Displaced people passes 100,000,000

 The Guardian has the story, focusing on the causes of displacement. But efficiently matching diverse refugees to places of temporary or permanent asylum is still one of the biggest unsolved matching problems.

Number of displaced people passes 100m for the first time, says UN. ‘Staggering milestone’ calls for urgent international action to address underlying causes of conflict, persecution and the climate crisis, says high commissioner for refugees.  by Diane Taylor

"The UN refugee agency (UNHCR) has said the global number of forcibly displaced people has passed 100 million for the first time, describing it as a “staggering milestone”.

"The UN high commissioner for refugees, Filippo Grandi, said the grim new statistic should act as a wake-up call for the international community and that more action is needed internationally to address the root causes of forced displacement around the world.

...

"The figure hit 90 million at the end of 2021, propelled by a range of conflicts including in Afghanistan, Burkina Faso, the Democratic Republic of the Congo, Ethiopia, Myanmar and Nigeria.

"Eight million Ukrainian people have been displaced within their home country as a result of the war, along with more than six million refugee movements registered from Ukraine.

“The international response to people fleeing war in Ukraine has been overwhelmingly positive,” said Grandi. “Compassion is alive and we need similar mobilisation for all crises around the world. But ultimately humanitarian aid is a palliative, not a cure. To reverse this trend the only answer is peace and stability so that innocent people are not forced to gamble between acute danger at home or precarious flight or exile.”

"The term “displaced person” was first used during the second world war, in which more than 40 million people were forcibly displaced."

Matching prisoners to jails: peer effects are of first order importance

 Akhil Vohra points me to this very interesting matching problem, which is apparently quite far from a good solution:

RIKERS ISLAND: City Jails Scrap Last Remnants of Pricey Consultant Plan as Deaths Mount BY  REUVEN BLAU, May 18, The City

"In 2018, the city Department of Correction began using a new detainee classification process created at great expense by consulting group McKinsey & Company. 

"The de Blasio administration had paid the white-shoe firm $27.5 million to create the system that used an algorithm based on a host of factors — including age, possible gang affiliation, and any prior history in jail — to determine where to house people behind bars with the least risk for confrontation. 

"On Tuesday, jail Commissioner Louis Molina announced that the pricey system — widely criticized for failing to reduce violence — will be formally scrapped after just four years as part of the department’s court-mandated overhaul plan. 

...

"jail officials have long struggled where to place new detainees to reduce the likelihood of fights. Top jail supervisors have traditionally tried to avoid creating housing units based on gang affiliation, according to current and former jail insiders. 

"Units made up of just one gang tend to get along with each other but also have the ability to gang up on the officers in the area and are more likely to join forces to ignore basic orders, jail experts say. 

"Housing units mixed with people from at least two different gangs as well as some people who are totally unaffiliated are considered the golden standard, according to criminologists. 

"But other factors are also important such as a person’s prior criminal history, age, and possible previous record in jail. 

...

"“It’s a revolving door of stupidity and poor decisions,” one high-ranking jail official, who spoke on condition of anonymity, told THE CITY. 

“We changed from that system because it wasn’t working, now we are reverting back to it,” the jail insider said. 

...

"Jail officials said the result was part of the chaos that has led to a massive spike in the number of stabbings and slashings among detainees and assaults on staff."

Erling Skancke defends his dissertation

 Erling Skancke defended his dissertation last week:

Here's his job market paper:

Welfare and Strategic Externalities in Matching Markets with Interviews (Job Market Paper) Recent debate in the medical literature has raised concerns about the pre-match interview process for residency and fellowship positions at hospitals. However, little is known about the economics of this decentralized process. In this paper, I build a game-theoretic model in which hospitals conduct costly interviews in order to learn their preferences over doctors. I show that increased interview activity by any hospital imposes an unambiguous negative welfare externality on all other hospitals. In equilibrium, both hospitals and doctors may be better off by a coordinated reduction in interview activity. The strategic externality is more subtle, and conditions are derived under which the game exhibits either strategic complementarities or substitutes. Moreover, an increase in market size may exacerbate the inefficiencies of the interview process, preventing agents from reaping the thick market benefits that would arise in the absence of the costly interviews. This effect increases participants' incentives to match outside of the centralized clearinghouse as markets become thicker, jeopardizing the long-term viability of the clearinghouse. The model also provides new insights into several market design interventions that have recently been proposed.

Congratulations, Erling! 

Welcome to the club.

Gabe Carroll and Jamie Morgenstern win the Social Choice and Welfare Prize

Congratulations to Jamie Morgenstern and Gabe Carroll. Their joint prize is a sign of how economics and computer science are advancing both separately and together.

JAMIE MORGENSTERN AND  GABRIEL CARROLL RECEIVE THE ELEVENTH SOCIAL CHOICE AND WELFARE PRIZE

"A jury composed of Pietro Ortovela (Princeton University), Ariel Procaccia (Harvard University), Szilvia Papai (Concordia Universtiy),  Arunava Sen (President of the Society for Social Choice and Welfare) and Marc Fleurbaey (Chair, President-elect of the Society for Social Choice and Welfare)  has chosen to award the eleventh Social Choice and Welfare Prize jointly to Gabriel Carroll (University of Toronto) and  Jamie Morgenstern (University of Washington).

"The purpose of the Social Choice and Welfare Prize is to honour young scholars of excellent accomplishment in the area of social choice theory and welfare economics. The laureate should be 40 years or less as of January of the year when the International Meeting of the Society for Social Choice and Welfare is scheduled to take place. During this meeting, the prize winner(s) will give a plenary lecture. For more information about the prize, please click here.

"The SCW prize medal "La Pensée" ("The Thought") is due to Raymond Delamarre (1890-1986), a rather well-known French sculptor associated with what has been called "Art Deco" (Chrysler Building and Empire State Building in New York, the architects Mallet-Stevens or Le Corbusier in France). He is in particular famous for his work at the entrance of the Suez Canal. A web site: www.atelier-raymond-delamarre.fr.

