Wednesday, April 11, 2012

A black market kidney sales dystopia in China

This is the kind of black market that keeps my surgeon colleague Frank Delmonico travelling around the world in an effort to firm up laws (and enforcement of laws) against kidney sales: Five Charged After Chinese Teen Sells Kidney to Buy iPhone

"Five people in southern China have been charged with intentional injury in the case of a Chinese teenager who sold a kidney so he could buy an iPhone and an iPad, the government-run Xinhua News Agency said on Friday.According to the Xinhua account, one of the defendants received about 220,000 yuan (about $35,000) to arrange the transplant. He paid Wang 22,000 yuan and split the rest with the surgeon, the three other defendants and other medical staff.
"The report did not say who received and paid for the kidney.

"China banned the trading of human organs in 2007, Xinhua said. Several other suspects involved in the case are still being investigated."
*********

See related recent posts:
Michael Sandel thinks more transactions should be repugnant
Organ transplants and prisoners in China, revisited

Tuesday, April 10, 2012

Organ transplants and prisoners in China, revisited

Once again, China Moves to Stop Transplants of Organs After Executions

"China said on Friday that within three to five years it planned to end the practice of transplanting organs from executed prisoners, a step that would address what for decades has been one of the country’s most criticized human rights issues.
...
"Mr. Huang did not acknowledge any ethical issues involved in taking organs from prisoners. Instead, he raised a medical issue, saying that the rates of fungal and bacterial infection in organs taken from executed inmates were often high, which he said explained why the long-term survival rates of organ transplant recipients in China were consistently below those of other countries.

"Nicholas Bequelin, a senior researcher in Hong Kong for Human Rights Watch, welcomed the policy announcement, which the rights group has campaigned for since 1994. But he noted that Mr. Huang, who turns 66 this year, is about to retire, along with most of the country’s top political leadership.

"That means the next generation of political leaders and Health Ministry officials will have to deal with the problem of how to obtain enough organ donations voluntarily to offset the country’s heavy dependence on prisoners.

“It’s not clear to me the government is going to have the political will to fulfill this promise,” Mr. Bequelin said."
*********

Here's an earlier post touching on this issue:
Tuesday, December 15, 2009, Kidney transplantation in China

Monday, April 9, 2012

Kidney donation, illegal immigration, finances

This story has it all, illness, compassion, bureaucracy, money, an illegal immigrant down on his luck and legal ones who have thrived... From Brother to Brother, a Kidney, and a Life

"Angel, the father of two American-born children, is an illegal immigrant. And a maze of conflicting health care and immigration policies meant that while the government would pay for a lifetime of dialysis, costing $75,000 yearly, it would not pay for a $100,000 transplant that would make dialysis unnecessary.*
...
"Angel’s quest for a transplant was chronicled in a Dec. 21 article in The New York Times about a paradox in health care rules. In New York, Medicaid, the federal-state health insurance program for the poor, covers the cost of dialysis, considering it an emergency measure, regardless of whether the patient is a legal resident of the United States. But while a transplant is far cheaper in the long run, that procedure is covered by Medicare, which does not extend to illegal immigrants.Mount Sinai, one of the world’s leading transplant centers, had originally set the price for the operation at $200,000 in advance, to cover any possible postoperative complications; it lowered that to $150,000, given the youth and health of the brothers, but barred further reductions as a slippery slope to unaffordable demands for uncompensated care.
...
"Mount Sinai, one of the world’s leading transplant centers, had originally set the price for the operation at $200,000 in advance, to cover any possible postoperative complications; it lowered that to $150,000, given the youth and health of the brothers, but barred further reductions as a slippery slope to unaffordable demands for uncompensated care. ... "

“It has nothing to do with legal or illegal,” said Dr. Kim-Schluger, whose mother escaped North Korea as a child and brought the family to the United States via South Korea, British Guyana and Jamaica. She went to Catholic school in New York, married a descendant of Eastern European Jewish immigrants and converted to Judaism. She said Angel was on her mind as she prepared Passover Seder.

“Yes, there are hundreds and hundreds of people like this,” she said. “But this is the one who knocked on our door.”
********

*see previous post: We pay for dialysis but not for transplants...

