Thursday, October 24, 2019

Prostitution in Washington DC (sex, not politics)

The NY Times has the story, on a bill being discussed that would legalize not only prostitution, but pimps and brothels.

In Washington, a Fight to Decriminalize Prostitution Divides Allies
Supporters say a bill being considered by the District of Columbia Council would protect prostitutes in the nation’s capital. Critics say it would be a boon to sex traffickers.

"Groups supporting decriminalization include the A.C.L.U., Black Lives Matter, Amnesty International and the World Health Organization.

"Opponents include the National Organization for Women and World Without Exploitation, a coalition of groups dedicated to ending sexual trafficking and exploitation.
...
“If the issue people have about pimps is that they are benefiting from other people’s labor, don’t they have managers who do that at McDonald’s?” she asked."

Wednesday, October 23, 2019

Designing effective reputation systems, by Donaker, Kim, and Luca in HBR

The Nov-Dec 2019 issue of the Harvard Business Review has an article offering some strategies for designing a reputation system that will have a better chance of being well populated and reliable:

Designing Better Online Review Systems
Geoff Donaker, Hyunjin Kim, Michael Luca

Tuesday, October 22, 2019

Same sex marriage, and abortion, to be legal in Northern Ireland

The Guardian has the story:

Northern Ireland to legalise abortion and same-sex marriage
Equality campaigners were celebrating before the midnight deadline for law to take effect

"Northern Ireland is to legalise abortion and same-sex marriage after an 11th-hour attempt by the region’s assembly to block change collapsed into farce.

Equality campaigners celebrated on Monday as the clock ticked towards midnight when laws extending abortion and marriage rights came into force, ushering in momentous social change as Northern Ireland aligned with the rest of the UK."

Monday, October 21, 2019

Exchange with the right of exclusion--Balbuzanov and Kotowski in Econometrica

Interesting...

Endowments, Exclusion, and Exchange
Ivan Balbuzanov, Maciej H. Kotowski
ECONOMETRICA: SEP 2019, VOLUME 87, ISSUE 5

Abstract: We propose a new solution for discrete exchange economies and resource-allocation problems, the exclusion core. The exclusion core rests upon a foundational idea in the legal understanding of property, the right to exclude others. By reinterpreting endowments as a distribution of exclusion rights, rather than as bundles of goods, our analysis extends to economies with qualified property rights, joint ownership, and social hierarchies. The exclusion core is characterized by a generalized top trading cycle algorithm in a large class of economies, including those featuring private, public, and mixed ownership. It is neither weaker nor stronger than the strong core.

"Our key contribution is the development of a new solution concept for discrete exchange economies and allocation problems, which we call the exclusion core. The exclusion core’s foundation is a reinterpretation of endowments in an exchange economy as a distribution of exclusion rights, rather than as bundles of things to trade. A simple idea—the ability to exclude others from goods in one’s own endowment—offers reallocation possibilities that are absent from traditional core solutions and is at the heart of the exclusion core’s rationale and predictive power. We formulate the exclusion core and analyze its properties in economies with single-unit demand, indivisible goods, and no transfers.
...
" we show that the exclusion core has a close association with David Gale’s top
trading cycle (TTC) algorithm (Shapley and Scarf (1974)). Beyond its theoretical elegance, the TTC algorithm is of substantial practical importance. Suitably generalized, it underpins implemented or proposed solutions to many market-design problems, including transplant organ exchange (Roth, Sönmez, and Ünver (2004)), student-school assignment (Abdulkadiro˘glu and Sönmez (2003)), airport landing-slot allocation (Schummer and Vohra (2013)), and refugee resettlement (Delacrétaz, Kominers, and Teytelboym (2016)). A generalized TTC algorithm characterizes the exclusion core in a large class of economies, including those with private, public, and mixed ownership."

Sunday, October 20, 2019

Amazon as a safe market-space for Hasidic business-NYT

The NY Times has the story about how Amazon is a good place to do business, if you don't like to leave home:

How Amazon Has Transformed the Hasidic Economy

"Amazon has become a lucrative place to do business for many Hasidic Jews, offering anonymity to a largely insular community and allowing women to work from home.
...
"The ability to sell merchandise easily and relatively anonymously on Amazon has transformed the economies of Hasidic enclaves in Brooklyn, suburban New York and central New Jersey, communities where members prefer to keep to themselves and typically do not go to college, let alone graduate from business programs.

