Tuesday, August 16, 2022

Kim Krawiec interviews Frank McCormick on the kidney shortage (and how to end it)

Here is Kim Krawiec's latest podcast (click on this link to listen, not the picture below...:): 

Taboo Trades 

AUGUST 06, 2022 KIM KRAWIEC
Taboo Trades
Bonus Episode: Ending the Kidney Shortage with Frank McCormick
00:00|44:40

Frank McCormick is an economist and the author of numerous articles focused on the shortage of kidneys for transplantation. He is retired from the Bank of America where he was Vice-president and Director of U.S. Economic and Financial Research. Today, we’re discussing his recent article, Projecting the Economic Impact of Compensating Living Kidney Donors in the United States: Cost-Benefit Analysis Demonstrates Substantial Patient and Societal Gains, co-authored with Philip J. Held, Glenn Chertow, Thomas G. Peters, and John P. Roberts. It is published in the journal, Value in Health and is available here: https://www.sciencedirect.com/science/article/pii/S109830152201957X/

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

In an email to his extensive mailing list, McCormick writes:

If you don’t have 45 minutes to spare, the key points I have to make are:

1. The death toll due to the shortage of transplant kidneys is much greater than is generally realized.  The Health Resources and Services Administration (HRSA) misleads everyone by saying only 19 people a day die waiting for a transplant organ -- because it counts only patients who die while on the waiting lists (for kidneys alone that number is about 13 deaths per day).

But HRSA does not count:

A. Patients who are removed from the wait list because their health has become so poor they may not survive a transplant operation (or for other reasons) who soon die;

B. Patients who are never placed on the waiting list to begin with, but who could be saved from a premature death by transplantation if there were no kidney shortage.

Adding the latter two groups raises the death toll due to the kidney shortage to more than 110 deaths per day (40,000 per year).

 2. This appalling death toll due to the kidney shortage could be completely ended if the government compensates kidney donors about $77,000 per donor (with a wide range of uncertainty surrounding that estimate).  But even if the required compensation is two or three times this amount, it would be trivial compared to:

A. The value of a longer and healthier life to a kidney recipient (and their caregiver), which my co-authors and I estimate at about $1.5 million.

B. The savings (mainly to taxpayers) from the kidney recipient not needing expensive dialysis therapy, which we estimate at about $1.2 million per recipient.

In the long run, this program of government compensation of kidney donors would not cost taxpayers anything; rather it would save them about $7 billion per year.

 References:

1. McCormick F, Held PJ, Chertow GM.  The Terrible Toll of the Kidney Shortage.   J Am Soc Nephrol 2018;29:2775-2776. https://jasn.asnjournals.org/content/jnephrol/29/12/2775.full.pdf.

 2. McCormick F, Held PJ, Chertow GM, Peters TG, Roberts JP.  Perspectives: Projecting the Economic Impact of Compensating Living Kidney Donors in the United States: Cost-Benefit Analysis Demonstrates Substantial Patient and Societal Gains.  Value in Health, online 9 June 2022.  https://doi.org/10.1016/j.jval.2022.04.1732.

Monday, August 15, 2022

U. Chicago celebrates Michael Kremer

 Theory in practice--Nobel laureate Michael Kremer is building up development economics at UChicago.  By Lucas McGranahan, The University of Chicago Magazine — Summer/22

"In 1985 a new college graduate named Michael Kremer traveled to Kenya hoping to learn more about a topic he had studied at Harvard: economic development in low-income countries. He didn’t anticipate that an official in the village where he was staying would invite him to teach at a new school—but Kremer stayed in the country for a year to do just that. In fact, he cofounded an organization, WorldTeach, to send more teachers to Kenya and ultimately to several other developing countries.

...

"When he returned to Kenya in the early 1990s, Kremer was just starting his academic career as an economist at MIT. ... One friend, a Kenyan who was working for a small Dutch nongovernmental organization operating in Africa, was trying to identify schools in which to roll out a program intended to improve learning. Kremer offered a casual suggestion: select schools in a systematic way, then compare outcomes in those schools with outcomes in the same number of similar schools where the program was not operating.

"After returning home Kremer heard from his friend that the NGO was interested in trying out the approach. It was the start of a relationship that helped determine the trajectory of Kremer’s research in economics: he got involved not only with the Kenyan school study but with other experiments being done by the organization, today called ICS Africa, helping it develop evidence-backed programs.

"Kremer’s desire to help was evolving into a scientific methodology, one that would complement the most established approaches in his discipline.

“Randomized controlled trials had been used in medicine for a very long time,” he says, noting that some economists and other social scientists had also used them. And yet the technique had not broken through widely in economics, which largely either focused on theoretical models or relied on existing data. 

...