Sunday, April 8, 2012

Which came first, the dyed Easter chick or the dyed Easter egg

Here's a repugnant transaction I had never heard of, complete with laws passed and repealed...
Nobody Minds Dyeing the Egg, but the Chicken Is Another Story


"Cute as they are, they are not made of marshmallow.

"If only they were, nobody would have a problem with newborn chicks that are dyed in brilliant colors — neon, Fruity Pebbles, pastel, Crayola box — to serve as festive Easter gifts. The dye is either injected in the incubating egg or sprayed on the hatchling, and while poultry farmers say it is harmless, many people object, saying it turns live birds into holiday playthings that are quickly discarded.

"About half the states and a scattering of municipalities have laws against the practice, but in Florida last month, the Legislature passed a bill to overturn a 45-year-old ban on dyeing animals.
...
"The outcry from animal rights groups has been swift.

“Humane societies are overflowing with these animals after Easter every year,” said Don Anthony of the Animal Rights Foundation of Florida. “This law has protected thousands of animals from neglect and abuse, and it shouldn’t be lifted on the whim of one dog groomer who wants to dye poodles purple.”

"Dyed Easter chicks have been a seasonal staple in parts of the country for generations, though the practice has gone largely underground as society’s tastes have changed.
...
"Easter is on Sunday, and while dyed chicks may show up for sale in various places, they will still be illegal in Florida, since the change would not take effect until July 1. "



HT: Ran Shorrer

Saturday, April 7, 2012

Michael Sandel thinks more transactions should be repugnant

The Atlantic publishes an essay adapted from his book What Money Can’t Buy: The Moral Limits of Markets: What Isn’t for Sale?

He is glad that kidneys can't be bought and sold, and regrets many of the things that can be, because he worries that allowing too broad a scope to markets may undermine the moral fabric of society.

He doesn't mention (but I am reminded of)  sumptuary laws that used to enforce the moral fabric by preventing people from wearing clothes above their social station.
********

Update: here's a review published in the April 20 WSJ:
In Economists We Trust: We are a society built on market-based solutions—but should everything have a price?

"Mr. Sandel is also pointing out another seemingly small but quite profound change in society. As recently as a generation ago, economists viewed their job as understanding prices, depressions, unemployment and inflation. It was dismal, but at least it was science. Somewhere along the way they expanded their portfolio to include the whole of human behavior.
...
"Proponents of market morality claim that it imposes no belief system, but that's just a smoke screen. Choosing to place utility maximization at the core of your belief system is no different from choosing any other guiding ideological precept. Every problem has an incentive-based solution; every tension can be resolved by seeking the maximally efficient outcome.

"This is a depressingly reductive view of the human experience. Men will die for God or country, kinship or land. No one ever picked up a rifle and got shot for optimal social utility. Economists cannot account for this basic fact of humanity. Yet they have assumed a role in society that for the past 4,000 years has been held by philosophers and theologians. They have made our lives freer and more efficient. And we are the poorer for it.

Friday, April 6, 2012

Unraveling of law internships in Israel

Haaretz reports:
Law students to apply for internships only from third year: Israel Bar Association's council approved the rules governing job offers for internships, though they still require the justice minister's approval.

"Law students will only be accepted for their internships during the third and next to last year of their studies from now on, the Israel Bar Association's council decided yesterday.
 ...
"In recent years, law students have started arranging a place for doing their articles as soon as they start their studies, said attorney Orrin Persky, the head of the Bar Association's committee on internships. He explained that this pressure emanated from both the students and the law firms and has created a market failure for finding such posts.
In addition, there are a large number of complaints about students canceling their internship positions, which they had agreed to a year or two earlier.
The new rules would require firms and all other bodies providing internships, such as the State Attorney's Office, to start interviewing no earlier than March 15 of the student's third year for the internship that will start in the following calendar year."


HT: Ran Shorrer

Thursday, April 5, 2012

2-Tier Tuition at a community college?