PAST LAUREATES :

2020 : PIETRO ORTOLEVA and  ARIEL PROCACCIA 

2018 : GEORGY EGOROV and DEBASIS MISHRA

2016 : FUHITO KOJIMA  and PARAG PATHAK

2014 : VINCENT CONITZER and TIM ROUGHGARDEN

2012 : LARS EHLERS and ADAM MEIROWITZ

2010 : FRANZ DIETRICH and CHRISTIAN LIST

2008 : TAYFUN SOMNEZ

2006 : JOHN DUGGAN

2004 : FRANCOIS MANIQUET

2002 : MATTHEW JACKSON

The Tenth Social Choice and Welfare Prize Lectures

Jamie Morgenstern

University of Washington

Gabriel Caroll

University of Toronto

Seventh Marketplace Innovation Workshop (MIW), May 23-26, 2022 (10:45am EST - 2:45pm EST)

 Seventh Marketplace Innovation Workshop (MIW),  May 23-26, 2022 (10:45am EST - 2:45pm EST)   The conference will be virtual

Here is the program.

Organizers:

Itai Ashlagi, Management Science and Engineering, Stanford University

Omar Besbes, Columbia Business School, Columbia University

Nicole Immorlica, Microsoft Research

Vahideh Manshadi, School of Management, Yale University

Nicolas Stier-Moses, Core Data Science, Meta Platforms

Fanyin Zheng, Columbia Business School, Columbia University

Plenary speakers

Alessandro Bonatti, MIT

Bar Ifrach, Uber Freight

Myrto Kalouptsidi, Harvard University

Azarakhsh Malekian, University of Toronto

Michael Schwarz, Microsoft

Peng Shi, University of Southern California

Tim Roughgarden, Columbia University

Gabriel Weintraub, Stanford University

Iowa State University celebrates Bertan Turhan

 The Iowa State University News Service has an article about the market design work of Bertan Turhan.

New model could improve matches between students and schools

"For the majority of students in the U.S., residential addresses determine which public elementary, middle, or high school they attend. But with an influx of charter schools and state-funded voucher programs for private schools, as well as a growing number of cities that let students apply to public schools across the district (regardless of zip code), the admissions process can turn into a messy game of matchmaking.

"Simultaneous applications for competitive spots and a lack of coordination among school authorities often result in some students being matched with multiple schools while others are unassigned. It can lead to unfilled seats at the start of the semester and extra stress for students and parents, as well as teachers and administrators.

"Assistant Professor of Economics Bertan Turhan at Iowa State University and his co-authors outline a way to make better, more efficient matches between students and schools in their new study published in Games and Economic Behavior. Turhan says their goal was to create a fairer process that works within realistic parameters.

“There are a lot of success stories in major U.S. cities where economists and policymakers worked together to improve school choice,” said Turhan. “The algorithm we introduced builds on that and could give school groups some degree of coordination and significantly increase overall student welfare in situations where there’s a lot of competition to get into certain schools.” 

...

"Over the next year, Turhan and his team will be studying the implementation of their model in India where two types of colleges have revamped their admissions process."

********

Here's the paper that was the occasion of the story:

Parallel markets in school choice by Mustafa Oğuz Afacan, Piotr Evdokimov, Rustamdjan Hakimov, and Bertan Turhan

Games and Economic Behavior, Volume 133, May 2022, Pages 181-201, https://doi.org/10.1016/j.geb.2022.03.003Get rights and content

Abstract: When applying to schools, students often submit applications to distinct school systems that operate independently, which leads to waste and distortions of stability due to miscoordination. To alleviate this issue, Manjunath and Turhan (2016) introduce the Iterative Deferred Acceptance mechanism (IDA). We design an experiment to compare the performance of this mechanism under parallel markets (DecDA2) to the classic Deferred Acceptance mechanism with both divided (DecDA) and unified markets (DA). Consistent with the theory, we find that both stability and efficiency are highest under DA, intermediate under DecDA2, and lowest under DecDA. While IDA is not strategy-proof, we show theoretically that strategic reporting can only lead to improved efficiency for all market participants. The experimental results are consistent with this prediction. Our findings cast doubt on whether strategy-proofness should be perceived as a universal constraint to market mechanisms.

Research on pedophilia presents career hazards

 It's not always easy to investigate repugnant things, let alone crimes.  Old Dominion University has parted ways with an assistant professor, Allyn Walker, who uses the pronoun "they."  They studied people who are sexually attracted to children, but don't act on their attraction, i.e. who aren't child molesters.  Walker's book on the subject drew unwanted attention and accusations that it promoted child molesting.

The Chronicle of Higher Ed has the story:

An Unacceptable Idea. A university says it supports free inquiry. So why does this pedophilia researcher no longer work there? By Emma Pettit

"Walker’s book, A Long, Dark Shadow: Minor-Attracted People and Their Pursuit of Dignity, examines adults who are sexually attracted to children but say they refrain from acting on that attraction. The scholar avoids the term “pedophiles,” even though its literal meaning describes only desire, not behavior, in part because it has come to be synonymous in the public mind with “child molester.” 

...

“Allow me to be clear: This book does not promote sexual contact between adults and minors,” Walker writes in the introduction. Knowing some readers might see it that way, though, Walker prepared. Before the book’s publication in June 2021, the scholar, then an assistant professor of sociology and criminal justice at Old Dominion University, wrote a memo for university leaders with talking points to respond to that misconception, should objections to the research arise.

...

"When Tucker Carlson covered the story, he referred to Walker as “a self-described ‘nonbinary assistant professor,’” adding, “we have no idea what that means, by the way, but that’s what this person calls him or herself.” Beside Carlson was a graphic that announced: “The Left’s Depraved New Low.”

"Students at Old Dominion also objected. They mounted a protest and urged the university to fire Walker. 

...

"Walker was placed on indefinite administrative leave.

...