But Amazon allows Hasidim to start selling without much experience and without making the investments required by a brick-and-mortar store. It permits Hasidic sellers to deal with the public invisibly — almost entirely by mail, by email or through package-delivery firms."

Saturday, October 19, 2019

Auction of John Nash and Reinhard Selten Nobel medals and memorabilia at Christie's, Oct 25

Great scholars pass away, and their estates need to put their affairs in order.
The auction house Christie's has several lots for sale, including the Nobel medals of John Nash and Reinhard Selten, and some items of Nash's work.

Here's Christie's front page for these auctions:
A ‘beautiful mind’ and his Nobel Prize
As Christie’s offers the medal given to John Nash in 1994, his biographer Sylvia Nasar reveals how he was nearly denied the prize that arguably saved his life

Here are the particular lots for sale:
LOT61|Sold in part to Benefit the John C.M. Nash Trust
For his brilliant insight into human behavior
JOHN FORBES NASH, JR., 1994
Estimate
USD 500,000 - USD 800,000
"The Nobel Prize and diploma are together with the following items relating to the ceremony: Typed letter signed, 11 October 1994, from the Royal Swedish Academy of Sciences, notifying Nash of his award; Nash's copy of Les Prix Nobel 1994, Stockholm: Nobel Foundation, 1995; Nash's handwritten dimensions for his formal attire, signed ("John Forbes Nash"), one page, c.October 1994; and Nash's nametag ("Dr. John F. Nash, Economics") bearing the Nobel logo."


LOT62|Sold in part to Benefit Scholarships to the California Institute of Technology
For refining Nash's work
REINHARD SELTEN, 1994
Estimate
USD 200,000 - USD 300,000
"The Nobel Prize and diploma are together with a group of 11 photographs of Dr Selten, all 1990s-2000s, various sizes, including shots of him teaching as well as accepting his Nobel Prize.

Fifty percent of the net proceeds of this sale (after all seller’s costs) will be donated to be used as financial aid for gifted students in mathematics and information technology from Eastern Europe studying at the California Institute of Technology."



LOT60 |THIS LOT IS SOLD IN PART TO BENEFIT THE NATIONAL ALLIANCE ON MENTAL ILLNESS
Nash's doctoral thesis
NON-COOPERATIVE GAMES, 1951
Estimate
USD 3,000 - USD 5,000
"Octavo (258 x 173mm). Original orange stapled wrappers (some light soiling to covers, a little rusting to staples). Provenance: John Forbes Nash, Jr."


LOT59|THIS LOT IS SOLD IN PART TO BENEFIT THE NATIONAL ALLIANCE ON MENTAL ILLNESS
Nash's first great contribution to Game Theory
FROM THE LIBRARY OF JOHN FORBES NASH, JR., 1950S
Estimate
USD 2,500 - USD 3,500
"A group of rare offprints from Nash's personal library, two of them annotated. "The Bargaining Problem" is annotated by Nash on the first page where he has commented "a bad choice of phrasing" next to the line "that they are equal in bargaining skill." Contributions to the Theory of Games, which includes Nash and Shapley's "A Simple Three-Person Poker Game" (for which an offprint is also present) has Nash's ownership signature on the first page."

LOT58|THIS LOT IS SOLD IN PART TO BENEFIT THE NATIONAL ALLIANCE ON MENTAL ILLNESS
''I think you will really go places''
JOHN FORBES NASH, JR., C.1940S
Estimate
USD 800 - USD 1,200
"A high school trigonometry paper replete with encouraging words from Nash's teacher, and retained by Nash for the rest of his life"

