from Seattle to New York, where they seemed to be ordinary couples working ordinary jobs, chatting to the neighbors about schools and apologizing for noisy teenagers.
"But on Monday, federal prosecutors accused 11 people of being part of a Russian espionage ring, living under false names and deep cover in a patient scheme to penetrate what one coded message called American “policy making circles.” "

The story in the Harvard Crimson adds an interesting detail: Kennedy School Grad Arrested in Russian Spy Raid.
"Called the “Boston Conspirators” in a complaint filed in the U.S. District Court for the Southern District of New York, Heathfield and Foley are alleged to have met with a “former legislative counsel for US Congress” and a “member of faculty in economics.” The documents redacted the affiliation of the faculty member."

It's true that the publication process in Economics is ridiculously slow, but I thought the internet had removed the need for cells of long term sleeper spies to find out what's in our working papers...

Live kidney donation: how to ask in Chicago

Harvey Mysel, a kidney recipient who went on to found the Living Kidney Donor Network, writes to ask me to let readers know of two workshops he is offering in Chicago in July on Having your donor find you

Signaling you're not 'overqualified' in a recession

The Globe reports on Deflating credentials to land a job.

"As the tight job market forces the unemployed to apply for lower-level positions, more job seekers are “dumbing down’’ credentials, wiping graduate degrees and high-level experience off their resumes, recruiters say. Applicants say the idea is to get hiring managers to at least look at their resumes, instead of figuring someone with extra qualifications will demand a bigger salary or leave for a higher-level opportunity once the economy turns around."

...

“Somebody finds out you know that much more than they do, they get nervous,’’ Carroll said.

"That’s true, says Robert Akerlof, a post-doctoral associate at the MIT Sloan School of Management, who is working on a theory about how it can be difficult to maintain authority over overqualified workers if they think a job, or a boss, is beneath them.

"Dumbing down a resume is a way for job seekers to show that they are going to be respectful, said Akerlof, citing the “20 percent rule,’’ which states that bosses should be 20 percent smarter than their employees.

“I think it’s not so much that you’re lying about what your resume is, it’s that you’re trying to convey an appropriate attitude,’’ he said."

Misc. organ transplant links

A Review of Organ and Tissue Donation Procedures by the Royal Australasian College of Physicians nicely summarizes some of the different ways deceased donor organs are dealt with around the world.

The ‘blood group O problem’ in kidney transplantation—time to change? discusses the Eurotransplant Kidney Allocation System, which apparently allows some O kidneys to go to patients who aren't type O.

Mike Rees' revolution of non-simultaneous non-directed donor chains continues to bear fruit in unexpected ways: LOYOLA PROGRAM A RADICAL SHIFT IN LIVING DONOR KIDNEY TRANSPLANTS
"In a first, four people step forward to donate kidneys to complete strangers across the country with no strings attached."...
"It's extremely rare when someone asking for nothing in return steps forward at a hospital and offers to donate a kidney to a complete stranger.
What's rarer still is what has happened at Loyola University Medical Center -- four people have stepped forward and offered to donate kidneys to four complete strangers and none have asked for a thing in return.
"This is completely unique and totally unheard of," said Garet Hill, founder of the nonprofit National Kidney Registry, which coordinated the donations. "We have never had four donors from one institution come forward at one time to offer up kidneys for donation with no strings attached."
The selfless acts by the four have helped Loyola launch its Pay-it-Forward Kidney Transplant Program, the first of its kind in the Midwest, and the largest number of altruistic donors to ever begin such a program in the United States."

Here's a collection of kidney exchange stories and videos from MSNBC, some rather old: http://article.wn.com/view/2010/05/04/Kidney_swap_program_posts_high_success_rate/

And here's a live donor story: From Fear To Elation: Prepping To Be An Organ Donor

Deceased donor allocation policies are also a very big deal. Alex Tabarrok at MR has a thought provoking post on one aspect of the debate: Optimizing Kidney Allocation: LYFT for LIFE which touches on the issue of how it's often difficult to make changes in health care policy that aren't Pareto improvements, even if they are improvements by other measures.

Decent work research prize

When I read that the International Labour Organization had a Decent Work Research Prize, my initial thought was "finally, a research prize for the rest of us." (It's hard to do exceptional work, but doing decent work seems like an achievable goal...)

But that turns out to be a mis-reading: here's the beginning of the prize description.

"The ILO’s International Institute for Labour Studies has created a research prize to annually reward outstanding contributions to the advancement of knowledge on the ILO’s central goal of decent work for all."

That seems like a good goal too:)

Changing sexual mores in China

Swinger Tests China’s Sex Morals
"On Thursday, a court sentenced Mr. Ma to three-and-a-half years in prison, a severe penalty for a crime that the Chinese government calls “crowd licentiousness.” Mr. Ma, now China’s most famous swinger, remains defiant and plans to appeal, saying his sex life is his own business, not subject to the law as long as he causes no social disturbance, according to his lawyer, Yao Yong’an. "
...
"The case of Mr. Ma, who was arrested last August and went on trial last month, has drawn attention across China not only for its titillating details, but also because it also raises questions about an authoritarian government’s attempts to curb sexual freedom and limit privacy in a society where rapid economic growth and the ubiquity of the Internet have upended traditional values. "
...
"The Communist Party no longer maintains the kind of tight control over people’s private lives that it did decades ago. Yet, some officials still try to prosecute citizens based on laws that seem increasingly out of step with social mores. One example is criminal law 301, under which Mr. Ma and 21 fellow swingers were prosecuted, and which can result in a five-year prison term.
Chinese Internet users and even some official news organizations have debated the case."
...
"The law against group sex, generally interpreted by judges as involving three or more people, is left over from an earlier law against “hooliganism” that was used to prosecute people who had sex outside of marriage, Ms. Li said. The hooliganism law was scrapped in 1997. One notable swingers case took place in the early 1980s, when the leader of a swingers club involving four middle-aged couples was executed, she added.
At least three recent surveys have shown that prosecution of group sex does not enjoy widespread support today.
Several Chinese news Web sites posted editorials echoing that sentiment after the verdict was announced. "

Couples match

The University of Alabama at Birmingham magazine (June 2010) writes about the couples match: Match Making--Software Helps Medical Couples Stay Together

(Here's a paper with a more technical description of how the couples match works...

Roth, A. E. and Elliott Peranson, "The Redesign of the Matching Market for American Physicians: Some Engineering Aspects of Economic Design," American Economic Review, 89, 4, September, 1999, 748-780.,

and here's a paper that's about why it works as well as it does...

Kojima, Fuhito, Parag A. Pathak, and Alvin E. Roth, " Matching with Couples: Stability and Incentives in Large Markets," working paper, April 8 2010.)

NYU in Abu Dhabi

I've blogged before about the problems of establishing and maintaining universities in places whose culture may be antagonistic to university culture.

NYU seems to be attacking that from an interesting angle in it's Abu Dhabi venture, the modal student will be an American: N.Y.U. Abu Dhabi Scours Globe for Top Students

Abu Dhabi "...is where N.Y.U. will open a campus in September with an inaugural freshman class of 150 students from 39 countries."..."Although the students come from 39 countries, with 43 languages, about a third are from the United States. The next four biggest sources are the United Arab Emirates, China, Hungary and Russia. "
...
"Backed by the open checkbook of the Abu Dhabi government, the wealthiest of the seven United Arab Emirates, N.Y.U. Abu Dhabi scoured the planet for candidates. It called on the Institute of International Education, which administers the Fulbright scholarships, to help it identify 900 of the world’s top high schools, and then pressed the schools for their best students.
Though based in Abu Dhabi, students will be encouraged to spend time at some of N.Y.U.’s 16 other sites, on five continents — more traditional study-abroad centers with short-term or narrowly focused programs. In a promotional booklet, the university sketched out a hypothetical plan for film and media majors, with sojourns in Berlin, Buenos Aires, Prague and New York.
The project carries risks. While Abu Dhabi is a relatively modern, multicultural Muslim state, homosexual acts are illegal and the Internet is censored. And there is no guarantee that the seemingly limitless resources of its oil-rich government will remain so, given the precarious global economy and Middle East politics.
But the Abu Dhabi government has agreed to pay for the entire N.Y.U. project, though neither it nor the university has detailed a price. And the emirate has embraced N.Y.U.’s vision of a liberal arts institution with full access to ideas, books and the Internet. "
...
"Some in the new freshman class, including Mr. Aqel, have already used Facebook to discuss a possible civil rights club. “In a way, it’s almost a challenge because we can’t hold protests,” Mr. Aqel said. “But I think we’ll be able to find creative ways to circumvent restrictions while maintaining respect for our host country.” "

You can pick up the thread of previous posts here: Universities and culture.