"Walker’s leave notice, obtained by The Chronicle, said that the action was being taken “due to concerns over your safety and that of the campus, and to address the immediate effects of the reaction to your research and book which has impacted the University’s mission of teaching and learning.”

...

“Research into sensitive topics and the expression of new or controversial views lie at the heart of academic research. … At the same time,” Hemphill wrote, “this freedom carries with it the obligation to speak and write with care and precision, particularly on a subject that has caused pain in so many lives.”

...

"on November 24, Walker and the university jointly announced that the assistant professor had “decided to step down.”

...

"Though the wave of reactions was mighty, leaders at Old Dominion could have done more “to resist the power of the misreading of Dr. Walker’s work” and to protect the scholar’s reputation in the institution’s messaging, the university’s chapter of the American Association of University Professors wrote in an open letter. Old Dominion’s response “essentially indicated that if a conflict emerges between academic freedom and hateful political groups that threaten violence, then the politics of hate will win,” Kent Sandstrom, a professor in Walker’s department and a former dean of the college, said in an email. “I can’t think of a more troubling precedent.”

...

"Walker’s Old Dominion contract ends this month. For the time being, at least, they have found an academic home. They’ll be a postdoctoral fellow at Johns Hopkins’s Moore Center for the Prevention of Child Sexual Abuse."

Frontiers of Economic Design (FED): Ellen Muir and I speak tomorrow (Friday) on Zoom

 We hope to start off this new seminar with a bang (9am Pacific time, noon on the East Coast, 18:00 in middle Europe...)

To hear us you have to register to get a link

Here's the seminar site:

Frontiers of Economic Design (FED)

"The goal of this seminar series is to bring young researchers in economic design and related areas together, to promote their work, and also to disseminate cutting-edge research. Each meeting will feature two presentations: one from an established researcher and one from a graduate student or post-doc. "

 

Black market tattoos in S. Korea: “No one’s trying to go to medical school to become a tattoo artist,”

 Tattooing is illegal (but tattoos are not) in S. Korea.  The NY Times has the story:

Tattoos, Still Illegal in South Korea, Thrive Underground. Tattoo artists, long treated as criminals for their work, say that it is time to end the stigma against their business.  By Christine Chung

"Under a ruling that has been in place since 1992, tattooing without a medical license can result in fines of up to $40,000 or even imprisonment. Opponents of decorative tattoos have invoked concerns about longstanding associations with organized crime, as well as fears about inadequate hygiene and potential harm inflicted by tattoo artists, who they say lack adequate skills.

"Attempts to overturn this ban have repeatedly failed. In March, the Constitutional Court in Seoul reaffirmed the tattoo industry’s illegality in a 5-to-4 ruling. South Korean tattoo artists and customers believe that the ruling is at odds with reality, citing drastically changed social norms that have fostered a thriving underground industry, greater openness and acceptance of tattoos, and rising international demand for what are known as “k-tattoos.”

"While tattoos have grown in acceptance in most parts of the world — exceptions include several Islamic countries — South Korea remains one of the few where the artists are treated as criminals. Tens of thousands of them work in secret here, under constant threat of exposure to law enforcement.

...

“No one’s trying to go to medical school to become a tattoo artist,” she said.

...

"Mr. Kim is the founder of a 650-member tattoo labor union that advocates rights of artists. Legalization would create safer, more sanitary environments for both customers and artists, he said.

"Tattoo artists often meet clients alone and trust strangers to keep their secret. Female artists are particularly vulnerable to sexual violence. In the past, the police have conducted sweeps rounding up artists, Sanlee said. Rival shops have been known to flag artists to the police.

“Since what we’re doing is illegal, we’re in the blind spot,” she said. “Because of that, there are many people that are exploiting the situation.”

Medical resident sleep time reduces harmful errors

 Here's a new study of the effect on patient safety of the limitation on resident work hours to no more than 16 hour shifts, which was in effect in the US from 2011 to 2017.

National improvements in resident physician-reported patient safety after limiting first-year resident physicians’ extended duration work shifts: a pooled analysis of prospective cohort studies  BMJ Quality & Safety Published Online First: 10 May 2022. doi: 10.1136/bmjqs-2021-014375by Matthew D   Weaver1,2, Christopher P Landrigan1,3,4, Jason P Sullivan1, Conor S O'Brien1, Salim Qadri1, Natalie Viyaran1, Charles A Czeisler1,2, Laura K Barger1,2

Abstract: Background The Accreditation Council for Graduate Medical Education (ACGME) enacted a policy in 2011 that restricted first-year resident physicians in the USA to work no more than 16 consecutive hours. This was rescinded in 2017.

Methods "We conducted a nationwide prospective cohort study of resident physicians for 5 academic years (2002–2007) before and for 3 academic years (2014–2017) after implementation of the 16 hours 2011 ACGME work-hour limit. Our analyses compare trends in resident physician-reported medical errors between the two cohorts to evaluate the impact of this policy change.

"Results 14 796 residents provided data describing 78 101 months of direct patient care. After adjustment for potential confounders, the work-hour policy was associated with a 32% reduced risk of resident physician-reported significant medical errors (rate ratio (RR) 0.68; 95% CI 0.64 to 0.72), a 34% reduced risk of reported preventable adverse events (RR 0.66; 95% CI 0.59 to 0.74) and a 63% reduced risk of reported medical errors resulting in patient death (RR 0.37; 95% CI 0.28 to 0.49).

"Conclusions These findings have broad relevance for those who work in and receive care from academic hospitals in the USA. The decision to lift this work hour policy in 2017 may expose patients to preventable harm."