LOT64|THIS LOT IS SOLD IN PART TO BENEFIT THE NATIONAL ALLIANCE ON MENTAL ILLNESS
A handwritten history of Game Theory at Princeton
JOHN FORBES NASH, JR., 2000S
Estimate
USD 2,000 - USD 3,000
"Nash's handwritten lecture on Game Theory at Princeton University. At the time of his death in 2015, Nash had been associated with Princeton for nearly 70 years, first as an ingenious doctoral student and for the final ten years of his life as a senior research mathematician. After winning the Nobel Prize in 1994, Nash entered a long period of renewed activity and confidence, and here he looks back on the field. His overview begins with the contributions of French mathematician and politician Emile Borel followed by Princeton colleagues John von Neumann and Oskar Morgenstern (he notes that von Neumann "entered the picture" in 1928, the year of his own birth). Nash comments that "scientific concepts often are discovered in stages," and credits Antoine Augustin Cournot and Frederik Zeuthen's work ahead of his own, as well as Shizuo Kakutani's fixed-point theorem. He also touches on the work of Albert Tucker, Alvin Roth, David Gale, Robert Aumann, and Lloyd Shapley."
************
I hope to update these items.  In the meantime, some related previous posts, including previous auctions that didn't meet the reserve price:

Saturday, September 3, 2016

Sunday, April 28, 2019


Hayek at auction at Sothebys


Tuesday, April 23, 2013 Crick's Nobel medal, and letter to his son describing DNA


**************************
Update:

Saturday, October 26, 2019

Auction results: Nobel medals of John Nash and Reinhard Selten

The auction is over, and (unlike in some previous auctions) all of the items sold.  The highest profile items, namely the Nobel medals and diplomas, went for $735,000 (Nash) and 225,000 (Selten).

 

Friday, October 18, 2019

Will IVF become more widely legal in France?

The Washington Post has the story:

Why an IVF bill is the next fault line for the French republic  By Camille Robcis

"Since 1994, France has banned surrogacy and restricted access to reproductive technologies to heterosexual couples who have been married or living together for more than two years, forcing single women and lesbian couples to travel to neighboring countries for fertility treatments, and gay men to resort to surrogates in countries such as the United States or the United Kingdom. On Tuesday, the French National Assembly is scheduled to vote on a bill that would finally allow access to assisted reproductive technologies, including IVF, for unmarried women and lesbian couples. Under the proposed law, the treatments would be reimbursed by Social Security, and French doctors helping these women with fertility treatments would no longer face legal sanctions. Surrogacy, however, would remain illegal.
...
"After a month of fierce legislative debates that have resulted in more than 2,000 proposed amendments to the bill, an estimated 75,000 marchers took to the streets of Paris on Oct. 6 in opposition. "

Thursday, October 17, 2019

NBER Market Design meeting, Cambridge, October 18-19

Market Design Working Group Meeting

Michael Ostrovsky and Parag A. Pathak, Organizers
October 18-19, 2019

NBER
Feldstein Conference Room, 2nd Floor
1050 Massachusetts Avenue
Cambridge, MA