"Kremer was born in New York City to parents who were both children of Jewish immigrants from Europe. He came of age in the orbit of Kansas State University, where his father, Eugene Kremer, taught architecture, and his mother, Sara Lillian Kremer, was a professor of English. He credits his mother, who authored two books on literary representations of the Holocaust, with teaching him the necessity of addressing preventable suffering and injustice in the world—the key motivation behind his work, from founding WorldTeach to conducting research in Kenya and beyond.

"Kremer and his wife and collaborator Rachel Glennerster—a British development economist who joined the UChicago faculty as an associate professor in 2021—take this intention to heart in their research as well as in their personal philanthropy: they’re part of the Giving What We Can Pledge, a commitment to give 10 percent or more of their lifetime income to high-impact charities.

...

"In the early 2000s, Kremer and a colleague set out to study a group of 75 schools in Kenya. They found that a school-based program providing deworming pills to all students reduced absenteeism by more than 25 percent—a staggering result improving the health and well-being of the children directly affected, and likely of the entire local population and its economy over time. In their 2004 paper, the authors argue that the positive spillover effects easily justify providing free universal treatment to school-age children in high-risk areas.

"Officials took note. After the study, with the support of NGOs, the program was scaled nationwide by the Kenyan government. From there it was picked up by multiple Indian states—and then by the Indian national government. Today the world’s second most populous country holds National Deworming Day twice a year, administered through public schools.

...

"In his Nobel lecture Kremer shared his greatest hope for the work he does: “innovations in social institutions designed to accelerate scientific and technological change and orient it toward human needs.”

Sunday, August 14, 2022

More on UNOS in the hot seat and calls for reform of the U.S. deceased donor transplant system

 Here's another report about the recent Senate Finance Committee hearing about UNOS, which includes a redacted version of the U.S. Digital Service report calling for UNOS's functions to be broken up. (UNOS, the United Network for Organ Sharing, is the federal contractor that runs the U.S. deceased donor transplant system.)

Transplant System Urgently Needs Overhaul, Experts Say— UNOS CEO skewered for alleged failures in management during a Senate Finance Committee hearing by Shannon Firth, Washington Correspondent, MedPage Today

"Members of the Senate Finance Committee and fellow witnesses roasted the head of the United Network for Organ Sharing (UNOS) during a hearing on Wednesday, over what Committee Chair Ron Wyden (D-Ore.) characterized as "gross mismanagement and incompetence."

...

"A report from the U.S. Digital Service issued last year determined that the network lacks the technical capacity to modernize the system. The report recommended that the contract for the system, worth $248 million, be separate from a contract for policy management, according to The Washington Post.

"Sen. Elizabeth Warren (D-Mass.), not one to mince words, told Brian Shepard, CEO of UNOS, "I'll just be clear. You should lose this contract. You should not be allowed anywhere near the organ transplant system in this country. And if you try to interfere with the process of turning the contract over to someone who can actually do the job, you should be held accountable for that."

HT: Frank McCormick

**********

And here is a Senate memo issued just prior to the hearing:

“A System in Need of Repair: Addressing  Organizational Failures of the U.S.’s Organ Procurement and Transplantation Network”

"This bipartisan investigation began in February 2020 when then-Chairman Charles Grassley, then-Ranking Member Ron Wyden, Senator Todd Young, and Senator Benjamin Cardin sent a letter to UNOS expressing their concerns about the adequacy of patient safety standards and belief that OPOs are failing to recover thousands of viable organs each year. 16 The letter also highlighted an investigation by the Department of Health and Human Services, Office of Inspector General (HHS OIG) and news reports, shining a light on “lapses in patient safety, misuse of taxpayer dollars, and tens of thousands of organs going unrecovered or not transplanted,” leading to questions about the adequacy of UNOS’ oversight of OPOs.”17

"In 2021, the investigation continued under the leadership of now-Chairman Wyden and Ranking Member Grassley of the Senate Judiciary Committee with a series of bipartisan requests for information sent to HHS,18 CMS,19 HRSA, and the Office of Management and Budget. Staff also broadened the scope of the investigation to include concerns about the inadequacy of the OPTN information technology system and its impact on patients. 

...

Based on documents and internal memoranda, the Committee found that:

• The OPTN is failing to provide adequate oversight of the nation’s 57 OPOs, resulting in fewer organs available for transplant.

• The lack of oversight by UNOS causes avoidable failures in organ procurement and transplantation resulting in risks to patient safety. These failures include testing procedure errors, transportation issues resulting in life saving organs being lost or destroyed in transit, and process and procedure failures.

• UNOS lacks technical expertise to modernize the OPTN IT system, resulting in risk of system interruption or technical failure with the potential to harm patients across the country."

...

"While not the sole focus of the Committee’s investigation, Senator Grassley and Senator Wyden’s staff also heard concerns from patients, transplant center staff, and OPO staff that UNOS lacks technological expertise or the willingness to develop and maintain an adequate IT infrastructure. Staff also heard concerns that the archaic IT system results in delays in placing organs, organs being discarded, and inaccurate data being used to place organs because of its dependence on staff manually entering hundreds of donor and transplant candidate data points rather than upgrading to systems better able to transfer data across Electronic Medical Record platforms.