***

"From 2003 to 2011, the Accreditation Council for Graduate Medical Education (ACGME) limited residents in their first postgraduate year to a maximum of 30 consecutive work hours, including 6 hours for continuity of care and educational activities (30 hours 2003 ACGME work-hour limit).2 Subsequent evaluations found that shifts of 24 or more hours were associated with increased odds of fatigue-related medical errors and preventable adverse events (PAEs),3 percutaneous injuries4 and motor vehicle crashes.5 A randomised controlled trial found that limiting first-year resident physicians to 16 consecutive work hours significantly improved resident alertness and patient safety.6 7 Altogether, a body of evidence accumulated suggesting that reducing or eliminating shifts longer than 16 hours did not negatively impact resident education and likely improved patient safety and resident quality of life.8 Subsequently, the Institute of Medicine of the National Academies (IOM) reviewed the available evidence and concluded that it was unsafe for any resident physician to provide clinical care for >16 consecutive hours without sleep.9 10 In response, the ACGME issued new work-hour regulations on 1 July 2011, limiting first-year resident physicians to a maximum of 16 consecutive work hours and emphasising a commitment to patient safety and mitigation of fatigue-related risks (16 hours 2011 ACGME work-hour limit).11

"The response within the medical community to the 16 hours 2011 ACGME work-hour limit was mixed.12 Many stakeholders expected the changes to diminish the educational experience.13 The increased frequency of patient handoffs raised concerns, as physician-to-physician handoffs have historically been non-standardised and prone to error.14 In addition, the work-hour limitations were not accompanied by an increased number of residency slots, leading to work compression and a shift in some responsibilities to other clinical providers,15 as well as concerns about resident physician understaffing. Several studies of the 16 hours 2011 ACGME work-hour limit found that it had no impact on hospital-level mortality or mortality following surgical procedures.16–18 In light of these studies and opposition to the work-hour limit from within the medical community, the ACGME lifted the 16-hour limit as of 1 July 2017, again allowing first-year resident physicians to be scheduled for 24 hours of continuous work, plus up to 4 hours for care transitions (28 hours 2017 ACGME work-hour limit)."

Fentanyl test strips save lives. Why do Kansas and Missouri ban them?

 You can imagine a world, with virtually no drug abuse, in which we would want to inhibit the recreational use of fentanyl and so might outlaw tools that might promote it.  But that isn't the world we live in, and instead simple tests for the presence of fentanyl can save lives by preventing fatal accidental overdoses.

Here's an editorial bemoaning the fact that these tests are sometimes banned.

Simple, cheap fentanyl test strips save lives. Why do Kansas and Missouri ban them? BY THE KANSAS CITY STAR EDITORIAL BOARD

 "As the Kansas and Missouri legislative sessions come to a close, there’s at least one more matter lawmakers in both states should attend to. They could save lives with tiny strips of paper that can detect the presence of fentanyl in recreational drugs. 

"Fentanyl test strips are designed to prevent people from overdosing on illegal recreational drugs that have been spiked with potentially fatal amounts of the synthetic opioid fentanyl. 

"Overdose deaths have risen to well over 100,000 a year in the United States. Synthetic opioids — primarily fentanyl — are the primary reason for the overall increase in total drug overdose deaths, according to the U.S. Drug Enforcement Administration. 

...

"But in some states, including Kansas and Missouri, the strips are considered drug paraphernalia and are not legal. Now there are proposals before both state legislatures to decriminalize them. This is not a partisan issue, and no one should oppose this move."

Happy birthday to Bob Wilson

  Happy birthday Bob!

U.S .annual overdose deaths surpass 100,000, a new high

The CDC has released some new (still preliminary) data on drug overdose deaths in the U.S.

Here's the NYT:

Overdose Deaths Continue Rising, With Fentanyl and Meth Key Culprits. New data shows a surge in overdose deaths involving fentanyl and methamphetamine. Overall, the nation saw a 15 percent increase in deaths from overdoses in 2021.  By Noah Weiland and Margot Sanger-Katz

"After a catastrophic increase in 2020, deaths from drug overdoses rose again to record-breaking levels in 2021, nearing 108,000, the result of an ever-worsening fentanyl crisis, according to preliminary new data published on Wednesday by the Centers for Disease Control and Prevention.

"The increase of nearly 15 percent followed a much steeper rise of almost 30 percent in 2020, an unrelenting crisis that has consumed federal and state drug policy officials. Since the 1970s, the number of drug overdose deaths has increased every year except 2018.

...

"Drug overdoses, which long ago surged above the country’s peak deaths from AIDS, car crashes and guns, killed about a quarter as many Americans last year as Covid-19.

***********

The Guardian  also has the story:

‘Completely devastating’: US passes 1m overdose deaths since records began. 2021 was a record year for overdose deaths with an estimated 107,622, CDC says, an increase of 15% from the previous year  by Melody Schreiber

"US overdose deaths in 2021 [were] a record year for such fatalities with an estimated 107,622, the US Centers for Disease Control and Prevention (CDC) said on Wednesday.

"It was an increase of 15% from the previous year, which was also a record.

"The US has now passed 1m overdose deaths since the CDC began collecting data about two decades ago.

"The surge in deaths in 2021 was fueled primarily by fentanyl, a highly dangerous synthetic opioid that accounted for about 70% of fatalities.

"Black American men and boys have the highest fatality rates from drug overdoses, followed closely by American Indian and Alaska Native men and boys – a significant increase among these demographics in recent years.

...

"The almost fiftyfold increase in illicit pills containing fentanyl happened between 2018 and 2021, she said – a “huge proliferation”.

*************

Here's a CDC chart:

12 Month-ending Provisional Number and Percent Change of Drug Overdose Deaths

Xenotransplantation and pork chops

 There's been recent news about xenotransplantation, with attempts made to transplant kidneys or hearts from genetically modified pigs into humans.  Those haven't been successful yet, but the organs weren't immediately rejected, because the special pigs involved don't have the alpha-gal sugar molecule on their cells that non-human mammals have and that immediately alerts human immune systems to reject the organ.

But while pig organs aren't ready for transplant yet, it turns out that there are some people who are allergic to the alpha-gal sugar, and hence to meat. But they can eat the meat of these almost-transplant-ready pigs.