Conference Code of Conduct
Friday, October 18
8:30 am
Continental Breakfast
9:00 am
Christina Aperjis, Power Auctions LLC
Lawrence Ausubel, University of Maryland
Oleg V. Baranov, University of Colorado, Boulder
Supply Reduction in the Broadcast Incentive Auction
9:45 am
Gianluca Brero, University of Zurich
Benjamin Lubin, Boston University
Sven Seuken, University of Zurich
Machine Learning-Powered Iterative Combinatorial Auctions
10:30 am
Break
11:00 am
Tayfun Sönmez, Boston College
M. Bumin Yenmez, Boston College
Affirmative Action in India via Vertical and Horizontal Reservations
11:45 am
Joshua Angrist, Massachusetts Institute of Technology and NBER
Parag A. Pathak, Massachusetts Institute of Technology and NBER
Roman Zarate, Massachusetts Institute of Technology
Choice and Consequence: Assessing Mismatch at Chicago Exam Schools
12:30 pm
Lunch
2:00 pm
Marek Pycia, University of Zurich
Invariance and Matching Market Outcomes
2:45 pm
Nicole Immorlica, Microsoft Research
Jacob D. Leshno, University of Chicago
Irene Y. Lo, Stanford University
Brendan Lucier, Microsoft Research
Information Acquisition Costs in Matching Markets
3:30 pm
Break
4:00 pm
Mohammad Akbarpour, Stanford University
Julien Combe, University College London
Yinghua He, Rice University
Victor Hiller, Université Paris 2
Robert Shimer, University of Chicago and NBER
Olivier Tercieux, Paris School of Economics
Unpaired Kidney Exchange: Overcoming Double Coincidence of Wants without Money
4:45 pm
Liran Einav, Stanford University and NBER
Amy Finkelstein, Massachusetts Institute of Technology and NBER
Yunan Ji, Harvard University
Neale Mahoney, University of Chicago and NBER
Voluntary Regulation: Evidence from Medicare Bundled Payments
5:30 pm
Adjourn
6:30 pm
Group Dinner at Bambara
(across the street from the Royal Sonesta Hotel)
Saturday, October 19
8:30 am
Continental Breakfast
9:00 am
Yannai A. Gonczarowski, Microsoft Research
Lior Kovalio, Hebrew University of Jerusalem
Noam Nisan, Hebrew University of Jerusalem
Assaf Romm, Hebrew University of Jerusalem and Stanford University
Matching for the Israeli "Mechinot" Gap-Year Programs: Handling Rich Diversity Requirements
9:45 am
Amanda Y. Agan, Rutgers University and NBER
Bo Cowgill, Columbia University
Laura K. Gee, Tufts University
Salary Disclosure and Hiring: Field Experimental Evidence from a Two-Sided Audit Study
10:30 am
Break
11:00 am
Nick Arnosti, Columbia University
Peng Shi, University of Southern California
Design of Lotteries and Waitlists for Affordable Housing Allocation
11:45 am
Daniel C. Waldinger, New York University
Targeting In-Kind Transfers Through Market Design: A Revealed Preference Analysis of Public Housing Allocation
12:30 pm
Adjourn
FORMAT
35 mins presenter
10 mins discussion

Wednesday, October 16, 2019

Rates of organ donation in countries with presumed consent versus those with explicit consent

Here's an illuminating figure from the 2018 paper
Sonya Norris, Legal and Social Affairs Division, 2018-02-14

Figure 5 - Deceased Organ Donor Rates (per million population), Consent Regimes and Number of Donors in Selected Countries, 2015


Presumed consent (opt-out) countries are graphed in yellow, and explicit consent (opt in) countries in blue.  Given the confusing and often confused discussion of those two regimes, it's noteworthy that both regimes appear near both the top and the bottom of the graph, i.e. there are both high and low donation rate countries using each donation regime.

Tuesday, October 15, 2019

Kidney Exchange: an opportunity for cooperation in North America: Canadian Transplant Summit

I'll be speaking tomorrow  at the 2019 Canadian Transplant Summit, giving two talks.

In the morning, I'll speak at the Canadian Donation and Transplantation Research Program (CDTRP) 6th Annual Scientific Meeting on "Computers and Kidney Exchange."

In the afternoon I'll speak on 
Kidney Exchange: An Opportunity for Cooperation in North America:

State-of-the-Art Opening Plenary Session - Modeling Organ Allocation in Transplantation

 Wed, October 16
 4:30 PM - 5:50 PM
 KC101+103
Session Chairs
Moderator
John Gill, University of British Columbia Division of Nephrology and Centre for Health Evaluation and Outcomes Sciences

Kenneth West, Dalhousie University

Presentations

Kidney Exchange: an opportunity for cooperation in North America
Alvin Roth, Stanford University, Nobel Laureate, Economics


Perspectives on organ transplantation as a donor family
Toby Boulet 

Monday, October 14, 2019

Congrats to Banerjee, Duflo and Kremer “for their experimental approach to alleviating global poverty"

The Royal Swedish Academy of Sciences has decided to award the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 2019 to
“for their experimental approach to alleviating global poverty”


From the Nobel press release:

"In the mid-1990s, Michael Kremer and his colleagues demonstrated how powerful this approach can be, using field experiments to test a range of interventions that could improve school results in western Kenya.

"Abhijit Banerjee and Esther Duflo, often with Michael Kremer, soon performed similar studies of other issues and in other countries. Their experimental research methods now entirely dominate development economics."