Debra Satz on noxious markets

The Stanford class day speech: Satz to graduates: Some goods should never be for sale by Stanford philosopher Debra Satz, whose interests extend to sales of kidneys

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

From the news story on her class day address:

"What are the different characteristics of markets? Why do some exchanges prompt "extreme revulsion"? Among the examples Satz raised: child labor, body parts, reproductive services, international arms, addictive drugs.
"What makes particular markets appear undesirable or, in my terminology, noxious?" she asked. The intrinsic nature of certain goods – friendship, a person's good name, various prizes and honor – can immediately diminish their value when they are sold.
There are also extrinsic reasons that make markets noxious, and this was Satz's focus. Is the agent fully aware of the consequences of his or her actions? Do all agents have the same information? Does the market cause extreme harm to individuals? And how extreme does it have to be to make it noxious? Does it cause harm to society?
As Satz said – with a nod to Tolstoy's line about unhappy families – "Each noxious market is noxious in its own way," and there will not be agreement on these issues. For example, the sale of kidneys is among one of the most difficult questions. Sales are illegal in every developed society, she said. Kidneys can be donated altruistically while the donor is alive or after death, but no society makes donation mandatory, even in death. Some would argue that with two kidneys people have more than they need. As of June 10, more than 80,000 Americans were on the waiting list for a kidney, and many of them will die waiting, Satz said. "...

"In closing, Satz threw up two final challenges: "Noxious markets" reflect some of the most fundamental problems of our globe, and they will not go away unless and until the underlying problems are addressed. That will require public debate and a willingness to confront hard issues."

HT: Michael Ostrovsky

And here's Megan McArdle on Satz: What We Should Feel and What We Should Not Sell

She quotes Satz's book Why Some Things Should Not Be for Sale: The Moral Limits of Markets on the following juxtaposition of moral positions:

"[T]here is a dilemma for those who wish to use the mother-fetus bond to condemn pregnancy contracts while endorsing a woman's right to choose an abortion. They must hold it acceptable to abort a fetus but not to sell it."

Lotteries for private schools

Over at the Education Sector, there's a movie review about school choice.

Analysis and Perspectives » What We're Watching » Tough Luck
A review of the film 'The Lottery'
Authors:
Chad Aldeman
Erin Dillon
Publication Date:
June 8, 2010

"The Lottery" (2010), directed by Madeleine Sackler. The film opens to a wider audience on June 8. For theater listings, visit: http://www.screenvision.com/s/showing/TheLottery/.


"Newark, N.J., Mayor Cory Booker supports charter schools. But he might hesitate before encouraging everyone to see the new documentary "The Lottery," which follows four young children and their families as they vie for a spot at Harlem Success Academy, a coveted charter school across the river in New York City. In the film, Booker says he no longer attends the lotteries that over-subscribed charter schools like Harlem Success Academy use to select students because they break his heart, and because "a child's destiny should not be determined on the pull of a draw."


"Many who see "The Lottery" will likely share Booker's conflicted feelings. The film does an excellent job of showing both the promise and the limits of charter schools and public school choice. When Booker uses the word "destiny," he's not exaggerating; the families feel that winning or losing this lottery will go a long way to determine their child's future. As one prospective Harlem Success parent says in the film, "They instill in those kids from the beginning that 'my goal is to become a college graduate.' I think that if I had had that type of setting ... I think that would have made a big difference in my life."


"And yet, it's no spoiler to alert audience members that some of the families profiled will lose the lottery; more than 3,000 families apply for 475 seats. Those who stay to attend a neighborhood school will be assigned to one of 23 elementary schools. At 19 of these schools, fewer than half of the students are reading on grade level. In contrast, at Harlem Success Academy, 95 percent of third-graders read at grade level, and 100 percent score proficient on the state math exam. Thus, the stakes for these four particular families are high.


""The Lottery's" strength is in showing the audience the school choice process through the eyes of these families..."

Misc. non-simultaneous kidney exchange chains

Allegheny General part of multistate kidney exchange
Wednesday, April 14, 2010, By Jill Daly, Pittsburgh Post-Gazette
"Twelve donors and 12 recipients with advanced renal disease will be part of the chain when it is completed."

A discussion in the Student BMJ of kidney exchange in England: Would you donate your kidney to a stranger? Donors give a kidney to strangers in paired, pooled, and chain kidney transplants

A big kidney exchange involving four DC area hospitals, organized at Georgetown U. Hospital, including a June 15 video on the Early Show with the crowd of patients and donors.

The National Kidney Registry, a private organization, has generated a report about some of their successful activities in organizing kidney exchanges in partnership with a number of hospitals, including many nonsimultaneous chaings: The National Kidney Registry: transplant chains--beyond paired kidney donation by Veale J, and Hil G., Clinical Transplants. 2009:253-64. [I haven't been able to find the whole article yet: Pub Med lists it as "in process," but here's the abstract:]
"Abstract: The National Kidney Registry (NKR) has facilitated more than 100 transplants at 24 centers in the past 2 years and the numbers are rapidly increasing. The NKR has inherent capability for rapid change as innovations are developed and incorporated in the approach to matching donors and recipients in transplant chains. Kidneys are shipped with geotracking devices utilizing existing OPO procedures whenever patients are willing to accept them. This reduces the need for donor travel and increases the geographic area where matches can be made. Out-of-sequence transplants can be performed to improve logistics. Matching software is designed to facilitate chain transplantation and incorporates metrics that help transplant centers develop strategies to improve the chances that their patients can be transplanted. Daily match runs and close attention to repairing broken chains have been critical to growing the number of transplants that can be facilitated. A number of new innovations are expected to increase the opportunities for patients and their potential living donors."

See a chain of stories on chains here.

Father's day

Father's Day is a great academic holiday, if you think of academics as being concerned not just with ideas and institutions, but with their whole history and earliest conception. Other kinds of coauthors sometimes have difficulty figuring out who did what. But my wife agrees that my contributions were seminal. She was the biggest contributor in the subsequent, germinal stages. The division of labor has been less clear in the happy, fast decades since.

Happy Fathers' Day to all you fathers and children out there.

Indian weddings in New England: the hotel market

The Boston Globe reports: For hotels, a perfect match--Recession-hit hosts embrace Indian weddings.

"On a hot, sunny Saturday in early May, a raucous wedding procession of women in bright, shimmery saris and men in long embroidered kurtas and sunglasses danced through a hotel parking lot behind a van blaring bhangra beats. The groom brought up the rear on a dappled white horse.

"It was the first time the Marlborough Best Western had hosted a traditional Indian wedding and, in keeping with Indian culture, it was an elaborate, all-day affair, with 450 guests.

"Best Western is among the many hotels actively pursuing this lucrative market as they struggle to make up for last year’s recession-diminished revenues.

"The InterContinental Hotel, the Ritz-Carlton, the Taj Boston, and the Westin in Waltham have all hosted Indian wedding expos in the past year. Hyatt Hotels Corp. developed an Indian wedding webinar to educate staff about ceremonial customs, cuisine, even popular brands of alcohol.

"And India New England, a newspaper published in Waltham, has had so much demand from advertisers that it put out two wedding supplements instead of one last year and plans to do the same this year.

“Literally, this market is just exploding,’’ said publisher Upendra Mishra."