"These concerns were validated in a report from the independent U.S. Digital Service (USDS), which is housed within the Executive Office of the President and provides consultation services to federal agencies on information technology.115 The report, titled Lives Are at Stake, states that UNOS has been able to wiggle through and around most new contract requirements for the OPTN technology by hand-waving at change with technical jargon, while making no substantive progress. The USDS also states that:116

• UNOS is incapable of modernizing the OPTN IT infrastructure;

• the core systems are fragile;

• OPTN technology limits policy development;

• UNOS is resistant to change; and,

• OPTN system is dependent on a disjointed and inadequate user experience.

"Ultimately, USDS determined that these technological failings are in fact placing lives at stake and recommended that HHS take action to create a better organ transplant system and enable better patient outcomes, including updating NOTA to create flexibility in how the OPTN is serviced by contractors."

...

"Based on the investigation’s findings, Committee staff makes the following recommendations to improve the OPTN:

• Remove barriers to competition by removing the specific requirement for HHS to contract only with a “non-profit entity that has an expertise in organ procurement and transplantation;”

• Increase the pool of potential bidders by clarifying that the OPTN functions described in NOTA and subsequent amendments may be operated by more than one contractor, since few contractors will have adequate clinical knowledge and expertise in IT, policy development, and data collection and reporting, and policy compliance activities;

• Promote innovation in all OPTN functions (e.g., policy development, compliance and patient safety mentoring, IT infrastructure, coordinating transport of organs, etc.) as the best qualified entities with distinct skill sets could compete for contracts for these functions;

• Remove a major barrier for entry for bidders by providing authority for HHS to procure a government owned, contractor operated modern IT system to facilitate the OPTN functions;

• Increase security and innovation in the OPTN system by ensuring the new IT system is based on current technologies and operated and maintained by a contractor with adequate IT knowledge and experience;

• Ensure the continued viability of the OPTN by authorizing HHS to collect fees from transplant hospitals when adding a patient to the national organ transplant waitlist. This would replace a current fee structure authorized by regulation which is not flexible enough to provide funding for multiple contracts;

• Increase transparency and accountability for chain of custody and transportation of organs procured for transplant by providing for public reporting, as appropriate, on the status of organs in transport; and,

• Increase accountability for organs lost, damaged, or delayed in transport by requiring oversight and corrective action for such incidents.

**********

Earlier:

Wednesday, August 3, 2022

Saturday, August 13, 2022

MATCH-UP 2022, August 24-26, 2022, TU Vienna, Vienna, Austria

 MATCH-UP 2022, August 24-26, 2022, TU Vienna, Vienna, Austria

registration for the workshop is only possible until August 16, 23:59 CET: https://www.eventbrite.at/e/match-up-2022-the-6th-workshop-on-preferences-under-matching-registration-368493533077

Here's the program:

24.08. Wednesday

13:30–14:15Registration
14:15–14:30Opening remarks
14:30–14:55Estelle Cantillon, Li Chen and Juan PereyraRespecting priorities versus respecting preferences in school choice: When is there a trade-off?
14:55–15:20Lars EhlersStudent-Optimal Interdistrict School Choice: District-Based versus School-Based Admissions
15:20–15:45Bnaya Dreyfuss, Ofer Glicksohn, Ori Heffetz and Assaf RommIncorporating Reference-Dependence Considerations in Deferred Acceptance
15:45–16:15Coffee break
16:30–16:55Xuan Zhang and Yuri FaenzaAffinely representable lattices, stable matchings, and choice functions
16:55–17:20Kemal Yildiz and Ahmet AlkanModular stable matching mechanisms
17:20–17:45Peter Biro and Gergely CsájiStrong core and Pareto-optimal solutions for the multiple partners matching problem under lexicographic preferences
17:30–19:30Poster session