The NY Times reports on what some are finding a repugnant transaction, and others see as the only way to avoid further cuts: 2-Year College, Squeezed, Sets 2-Tier Tuition

"SANTA MONICA, Calif. — For years now, administrators at the community college here have been inundated with woeful tales from students unable to register for the courses they need. Classes they want for essential job training or to fulfill requirements to transfer to four-year universities fill up within hours. ...

"Now, though, Santa Monica College is about to try something novel. This summer it will offer some courses for a higher price, so that students who are eager to get into a particular class can do so if they pay more. ...

"Since 2009, enrollment in California community colleges has fallen by 300,000 students, to 2.6 million, and many believe the difficulty of registering for classes is the most important deterrent.

"For generations, community colleges have been seen as a social equalizer, providing a relatively inexpensive education for poor students, immigrants and others without the skills, grades or money to attend a four-year institution.

"So the two-tiered tuition structure being proposed here is raising eyebrows, and fundamental questions, about the role and obligations of community colleges. Will the policy essentially block some of the people it is designed to benefit? Many students believe the new policy — if the state does not block its implementation, which it could yet do — will unfairly exclude the poorest students and create a kind of upper and lower class of students.

"A financial squeeze since the recession led first to a reduction of federal and then state financing for colleges and universities. Since 2008, California’s community college system has lost $809 million in state aid, including $564 million in the most recent budget, even as more students than ever before try to enroll.

"Currently, each community college class costs $36 per credit hour. Under Santa Monica’s plan, the more expensive courses would cost $180 per credit hour — just enough to cover the college’s costs, Dr. Tsang said.

"While the college is still ironing out the details, it expects to offer about 200 courses at the higher tuition price, in addition to hundreds of regularly priced courses. College officials say that nearly every class is filled to capacity and that they are asking departments to choose which courses have the highest demand so they can offer more of those — typically basic courses in English, writing, math and science.
...
"Janet Harclerode, an English instructor and president of the college’s Academic Senate, said that many professors viewed the new plan as having a “real ick factor,” but that few saw any real alternative. Many instructors have already accepted extra students in their classrooms, even allowing a few to sit on the floor when seats were scarce.

“We hope that this is just a stopgap measure, before taxpayers step up and the state really starts to reinvest in the colleges,” she said."
**********
In the wake of the initial announcement, Chancellor Asks Community College to Hold Off on Tuition Plan

"The chancellor of the California community college system has requested that Santa Monica College hold off on its plan to offer popular courses with higher tuition this summer, saying that the legality of the program is still in question. 

 "The request came a day after a student protest at the college ended with a campus police officer spraying dozens of people with pepper spray, several of whom suffered minor injuries. Many students and faculty members have criticized the plan saying it violates the long tradition of community colleges as havens for those without the means to afford four-year colleges.

 "The chancellor, Jack Scott, had already made it clear that he was wary of the community college’s plan to charge more for some popular classes and said it could violate state education codes. He has asked the state’s attorney general for an opinion, which he expects to receive in the next week."

***********
Update, April 19: Chancellor’s Office Says Santa Monica College’s 2-Tier Pricing Plan Is Illegal

Contraception as a repugnant transaction (the return of...)

Former Pennsylvania senator Rick Santorum's campaign for the Republican presidential nomination has done a lot to put contraception back in the public spotlight.  It isn't so long ago that contraception was a prototypical repugnant transaction: something that lots of people wanted to do, but others didn't want them to. The Connecticut law was struck down in the famous Supreme Court decision Griswold v. Connecticut (1965).Here's an article remembering how contraception became legal in Connecticut and Massachusetts: Catholics and Contraception: Boston, 1965

"Two states had very strong anti-contraception laws on the books in 1965. The Supreme Court was considering the constitutionality of Connecticut’s all-out ban on the use of contraception. In Massachusetts, a state legislative panel was holding an open hearing on a proposal submitted by State Representative Dukakis, a politically ambitious lawyer who had been in office for three years, to remove an 86-year-old bar to the distribution of birth control devices and information.

"It was not the first time in Massachusetts a repeal of the ban had been considered. In 1948, Cushing, then an archbishop, led a public charge against Referendum No. 4, a statewide ballot measure designed to relax the ban on contraception. From the pulpit and on the radio, the Catholic campaign argued that birth control was “still against God’s law.” Cushing defined contraception at the time as “anti-social and anti-patriotic, as well as absolutely immoral.” The campaign was a bitter one. In the end, 57 percent of voters rejected the referendum.