..."The weddings, [wedding planner and decorator Shobha Shastry] said, typically range from $50,000 to $150,000 and can go as high as $300,000.

"The average cost of a wedding in Massachusetts, by comparison, is closer to $30,000, according to the research company the Wedding Report Inc."

..."There are about 1,500 Indian weddings a year in the region, according to India New England — more than double the number 10 years ago."

Unraveling of day care

The WSJ reports on the increasingly early reservations being made for day care:Day Care? Take a Number, Baby

"These days, many parents are so intent on getting high-quality care for their kids, that they are signing up at popular child-care centers at the moment they know they are expecting a baby—or before. Some child-care centers don't even offer applications, but merely hand parents a wait-list form. That means some kids spend the first two years of their lives on a day-care wait list.

"With more women than ever in the work force, many of the country's roughly 11,000 nationally accredited child-care centers are full to capacity. The rules governing wait lists are roughly the same for all of them: Slots are assigned on a first-come, first-served basis. Infant care usually has the longest wait lists. Siblings of children who are already enrolled typically get first dibs on openings, to keep families together.

"Even so, the decision-making process behind filling these coveted slots is complex.

"Directors must match up age groupings so classmates' napping and eating routines are similar. And they must coordinate children's admission to match the unpredictable "graduation" dates of older children.

"To secure a slot, directors advise wait-listing your child at least a year or more before you expect to need care. Jessica Cavens put her baby-to-be on a child-care wait list last August, as soon as she got the results of her home-pregnancy test. The child-care center director got the good news even before the baby's grandparents. Now, one year later, Ms. Cavens's baby, Peyton, has been promised a coveted slot in August in the infant-care room at Primrose School at Stapleton, Colo.

"Some child-care centers allow parents to wait-list children not yet conceived. At centers franchised by Goddard Systems Inc., with 362 schools in 37 states, directors generally accept a wait-list entry before conception as long as parents pay a refundable deposit, usually of about $200, says Joseph Schumacher, chief executive of the King of Prussia, Pa., company.

"Other directors accept wait-list entries with no questions asked. "I can't do a pregnancy test," says Vallerie Tribble, director of Innovation Station Child Development Center, Alexandria, Va., owned by Bright Horizons Family Solutions, Watertown, Mass.

"Alyssa Soper, director of Bright Horizons at the Prudential Center in Boston, where wait lists are about a year long, says she gets wait-list requests from families who say "they're trying or thinking about" having a baby.

"It pays to enroll all your kids at the same center. Even signing up an older sibling for after-school care or summer camp at your target center may be enough to earn his or her younger sib a slot."

HT: Benjamin Kay at UCSD

Misc. kidney exchange news

A May 17, 2010 story: Innovative Transplant Procedure at Emory Opens Door to More Patients in Need

"The Emory Transplant Center at Emory University Hospital in Atlanta has recently opened its innovative Paired Donor Kidney Exchange Program, providing greater hope for patients in need of kidney transplants."
...
"Dr. Newell and his team this past month completed the third paired donor exchange surgeries involving a total of six patients - three donors and three recipients - from Texas, Colorado and Georgia. As part of this, as well as one of the two previous exchanges, Emory partnered with the Texas Transplant Institute in San Antonio, the largest independent paired donor program in the country. The program is led by Adam Bingaman, MD, a former Emory trainee who completed both his residency in general surgery and his PhD work at Emory School of Medicine. "To get the ball rolling initially on our program here at Emory, one of the first things we did was partner with the Alliance for Paired Donation," says Dr. Newell. "APD maintains a database of patients who have incompatible donors from over 50 other transplant centers, and the Alliance runs a computer program once a month to find matches between them.
"After about a year, we decided to focus on developing our own database rather than depending on APD's, and we naturally approached Dr. Bingaman about collaborating," says Newell. "Now, building our own listing of donor-recipient pairs remains paramount, an effort expedited by weekly meetings and consultations. Whenever new candidates are added, the data is shared with Dr. Bingaman's program, further increasing each patient's chance of receiving a compatible kidney from a living donor.""

Here's a paper in the June 2010 American Journal of Transplantation:
Ethical Considerations for Participation of Nondirected Living Donors in Kidney Exchange Programs
E.S. Woodle, J. A. Daller, M. Aeder, R. Shapiro, T. Sandholm, V. Casingal, D. Goldfarb, R. M. Lewis, J. Goebel and M. Siegler ; for the Paired Donation Network

ABSTRACT Kidneys from nondirected donors (NDDs) have historically been allocated directly to the deceased donor wait list (DDWL). Recently, however, NDDs have participated in kidney exchange (KE) procedures, including KE 'chains', which have received considerable media attention. This increasing application of KE chains with NDD participation has occurred with limited ethical analysis and without ethical guidelines. This article aims to provide a rigorous ethical evaluation of NDDs and chain KEs. NDDs and bridge donors (BDs) (i.e. living donors who link KE procedures within KE chains) raise several ethical concerns including coercion, privacy, confidentiality, exploitation and commercialization. In addition, although NDD participation in KE procedures may increase transplant numbers, it may also reduce NDD kidney allocation to the DDWL, and disadvantage vulnerable populations, particularly O blood group candidates. Open KE chains (also termed 'never-ending' chains) result in a permanent diversion of NDD kidneys from the DDWL. The concept of limited KE chains is discussed as an ethically preferable means for protecting NDDs and BDs from coercion and minimizing 'backing out', whereas 'honor systems' are rejected because they are coercive and override autonomy. Recent occurrences of BDs backing out argue for adoption of ethically based protective measures for NDD participation in KE.

Paying It Forward
Tulane surgeons performed what is believed to be the first “domino” paired-donor kidney exchange in Louisiana at Tulane Medical Center. Three patients in dire need of a kidney transplant received new organs from people they had never met.

Online labor markets, as an experimental lab

There are a growing number of online labor markets (for a description of a wide range, see Work the New Digital Sweatshops By Jonathan Zittrain).


A recent paper explores their use for conducting experiments: The Online Laboratory: Conducting Experiments in a Real Labor Market by John Horton, David Rand and Richard Zeckhauser . They suggest that Amazon's Mechanical Turk is a convenient venue to do experiments, with some natural advantages (e.g. it's possible to recruit large numbers of participants, who don't need to know they are in an experiment), in which adequate control is possible.


"Abstract: "Online labor markets have great potential as platforms for conducting experiments, as they provide immediate access to a large and diverse subject pool and allow researchers to conduct randomized controlled trials. We argue that online experiments can be just as valid – both internally and externally – as laboratory and field experiments, while requiring far less money and time to design and to conduct. In this paper, we first describe the benefits of conducting experiments in online labor markets; we then use one such market to replicate three classic experiments and confirm their results. We confirm that subjects (1) reverse decisions in response to how a decision-problem is framed, (2) have pro-social preferences (value payoffs to others positively), and (3) respond to priming by altering their choices. We also conduct a labor supply field experiment in which we confirm that workers have upward sloping labor supply curves. In addition to reporting these results, we discuss the unique threats to validity in an online setting and propose methods for coping with these threats. We also discuss the external validity of results from online domains and explain why online results can have external validity equal to or even better than that of traditional methods, depending on the research question. We conclude with our views on the potential role that online experiments can play within the social sciences, and then recommend software development priorities and best practices. "

Renting art at Brandeis

Can a university profit from artwork it owns (that has been donated to it)? Last year Brandeis University raised a storm by proposing to close its museum and sell its art (see my posts here and here.) Now it has proposed renting some of its art (here's the story from the Brandeis student newspaper, The Justice), and that too has generated some criticism. But the Globe thinks renting rather than selling is supportable, here's their editorial:Brandeis: Renting out art for art’s sake

"Brandeis University is raising eyebrows in the museum world with its plans to lend out artworks for money, but exploring this option is a reasonable way to preserve the financially strapped school’s collection.
"Last year, Brandeis considered closing the renowned Rose Art Museum and selling off some of its 7,500 objects. Had that happened, both the school and the region would have been worse off for it. Now, the Globe recently reported, the school is hiring auction house Sotheby’s as a lending broker. Collecting fees from institutions that might want to display some of the museum’s works could generate badly needed funding and might even increase awareness of the Rose as well."