The Atlantic has the story:

A Tick Bite Made Them Allergic to Meat. And an organ-transplant company has an unexpected solution. By Sarah Zhang

"It just so happens that the same molecule—a sugar called alpha-gal—that causes the human immune system to reject pig organs also causes the tick-associated red-meat allergy, known as alpha-gal syndrome. To make a pig whose organs could be harvested for transplant, Revivicor first had to make an alpha-gal-free pig. And when it did, the company realized that transplant surgeons weren’t the only ones interested.

"Since last fall, Revivicor has been quietly sending refrigerated packages of alpha-gal-free bacon, ham, ground pork, chops, and pork shoulders to people in the alpha-gal-syndrome community. These packages were free, but Revivicor has told the FDA it is exploring a mail-order business. And so a biomedical company has found itself an accidental purveyor of specialty pork products."

************

In the background of this story is Revivicor part of the public benefit corporation United Therapeutics, founded by the remarkable Martine Rothblatt.

 

The No Club, by Babcock, Peyser, Vesterlund and Weingart

 I had the pleasure of hearing Lisa Vesterlund talk about her new book, The No Club: Putting a Stop to Women’s Dead-End Work, by Linda Babcock, Brenda Peyser, Lise Vesterlund, and Laurie Weingart.

One nice market design suggestion comes from the (well documented) observation that it's disproportionately women who volunteer for 'non-promotable' tasks, such as note-taking at meetings, and writing up the minutes afterwards. These are tasks that anyone can do pretty well, so the suggestion is that they should be assigned by lottery, rather than by seeing who volunteers...

Medical residents organize to bargain collectively

Medpage has the story:

A Tale of Two Hospitals: Resident Mistreatment and Exploitation— The pandemic has ignited a wave of resident unionization by Jessie Ge, MD, and Rayyan Kamal, MD 

Stanford Health Care

"In December 2020, Stanford Health Care rolled out a COVID-19 vaccination plan that excluded nearly all 1,400-plus resident and fellow physicians from eligibility. For the residents and fellows who had been working tirelessly at the frontlines of the pandemic, this was the last straw. In our view, this didn't appear to be a one-time mistake of some algorithm, but a continued pattern of employer neglect and exploitation of our labor. That's when we knew we had to start organizing for real power.

"A little over a year later, on February 22, 2022, we had gathered supermajority support from our co-workers to unionize with the Committee of Interns and Residents (CIR). However, our request for voluntary recognition from Stanford was denied. In the face of potential anti-union tactics from Stanford, we communicated through our own website and tweetorials, re-centering our mission for a meaningful voice and focusing on widespread support, not only from our own residents, but also from our local elected officials and other labor unions.

"The Stanford nurses were some of our biggest supporters -- we shared a need for better working conditions to deliver better patient care. They have been unionized for over 50 years, and their collective strength protected them from being stretched even thinner during the pandemic. ... Despite a tough employer campaign to defeat our union, we won our election 835 to 214 this week.

...

Greater Lawrence Family Health Center

"On March 15, 2022, we officially won our union. While the hospital's efforts did manage to turn a few who had initially supported the union, 72% of our unit voted in favor of CIR in an election where every single resident participated. A 100% turnout rate is unprecedented even in a small program. It speaks volumes to how connected we've become throughout this process. We are in solidarity with house staff everywhere going public, filing for unionization, and taking the next step toward social progress and justice for academic medicine.

"While we don't know where this new movement in resident unionization will ultimately lead, we know we're headed in the right direction. Doctors are people too and we must rehumanize medicine for everyone -- both our patients and the people who make hospitals run.

"Jessie Ge, MD, is a fourth-year urology resident at Stanford Health Care. Rayyan Kamal, MD, is a second-year family medicine resident at Greater Lawrence Family Health Center.

****************

Related:

Wednesday, December 22, 2021

Will unionization at universities change the United Auto Workers?

Surrogacy in wartime Ukraine

 The NY Times follows the war-disrupted surrogacy market in Ukraine, where in addition to the normal surrogacy issues, surrogates have to decide whether to deliver in Ukraine or in Poland (where surrogacy isn't recognized), and parents have to decide whether to attend the birth in Lviv or wait for the baby in Poland.  It's tough stuff, for both surrogates and parents.  I'll just excerpt some of the background information on surrogacy.

The Nightmare of Being a Surrogate Mother in Wartime. Ukraine’s booming surrogacy business has become a logistical and ethical mess — and hell for the women at the center.   By Susan Dominus

"After a friend of hers worked as a surrogate, Maryna started considering the possibility. Ukrainian law required that women who would be hired as surrogates had already successfully given birth, and she had two healthy daughters. By helping another family, she hoped to buy a home, a goal that would otherwise have been a significant stretch for her and her husband, who worked on cars. On Aug. 21, she was impregnated with two embryos for a couple in North America. Surrogates for Delivering Dreams typically earn around $18,000 a year, but because she was pregnant with twins, she would be paid a bonus of several thousand more. In Ukraine, a typical schoolteacher would make less than a quarter of that over the course of a year.

...

"Delivering Dreams, Kersch-Kibler’s agency, celebrates, in its name, the meaningful benefit of surrogacy to both parties in the arrangement — for the parents, the gift of a biological child; for the surrogate mother, a potentially life-altering sum of money. That arrangement is also, however, a business contract, which entails, for the expectant women, a job — one with managers, rules, oversight and risks to their physical health.

"Even as reproductive technology has advanced, the number of countries that explicitly permit international paid surrogacy has dropped. Opponents of the practice argue that the transactional arrangement commodifies one of the most profound human experiences, the birth of a child. Feminists tend to divide on the ethical issue of surrogacy, with some seeing in the practice a means of financial autonomy, and others perceiving it, especially in less-developed countries, as a kind of reproductive coercion: Could a woman really be said to have choice in deciding to become a surrogate, if doing so was the only way to lift her family out of poverty?