25.08. Thursday

9:00–9:25Niclas Boehmer, Klaus Heeger and Stanisław SzufaA Map of Diverse Synthetic Stable Roommates Instances
9:25–9:50Klaus Heeger and Ágnes CsehPopular matchings with weighted voters
9:50–10:15Inbal Rozenzweig, Reshef Meir and Nicholas MatteiMitigating Skewed Bidding for Conference Paper Matching
10:15–10:40Sai Srivatsa Ravindranath, Zhe Feng, Shira Li, Jonathan Ma, Scott Kominers and David ParkesDeep Learning for Two-Sided Matching
10:40–11:10Coffee break
11:10–11:35Yannai Gonczarowski, Ori Heffetz and Clayton ThomasSelf-Explanatory Strategyproof Mechanisms
11:35–12:00Assaf Romm, Alvin Roth and Ran ShorrerStability vs. No Justified Envy
12:00–12:25Rupert Freeman, Geoffrey Pritchard and Mark WilsonOrder Symmetry: A New Fairness Criterion for Assignment Mechanisms
12:25–14:00Lunch break
14:00–15:00Keynote: Vijay Vazirani
Note: Different from the other talks, will be held in Hörsaal 1 (lecture hall 1).
Online Bipartite Matching and Adwords
15:00–15:25Danny Blom, Bart Smeulders and Frits SpieksmaRejection-proof Kidney Exchange Mechanisms
15:25–15:50Peter Biro, Flip Klijn, Xenia Klimentova and Ana VianaShapley-Scarf Housing Markets: Respecting Improvement, Integer Programming, and Kidney Exchange
15:50–16:30Coffee break
16:15–16:40Josue Ortega and Thilo KleinImproving Efficiency and Equality in School Choice
16:40–17:05Ran Shorrer and Sandor SovagoDominated Choices in a Strategically Simple College
17:05–17:30Daniel Kornbluth and Alexey KushnirUndergraduate Course Allocation through Pseudo-Markets
17:30–18:00Group photo in front of the main university building (Karslplatz)
18:30–22:00Bus ride to and dinner at Heuriger

26.08. Friday

9:00–10:00Keynote: Sophie Bade
Held in Hörsaal 8 (lecture hall 8).
TBA
10:00–10:25Nick Arnosti, Carlos Bonet and Jay SethuramanA Systematic Approach to Selection Problems
10:25–10:50Di Feng, Bettina Klaus and Flip KlijnA Characterization of the Coordinate-Wise Top-Trading-Cycles Mechanism for Multiple-Type Housing Markets
10:50–11:20Coffee break
11:20–11:45Haris Aziz and Zhaohong SunMulti-Rank Smart Reserves
12:45–12:10Jean-Jacques Herings and Yu ZhouEquilibria in Matching Markets with Soft and Hard Liquidity Constraints
12:10–13:45Lunch break
13:45–14:10Karolina VockeAnonymity and stability in large many-to-many markets
14:10–14:35Kristóf Bérczi, Erika Renáta Bérczi-Kovács and Evelin SzögiA dual approach for dynamic pricing in multi-demand markets
14:35–15:00Georgy Artemov, Yeon-Koo Che and Yinghua HeStable Matching with Mistaken Agents
15:00–15:25Federico Bobbio, Margarida Carvalho, Andrea Lodi, Ignacio Rios and Alfredo TorricoCapacity Planning in Stable Matching: An Application to School Choice
15:25–16:00Coffee break
16:00–16:25Haris Aziz, Anton Baychkov and Peter BiroCutoff stability under distributional constraints with an application to summer internship matching
16:25–16:50Kenzo Imamura and Yasushi KawaseEfficient matching under general constraints
16:50–17:15Zheng Chen, Bo Li, Mingming Li and Guochuan ZhangFair Graphical Resource Allocation with Matching-Induced Utilities
17:15–17:40Bo Li, Fangxiao Wang and Yu ZhouMaximin Share Fair Allocation of Indivisible Chores: Beyond Additive Valuations
17:40Closing remarks

Friday, August 12, 2022

Are sociology and economics coming closer together? Philippe Steiner in Acta Oeconomica

 Professor Philippe Steiner, of the Groupe d’Etudes des Méthodes de l’Analyse Sociologique de la Sorbonne, thinks that these days sociology and economics may be coming closer to each other than they have for some time.

New economic sociology and economic theory by Philippe Steiner, Acta Oeconomica 72 (2022) S1, 23–40  DOI: 10.1556/032.2022.00017

"Abstract: The paper begins with a brief reminder of the origin of economic sociology. It then surveys research by economic sociologists from the 1980s to the present, with a focus on their relation to political economy, which ranges from close to arm's length. Finally, beyond any differences between economic theory and economic sociology, the paper considers how both approaches can be connected in the socio-historical and economic study of economic inequalities by Thomas Piketty, and the use of matching markets by Alvin Roth."

...

"In the final part the paper seeks to show that economists have developed approaches that permit a fruitful combination of sociology and political economy, even using some of the more technical aspects of modern economics.

...

"After the 1930s economic sociology lost its appeal for economists, as well as sociologists, and gave way to the “Parsonian peace” according to which economists deal with value, while sociologists deal with values (Stark 2009: 7).

...

"There was a revival of economic sociology during the 1970s on both sides of the Atlantic. In the United States, this began with Mark Granovetter’s work on the labor market (Granovetter 1974), and then with a new interpretation of the social embeddedness of the market (Granovetter 1985). This was something that Polanyi had stressed in his book, noting the catastrophic consequences that follow the management of humanity, nature and politics as if they were market goods (labor, land and money) regulated by “supply and demand” in their respective markets. In the same period, Viviana Zelizer (1979, 1985) brought the sociology of culture closer to the sociology of economic life. In Europe, Pierre Bourdieu proposed a new interpretation of the market for cultural goods (or symbolic goods), to explain the functioning of the art market (Bourdieu 1971).