Update: [6:14:18 AM] Bettina Klaus writes "saw your blogpost on renting art and remembered that my Maastricht neighbors are renting some http://www.bonnefanten.nl/en/art_lease (Bonnefanten Art Lease Contemporary art at your home)

The market for shorthand

When I was in high school in New York City in the 1960's, there was a department called Secretarial Studies that taught typing and shorthand (in two flavors, Gregg and Pitman). The students were mostly girls planning on looking for work as secretaries.

Well, recording machines changed the way people dictated letters (and computers of course changed it again), and nowadays the WSJ reports that you need a translator to recover the contents of old shorthand notes:Do You Know, Offhand, Anyone Who Knows Shorthand?As a Skill Fades, Translators Are in Demand; Ms. Sanders Charges 20.5 Cents a Word

It's probably also hard to find someone to repair buggy whips, not to mention recovering files stored in WordPerfect on floppy disks...

If anyone needs someone who once mastered Scribe (since displaced by TeX), let me know.

Heart transplant pro golfer

Until I read the story, I wasn't sure how to parse this AP headline: Heart Transplant Survivor Gets Shot at US Open

It turns out the headline means the golfer Erik Compton got _a_ shot at playing in the Open. He's a survivor of two heart transplants who wants to make a living playing golf. He's one of 156 players in possession of what he calls a Golden Ticket -- a tee time this week at Pebble Beach to play in the U.S. Open."

Universities and culture

A Campus Where Unlearning Is First reports on the challenges facing the American University in Cairo in its quest to offer an American style education to Egyptian students. It starts with what the university president calls "disorientation."

"During disorientation, the students — 85 percent of them Egyptians — are taught to learn in ways quite at odds with the traditional method of teaching in this country, where instructors lecture, students memorize and tests are exercises in regurgitation."


See this earlier post touching on university culture and national culture: Worldwide university rankings, compared to GNP .

Live Liver donation tragedy

The Boston Globe reports: At the Lahey, a stunning, rare tragedy--Donor dies in liver transplant attempt.

"A man who agreed to donate part of his liver to help a sick relative died while undergoing the transplant procedure at Lahey Clinic in Burlington two weeks ago, the hospital said yesterday.

"It was only the third death of an adult living liver donor in the United States in the two decades since the first procedure was done, according to two leading transplant surgeons. A total of 4,036 have been performed.

"While any surgery carries risks, specialists said the death of a living donor is especially upsetting because they are generally young and healthy and are undergoing an operation they do not need for the benefit of a family member or close friend."

..."“The safety of the donor is foremost in everyone’s mind,’’ said Dr. James Markmann, chief of transplant surgery at Massachusetts General Hospital. “It is a very safe operation, but the risk is not zero. If you do enough [of these operations], it will happen. Our thoughts go out to the donor’s family. They did a wonderful thing, and it’s tragic that it ended up this way.’’

"Markmann put the risk of death at one or two in 1,000 operations and said the risks to donors are like those for any type of major surgery, including infection, but generally are less because patients are healthy. He said these risks are weighed against the benefits to recipients: 10 to 15 percent of people waiting for a liver donation die each year because of a shortage of cadaver donors. About 1,500 liver transplant candidates died last year across the United States."

"Dr. Giuliano Testa, director of liver transplantation at the University of Chicago Medical Center, said there have been just three deaths of adult liver donors, the last in 2002 at Mount Sinai Medical Center in New York. He called the Lahey team one of the most “experienced and most expert’’ in the country."

..."Until 2001, the number of liver transplants from living donors in the United States had been growing, reaching a peak of 524 that year. Since then the number has declined, with 219 operations performed last year. Of those, 24 were done at Lahey.

"Surgeons said that the Mount Sinai death may have had a chilling effect on living liver donor transplants, but that in 2002 the cadaver liver allocation system was reorganized so that organs went to the sickest patients. This change reduced the need for living donors.

"Of the 323 living donor liver transplants done in Massachusetts since 1994, 215 were performed at Lahey. This is the first donor death since the program began in 1999, the hospital said."

Organs for sale? Repugnance as controversy to sell magazines

Mohammad Mahdian points out this ad for the Economist magazine, entitled
"Trading Human Organs Should Be Allowed"

Dating sites that limit your options

A new paper by my HBS colleagues Hanna Halaburda and Misiek Piskorski discusses why a dating/matrimony site that limits your options (like eHarmony) might be attractive. Their paper is called Platforms and Limits to Network Effects

The idea is that, even if you would prefer to have lots of options yourself, you might prefer to be one of a small set of options your dating partners are considering.

Abstract:We model conditions under which agents in two-sided matching markets would rationally prefer a platform limiting choice. We show that platforms that offer a limited set of matching candidates are attractive by reducing the competition among agents on the same side of the market. An agent who sees fewer candidates knows that these candidates also see fewer potential matches, and so are more likely to accept the match. As agents on both sides have access to more candidates, initially positive indirect network effects decrease in strength, reach their limit and eventually turn negative. The limit to network effects is different for different types of agents. For agents with low outside option the limit to network effects is reached relatively quickly, and those agents choose the platform with restricted number of candidates. This is because those agents value the higher rate of acceptance more than access to more candidates. Agents with higher outside option choose the market with larger number of candidates. The model helps explain why platforms offering restricted number of candidates coexist alongside those offering larger number of candidates, even though the existing literature on network effects suggests that the latter should always dominate the former.

College admissions and "demonstrated interest"

Signaling is important, says a recent article in the Chronicle of Higher Ed: The Dynamics of Demonstrated Interest

"This year, American University received a record 17,000 admissions applications, a 13 percent increase over last year.

.... as colleges become more selective, they often find themselves competing with institutions a rung or two higher on the ladders of selectivity and desirability, at least for the top students.

Although there's prestige in this kind of association, there's also uncertainty. How many applicants would turn down a super-selective, big-name college to attend a somewhat less-selective, less-famous one? How do you know whether a student considers your college a top choice or a "safety school"? How does an applicant's sense of "fit" with a college relate not only to matriculation, but also retention?

"In recent years, such questions have prompted American's admissions team to look more closely at "demonstrated interest," the popular term for the contact students make with a college during the application process, such as by visiting the campus, participating in an interview, or e-mailing an admissions representative. In theory, it's a way to measure the likelihood that an applicant will matriculate—and succeed if they do.

"The practice is not new, but its importance has grown at some selective colleges in this era of ballooning applications and economic uncertainty. From 2003 to 2006, the percentage of colleges rating demonstrated interest as a "considerably important" factor increased to 21 percent from 7 percent, according to an annual survey by the National Association for College Admission Counseling. Since then, that number has held steady (another 27 percent of colleges now deem it "moderately important"). ...

"Recently, American has created more opportunities for students to do just that. The admissions office has broadened its recruitment strategies to include online chats for prospective applicants. Participation is noted in each student's file. ...

"Demonstrated interest often dovetails with another strategy for managing uncertainty: the waiting list. This year, American offered a spot on its waiting list to about 2,000 students, a seemingly large number considering that the university had accepted approximately 7,300 students for its freshman enrollment target of 1,450.

"Applicants who received waiting-list invitations from American fit a range of descriptions. Some were less competitive than the applicants the university accepted, but others were top-notch students who did not seem like a good fit for the university. In some cases, the reason was a lack of demonstrated interest, Ms. Alston says."

Teachers who tamper with standardized test scores

"John Fremer, a specialist in data forensics who was hired by an independent panel to dig deeper into the Atlanta schools, and who investigated earlier scandals in Texas and elsewhere, said educator cheating was rising. “Every time you increase the stakes associated with any testing program, you get more cheating,” he said."