A kidney exchange chain initiated by a deceased donor, in Italy

 Deceased Donor–initiated Chains
First Report of a Successful Deliberate Case and Its Ethical Implications
Furian, Lucrezia MD1; Cornelio, Cristina PhD2; Silvestre, Cristina MD, PhD1; Neri, Flavia MD1; Rossi, Francesca PhD2,3; Rigotti, Paolo MD1; Cozzi, Emanuele MD, PhD4; Nicolò, Antonio PhD

Transplantation: October 2019 - Volume 103 - Issue 10 - p 2196–2200
doi: 10.1097/TP.0000000000002645

Background. It has been suggested that deceased donor kidneys could be used to initiate chains of living donor kidney paired donation, but the potential gains of this practice need to be quantified and the ethical implications must be addressed before it can be implemented.

Methods. The gain of implementing deceased donor–initiated chains was measured with an algorithm, using retrospective data on the pool of incompatible donor/recipient pairs, at a single center. The allocation rules for chain-ending kidneys and the characteristics and quality of the chain-initiating kidney are described.

Results. The benefit quantification process showed that, with a pool of 69 kidneys from deceased donors and 16 pairs enrolled in the kidney paired donation program, it was possible to transplant 8 of 16 recipients (50%) over a period of 3 years. After obtaining the approval of the Veneto Regional Authority’s Bioethical Committee and the revision of the Italian National Transplant Center’s allocation policies, the first successful case was completed. For the recipient (male, aged 53 y), who entered the program for a chain-initiating kidney with a Kidney Donor Risk Index of 0.61 and a Kidney Donor Profile Index of 3%, the waiting time was 4 days. His willing donor (female, aged 53 y) with a Living Kidney Donor Profile Index of 2, donated 2 days later to a chain-ending recipient (male, aged 47 y) who had been on dialysis for 5 years.

Conclusions. This is the first report of a successfully completed, deliberate deceased donor–initiated chain, which was made possible after a thorough assessment of the ethical issues and the impact of allocation policies. This article includes a preliminary efficacy assessment and describes the development of a dedicated algorithm.
**********

See earlier post:

Monday, April 11, 2016

Sunday, October 13, 2019

Matching markets @ Simons Institute are multi-disciplinary

Two recent blog posts at the algorithmic game theory blog Turing's Invisible Hand remark on the multi-disciplinary nature of modern matching theory and market design, which involves economics, computer science, operations research and mathematics...


Matching Markets @ Simons: Driven by Theory, Driving the Economy by robertkleinberg

"A more notable aspect of matching theory in recent years has been its impact on the design of real-world marketplaces. Over the two workshops, a mix of speakers from academia and industry covered a host of markets, including payment routingonline advertisingkidney exchangereal-estatepublic housingride-sharinglong-haul truckingrestaurant reviewsschool choicefood-banks and many many others. A common theme that emerged was that online marketplaces, with the support of good algorithm and mechanism designers, are slowly taking over the economy."

and

Blind Folks and the Evolving Elephant – by Vijay Vazirani

"The “blind men’’ in this case are entire disciplines which can lay claim to the field of matching markets. Of course, the obvious one is economics – the founders of this field, namely Gale and Shapley, were mathematical economists and the 2012 Nobel Prize in Economics was awarded to Alvin Roth and Lloyd Shapley for work on these markets.
A key enabler was researchers in systems and networking. Their scientific revolutions of the Internet and mobile computing put matching markets on an exciting, new journey and their systems run these centralized markets on powerful computers.
The discipline of algorithm design has had an umbilical connection to matching markets: At the birth of this field lies the highly sophisticated Gale-Shapley stable matching algorithm (1962), whose pivotal game-theoretic property of incentive compatibility follows as a free gift from polynomial time solvability — it was established two decades after the discovery of the algorithm! Yet most researchers, including those in theoretical computer science, are not aware that algorithm design is also a legitimate claimant to this field. Indeed, the very “engine’’ that runs almost each one of these markets is a sophisticated algorithm chosen from the “gold mine’’ of matching theory! Besides stable matching, this includes maximum matching and online matching and their numerous variants."