"As regards the relation to economic theory, the new economic sociology unfolds along four axes: (i) Granovetter established a close and direct relationship between economic sociology and the neo-classical theory of job search, together with the theory of transaction costs; (ii) Zelizer distanced herself completely from economic theory, although her sociology of economic life deals with central economic phenomena such as insurance, money, and law; (iii) Neil Fligstein developed an economic sociology close to institutionalist political economy, focusing on key institutions of the market, notably those regulating competition; finally, (iv) Bourdieu employed an original conceptualization of fields in order to explain the functioning of the markets of symbolic goods (fashion, painting, literature), while at the same time developing a methodological criticism of economic theory.

...

"In the case of the creation of the life insurance market in the United States, Zelizer started from the following paradox: while changes in social structure – fewer landowners, less mutual aid between neighbors – made it increasingly rational to insure one’s life to avoid leaving one’s wife and children destitute in the event of premature death, the life insurance market remained sluggish during the 19th century compared to what it was in Great Britain and in France. How do we explain this apparent lack of self-interested behavior in American male breadwinners? Zelizer’s answer employed several cultural arguments, including one based on the relationship to religion. During this period there was a widespread idea that to insure oneself against premature death was to oppose the will of God, even to not trust his wisdom. This was the reason for the reluctance to accept this new market product, the life insurance contract. A strength of her argument is also that she is careful not to oppose social behavior and self-interested economic behavior head-on. In fact, two phenomena directly linked to religion intervene to modify this cultural relationship to life insurance. First, she points to the fact that the religious sects that sent pastors to frontier regions took out life insurance on them so that the sect would not have to take care of their families if they died – a financial interest played its part in religious institutions. Second, she notes a reversal in the religious discourse on life insurance. In the beginning of the 20th century not only preachers, but also the rhetoric of insurance salesmen emphasized that the good father is he who takes precautions against premature death, hence this good father must be insured. Both culture and the economy began to structure behaviors that promoted a developing insurance market.

...

"While economists continued to employ the hypothesis of rationality, this is no longer central to the discourse of economic sociologists; the idea that economists are remote from the historical and social dimension has also lost its intensity. Instead, other criticisms have emerged, especially associated with the idea of performativity. At present there is neither conflict, or mutual indifference. Indeed, in several fields there are signs of an explicit or implicit rapprochement. I would like to mention two in particular.

"First of all, given the capacity of modern computers to process large databases, economists can deploy econometric tools in ways that accurately account for historical and social facts, as Thomas Piketty (1998, 2013, 2019) does. Second, by pursuing the strategy of economic engineering proposed by Alvin Roth (2002), economists take up the practical work of constructing institutions of exchange, exemplified by design economics and matching markets economists, developing what sociological economists have called the economic performation of the economy by economics (Callon 1998; MacKenzie et al. 2007)"

**********

Earlier

Thursday, January 6, 2022

Thursday, August 11, 2022

MEDIEVAL MATCHING MARKETS by Lars Boerner and Daniel Quint

 As I'll explain below, here's a long-awaited paper that fully qualifies for that description:

MEDIEVAL MATCHING MARKETS by Lars Boerner and Daniel Quint, International Economic Review, First published: 15 July 2022 https://doi.org/10.1111/iere.12600

Abstract: We study the regulation of brokerage in wholesale markets in premodern Central Western Europe. Examining 1,804 sets of rules from 82 cities, we find brokerage was primarily a centralized matchmaking mechanism. Brokerage was more common in towns with larger populations, better access to sea ports and trade routes, and greater political autonomy. Brokers' fee structures varied systematically: price-based fees were more common for highly heterogeneous goods, quantity-based fees for more homogeneous goods. We show theoretically that this was broadly consistent with total surplus maximization, and that brokerage was more valuable in markets with unequal numbers of buyers and sellers.

...

"We investigate how societies organized markets and whether their market policies were well designed to have a positive effect on welfare. We look at one important type of regulated allocation process, the organization of intermediation in the form of brokerage, primarily in wholesale markets. Regulated intermediation first appeared in European towns during the second half of the 13th century. Early regulations can particularly be found in Italy and the Lower Countries (van Houtte, 1936; Rezzara, 1903). However, a comprehensive quantitative study on the origin, spread and development of the brokerage institution is missing so far. Origins of brokerage have been linked to the urbanization process of the 13th century (van Houtte, 1936); whether it can be related to preceding medieval Arabic merchant institutions or Roman law is an open debate (van Houtte, 1936; Lieber, 1968).

"We study 231 cities in Central and Western Europe, roughly in the area of the Holy Roman Empire north of the Alps, during the period from 1200 to 1700. This area and period are particularly appealing for empirical investigation because local municipalities were typically economically and politically autonomous. Thus, each city could implement its own types of regulations and allocation mechanisms, leading to potentially rich variation in detail.