From the NY Times story: Under Pressure, Teachers Tamper With Test Scores, reporting that "investigations in Georgia, Indiana, Massachusetts, Nevada, Virginia and elsewhere this year have pointed to cheating by educators. Experts say the phenomenon is increasing as the stakes over standardized testing ratchet higher — including, most recently, taking student progress on tests into consideration in teachers’ performance reviews."

Afghan child weddings

The NY Times writes about the floggings administered to twp runaway child brides, in a story that also includes some interesting background: Child Brides Escape Marriage, but Not Lashes.

The case of Khadija Rasoul, 13, and Basgol Sakhi, 14, from the village of Gardan-i-Top, in the Dulina district of Ghor Province, central Afghanistan, was notable for the failure of the authorities to do anything to protect the girls, despite opportunities to do so.Forced into a so-called marriage exchange, where each girl was given to an elderly man in the other’s family, Khadija and Basgol later complained that their husbands beat them when they tried to resist consummating the unions. "

Super duper

Duper of Harvard Got Into Stanford
Student Accused of Lying to Harvard Was Admitted to Stanford, Too

"Adam Wheeler, the Delaware man charged with lying about his credentials to get into Harvard and to secure nearly $50,000 in financial aid and prizes, was later admitted to Stanford as a transfer student, Massachusetts prosecutors said in court documents released Wednesday."
"Cara O’Brien, a spokeswoman for Middlesex Superior Court in Massachusetts, told my colleague Abby Goodnough that the documents reveal that Mr. Wheeler was admitted to Stanford this year as a transfer student for the 2010-11 school year. Massachusetts authorities have said that Mr. Wheeler left Harvard last fall after university officials confronted him with allegations that much of his application for a Rhodes Scholarship had been plagiarized."

See my earlier post for the background: College admissions fraud, at Harvard

Update: and here's the Dec. 16, 2010 Globe story covering his guilty plea and sentencing.

Personal data for sale

Web Start-Ups Offer Bargains for Users’ Data

The budgeting Web site Mint.com, for example, displays discount offers from cable companies or banks to users who reveal their personal financial data, including bank and credit card information. The clothing retailerBluefly could send offers for sunglasses to consumers who disclose that they just bought a swimsuit. And location-based services like Foursquare and Gowalla ask users to volunteer their location in return for rewards like discounts on Pepsi drinks or Starbucks coffee.

These early efforts are predicated on a shift in the relationship between consumer and company. Influenced by consumers’ willingness to trade data online, the sites are pushing to see how much information people will turn over."...

"New companies including WeShop, Aprizi, Blippy and Dopplr are trying to exploit the data that people seem so willing to give up. Some are even allowing shoppers to set what terms they want — free shipping, half-price discounts, only fair-trade products. They can also list what they are shopping for, like a gray cashmere sweater under $100, for instance, and let the retailers fight it out for the right to make a sale.

“The whole privacy debate has grown up around people using your data without your permission,” said Antony Lee, chief executive of WeShop. “If you want to use your data to your benefit, that’s for you to do,” Mr. Lee said."

Experimental economics and market design

As I prepare my chapter on that subject for volume 2 of the Handbook of Experimental Economics, I've belatedly posted a related paper, which has a section on experiments in market design from which I'll cheerfully borrow:

Roth, Alvin E. " Is Experimental Economics Living Up to Its Promise? , in Frechette, Guillaume and Andrew Schotter (editors), in The Methods of Modern Experimental Economics , Oxford University Press, forthcoming.

Outsourcing online courtship

The Washington Post has a story about services (like Virtual Dating Assistants) that allow online courtship to be outsourced: Online dating assistants help the lonely and busy

"Last June, Valdez, now 25, founded Virtual Dating Assistants -- a company that "specializes in making the dating dreams of busy individuals come true."

"Author Timothy Ferriss popularized the concept when he wrote about outsourcing his online dating accounts to teams of competing writers in his 2007 book, "The 4-Hour Work Week."

"Valdez's Atlanta-based firm is hardly the only outfit to offer such services. Dozens of profile-writing shops such as Arlington County-based TargetLove have popped up in the past few years, and dating coaches are increasingly managing their clients' online pursuits. Not to mention the well-intentioned friends and relatives who have taken over the process for the hapless singles in their lives.

"But Valdez and his team of 45 freelance writers, including Hartshorn, do it all: write a client's profile, pick out potential matches, send introductory e-mails and message back and forth until a date is confirmed. Then they turn over the correspondence and tell the lucky fellow where and when he's meeting Madame X. (And it's almost always that gender dynamic; 80 percent of the firm's clients are men.)...

"Mark Brooks, founder of Online Personals Watch, a site that tracks Internet dating trends, says this type of outsourcing is an ethically questionable form of "misrepresentation." Still, he expects the field to grow.

"Professional matchmakers often charge $5,000 or more a year and have a limited pool of matches. Online dating sites are populated with countless singles but can require more attention than some users are willing to devote. "It may look like instant gratification, like you dive into the pool and instantly come up with a fish, but it doesn't really work like that," Brooks says. "You've got to tap, tap, tap on the keyboard quite a lot to get anywhere."

The market for young soccer players

The NY Times Sunday Magazine reports on How a Soccer Star Is Made . (Shades of both Harry Potter and Ender's Game...)


"The youth academy of the famed dutch soccer club Ajax is grandiosely called De Toekomst — The Future. ...Ajax once fielded one of the top professional teams in Europe. With the increasing globalization of the sport, which has driven the best players to richer leagues in England, Germany, Italy and Spain, the club has become a different kind of enterprise — a talent factory. It manufactures players and then sells them, often for immense fees, on the world market.
...
"Like other professional clubs in Europe and around the world, Ajax operates something similar to a big-league baseball team’s minor-league system — but one that reaches into early childhood. ... for some families, the first time they realize their boys are under serious consideration is when a letter arrives from Ajax requesting that they bring their sons in for a closer look, an invitation that is almost never declined.
...
"Ajax puts young players into a competitive caldron, a culture of constant improvement in which they either survive and advance or are discarded. It is not what most would regard as a child-friendly environment, but it is one that sorts out the real prodigies — those capable of playing at an elite international level — from the merely gifted.
...
"About 200 players train at De Toekomst at any given time, from ages 7 to 19. (All are male; Ajax has no girls’ program.) Every year, some in each age group are told they cannot return the following year — they are said to have been “sent away” — and new prospects are enrolled in their place.
...
"I asked Martin Jol, the coach of Ajax’s first team, if it was difficult for him to nurture young players knowing he would lose them just as their talent blossomed. “I think that is the purpose of Ajax, to develop players and bring them up to the first team as young as possible,” he answered. “And then we sell them, not for peanuts but for a lot of money.”
...
"In the U.S., we think of money as corrupting sport, especially youth sport. At Ajax, it is clarifying. With the stakes so high — so much invested and the potential for so much in return — De Toekomst is a laboratory for turning young boys into high-impact performers in the world’s most popular game. "
...
"Parents pay nothing except a nominal insurance fee of 12 euros a year, and the club covers the rest — salaries for 24 coaches, travel to tournaments, uniforms and gear for the players and all other costs associated with running a vast facility. Promising young players outside the Ajax catchment area usually attend academies run by other Dutch professional clubs, where the training is also free, as it is in much of the rest of the soccer-playing world for youths with pro potential. (The U.S., where the dominant model is “pay to play” — the better an athlete, the more money a parent shells out — is the outlier.)
" How the U.S. develops its most promising young players is not just different from what the Netherlands and most elite soccer nations do — on fundamental levels, it is diametrically opposed.
Americans like to put together teams, even at the Pee Wee level, that are meant to win. The best soccer-playing nations build individual players, ones with superior technical skills who later come together on teams the U.S. struggles to beat. In a way, it is a reversal of type. Americans tend to think of Europeans as collectivists and themselves as individualists. But in sports, it is the opposite. The Europeans build up the assets of individual players. Americans underdevelop the individual, although most of the volunteers who coach at the youngest level would not be cognizant of that.
...
"De Toekomst is not where you come to hear a romantic view of sport. No one pretends that its business is other than what it is. “We sold Wesley Sneijder for a ridiculous amount of money,” Versloot said. “We can go on for years based on what he was sold for.”
...
"Versloot said that, on average, one and a half products of De Toekomst per season will rise to the first team and go on to a significant, well-compensated pro career. Some of the others will gravitate to second- or third-tier pro circuits or the high amateur ranks in the Netherlands, where the best players make “black money,” under-the-table payments. The pressure to emerge from the academy as one of its top products — and to produce them — is immense. “It is always a very tense atmosphere here, for everyone,” Versloot said. “You have to just get used to it.”
...
"Fulham, like Ajax, is often a seller of talent. It recently sold a 20-year-old to Manchester United for seven million pounds, or more than $10 million. “It’s a little ugly talking about the financial terms,” Jennings said. “I don’t like to do it. It feels not too far off from the slave trade."