"Concerns about trafficking and exploitation led India to pass a law in 2019 that officially shut down what was once, according to a 2012 estimate, a $2.3 billion surrogacy industry. Cambodia, Thailand and Nepal also once served as frequent destinations for foreigners seeking paid surrogates until those countries, too, legally restricted the practice.

"In those countries, as in many others, the only form of surrogacy allowed is among nationals, provided that no compensation is received. Altruistic surrogacy — in which only pregnancy-related expenses are covered — is legal in countries like England and the Netherlands; in heavily Catholic countries like France, Belgium and Spain, the intended parents of children born to surrogates often face challenges claiming their legal rights as parents, despite a European Court of Human Rights decision, finalized in 2019, that recognized children’s inherent right to belong to their biological families. In other countries, like Argentina and Albania, the law does not address the issue one way or another, diminishing the market for commercial surrogacy, as the ambiguity leaves all parties vulnerable in the event of a dispute. In the United States, legal protections vary state by state: Some states, like Illinois and California, allow surrogacy contracts; others do not recognize surrogacy contracts but do provide for judicial recognition of intended parents’ claims to children born with the help of a surrogate. In Michigan, paying a woman to be a surrogate is a felony.

...

"Since various countries have restricted international surrogacy, agencies have rushed in to take advantage of Ukraine’s relatively well regulated market. One Ukrainian embryologist has estimated that before the war, roughly 3,200 implantations were performed in the country each year — creating, through the fees and also the associated tourism, a new, thriving economic sector. Typically, parents who opt for surrogacy fly into the country and work with a local clinic, conceiving embryos that are subsequently implanted in the wombs of Ukrainian women whom they have interviewed (usually by video call) or chosen from descriptions the agency provides. In some, but not all, cases, the parents choose to build a relationship with the woman carrying their child, texting regularly, even flying in to visit her; almost always, the parents fly back into the country nine months later, either to be there for the birth, if all parties agree, or to receive their newborn and take the child back home.

"Even under the best of circumstances, the arrangement can be fraught. Now, Ukraine’s surrogates are working under the worst of circumstances, forcing everyone involved — agencies, intended parents and surrogates — to make decisions based on imperfect information regarding matters of life and death. The starkness of war has laid bare the many ethical tensions that exist in surrogacy arrangements, casting into bold relief the power dynamics that underlie a contract in which a woman signs over the whole of her physical self.

(Mis)Matching airmen to bases

 The Military Times has this story, suggesting that the Air Force still has lots of room to improve it's internal matching procedures:

Air Force to end preferred basing for enlisted as it changes how airmen find new jobs.  By Rachel S. Cohen

"The Air Force this month will suspend its 4-year-old “base of preference” program for airmen who are on at least their second enlistment contract, saying it fails to send most applicants to the installations they want.

"Stopping the initiative at the end of May can also offer the service more flexibility to move airmen around as military staffing needs dictate.

The change affects “career airmen,” or those who have reenlisted at least once. They previously needed to spend at least four years in their jobs before leaving for a preferred base.

...

"That success rate would have been way higher if we actually had a resource where your standard airman could easily see what bases had openings/low manning, without having to have your [senior enlisted leader] ask your [career field manager] (who probably gets pinged about that at least once a week from people all over the world),” Reddit user JustHangInThere wrote April 28."

**********

Here's a post from 2020 about a NAS report that offered some suggestions on how to improve Air Force matching of personnel to bases and jobs:

Tuesday, December 1, 2020

The labor market that is the military: a report from the National Academies of Science, Engineering, and Medicine

HT: Cherie Shauvin

Repugnance and market design in translation: video and transcript (en español, en argentina)

 I recently was interviewed by Jorge Fontevecchia via Zoom in Argentina. Among other things, we spoke (in English) about how both markets and bans on markets need social support to work well. You can listen to the interview as it was broadcast on Argentine tv, in Spanish translation, with voice-over (i.e. you can only hear me vaguely in the background, and a Spanish speaking lady's voice conveys my answers...).

A  Spanish transcript is here:

Alvin Roth: “La repugnancia afecta a mercados, y la prohibición de algunos de ellos sigue siendo muy controvertida”

When I look at the result in Google Translate, the back-translation produces some unexpected results (as well as the expected result that "repugnance" comes back as "disgust."  Here's an example of a funny Q&A involving the dual meanings of the Spanish word "tiempo":

How does the passage of time affect the markets?

“Weather affects markets in many ways..."

But here's a Q&A that back-translated well enough to get the gist (modulo some pronouns):

Do you think that whenever there is a transaction involving money, what is being exchanged automatically becomes an object or thing because there is money involved?

“I don't agree with that at all. He's probably getting paid to do this interview that he's doing, but his employer is paying him because he's an expert journalist and interviewer. And sadly, I'm not getting paid for this interview, but you and I are no less human. There is nothing about the transaction that you are not doing as part of your job, and I do it just for fun. Nothing in that transaction makes one of us more or less human. When I think of merchandise [commodities], I think of things that are not different from each other. If I were a baker and I wanted to buy wheat I could buy it at a commodity market, it has all sorts of descriptive terms, we make bread with number two hard red winter wheat, that's a complete description. I don't have to care which farmer you buy it from because it has been well described. But when you want to hire a baker in your bakery, you don't just hire a baker because they are not commodities. You have to find a particular person that you want to hire and you don't make an offer to the general market saying, I want 5 thousand bushels of wheat, but to a particular person saying, I want to hire you. That doesn't depersonalize the market at all."

***********

Update:

Here's a Portugese translation, on which Google translate also works reasonably well:

Alvin Roth: “Um dos problemas mais difíceis que estamos vendo no mundo agora tem a ver com o reassentamento de refugiados”

*Por Jorge Fontevecchia – Cofundador da Editoria Perfil – CEO da Perfil Network.

School choice with outside options , by Akbarpour, Kapor, Neilson, van Dijk, and Zimmerman in J.Pub.E.

