Tuesday, April 28, 2015

Jerusalem Conference on Education and Economics, April 29

I'm on my way to Israel, to participate in a conference on Education and Economics.

The webpage, in Hebrew, is here: כנס ירושלים לחינוך וכלכלה, 29.4  (Jerusalem Conference on Education and Economics, April 29)

I will participate late in the day, in a conversation with the mayor of Jerusalem, followed by the President.

19:00: Nobel laureate in economics for 2012, Professor Alvin Roth , a conversation with the Mayor of Jerusalem, Nir Barkat , education and implementation of economic theories in the public sector.

19:30: Address by President Reuven (Ruby) Rivlin

I gather that this last session may be carried on Channel 2, although I expect that my conversation with the mayor will be conducted in English. (I also expect that it will focus on school choice.)

Monday, April 27, 2015

Sally Satel: more on compensating kidney donors

April 18 in The Pacific Standard: Sally Satel on The case for compensating kidney donors

"The current system is a qualified failure. For the past decade, transplant operations for all organs have hovered between 27,000 and 29,000 annually, and, in 2014, was the lowest it's been in 11 years.The European model of "presumed consent," wherein a person's organs are taken posthumously unless an individual has specifically forbidden their retrieval, is not a potent solution as less than one percent of deceased individuals are medically eligible to donate.

"Hence, there is a desperate organ shortage in the United States. The situation in other countries, especially poorer countries without good access to dialysis — a death sentence without immediate transplant — is even worse. As a result, the overseas black market is burgeoning. The World Health Organization estimates that 10 percent of all transplants are performed under shadowy, illicit conditions where the risks are high: Corrupt brokers deceive impoverished and illiterate donors about the nature of surgery, cheat them out of payment, and ignore their post-surgical needs. For the recipient, organ quality can be poor and post-operative management dicey. (The exception appears to be Iran, where organ sales are monitored by the government. There, potential donors exceed the number of needy patients.)
"Compensating organ donors is not a new idea. In 1983, Al Gore, who championed NOTA, explicitly suggested rewarding donors if altruistic volunteering did not keep up with demand. Moreover, NOTA's legislativehistory implies that the law's felony provision against "valuable consideration" in exchange for an organ was intended to prohibit brokered or direct cash sales between buyer and seller. It is silent regarding a system of in-kind, third-party compensation.
Here is a plan for donor benefits: A governmental entity, or a designated charity, would offer in-kind rewards, like a contribution to the donor's retirement fund, an income tax credit, or a tuition voucher worth roughly $50,000 in value. (This is the amount typically proposed by advocates of incentives.) To enhance deceased donation, a funeral benefit could be offered.
With a third party providing the reward, all recipients, not just the financially secure, will benefit. An imposed waiting period of at least six months would help limit impulsive live donation and, most important, any subsequent remorse. Prospective donors would be carefully screened for physical and emotional health, as is done for all donors currently. Their kidneys could be distributed, according to exiting allocation policies now in place for cadaver organs.
Donors would be guaranteed follow-up medical care for any complications, which is not ensured now. And the cost of the benefits could be underwritten by the enormous savings from dialysis.
Will rewarded donation attract only low-income prospective donors? Perhaps. One option is to require a minimum income for donors, but that strategy prevents all interested parties from participating. Better to start with the assumption that low-income people are capable of making decisions in their own interest. In the end, regardless of who ends up donating, a sound plan ensuring that donors are thoroughly informed, their health protected, and their sacrifice amply rewarded is an ethical one.
How to achieve this? We should start with pilot projects. The Department of Health and Human Services probably could initiate pilot trials, if motivated. The Center for Medicare and Medicaid Innovation has impressively broad authority. In theory, the Center could issue NOTA waivers to academic medical centers interested in administering a pilot program wherein living donors would be rewarded with five years of Medicare coverage.
States should also get involved. The late Pennsylvania Governor Robert P. Casey, who had received a heart and liver transplant a year earlier, signed a 1994 law that would enable a bereaved family of an organ donor to get a burial benefit of up to $3,000 paid by the state directly to the funeral home. State health officials ended up with cold feet, fearing that the law flouted NOTA, but some bold state should proceed with a funeral benefit and force the Department of Justice to action, spurring a vital national debate in the process.
Congressional action is another approach. Lawmakers could amend NOTA to permit pilot trials of incentives by clarifying the intent of the law as a restraint on cash exchange between buyer and seller with or without a broker. The need for a new approach to expanding the supply of donors should resonate with lawmakers on several levels. The first is public health (needless deaths), the second is fiscal (the enormous cost to Medicare — roughly seven percent of its budget is spent on dialysis and its complications), the third is human rights (the global black market); and the fourth is race (minorities are disproportionately disadvantaged by the organ shortage as they are less likely to be referred for transplant)."