"Everyone draws the line somewhere. Jennings told me that he recently received a call from a rival club asking if it could schedule a game against his “elite 5s” — 5-year-olds. He replied, “We don’t have elite 5s, but we’ll play your expectant mothers.”
...

"Ronald de Jong invited me to go scouting with him one Saturday. He had his eye on a specific target — “a 2004,” he said, referring to a birth year. A 5-year-old whom he had seen and was checking in with every month or so. This boy might not even be in school yet, I pointed out. “I don’t think he is,” de Jong said with a slight smile, as if he recognized the absurdity. “I believe he’s in day care.”

Auction design patents

My market design colleagues and I have tried to put our algorithms for school choice, kidney exchange, and labor market clearinghouses in the public domain. But in one very competitive commercial area of market design, involving auction rules, it is not uncommon for designers to seek patents.

System and method for a hybrid clock and proxy auction is a patent issued on June 1, 2010 to Larry Ausubel, Peter Cramton, and Paul Milgrom. (Here is a link to other auction patents by Ausubel et al.)

National Kidney Foundation: End the Wait

Here's a press release from the NKF: NKF Names Co-Chairs for END THE WAIT! Exec Committee

"Transplant surgeon Dr. Francis L. Delmonico and non-directed kidney donor Bill Singleton were named the first co-Chairs of the END THE WAIT! Executive Committee, the National Kidney Foundation (NKF) announced June 4.

NKF launched the END THE WAIT! initiative at the start of 2009 to address the urgent need to increase the number of organs available for transplantation in the United States.

"The END THE WAIT! initiative is a virtual call-to-arms that the current system of organ donation and transplantation is not sustainable to fulfill the needs of our patients. In collaboration with other major organizations in the kidney care, donation and transplant communities, we are leading this charge to address the inconsistent practices across the United States that are no longer acceptable," said John Davis, National Kidney Foundation CEO. “We know that Dr. Delmonico's vast professional experience as one of the nation's preeminent transplant experts and Mr. Singleton's personal experience as a living donor will help provide the knowledge and perspective needed to move our ambitious agenda forward and implement our END THE WAIT! recommendations.”

END THE WAIT! recommendations focus on improving the donation process, eliminating barriers to donation, instituting best practices and increasing living and deceased donation.

The recently-passed Healthcare Reform Bill prohibits insurance companies from denying medical coverage to those with pre-existing conditions. In the past, living kidney donors had been viewed as having a pre-existing medical condition by some insurance companies and denied medical coverage. Certainly, such practices constitute barriers to donation and eliminating that was one of the END THE WAIT! recommendations," Davis added.

“We will continue to fight for patients to receive comparable care from one region of the country to another, for example by maximizing programs such as paired kidney donation that are not currently accessible to all patients,” said Dr. Delmonico, transplant surgeon at Massachusetts General Hospital and Professor of Surgery at Harvard Medical School. “Others priorities will focus on removing disincentives to living donation, including covering all donation-related expenses.”

“The list of Americans now waiting for organs continues to increase each day,” said Singleton, a long-time NKF volunteer and former board member who became a kidney donor in December 2009 as part of the largest kidney exchange in the world to date. “I'm committed to helping other potential donors learn more about the process. I know we can help educate people and remove barriers through END THE WAIT!”

Market design at 9am

A former student, Abe Othman, endorses our market design course even though it was held early Friday mornings: Foundational Paper: The Economist as Engineer

College waiting lists and double depositing

An article on congestion in college admissions: The Dirty College Admissions Trick.

"Why are waitlists so long this year? Marc Zawel on the increasingly common practice of "double depositing," and how a few bad apples could land you in waitlist limbo all summer long."
HT: Steve Leider

A market design collaboration between an economist and computer scientists

I've written earlier about the work on course allocation by Eric Budish. The new mechanism he proposed is by no means computationally trivial to implement, and together with Abe Othman, a computer science grad student at CMU (who took my Market Design class when he was an undergraduate at Harvard), he has been working on making this a practical too. A report of their work has now appeared:

Finding Approximate Competitive Equilibria: Efficient and Fair
Course Allocation, Abraham Othman, Eric Budish, and Tuomas Sandholm, Proc. of 9th Int. Conf. on Autonomous Agents and Multiagent Systems (AAMAS 2010), van der Hoek, Kaminka, Lespérance, Luck and Sen (eds.), May, 10–14, 2010, Toronto, Canada, pp. 873-880


Abstract: In the course allocation problem, a university administrator seeks to efficiently and fairly allocate schedules of over-demanded courses to students with heterogeneous preferences. We investigate how to computationally implement a recently-proposed theoretical solution to this problem (Budish, 2009) which uses approximate competitive equilibria to balance notions of efficiency, fairness, and incentives. Despite the apparent similarity to the well-known combinatorial auction problem we show that no polynomial-size mixedinteger program (MIP) can solve our problem. Instead, we develop a two-level search process: at the master level, the center uses tabu search over the union of two distinct neighborhoods to suggest prices; at the agent level, we use MIPs to solve for student demands in parallel at the current prices. Our method scales near-optimally in the number of processors used and is able to solve realistic-size
problems fast enough to be usable in practice.

Money and medicine in Britain's National Health Service

The London Times reports NHS bars woman after she saw private doctor

"A WOMAN has been denied an operation on the NHS after paying for a private consultation to deal with her severe back pain.
Jenny Whitehead, a breast cancer survivor, paid £250 for an appointment with the orthopaedic surgeon after being told she would have to wait five months to see him on the NHS. He told her he would add her to his NHS waiting list for surgery.
She was barred from the list, however, and sent back to her GP. She must now find at least £10,000 for private surgery, or wait until the autumn for the NHS operation to remove a cyst on her spine. "

The managing of waiting lists for scarce resources is a tough business.

Kidney exchange at VA hospitals

It's exciting to see kidney exchange growing. The issues that the Veterans Affairs hospitals face reflect the progress in the last few years at other kinds of hospitals and kidney exchange networks.