"Cushing had won, but victory came at a cost. “Deployment of the Church’s political muscle,” the historian Leslie Tentler argues, offended non-Catholics in and out of the commonwealth. Four years later, the toll hit home as Cushing confided to a friend, “I hate to think of going through another battle.”

"Even then, Dukakis recalls, “the memory of the ’48 battle was fresh in our minds.” That seems to have been also true for Cushing (now a cardinal). He clearly had a change of heart on the appropriateness of laws like the state’s birth control restrictions, which sought to impose moral behavior at odds with individual conscience. More generally, he had adopted a conciliatory tone. Two days before a fellow Massachusetts Catholic won the first primary of the 1960 presidential campaign, Cushing argued that a Christian must engage in “friendly discussion with those whose views of life and its meaning are different than his own.” The times had changed, and so had he.
...
"When a bill that would allow physicians to prescribe birth control to “any married person” was introduced in the next legislative session — a bill otherwise similar to the one House members had rejected 119–97 the year before — Cushing endorsed it publicly by praising its “safeguards” while reaffirming his position that Catholics did “not seek to impose by law their moral view on other members of society.” This time the bill passed, 136–80. The Senate followed suit, and Volpe signed the amendment to the state’s General Laws on “Crimes against Chastity, Morality, Decency, and Good Order
...
"The solution was not perfect (the Supreme Court ruled in 1972 that limiting contraception to married couples was unconstitutional)..."

Wednesday, April 4, 2012

Prostitution, in Canada and France

Two stories on the same day last week caught my eye. Here they are, both from the Globe and Mail:

Landmark ruling legalizes brothels in Ontario
"Ontario’s highest court has legalized brothels in a sweeping decision that condemned current prostitution laws for adding to the hazards of a highly dangerous profession."

Strauss-Kahn faces preliminary charges in prostitution case
"Dominique Strauss-Kahn was handed preliminary charges Monday alleging he was involved in a French prostitution ring, his lawyer said. The former International Monetary Fund chief is denying wrongdoing."

Tuesday, April 3, 2012

International Economic Science Association Conference 2012

Here's the announcement (note the April 21 submission deadline):

The Center for Experimental and Social Science (CESS) at the New York University is pleased to host the Economic Science Association Conference New York 2012 on June 21-24 2012. To submit papers or to register, click Submission or Registration, respectively. To find further information, click Location and Accommodation.

We proudly present our keynote speakers:
Important dates
April 21st: Submit your paper
May 4th: Notification of acceptance & preliminary program
May 10th: Early registration cutoff
June 1st: Late registration cutoff
Fees
Early registration fees are $325/faculty and $225/students by May 10th 2012 deadline
Late registration fees are $425/faculty and $325/students by June 1st 2012 deadline
Local organizers
Guillaume Frechette (Frechette@nyu.edu)
Andrew Schotter (andrew.schotter@nyu.edu)
Caroline Madden (caroline.madden@nyu.edu)


Sponsored by the C.V. Starr Center for Applied Economics

Monday, April 2, 2012

Market design for radio spectrum: new NSF program

Here's an   announcement that recently went out from the National Science Foundation:

"Dear Colleagues,

"I am writing to you today because of a just published NSF solicitation with the title “Enhancing Access to the Radio Spectrum (EARS)” [and a submission deadline of June 14, 2012]. The complete solicitation can be found here: http://www.nsf.gov/funding/pgm_summ.jsp?pims_id=503480 .

"The synopsis reads:
“The National Science Foundation's Directorates for Mathematical and Physical Sciences (MPS), Engineering (ENG), Computer and Information Science and Engineering (CISE), and Social, Behavioral, and Economic Sciences (SBE) are coordinating efforts to identify bold new concepts with the potential to contribute to significant improvements in the efficiency of radio spectrum utilization, and in the ability for traditionally underserved Americans to benefit from current and future wireless-enabled goods and services. EARS seeks to fund innovative collaborative research that transcends the traditional boundaries of existing programs, such as research that spans disciplines covered by two or more of the participating NSF directorates.”