"We identify cities with (and without) brokerage regulations and find in cities with regulations a dominant brokerage design with specific combinations of rules. The dominant design was a sort of centralized matchmaking mechanism: a few licensed brokers specializing in a particular product were given the exclusive right to offer a service pairing mainly foreign merchants with local buyers, and their behavior was strictly regulated. Brokers were not allowed to do any business on their own behalf and were restricted in what information they could disclose. The brokerage service was open to everybody, to the rich and poor, and to foreign and local merchants. Brokers received a predefined fee based on the transactions they generated—most commonly either a fixed fee per unit traded or a fixed fraction of the sales price."

**********

I normally don't blog about papers twice, i.e. if I've blogged about the working paper I don't blog again about the published paper.  But this one has changed since I first blogged about it, and it implicitly tells us something about the current (but still medieval) publication system in Economics, since that was more than a decade ago. Here's the earlier (2011) blog.

Wednesday, February 16, 2011

Wednesday, August 10, 2022

Pharmacy Benefit Managers--Alex Chan on NPR's Planet Money podcast

 Alex Chan is interviewed on the role of pharmacy benefit managers, their role in drug pricing, and some problems with the market design.


Tuesday, August 9, 2022

Do repugnant markets corrupt society? Kim Krawiec calls for evidence...

 Kim Krawiec, who studies taboo trades from a legal perspective, thinks that people who claim that repugnant transactions undermine society should be asked to provide evidence.

Krawiec, K. (2022). Markets, repugnance, and externalities. Journal of Institutional Economics, 1-12. doi:10.1017/S1744137422000157

Abstract: This Article considers one aspect of the ongoing debate about the moral limits of markets – namely, the purported harmful effects of market transactions on particular relations, goods, services, or society at large, due to an inappropriate valuation. In other words, the argument is that some markets are ‘repugnant’ because they degrade and corrupt a variety of nonmarket values and relations, not just to the willing parties to the exchange, but to larger segments of society. This objection contains both a (frequently unacknowledged) empirical component and a moral component. This Article critiques these empirical claims on two grounds. First, market skeptics fail to provide evidence of the negative effects they hypothesize, despite widespread variation over time and across legal regimes. Second, these objections fail to account for the well-documented human tendency to fashion repugnant exchanges in a manner that reinforces – rather than undermines – deeply held values and relationships.

...

"how do we, as a society, determine what is up for sale and what must be immune from market forces? Although all cultures and time periods have proclaimed some transactions too sacred for the marketplace, those boundaries vary greatly across times and cultures and are often contested at the margins (Fiske and Tetlock1997). Once-common practices such as slavery, commutation (a direct payment to the government in exchange for relief from military service), substitution (paying another for military service in one's place), and the purchase of indulgences are no longer acceptable in most societies ( Krawiec2009a; NY Times, 1864). At the same time, formerly taboo practices, such as charging interest on a loan or accepting money in exchange for the practice of law are now widespread – although, in the case of charging interest, not universally so (Rossman2014).

...

"Many justifications have been offered for limits on ‘repugnant’ (Roth 2007) or ‘taboo’ ( Fiske and Tetlock1997) markets. This article considers a single, but prominent, objection – that some markets degrade and corrupt a variety of nonmarket values and relations, not just to the willing parties to the exchange, but to larger segments of society. This objection often involves concerns about the purported harmful effects of market transactions on particular relations, goods, services, or society at large due to an inappropriate valuation and has both a (frequently unacknowledged) empirical component and a moral component.

"The objection is empirical because it contends that markets in certain items and activities change the way in which society and its members perceive those items and activities or the non-market relationships through which they would otherwise be supplied. It is also a moral claim, because it rests on a contention that the change is inevitably negative – that certain modes of valuation and visions of the world are superior to others, or at least unsuitable to certain situations ( Anderson1993).

...

"This Article critiques these empirical claims on two grounds. First, as noted by others, market skeptics fail to provide evidence of the negative effects they hypothesize, despite widespread variation over time and across legal regimes. Second, and more importantly, these objections fail to account for the well-documented human tendency to fashion repugnant exchanges in a manner that reinforces – rather than undermines – deeply held values and relationships. The fact that a particular transaction is deemed morally repugnant by large swathes of society does not, after all, mean that such transactions disappear, even in the face of strong legal sanctions and criminal prohibitions. But it does mean that such exchanges may be managed, obfuscated, or reframed in some way, acknowledging and reinforcing the taboo in the process.

...

"to the extent that some, including Sandel (2012), have explicitly contended that ‘market creep’ has occurred without public awareness or debate, that claim is undermined by the full extent to which participants in and third-party observers of repugnant exchange have, in fact, debated, modified, and managed those exchanges over time."