Paired kidney exchange attracts VA: Growing practice may be allowed at four hospitals that do transplants

"Sometime in the next month, more than 600 veterans waiting for kidney transplants at VA hospital transplant centers in Pittsburgh and three other locations across the country could have a new option for finding an organ match.
William Gunnar, national director of surgery for the Veterans Health Administration, said he is reviewing the idea of letting the four VA hospitals that do kidney transplants -- in Pittsburgh, Nashville, Iowa City and Portland -- join the still novel but growing practice known as paired kidney exchange."
...
"Kidney transplant administrators at all four VA hospitals said they would like to take part in paired kidney exchanges after discussing it for four years, and are hoping for a favorable review from the central office.
"It's a no-brainer," said Mohan Ramkumar, kidney transplant program medical director at VA Pittsburgh Healthcare, which has 194 people on its waiting list and does about 40 transplants annually. "The more transplants you can do, the more money you save from dialysis, and the more people you help."
"I don't know if it will do a tremendous amount to cut down on our waiting list, but it could help. It would be one more option," said Dr. Ramkumar.
Last year, of the roughly 17,000 kidney transplants done nationally, 304 of them were the result of paired exchanges. But that's up from just 74 in 2006, according to The United Network for Organ Sharing, an organization that oversees the nation's organ and transplant network. Experts expect those figures to continue to grow rapidly as the concept takes hold."
...
"The VA used to have 20 hospitals that did kidney transplants. But when Medicare in 1973 started paying for all kidney transplants, veterans chose private hospitals for transplants, and the VA closed its programs.
When Medicare started charging co-pays for its services in the 1990s, veterans asked the VA to do kidney transplants. In 2001, the VA chose three hospitals to restart their programs, with Pittsburgh joining them a year later."
...
"Though most of the nation's kidney transplant centers already are members of at least one of the various paired kidney exchange consortium -- which orchestrate exchanges between different hospitals -- the VA has moved more cautiously.
"There have been some accusations over the years that this ethically and legally borders on potentially selling organs," said Dr. Gunnar.
A 2007 federal law specifically said that paired kidney exchanges was not selling organs, which would be a violation of the National Organ Transplant Act, but Dr. Gunnar said a legal opinion was still needed to move forward.
Ethically, a big issue for paired kidney exchanges is dealing with altruistic donors not tied to a specific transplant recipient, said Judy Kazmar, kidney transplant coordinator for the Portland VA hospital, which has 152 people on its waiting list and does about 30 transplants a year there.
"We're pretty conservative here. And with donors, we need to know, what's their motive for donating?" Ms. Kazmar said. "I think paired donations is a good idea, but it has a lot of logistics to it to work out."
If the VA does decide to go ahead with paired exchanges, one idea would be to start with its own pilot program of sorts.
"I think a consortium among ourselves would be best to start with, and then look at joining a larger consortium or national program," said Anthony Langone, kidney transplant medical director for the Nashville VA hospital, which has about 200 people on its waiting list and does about 30 kidney transplants a year.
The VA also is debating how to pay the thousands of dollars to pre-screen potential donors -- some of whom might not donate -- and how to assign long-term, post-surgical care to donors who aren't veterans, said Dr. Thomas.
"We as a nation have done badly dealing with long-term care for living donors," he said. "We want to make sure we get it right." "

Veil travails

French cabinet approves veil ban
" The French cabinet has approved a draft law to ban the wearing of full-face veils in public spaces, opening the way for the text to go before parliament in July.The bill calls for $185 fines and, in some cases, citizenship classes for women do not comply with the ban.
Addressing the cabinet meeting on Wednesday, Nicolas Sarkozy, the French president, said: "Citizenship should be experienced with an uncovered face. There can be no other solution but a ban in all public places."...
"The bill includes a new offence - inciting to hide the face - with anyone convicted of forcing a woman to wear such a veil risking a year in prison and a $18,555 fine."
...
"The bill is set to go before parliament in July and is widely expected to become law."

Design of financial clearinghouses: Over the counter derivatives markets

The Bank for International Settlements' Committee on Payment and Settlement Systems has, in a followup to the recent financial crisis, issued two reports.


The first concerns clearinghouses-- Central Counterparties (CCPs). Here is the summary, and the report. From the summary:

"Over the past several years, public and private sector entities have undertaken a coordinated effort to improve the post-trade infrastructure for OTC derivatives transactions. The recent financial crisis demonstrated the need to further enhance the safety and transparency in the OTC derivatives markets. As a result, authorities in many jurisdictions have set out several important policy initiatives encouraging greater use of CCPs for OTC derivatives markets. The CPSS and the Technical Committee of IOSCO support these positive developments.
A well designed CCP can reduce the risks and uncertainties faced by market participants and contribute to the goal of financial stability. Nevertheless, because of the complex risk characteristics and market design of OTC derivatives products, clearing them safely and efficiently through a CCP presents unique challenges that clearing listed or cash-market products may not. "


Some of the challenges seem to be in making the products well defined...


These apply also to Trade Repositories, which are meant to be simple registers of what positions are held. Again, here's the summary and the report.

Promoting young faculty at Harvard

The Chronicle reports At Harvard, Tenure Isn't Just for Old People Anymore (and the issue, they surmise, is two career households).

"For decades, assistant professors at Harvard University knew better than to get too comfortable. After all, they probably wouldn't be staying there very long.
Unlike the typical university, Harvard didn't have a tenure track. Instead, most young scholars spent several years capitalizing on the university's famous name and resources, then moved on to a tenured job somewhere else. Meanwhile, Harvard usually reserved tenure for senior stars with established reputations whom it lured away from other universities.
In the last several years, however, Harvard has changed. Of the 41 people to whom the university offered tenure last year, half started as junior scholars there. The university had been finding it harder to persuade senior faculty members to pick up their families and move, even to storied Cambridge, so it has developed a tenure track and begun grooming those coming up through the ranks."...

"Plucking senior scholars from other campuses worked well for Harvard when the desired scholars had spouses or other partners who didn't work. "It used to be that if you were Harvard, you crooked your finger and people came," says Susan Carey, who heads the university's psychology department.
But over the last couple of decades, as dual-career couples became the norm, Harvard's offers were less compelling. Many senior scholars were unwilling to move if it meant spouses had to give up their jobs.
"The old days when the guy came home and said, 'Honey, we're moving to Cambridge, pack up,' just don't exist anymore," says Lizabeth Cohen, chairwoman of the history department. "We were investing huge amounts of time in senior searches and not getting the yield to make it worth it." "

Spousal Hiring

In The Intricacies of Spousal Hiring, David Bell, a former Johns Hopkins dean writes

"My experience in the dean's office confirmed my impressions as to the need for spousal hiring. Johns Hopkins simply could not have built its faculty without a willingness to create positions for spouses and partners.
In case after case, that willingness was, by far, the single most important factor in recruitment. We could increase a salary offer by tens of thousands of dollars a year; provide lavish research accounts; promise a scandalous number of sabbatical leaves—none of it mattered if it meant that a candidate still faced the prospect of a long-distance commute or a major professional sacrifice by a spouse."

Paul Milgrom on spectrum auctions in India and Germany

Paul Milgrom writes on Success in Spectrum Auctions in India and Germany, in which he played an active role consulting to bidders.

Organ sales in China

MSNBC reports Organ trafficking trial exposes grisly trade: Chinese man accused of selling black market body parts
"China in 2007 banned organ transplants from living donors, except spouses, blood relatives and step or adopted family members, but only launched a national system to coordinate donation after death last year.
Its efficiency has yet to be proved. Nearly 1.5 million people in China need organ transplants each year, but only 10,000 can get one, according to the Health Ministry.
The defendants in the two Beijing trials face up to five years for their role as go-betweens between donors and buyers, which could "damage society and moral values", the Procuratorial Daily reported. They are still waiting for their verdict.
But at least two of them say they are being unfairly hounded for playing a vital role in helping both the sick and poor.
"I believe I was helping people, not harming others," the paper quoted defendant Liu Qiangsheng as saying.
Liu says he got into the business after selling half his own liver in 2008 to help pay for this father's medical bill. A friend of the recipient, who was waiting in despair for a liver, asked him to find another organ provider.
"I saved the life of the person who received my liver. He was only in his 30s. I do not regret it," he said.
His partner, Yang Shihai, had also sold one of his own kidneys, the paper reported.
"The donors were free. They were not controlled by us. They sold their organs voluntarily," it quoted Yang saying.
Middlemen specialized in faking documents allowing donations between strangers have helped raise transplants from living donors to 40 percent of donations, from 15 percent in 2006, the official China Daily reported last year.
However the majority of organs for transplant are still harvested from executed criminals, the paper said. Beijing hopes the new system will end both live transplants and taking organs from prisoners, which makes senior officials uncomfortable.
"(Executed prisoners) are definitely not a proper source for organ transplants," Vice Minister Huang Jiefu told China Daily."

An incongruous note: In the middle of the story was an ad saying "Buy 1 Get 1 Free." (It turned out to be an ad for eyeglasses...)