Saturday, October 12, 2019

Medal of Honor

Some months ago I bookmarked a piece in the Wall Street Journal, about the Medal of Honor, the U.S. military's highest combat award.  It talks about life after the medal, for the recipients of this very famous award.  They find they  have some obligations to represent the armed services, the medal itself and the others who have received it, in addition to their own colleagues left behind on the battlefield.  It's a much more complicated honor than other kinds of awards for extraordinary accomplishment, which are also often done in teams, such as scientific awards (which are for happier, less desperate accomplishments that are survived by all the participants).  The article speaks about how previous medal winners support new ones with advice and encouragement on what they should expect. At the time the story was published (in May 2019) there were 70 living recipients of the Medal of Honor.

Here's the WSJ story:

‘It’s a Lifelong Burden’: The Mixed Blessing of the Medal of Honor
America’s highest award for combat valor is both a gift and a constant reminder of what’s often the worst day of recipients’ lives  By Michael M. Phillips.

"For those who earn it, the medal is a loaded gift. It’s a source of instant celebrity, and an entree into a world of opportunity and adulation. It’s also a reminder of what is often the worst day of their lives. And it is a summons to a lifetime of service from those who did something so courageous as young men—so at odds with their own chances of survival—that it was beyond what duty demands."



Friday, October 11, 2019

Followup on Robert Kraft: disappearing sex trafficking in Florida

Vanity Fair has a followup on the widely publicized Florida investigation of sex trafficking that included the arrest of Patriots owner Robert Kraft.  The reporter points out that the trafficking charges have evaporated, and in general concludes that much of the concern with trafficking is in fact simply targeted at voluntary foreign sex workers:

“YOU WON’T BELIEVE WHAT HAPPENED”: THE WILD, DISTURBING SAGA OF ROBERT KRAFT’S VISIT TO A STRIP MALL SEX SPA
After the Patriots owner made two trips to Orchids of Asia Day Spa, where a half-hour “massage” costs $59, he was charged with soliciting a prostitute. What happened next was not what anyone expected.
BY MAY JEONG

"Human trafficking is a serious problem: The Department of Health and Human Services calls it the world’s “fastest-growing criminal industry.” But some anti-trafficking groups, in search of funding, routinely overstate the scale of the commercial sex trade. They frequently claim that 300,000 minors are “at risk” for being sold into sexual slavery in America each year—a number that has been debunked by researchers as wildly overinflated. (The Washington Post dismisses it as a “nonsense statistic.”) In 2018, the FBI confirmed a total of 649 trafficking cases in America, adults included.
...
"Florida’s new sex registry is the latest in a long line of similar laws. One of America’s first laws against prostitution, in fact, was the 1870 Act to Prevent the Kidnapping and Importing of Mongolian, Chinese, and Japanese Females for Criminal or Demoralizing Purposes, intended to protect the public from “scandal and injury.” The law was a precursor to the Page Act of 1875, which aimed to “end the danger of cheap Chinese labor and immoral Chinese women,” which in turn was a precursor to the Chinese Exclusion Act of 1882—the first law to bar all members of a specific ethnicity or nationality from immigrating.

"The raids on Orchids and other massage parlors in South Florida were conducted in the name of rescuing women from sex trafficking. But the only people put in jail were the women themselves. A few, like Lulu and Mandy, managed to post bail and were placed under house arrest. But others were transferred to the custody of ICE. Women who migrated to America in search of work—who chose the least bad option available to them—were being punished for what one of their lawyers calls “the crime of poverty.”
...
"Within weeks of the raids, the state’s case had evaporated. There was no $20 million trafficking ring, no women tricked into sex slavery. The things the state had mistaken as markers for human trafficking—long working hours, shared eating and living arrangements, suspicion of outside authorities, ties to New York and China—were, in fact, common organizing principles of many Chinese immigrant communities. As an assistant state attorney in Palm Beach told the court on April 12: “There is no human trafficking that arises out of this investigation.”
********

See earlier post:

Thursday, March 7, 2019

Thursday, October 10, 2019

2019 ESA North American Meetings

The 2019 Economic Science Association (ESA) North American meetings will be held in Los Angeles, California at the campus of Loyola Marymount University from Thursday evening, October 10th through Saturday evening, October 12th, 2019. 
Keynote Speakers:
Panel on Research Methods:


Here's the program.