Monday, August 8, 2022

Renewal: "My donor wanted to give me her kidney — and get home in time for Shabbat"

 When reporter Stewart Ain needed a kidney transplant, he contacted Renewal. He explains the process that led to him being matched to an altruistic donor and transplanted.

My donor wanted to give me her kidney — and get home in time for Shabbat  By Stewart Ain

"Two months later, my wife Meryl and I were sitting in Renewal’s office speaking with Rabbi Josh Sturm, Renewal’s director of outreach, and Miriam Lefkowitz, Renewal’s kidney coordinator. We were told to reach out to friends, relatives, neighbors — everyone we knew — and ask them to listen to an online presentation the rabbi would make about what kidney donation entails and how it literally gives the recipient a new life. 

"As we walked out the door, the rabbi said they had found that if at least 200 people listened to the presentation, the odds were very good a donor would be found. And the donor would not necessarily be someone actually listening online but often from the advance publicity the presentation would generate.

"Renewal created a flier for us with information about the upcoming presentation. At my request, several synagogues posted it on their websites, a couple of Jewish weekly newspapers ran it each week, and Hadassah Magazine featured my story in an article about kidney transplants. One of the three synagogues we belong to contacted the NBC station in West Palm Beach, Florida. The station’s reporter interviewed both me and one the synagogue’s rabbis. A story about my need for a kidney was on the evening newscasts.

"The presentation took place during the 10 days between Rosh Hashanah and Yom Kippur last fall. More than 250 computers tuned in. In the following days I learned that several people had asked Renewal for the nasal-swab kit needed to see if they were a match for me. Later, I heard from several friends and relatives that they had been disqualified as donors for various reasons. "

His donor may not have been one of those who had heard the presentation about his case.

"The idea of donating one of her kidneys surfaced again last Hanukkah when someone mentioned that their daughter had just donated a kidney through Renewal. She contacted the organization in November, and three days later received a swab kit. On Jan. 17, a rabbi from Renewal called and asked if she was still interested in donating. When she said yes, she was told she was a match for two people.

“I remember saying, `I’m not going to play God, let whoever is a better match have it,” she said."

Both patient and donor are doing well.

Sunday, August 7, 2022

Jobs and spouses in Denmark

 Matching is both consequential and difficult: it is how we sort into jobs and careers, and marriages and families.  Here's a paper that looks at the relationship between those two matching markets, taking advantage of the fact that Danish medical grads get random priorities, which determine their early-career job matches.

Causal Effects of Early Career Sorting on Labor and Marriage Market Choices: A Foundation for Gender Disparities and Norms  by Itzik Fadlon, Frederik Plesner Lyngse & Torben Heien Nielsen, NBER WORKING PAPER 28245, DOI 10.3386/w28245 ISSUE DATE December 2020, REVISION DATE July 2022

Abstract: "We study whether and how early labor market choices determine longer-run career versus family outcomes differentially for male and female professionals. We analyze the physician labor market by exploiting a randomized lottery that determines the sorting of Danish physicians into internships across local labor markets. Using administrative data spanning ten years after physicians’ graduations, we find causal effects of early-career sorting on a range of life cycle outcomes that cascade from labor market choices, including human capital accumulation and occupational choice, to marriage market choices, including matching and fertility. The persistent effects are entirely concentrated among women, whereas men experience only temporary career disruptions. The evidence points to differential family-career tradeoffs and the mentorship employers provide as channels underlying this gender divergence. Our findings have implications for policies aimed at gender equality in outcomes, as they reveal how persistent gaps can arise even in institutionally gender-neutral settings with early-stage equality of opportunity."


"placement into medical internships—i.e., physicians’ first jobs—is governed in Denmark by a purely randomized lottery ... As we verify, students with the best lottery ranks,who are the ones that choose  first,are  effectively  unrestricted in their  choices  and  are assigned  their  highest priorities,whereas students with the worst lottery ranks,who are the ones that choose last and well after their choice sets have narrowed, are assigned their lowest priorities.

...

"we exploit a novel dataset that combines the formal lottery data we have digitized with a range of administrative datasets on all medical doctors in Denmark. ... we can link households using spousal and parent-child linkages to investigate family formation and fertility. Together, the data allow us to study a wide range of lifecycle choices, in both the labor market and the marriage market, which provides us with the unique advantage of conducting a comprehensive analysis on the broad potential causal effects of early careerson work versus family tradeoffs. The data allow us to track our sample over a long period of up to ten years after the treatment.

...

"We show that the women who have more children due to the treatment also invest less in human capital, and that their location decisions reflect family considerations as they show increased propensity to live near grandparents. This is consistent with women crowding out long-run career goals for more family-oriented choices as  a  result  of  unfavorable early-career placements.  In  comparison,  men engage in career-oriented actions in response to unfavorable placements,which help them fend off potential adverse effects. .... the data are strongly inconsistent with differential preferences  over  entry-level  positions as  a  channel. Males  and  females  reveal  very  similar  aggregate preferences in their choices over entry-level markets and positions.


