Sunday, March 16, 2014

The IGM panel of economists speaks (in many voices) on paying for kidneys

The Initiative on Global Markets is an opinion poll of leading academic economists on a large variety of public policy questions, which they can answer on a range from "strongly agree" to "strongly disagree," along with "uncertain" or "no opinion". They are also asked to assess their confidence in their answer A recent question was
Supplying Kidneys: A market that allows payment for human kidneys should be established on a trial basis to help extend the lives of patients with kidney disease.

Here's a histogram of replies

Some answers were accompanied by comments, and I include all of those below...

AutorDavid AutorMITNo Opinion
Not enough info to answer. Not in favor of a kidney market that sells to highest bidder. Other ideas maybe. Question is not actionable. 
Bio/Vote History
BanerjeeAbhijit BanerjeeMITDisagree8
That would mean valuing people's lives by their incomes. We already do that but moving further in that direction seems wrong. 
Bio/Vote H
BrunnermeierMarkus BrunnermeierPrincetonAgree6
It is important that the market is "well regulated" in order to avoid abuse and exploitation of the vulnerables. 
ChevalierJudith ChevalierYaleStrongly Agree9
This certainly may have unintended consequences but it is hard to fault attempting to create more supply.
DuffieDarrell DuffieStanfordAgree3
Under strong governance that mitigates exploitation, this market may save lives on mutually consenting terms.
Bio/Vote History
EdlinAaron EdlinBerkeleyUncertain7
Dangerous ground, but a well-regulated experiment could be beneficial. Payments to fill out donor cards might increase supply, for example 
Bio/Vote History
EichengreenBarry EichengreenBerkeleyUncertain1
A market with or without subsidies for low income patients?
HallRobert HallStanfordUncertain9
Hard to know because we don't have much of an understanding of why people make organ gifts.
Bio/Vote History
HartOliver HartHarvardAgree8
I'd like to see it but I'm not sure the public is ready. Also would insurance cover this? Would people be able to top up (presumably)?
HoxbyCaroline HoxbyStanfordUncertain8
Would improve allocative efficiency but means- and health-conditioned vouchers would presumably have to be used to address ethical concerns.
JuddKenneth JuddStanfordStrongly Agree10
There is no reason to block this voluntary exchange. There may be unique challenges in applying laws against fraud, but nothing too hard.
NordhausWilliam NordhausYaleAgree5
Perhaps experiments in different regimes better idea.
SamuelsonLarry SamuelsonYaleDisagree6
We need to rationalize our organ allocation mechanism, but a market is not the only way, and is not obviously the best way. 
SchmalenseeRichard SchmalenseeMITUncertain7
How to deal with donors who don't understand risks, increased incentives to steal & import, perceived inequities...? Not simple.
ShapiroCarl ShapiroBerkeleyAgree8
Experiments seem valuable here, using health outcomes as our metric. Matching donors and recipients based in part on payment may be helpful.
Bio/Vote History
ShimerRobert ShimerChicagoStrongly Agree7
The biggest impact would be to increase kidney supply, so few obvious losers from this policy
Bio/Vote History
StokeyNancy StokeyChicagoUncertain1
It would surely save lives of those with kidney disease. It would probably have unintended consequences as well.
Bio/Vote History
ThalerRichard ThalerChicagoUncertain5
How should we incorporate the fact that nearly all non-economists hate this idea? Do we declare them wrong and proceed?
Bio/Vote History
UdryChristopher UdryYaleStrongly Agree1
As an economist, I strongly agree that there would be tremendous gains. But I'm uncertain of the appropriate bounds on market transactions.
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