There's a session on Market Design and Matching:

The Important of Cardinal Information in Matching Clayton Featherstone

Why Do Some Clearinghouses Yield Stable Outcomes? Experimental Evidence on Out-of-Equilibrium Truth-Telling Colin Sullivan

Competition with Indivisibilities and Few Traders Weiwei Zheng

Driving to the Beat Sotiris Georganas

Wednesday, October 9, 2019

Very quick questions and answers about market design and experimental economics--video

Two minutes of Q&A from my recent visit to Lancaster:

Tuesday, October 8, 2019

Transplantation rates for patients in non-profit versus for-profit dialysis centers

From JAMA,September 10, 2019  Volume 322, Number 10:
J::AMA
September 10, 2019 Volume 322, Number 10Association Between Dialysis Facility Ownership and Accessto Kidney Transplantation

Jennifer C. Gander, PhD; Xingyu Zhang, PhD; Katherine Ross, MPH; Adam S. Wilk, PhD; Laura McPherson, MPH; Teri Browne, PhD;Stephen O. Pastan, MD; Elizabeth Walker, MS; Zhensheng Wang, PhD; Rachel E. Patzer, PhD, MPH

"MAIN OUTCOMES AND MEASURES: Access to kidney transplantation was defined as time from initiation of dialysis to placement on the deceased donor kidney transplantation waiting list,receipt of a living donor kidney transplant, or receipt of a deceased donor kidney transplant.Cumulative incidence differences and multivariable Cox models assessed the associationbetween dialysis facility ownership and each outcome.
RESULTS: Among 1 478 564 patients, the median age was 66 years (interquartile range, 55-76years), with 55.3% male, and 28.1% non-Hispanic black patients. Eighty-seven percent ofpatients received care at a for-profit dialysis facility. A total of 109 030 patients (7.4%)received care at 435 nonprofit small chain facilities; 78 287 (5.3%) at 324 nonprofitindependent facilities; 483 988 (32.7%) at 2239 facilities of large for-profit chain 1; 482 689(32.6%) at 2082 facilities of large for-profit chain 2; 225 890 (15.3%) at 997 for-profit smallchain facilities; and 98 680 (6.7%) at 434 for-profit independent facilities. During the studyperiod, 121 680 patients (8.2%) were placed on the deceased donor waiting list, 23 762 (1.6%)received a living donor kidney transplant, and 49 290 (3.3%) received a deceased donorkidney transplant. For-profit facilities had lower 5-year cumulative incidence differences foreach outcome vs nonprofit facilities (deceased donor waiting list: −13.2% [95% CI, −13.4% to−13.0%]; receipt of a living donor kidney transplant: −2.3% [95% CI, −2.4% to −2.3%]; andreceipt of a deceased donor kidney transplant: −4.3% [95% CI, −4.4% to −4.2%]). AdjustedCox analyses showed lower relative rates for each outcome among patients treated at allfor-profit vs all nonprofit dialysis facilities: deceased donor waiting list (hazard ratio [HR], 0.36[95% CI, 0.35 to 0.36]); receipt of a living donor kidney transplant (HR, 0.52 [95% CI, 0.51 to0.54]); and receipt of a deceased donor kidney transplant (HR, 0.44 [95% CI, 0.44 to 0.45]).
CONCLUSIONS AND RELEVANCE: Among US patients with end-stage kidney disease, receiving dialysis at for-profit facilities compared with nonprofit facilities was associated with a lower likelihood of accessing kidney transplantation. Further research is needed to understand the mechanisms behind this association.

Here are the figures. "For-profit large chains" seem to give the slowest access to being put on the transplant waiting list, receiving a living donation, or receiving a deceased donation.



HT: Irene Wapnir

Monday, October 7, 2019

Different misconduct in sperm donation

One reason it is rewarding to study unregulated markets is that it gives you some idea of why some regulation might be desirable.  The growth in DNA registries has allowed many children of sperm donors to identify their biological father, and it also allows donors to identify their children, sometimes with unsettling results.