Saturday, August 6, 2022

Market design in an historical perspective, by Basshuysen in J. Economic Methodology

 I pay some attention to how market design is discussed in the history/sociology of science and methodology/history of thought literatures (even though I know how Feynman thought they are related to ornithology).

 Here's a pretty sympathetic, modern view.

Philippe van Basshuysen (2022) Markets, market algorithms, and algorithmic bias, Journal of Economic Methodology, DOI: 10.1080/1350178X.2022.2100919

ABSTRACT: "Where economists previously viewed the market as arising from a ‘spontaneous order’, antithetical to design, they now design markets to achieve specific purposes. This paper reconstructs how this change in what markets are and can do came about and considers some consequences. Two decisive developments in economic theory are identified: first, Hurwicz’s view of institutions as mechanisms, which should be designed to align incentives with social goals; and second, the notion of marketplaces – consisting of infrastructure and algorithms – which should be designed to exhibit stable properties. These developments have empowered economists to create marketplaces for specific purposes, by designing appropriate algorithms. I argue that this power to create marketplaces requires a shift in ethical reasoning, from whether markets should reach into certain spheres of life, to how market algorithms should be designed. I exemplify this shift, focusing on bias, and arguing that transparency should become a goal of market design"

I have to admit, I found this section heading charming (and not as funny as everyone else should:)

"2. What are markets, what can they do? From Hayek to Hurwicz to Roth"


Friday, August 5, 2022

Busing for schools in Boston and NYC, by Angrist, Gray-Lobe, Idoux & Pathak

 One of the spinoffs of the design of school choice systems in Boston, NYC and elsewhere is that it has opened up the empirical study of school effectiveness, by allowing economists to use some randomness in the assignments while controlling for family preferences to distinguish school effects from student selection.  It has turned out that it's hard to change test scores through school assignments, and neighborhoods remain important. But integration responds to voluntary choice, although the paper below doesn't find effects on college attendance after controlling for the selection of travel by students.

Still Worth the Trip? School Busing Effects in Boston and New York by Joshua Angrist, Guthrie Gray-Lobe, Clemence M. Idoux & Parag A. Pathak, NBER WORKING PAPER 30308  DOI 10.3386/w30308  July 2022

Abstract: "School assignment in Boston and New York City came to national attention in the 1970s as courts across the country tried to integrate schools. Today, district-wide choice allows Boston and New York students to enroll far from home, perhaps enhancing integration. Urban school transportation is increasingly costly, however, and has unclear integration and education consequences. We estimate the causal effects of non-neighborhood school enrollment and school travel on integration, achievement, and college enrollment using an identification strategy that exploits partly-random assignment in the Boston and New York school matches. Instrumental variables estimates suggest distance and travel boost integration for those who choose to travel, but have little or no effect on test scores and college attendance. We argue that small effects on educational outcomes reflect modest effects of distance and travel on school quality as measured by value-added."


"School transportation expenditures today are driven in part by the fact that many large urban school districts allow families to choose schools district-wide, lengthening school commutes for some. District-wide  choice  is  a  feature  of  school  assignment  in  Boston,  Chicago,  Denver,  Indianapolis,Newark,  New Orleans,  Tulsa,  and Washington,  DC, to name a few.  In choice districts,  seats at over-subscribed schools are typically allocated by algorithms that reflect family preferences in the form of a rank-order list and a limited set of school priorities.  ...  Choice in large urban districts is appealing because choice systems potentially decouple school assignment from underlying residential segregation.  Moreover, where school quality is unevenly distributed over neighborhoods, district-wide choice affords all students a shot at schoolsviewed as high-quality.

"This  paper  asks  whether  school  travel  in  the  modern  choice  paradigm  is  working  as  hoped, boosting integration and learning, especially for minority students.  Our investigation focuses on Boston and New York, two cities of special interest because of their high transportation costs and because they’ve long been battlegrounds in the fight over school integration.  We estimate the effects of non-neighborhood school enrollment for students for whom school travel is facilitated by school choice.  In both cities, students who opt for non-neighborhood schooling have higher test scores and are more likely to go to college than those who travel less.  But these estimates may reflect selection bias arising from the fact that more motivated or better-off families are more likely to travel. 

"We  solve  the  problem  of  selection  bias  using  the  conditional  random  assignment  to  schools embedded in Boston and New York’s school matching algorithms.  A given student may be offered a seat at a school in his or neighborhood, or a seat farther away.  Conditional on an applicant’s preferences  and  school  priorities,  modern  choice  algorithms  randomize  seat  assignment,  thereby manipulating distance and travel independently of potential outcomes.

...

" A parsimonious explanation for our findings, therefore, is that travel facilitates integration but does not translate into large enough changes in value-added to change education outcomes much."