"A number of economists participated in an EARS Workshop here at the NSF in 2010. The final workshop-report can be found at: http://www.nsf.gov/mps/ast/nsf_ears_workshop_2010_final_report.pdf .

"It is my hope that you could spread the word among potentially interested social scientists who may want to submit an interdisciplinary proposal that has social science as its central component.

"According to the solicitation:
“The key research areas of interest to the EARS program include, but are not limited to, those that impact a wide range of technologies, applications, and users. Some broad examples and general topic areas include, but are not limited to:”
...
-       " Security of wireless signals and systems in the context of spectrum sharing.
-        ...
-      " Economic models for spectrum resource sharing. There exists a need for interdisciplinary research in the areas of market and non-market-based mechanisms for spectrum access and usage to efficiently organize the sharing of scarce spectrum resources. Examples of research themes include, but are not limited to, real-time auctions, market design, spectrum valuation, spectrum management for the home user and managing mixed-rights spectrum.
-        New and novel measurement-based spectrum management techniques, including agent-based systems, policy-based spectrum management, local and scalable spectrum management.”

"I would be thankful if you could forward information about the solicitation to other potentially interested researcher.

"Please feel free to send us any suggestions you may have to ensure that Social, Behavioral and Economic Sciences will be prominently represented among the EARS proposal submissions."


Michael Reksulak, Ph.D.
Program Director, Economics
National Science Foundation
4201 Wilson Boulevard, Suite 995
Arlington, VA  22230

Sunday, April 1, 2012

FCC incentive auctions

Here's a good way to begin to design an auction: FCC hires top economists

"As the Federal Communications Commission (FCC) moves to implement its new authority to sell valuable radio spectrum via incentive auctions, it is seeking advice from a group of economists with expertise in auction design and competition policy.

"The commission has retained a group of prize-winning economists led by Paul Milgrom, the Ely Professor of Humanities and Sciences at Stanford University. Milgrom, who is considered one of the foremost thinkers in auction theory and design, helped the FCC create its first spectrum auctions — which have served as a blueprint for similar auctions around the world.
"Milgrom will be assisted by Professors Jonathan Levin and Ilya Segal, also of Stanford. Levin chairs the university's economics department, and is a winner of the prestigious John Bates Clark medal, an award for young economists whose winners often go on to win the Nobel Prize in economics. Segal is a recipient of the Compass-Lexecon prize, which is awarded to significant contributors to the understanding and implementation of competition policy.

"The Stanford professors will be joined by Washington, D.C., based Lawrence Ausubel, an auction design expert who teaches at the University of Maryland."

Saturday, March 31, 2012

Sports agents and the NCAA

Joe Nocera in the NY Times talks about yet another way that professional and college hockey interact differently than do other sports: The Hockey Exemption. Professional agents, it appears, are transparently involved.

"By their mid-teens, good hockey players have the option of joining a Canadian junior league. Once they become eligible for the pro draft at age 19, they have to decide whether to sign with the team that drafts them or go to college. To help guide these decisions, agents often talk to the professional teams that draft their players; they also talk to college coaches."
*****************
In a previous post, I wrote about  Hockey: the NHL draft is different

Friday, March 30, 2012

30 Rock "Kidney Now" song

Live kidney donation, set to music on the small screen, from 30 Rock:

Here's the song: 


and here's a bit of the drama...




 HT: Mike Wheeler

Thursday, March 29, 2012

Competition among kidney exchanges

I'll be spending today and tomorrow at a "consensus conference" to assess just how much consensus there may be among the different networks presently enabling kidney exchange. Here's a NY Times article on the conference...