Kidney exchange at Northwestern

Tomorrow (Wednesday) afternoon I'll be giving the Nancy L. Schwartz Memorial Lecture at Northwestern, and I'll talk a lot about kidney exchange.

So it's a good time to mention a big exchange chain that was completed last month entirely at Northwestern Memorial Hospital, which has one of the biggest living donor transplant programs in the country: Sixteen Patients, Eight Kidney Transplants, Three Days... One Life Changing Event .

This was an innovative non-simultaneous altruistic donor chain, conducted over three days (with 3 transplants done the first day, 3 the second, and 2 the third.)

Here's a page containing (scroll down) a May 19 video interview with the non-directed donor, and two of the transplant docs, John Friedewald and Joseph Leventhal.

Some of my earlier posts on the revolution caused by non-simultaneous chains are below:

Advances in kidney exchange, in the New England Journal of Medicine

Kidney Exchange in People Magazine

Non-simultaneous kidney exchange chains

More non-simultaneous kidney chains

Progress towards a sensibly organized national kidney exchange.

(John Friedewald, the Northwestern transplant nephrologist interviewed about the story at the top of this post, is the chair of the UNOS Kidney Paired Donation Work Group charged with organizing a pilot national program...)

Predicting behavior in games: a competition

Sometimes an experimental design is meant in part to solve a market design problem. That's the case with the call for entries reproduced below. You are invited: Enter and win:)

The market design issue is twofold. Scientific publishing gives a lot of incentives for reporting positive results about interesting problems, but can have the effect of suppressing negative results (the "file-drawer effect") or sometimes promoting false positives. It is also hard for researchers to report how models perform on representative random samples of problems, both because this requires relatively big and costly experiments, and because randomly chosen problems (some of which are, by themselves, boring) may not be as rewarding to examine as are problems carefully selected to showcase the virtues of a particular model.


The competitions we're proposing are an attempt to ameliorate both incentive problems. The hosts of the competition will run the necessary experiments on random samples of games, and invite researchers to submit models to predict the observed behavior. (Researchers can test their model on a first random sample of games for which the experimental results are reported before the competition, and they are invited to predict results for a second random sample of games that will not be published until all the models are submitted.) So the competition is cheap to enter (the random sampling experiments are already taken care of), and the entries are submitted before their authors know how well they will perform.


Here's the call for a competition to predict behavior in market entry games. And here is a version just sent out by email:

Ido Erev, Eyal Ert, Al Roth and Games Editorial Office invite you to participate in the choice prediction competitions that will be conducted as part of the special issue of the journal Games (http://www.mdpi.com/journal/games/) on “Predicting Behavior in Games” (http://www.mdpi.com/si/games/predict-behavior/). Below is the call to participate in the first competition which focuses on market entry games.
The first “Games” competition: Predicting behavior in market entry games.
The first competition focuses on the prediction of behavior in repeated 4-person market entry games. The organizers first ran (in March 2010 at Harvard) an experimental study of (40) games that were randomly selected from a well-defined space of market entry games. The raw experimental results of this study, referred to as the “estimation experiment,” are presented in the competition’s website (http://sites.google.com/site/gpredcomp/).
In addition, the competition website includes the rules of the competition, and a link to a paper that summarizes the results of the estimation experiment and explores the value of several baseline models (http://www.mdpi.com/2073-4336/1/2/117/.)
The site explains that the goal of the participants in the competition is to predict the results of a second experiment. This study, referred to as the “competition experiment,” will be run by the organizers in May 2010 (but the results will be kept confidential until 2 September 2010). The competition experiment will use the same method as the estimation experiment, but will study different games (drawn from the same space of games) and different subjects.
To participate in the competition you will have to email us a computer program (in MATLAB, Visual Basic, or SAS) that reads the parameters of the games (the incentive structure) as input, and predicts the main results as output. The program should be an implementation of your favorite model. To develop and/or estimate your model you are encouraged to analyze the data of the estimation experiment, and to build on the baseline models that were posted in the competition website.
The submitted models will be ranked based on the mean squared deviation between the predictions and the results of the competition experiment. The prize for the winners will include an invitation to publish a paper that describes the winning model in Games, and an invitation to a special workshop.
The submission deadline for this competition is 1 September 2010. You are allowed to submit one model as a first author and to co-author up to three additional submissions.
Best regards,

Ido Erev, Eyal Ert and Al Roth
Guest Editors
Games Special Issue "Predicting Behavior in Games"
http://www.mdpi.com/si/games/predict-behavior/

Gifts of kidneys and gifts of gratitude

The ethics column in today's NY Times Sunday Magazine begins with this query:
"Last fall, a stranger donated a kidney to my husband. We offered her a gift after the operation, which she declined. Recently she wrote us that her house is in foreclosure, and she needs money. We obviously have no legal responsibility to respond, but what is our ethical responsibility? I wish it were legal to sell organs; it would be much cleaner in many ways. NAME WITHHELD "

The column's author and resident ethics guru, Randy Cohen, offers this response:
"You’ve no moral obligation to send money to the organ donor. She admirably — heroically — provided her kidney as a gift. An essential quality of a gift is that it comes with no strings, with no reciprocal obligations. Otherwise, it would be a sort of disguised sale. United States law prohibits the sale of organs, wisely, in my view. To permit such transactions is to allow those with money to harvest the organs of those without. Even if you prefer that system of organ allocation — many honorable people do — it was not what you and the donor agreed to.

That said, it is a fine thing to echo generosity, to respond to the subsequent and unanticipated travails of someone who has done so much for you. You need not put yourself in dire financial peril to send this woman money, but if you choose to help her, that would be estimable.

Perhaps it is my suspicious nature, an occupational hazard, but I see at least the possibility that she might have known about her money trouble for some time, and the hope of alleviating it may have been part of her motivation to donate a kidney, a desperate and pitiable measure. If you believe that she planned to psychologically pressure you into, in effect, paying for a kidney, you should decline to collaborate in cloaking an organ sale as a gift."

Update: my colleague Greg Mankiw, reflecting on his favorite textbook, summarizes the article this way.

Do two rights make a wrong?

via Greg Mankiw's Blog by Greg Mankiw on 23/05/10

Users of my favorite textbook know that it includes, in Chapter 7, a case study on whether kidneys should be traded in a market. Today's NY Times has a related article.

The paper's so-called "Ethicist" is dealing with this situation:

1. Person A receives a kidney transplant as a donation from person B.
2. A short time later, person B is having financial troubles and her home may go into foreclosure. Person A is considering her giving some money to help out.

So what does the "Ethicist" say about all this? Apparently, both of these gifts are noble acts, worthy of the highest praise and admiration. Unless, that is, there is some reason to think they are linked together. In that case, the reallocation of resources (kidney, cash) would be a despicable market transaction.

I suspect that few economists would concur. Indeed, the essence of market transactions is a kind of reciprocal altruism, enforced by contract. It might be nice if the world could work using pure altruism alone, but that seems highly unrealistic. The sad truth is that under the Ethicist's code of conduct, we have more deaths and more foreclosures than necessary, all in the name of fairness.

Scalping world peace as NY ticket resale laws expire

The NY Times reports on Scalping World Peace, Outside Radio City
"The appearance of the Dalai Lama at Radio City Music Hall has inspired a certain chant on the Avenue of the Americas.

“Tickets for the Dalai Lama, tickets,” intoned a not-particularly-spiritual-seeming 55-year-old scalper from Brooklyn, standing on the corner of 50th Street on Friday afternoon. “Anyone selling tickets? Tickets.
...
“It’s difficult to bargain with Dalai Lama fans,” Richie said later. “They don’t even know what ‘orchs’ are,” meaning orchestra seats. “They’re always looking for cheap seats. They have no concept of premium seating.” "

This is taking place in an unsettled legal environment: The Times reported last week
Legal Ticket Scalping Law to Lapse as Albany Debates a New Provision, and here's yesterday's Daily News: Gov. Paterson reenacts 1920s ticket scalping law, serving notice to StubHub, Ticketmaster and others