 One of the differences between market design and the theoretical mechanism design literature is that in mechanism design, the theorist creates the whole universe of strategies available to participants, while in practical market design, the marketplace being designed is part of some larger economic environment, which gives the participants potentially bigger strategy sets.

Here's a paper that takes that point of view with respect to school choice. In the empirical part of the paper, a switch from a manipulable immediate acceptance algorithm to a strategy proof  deferred acceptance algorithm influences families with an outside option (a guaranteed continuation in the school where they are enrolled in pre-kindergarten) differently from families without that safe option.  When the manipulable algorithm is used, families without an outside option often find it too risky to compete for scarce spaces in the most desirable schools, which they can safely do when the strategy proof algorithm is employed.

Centralized School choice with unequal outside options by Mohammad Akbarpour, Adam Kapor, Christopher Neilson, Winnie van Dijk, Seth Zimmerman, Journal of Public Economics, Volume 210, June 2022, 104644

Abstract: We study how market design choices exacerbate or mitigate pre-existing inequalities among participants. We introduce outside options in a well-known school choice model, and show that students always prefer manipulable over strategy-proof mechanisms if and only if they have an outside option. We test for the proposed relationship between outside options and manipulability in a setting where we can identify students’ outside options and observe applications under two mechanisms. Consistent with theory, students with an outside option are more likely to list popular, highly-rated schools under the Boston mechanism, and this gap disappears after switching to a Deferred Acceptance mechanism.

*******

Related earlier posts:

Monday, January 28, 2019

School choice in New Haven: studied by Kapor, Neilson and Zimmerman and switching from immediate to deferred acceptance

Sunday, March 22, 2020

School choice without the assumption of full-information equilibrium by Kapor, Neilson and Zimmerman

And here's a post about a paper that takes outside options seriously from a different point of view.

Monday, December 14, 2020

Designing centralized marketplaces that work gracefully with pre-existing decentralized ones, in Management Science, by Benjamin Roth and Ran Shorrer

Signaling for Otolaryngology residency programs

 Here's a report on the use of signaling for residency positions, from the Oto match.

Pletcher, Steven, Chang, C.W., Thorne, Marc, MD, MPH & Malekzadeh, Sonya. (2022). The Otolaryngology Residency Program Preference Signaling Experience. Academic Medicine, 97, 664-668. https://doi.org/10.1097/ACM.0000000000004441

"The average applicant to Otolaryngology-Head and Neck Surgery in the 2021 residency application cycle applied to more than 50% of otolaryngology programs nationwide, submitting 77 applications, 1 a 34% increase over 5 years. 2 This surge has made it difficult for residency programs to holistically review applications and has limited opportunities for applicants to stand out to programs of particular interest.

...

"A formal preference signaling process provides all applicants with access to a known and stable quantity of signals. Through this process, at the time of application submission, students send a signal to indicate to a defined number of residency programs their particular interest in those programs. Such signals allow students to stand out to their favored programs and allow programs to receive a list of highly interested applicants. To our knowledge, this approach has not been used previously in the residency application process. Yet, articles advocating for signaling exist in the otolaryngology literature, 5-7 and the methodology, rationale, and results of preference signaling for graduates of economics PhD programs applying for faculty positions have been described. 8

"An OPDO working group, comprising the 4 authors, drove the establishment of a signaling process. In the spring of 2020, we held a series of meetings and webinars to engage stakeholders in the development and implementation of a signaling process. We included students, program directors, and specialty societies, such as the Society of University Otolaryngologists and the Association of Academic Departments of Otolaryngology Otolaryngology Chairs Organization. Additional discussions with the Association of American Medical Colleges, the Electronic Residency Application Service (ERAS), and the National Resident Matching Program also took place.

"In hindsight, establishing consensus across stakeholders proved to be the most challenging hurdle to successful implementation of our signaling process. Stakeholders had to accept this change and the inherent risks of implementing a "never before in medicine" process. These discussions, however, also provided a critical opportunity to refine our proposal and create an educational ecosystem that accepted this signaling process.

...

"All otolaryngology residency programs attested to the code of conduct, and none opted out of the signaling process. By October 21, 2020, the date that applications were released to programs, 611 students had submitted applications to otolaryngology residency programs, 559 applicants had submitted a Match list including an otolaryngology program, and 558 applicants had participated in the signaling process. Of 119 non-military otolaryngology residency programs, 118 received at least 1 signal. The number of signals received per program ranged from 0 to 71 with a mean of 22 (standard deviation 17) and a median of 16 

...

"Program directors most commonly reported using signals as a tiebreaker for similar applications and as part of an initial application review algorithm. One program required a signal to offer an applicant an interview.

...

"Applicants reported applying to a mean of 77 programs (standard deviation 21), including their 5 signaled programs. The rate of receiving an interview offer was significantly higher for signaled programs (58%, 670/1,150) compared with both nonsignaled programs (14%, 2,394/16,520; P < .001) and the comparative nonsignal program (23%, 53/230; P < .001; see Figure 2). To assess the impact of signaling across the spectrum of applicant competitiveness, we divided applicants into quartiles based on their overall likelihood of receiving an interview offer. Signals had a significant impact (P < .001) on interview offers across all quartiles (see Figure 3).

...

"The magnitude of signal impact we found likely represents both an increased rate of interview offers from signaled programs and a decreased rate of interview offers from nonsignaled programs. In contrast to our 5 signals, the American Economic Association provides 2 signals for graduates of economics PhD programs applying for faculty positions, suggesting that signal scarcity preserves its value and intent. 8 Decreasing the number of signals would force applicants to narrow their list of programs of primary interest and would disincentivize signaling "dream" programs. By increasing the number of signals, the lack of a signal becomes an indication of disinterest. If enough signals are provided, signaling could have a similar impact on the application process as an application cap. The ideal number of signals then must be explored.