Lack of Unified System Hampers Kidney Transplant Efforts

"Many of the most prominent names in the field of kidney transplantation agree that the way to maximize the number of transplants through paired exchanges is to create a single, nationwide registry. That, they note, would vastly expand the pool of potential matches among transplant candidates who have willing but incompatible donors.
"And yet, more than a decade after the first organ swap in the United States, the transplant world remains disjointed, with competing private registries operating with little government oversight or regulation. The federal government started a paired exchange pilot project in late 2010, but it lags far behind nonprofits like the National Kidney Registry in making successful matches."
...
"In late March, a consortium of medical societies plans to hold a “consensus conference” near Washington to begin the search for common principles, and perhaps a common structure.
“Organs should be seen as a national resource,” said the meeting’s organizer, Dr. Sandy Feng, a transplant surgeon at the University of California, San Francisco, medical center. “And so we should look for agreed-upon principles to guide practice.”
************

Update: post conference, some political spin run through a well meaning NY Times reporter: Experts Recommend Single Registry to Oversee Kidney Transplant Donations

Wednesday, March 28, 2012

New challenges in multi-hospital kidney exchange

Ashlagi, Itai and Alvin E. Roth, "New challenges in multi-hospital kidney exchange," American Economic Review papers and proceedings, May 2012, forthcoming.

 Abstract: The growth of kidney exchange presents new challenges for the design of kidney exchange clearinghouses. The players now include directors of transplant centers, who see sets of patient-donor pairs, and can choose to reveal only difficult to match pairs to the clearinghouse, while withholding easy to match pairs to transplant locally. This reduces the number of transplants. We discuss how the incentives for hospitals to enroll all pairs in kidney exchange can be achieved, and how the concentration of hard to match pairs increases the importance of long, non-simultaneous nondirected donor chains

Tuesday, March 27, 2012

Kidney exchange in Britain

David Manlove, who wrote in 2010 about Britain's first 3-way kidney exchange, writes today about work with his former student Gregg O'Malley:

" I thought you might be interested to see a paper that my colleague Dr Gregg O’Malley and I have recently written on our experience of collaborating with NHS Blood and Transplant on their paired and altruistic kidney donation matching scheme.  The paper is available in technical report form here: http://www.dcs.gla.ac.uk/publications/paperdetails.cfm?id=9383, and is to appear at SEA 2012 (http://sea2012.labri.fr).

As part of this research, Gregg has created two web applications for producing optimal solutions to kidney exchange problems.  The first, at http://kidney.optimalmatching.com, finds a solution that is optimal with respect to the precise criteria involved in the UK scheme.  The second, at http://toolkit.optimalmatching.com, is capable of accepting alternative optimality criteria (and comparing and contrasting simultaneously the effect of using different optimality criteria).

Although the web applications were built primarily with the UK application in mind, we hope that they may be interesting and useful for those involved in similar matching schemes elsewhere.

Best regards,
David"

Compensation for donors, organ trafficking, and the Declaration of Istanbul

The American Journal of Transplantation publishes an article suggesting that organ trafficking can only be effectively ended by ending the shortage of organs, which will involve careful trials of incentives for donors.  It also publishes an editorial disagreeing with this proposal, and saying that enforcement of laws against trafficking depend on a ban on compensation to donors.

The March 2012 issue of
American Journal
of Transplantation

F. Ambagtsheer and W. Weimar
This personal viewpoint expresses the opinion of the authors on how prohibition of organ trade can be improved. See editorial by Glazier and Delmonico on page 515.



A. K. Glazier and F. L. Delmonico
The authors provide a critical response to the viewpoint by Ambagtsheer and Weimar (page 571) regarding the Declaration of Istanbul and its stance toward transplant commercialism, organ trafficking and donation.

Monday, March 26, 2012

Uriel G. Rothblum, 1947-2012

Uri Rothblum in his office at the Technion in 2003
My old friend Uri Rothblum passed away today, after a heart attack. We met when we entered graduate school in 1971. He was a man of many parts: a good friend, a devoted husband, a proud dad of three grown sons, and an important and dedicated and tireless scholar.

Update: there's a website at the Technion where friends can post comments in memoriam.

Joel Klein on school choice

Joel Klein, who was Chancellor of NYC schools when school choice was introduced in New York City high schools, writes in the Daily News: Harness the power of school choice: Competition works in education, too


Of course, details matter: see yesterday's post on an effort that didn't quite work out as planned, in San Francisco. Yesterday's post also has links to some school choice efforts that seem quite promising, however.