Here's a story from the Washington Post:

Sperm donor says fertility clinic ‘lied’ after discovering he fathered 17 kids ― most in the same area

"It was 1989 when he gave his sperm to the fertility clinic at Oregon Health & Science University, where he was a first-year medical student, believing his donation would help infertile couples and advance science. The facility promised that once his sperm had conceived five babies in mothers living on the East Coast, the rest would be used for research, Cleary said at a Wednesday news conference. He had assured his wife that the donor kids were far enough away that their own four children could never run into them in their Oregon town, or unwittingly befriend them or fall in love with them.

“So you can imagine his shock,” his attorney Chris Best said at the news conference, “when, after 30 years, Dr. Cleary recently [learned] that no less than 17 children have been born from his donations” ― all of whom were born in the state of Oregon and the Pacific Northwest."

Ride sharing and shared rides as public transportation: Via

The ride sharing company in the U.S. that is perhaps closest to a public transportation model is Via, which offers shared rides from near where you are to near where you are going. That is, it's a ride sharing service which has you walk to a nearby corner to be picked up, pooled with other riders who are headed the same way, and dropped off near your destination.

Via is also taking other steps towards deploying their technology in a public transportation way: here's their recent announcement of a contract with New York City schools to manage school buses:

Via Selected to Power New York City’s School Bus System

"August 21, 2019 (New York, NY) — Via, the leading provider and developer of on-demand public mobility, was selected by the New York City Department of Education to provide a revolutionary school bus management system for the nation’s largest school district. “Via for Schools” will be the first integrated, automated school bus routing, tracking, and communication platform in the world. Parents and students will have the ability to track, in real-time, their bus’ whereabouts and receive frequent and reliable communications in the event of service changes, improving safety and bringing important peace of mind to all users of the system. By utilizing Via’s best-in-class algorithms to optimize school bus routing, the Department of Education will be able to achieve operational efficiencies and reduce transportation costs.

“We are delighted to be partnering with the New York City Department of Education to set a new standard of excellence in school transportation,” said Daniel Ramot, co-founder and CEO of Via. “Via was founded in New York, where we are proud to operate the city’s most efficient on-demand shared ride service. We’re thrilled to have an opportunity to further serve the New York community by applying our technology to operate a world-class school bus system.” 

“Through our partnership with Via, we’ll soon have a state-of-the-art app for families to track buses and get real-time automatic updates,” said Schools Chancellor Richard A. Carranza. “We are grateful for the City Council’s advocacy, leadership and partnership. Safe and reliable transportation is critical for all families, and we’re committed to getting it right this year.”

As the largest school district in the nation, the NYC Department of Education (DOE) transports approximately 150,000 students on 9,000 bus routes each and every day to get students safely to and from school across the City. Via for Schools is purpose built to serve the city’s diverse student populations, including General Education, Special Education, Students in Temporary Housing, and others through one integrated school transportation system. The system will utilize a flexible algorithm, which allows for both stop-to-school and home-to-school pickups, accommodating students regardless of their learning style, mobility constraints, or place(s) of residence.

Via’s technology is already in use in more than 50 markets across the globe, by such leading public sector transportation providers as Los Angeles Metro, Transport for London, and Berliner Verkehrsbetriebe (BVG). For Via for Schools, the company’s intelligent routing system will optimize school buses’ daily, fixed routes to be as efficient as possible, while also providing the flexibility to respond dynamically to realities on the ground such as street closures and traffic. The system is expected to significantly improve operational efficiency and aims to ultimately reduce transportation costs for the NYC DOE. Parents and students will benefit from improved visibility and communications regarding system status and unexpected changes, including real-time bus locations, student boardings and alightings, route changes, and vehicle delays.

About Via

Via is re-engineering public transit, from a regulated system of rigid routes and schedules to a fully dynamic and highly efficient on-demand network. Via’s technology is deployed in more than 20 countries worldwide through dozens of partner projects with public transportation agencies, private transit operators, taxi fleets, private companies, universities, and school systems, seamlessly integrating with public transit infrastructure to power cutting-edge on-demand public mobility.  First launched in New York City, the Via platform operates in the United States and in Europe through its joint venture with Mercedes-Benz Vans, ViaVan. For more information, visit ridewithvia.com."