Sunday, April 26, 2015

Multi-unit allocation workshop at Penn, Apr 26, 2015


9:30 - 10:30 amJacob Leshno (Columbia)
A Supply and Demand Framework for Two-Sided Matching Markets 
10:45 - 11:45 amBumin Yenmez (CMU Econ)
Matching with Externalities 
11:45 - 12:45 pmBreak
12:45 - 1:45 pmMichael Richter (Yeshiva)
Continuum Mechanism Design with Budget Constraints
2:00 - 3:00 pmGabriel Y. Weintraub (Columbia)
Repeated Auctions with Budgets in Ad Exchanges: Approximations and Designs 
3:15 - 4:15 pmHaoxiang Zhu (MIT)
Welfare and Optimal Trading Frequency in Dynamic Double Auctions 
4:30 - 5:30 pmTadashi Hashimoto (Yeshiva)
Equilibrium Selection and Inefficiency in Internet Advertising Auctions

Organizer: Mariann Ollar
Sponsored by the UPenn Market Design Working Group

A quick internet search for the marriage-market illustration yields this:

Saturday, April 25, 2015

Harvard celebrates Carmen Wang

One of the most interesting young market designers at Harvard these days is  Carmen Wang, a Ph.D. student in the Business Economics program. Here's an article about her work on blood donation registries, and her hope to combine market design with behavioral economics: The Real Price of Blood--How one GSAS student uses the tools of behavioral economics to increase blood donations

It begins this way:
"Love isn’t the only thing money can’t buy—blood is, too. And yet, though no money is exchanged, blood can find ways of getting to the people who need it, though not often in ways where demand and supply are aligned. In the days following the Boston Marathon bombing, people rushed to give blood in support of the victims, eager to donate one of the human body’s most precious resources to others, free of charge.

"While this altruistic impulse is certainly commendable, according to Carmen Wang, it is sometimes misguided. “In that instance, the American Red Cross had to issue an announcement thanking would-be donors and informing them that they already had an adequate supply of blood.” But at other times, for example when the flu or cold virus afflicts many regular donors, blood supply dips, and blood banks have trouble finding people willing to give."

Friday, April 24, 2015

Contagion, for good and ill

Frank Bruni had a recent NY Times column that reminded me of the chain of high school suicides:
"Between May 2009 and January 2010, five Palo Alto teenagers ended their lives by stepping in front of trains. And since October of last year, another three Palo Alto teenagers have killed themselves that way, prompting longer hours by more sentries along the tracks. The Palo Alto Weekly refers to the deaths as a “suicide contagion.”

Sometimes something similar happens with good acts, and I was reminded of that by this recent story from Israel (about a different kind of chain of kidney donations than I usually write about):

Chain Reaction of Good Will
"Avraham Shapira donated a kidney to a stranger and set off a series of altruistic gestures. A few months later his cousin, Yehuda Rabinovich, was inspired by Shapira and also donated a kidney to a stranger. From there the movement spread around the Shomron region. So far six people have donated kidneys to complete strangers."

Thursday, April 23, 2015

American Society of Transplantation conference on Resolving the Organ Shortage

Here's an early announcement of a conference scheduled for February 2016, organized by the American Society of Transplantation, which reflects some of the intense discussion going on in the transplant community about how to alleviate the shortage of transplantable organs.

(As background, recall these three recent posts:

Friday, April 3, 2015

There's no consensus on incentives for kidney donation, but maybe there is on removing disincentives

Two major transplantation societies cautiously consider incentives for organ donation

Wednesday, April 22, 2015

The latest, longest kidney exchange chain, involving 68 people, 34 transplants

The National Kidney Registry has completed a new, long non-simultaneous nondirected donor chain, maybe the longest to date. Here are some stories, from the local press at some of the hospitals involved.

Kidney exchange in which Allegheny General Hospital participates enables 34 transplants
 "A Somerset County man and 33 other renal disease patients received new kidneys this year in an unprecedented national chain of organ transplants, Allegheny General Hospital announced Wednesday.
The North Side hospital is among 26 domestic transplant centers that participated in the exchange, run through March by the nonprofit National Kidney Registry. It is the largest multi-center paired kidney exchange so far in the United States, the registry said."

The final link: UW Hospital completes longest chain of kidney donations

"A Wisconsin woman received the final kidney transplant at the University of Wisconsin Hospital in March, completing the longest chain of kidney donations.

"UW Hospital is a member of the National Kidney Registry, an organization that works to match kidney donors with recipients for transplants. The registry organized the completed kidney chain, which started and ended at UW Hospital.
"Of the 68 people in the kidney chain, 34 donors and 34 recipients, five were connected through UW Hospital, Miller said."

D.C., Md., Va. hospitals participate in largest-ever multi-hospital kidney transplant chain
"With 34 donors and 34 recipients, Chain 357, nicknamed a “chain of love,” is the country's largest-ever multi-hospital kidney transplant chain. The National Kidney Registry worked with 26 hospitals across the country to make sure every link of the chain connected.
"Since Jan. 6, the chain has bounced across the country, including stops at MedStar Georgetown Transplant Institute in Washington, D.C.; Walter Reed National Military Medical Center in Bethesda, Md.; University of Virginia Hospital in Charlottesville, Va.; and two bouts at the University of Maryland Medical Center in Baltimore, Md."