"Our data demonstrated that signaling allowed applicants to influence their likelihood of receiving an interview offer from programs of particular interest. Given the distribution of signals received across programs, we believe that signaling also improved the distribution of interview offers among applicants, which could mitigate interview hoarding. 

...

"While applicants appear to benefit significantly from signaling, they also bear the responsibility of targeting their signals appropriately.

...

"Multiple specialties have expressed interest in adopting a similar program. However, otolaryngology is not representative of all medical or surgical specialties. It is a small, competitive surgical subspecialty with a 63% Match rate and no unmatched residency slots in the 2021 cycle. While the impact of signaling may vary significantly outside of these parameters, we are optimistic that the benefits will carry over to other specialties. Incorporating a signaling option within ERAS would facilitate both wide adoption and further analysis of such a process."

Streets of Gold, by Ran Abramitzky and Leah Boustan

 Ran Abramitzky writes:

As some of you know, I have a book coming out soon (with my long-time collaborator Leah Boustan) using big data to tell a new story about immigration and the American Dream. 

I’m thrilled to announce that Streets of Gold: America’s Untold Story of Immigrant Success will be published at the end of the month by PublicAffairs with preorders (hardcover and Kindle) available now. Audio book is also coming soon. 

 

 Leah and I felt compelled to write this book because we believe that immigration is one of the most fraught, and possibly most misunderstood, topics in American public life. Most of the things that we believe about immigration – both on the left and on the right – are based largely in myth, not in facts.

In setting out to establish the facts, we were like curious grandchildren searching for our own family tree, but a million times over. We analyzed millions of immigrant families in the past and today. What we found surprised us, overturning many of our own preconceptions. 

• Upward Mobility: Children of immigrants from nearly every country, especially those of poor immigrants, do better economically than children of U.S.-born residents – a pattern that has held for more than a century. 
• Rapid Assimilation: Immigrants accused of lack of assimilation (such as Mexicans today and the Irish in the past) actually assimilate fastest. 
• Improved Economy: Immigration changes the economy in unexpected positive ways. 

The book is a fast read, and we interweave the data with stories of immigrant families.  

I would truly appreciate your help leading up to the book’s launch. If you are interested in buying a copy, think about pre-ordering now. Preorders are essential for raising the visibility of new books. Please also share the word with other friends and family who are interested in America’s immigration history. 

 

Thank you! 

Ran

 

P.S. the book got some great endorsements (pasting here shortened versions):

“This wonderful and highly readable book sets the record straight about the hot-button issue of immigration. A must-read for anyone who care about this important issue.”

Daron Acemoglu, MIT, coauthor of Why Nations Fail

 

“A compelling story about how millions of immigrant families achieved the American Dream that will help reshape the narrative about immigration and opportunity in the United States.”

Raj Chetty, Harvard University

 

“Uplifting in its message, engaging in its composition, and powerful in its significance, Streets of Gold is A New World Symphony in words and numbers.”

Claudia Goldin, Harvard University

 

“Streets of Gold has the facts about the amazing and often surprising history of American immigration.” 

Angus Deaton, Nobel Laureate in economics

 

“A gem of a book, grounded in deep original research and made lively by moving personal accounts”

Esther Duflo, Nobel Laureate in economics

 

“A highly engaging book that separates fact and fiction and busts many of the myths that pervade the current discussion on immigration policy.”

Guido Imbens, Nobel Laureate in economics

 

“Unprecedented data, empathetic personal histories, joyous writing, practical solutions and a compelling counter-Zeitgeist narrative.”

David Laitin, Stanford University

 

“The optimism that runs through Streets of Gold is based on rock solid-evidence.”

Doug Massey, Princeton University

 

“Armed with reams of new data, elegantly written, and meticulously researched, Streets of Gold is as timely as it is magisterial.”

 Joel Mokyr, Northwestern University

 

“Fascinating and hard to put down history of American immigration, based on new sources of data, and conveyed by powerful story-telling”

Alvin E. Roth, Nobel laureate in economics

 

“Pathbreaking.”

Andrew Selee, President, Migration Policy Institute 

 

“An absolute treasure, the perfect book on immigration.”

Zack Weinersmith, New York Times Bestselling author of Soonish

 

Drought, hunger, and early marriage in Ethiopia

 Sometimes the problem is hunger, and early marriage is seen as the solution.

The Guardian has the story

Ethiopian drought leading to ‘dramatic’ increase in child marriage, Unicef warns. With hunger across Horn of Africa and 600,000 children out of school, ‘desperate’ parents push more girls into early marriage by Lizzy Davies

"Three consecutive failed rainy seasons have brought hunger, malnutrition and mass displacement to millions of people in the Horn of Africa, including parts of Ethiopia, Somalia, Kenya and Djibouti.

"Many girls in Ethiopia now face being married at a young age as their parents seek to find extra resources through dowries from the husband’s family, and hope their daughters will be fed and protected by wealthier families, warned Catherine Russell, Unicef’s executive director.

...

"In the East Hararghe zone, home to 2.7 million people, child marriage cases increased by 51%, from 70 recorded during a six-month period in 2020-21 to 106 in the same period a year later.

"It was just one of six drought-affected areas in Oromia to have seen a sharp rise in child marriages, Unicef said. Across those zones, cases have almost quadrupled. According to data received by Unicef this week, 672 cases of child marriage were recorded between February and August last year, whereas in the six months from last September to March this year, that number leapt to 2,282, local government figures showed.

"“We’re seeing increases in child marriage that are quite dramatic,” Russell said, noting that more than 600,000 children are thought to have dropped out of school as a result of the drought.

...

“These people [have their daughters married] because they’re desperate for one reason or another: they’re afraid of violence; they’re afraid for the safety of the girls; they need resources; they can’t afford to feed them,” Russell said.

...

"According to demographic data from 2016, 40% of girls in the east African country are married before the age of 18 and 14% are married before their 15th birthday.

...

"The drought is also pushing up the rates of severe acute malnutrition in the affected areas, with admission rates for children under five years old 15% higher in February this year than February last year."