Showing posts with label audio. Show all posts
Showing posts with label audio. Show all posts

Thursday, February 8, 2024

Morally contested markets on NPR's Planet Money (including kidneys, revenge and insider trading)

 The NPR show Planet Money discusses kidney sales, revenge, and insider trading. The hosts are enthusiastic about at least thinking about all of these.* 

They start with a discussion of organ transplants, and in the first 9 minutes of the show you can hear some parts of an interview with me, discussing tradeoffs (and possible titles for a book I'm working on).  Then they talk to Siri Isaksson about retaliation, and after that to Chester Spatt about insider trading.

 

They write:

"There are tons of markets that don't exist because people just don't want to allow a market — for whatever reason, people feel icky about putting a price on something. For example: Surrogacy is a legal industry in parts of the United States, but not in much of the rest of the world. Assisted end-of-life is a legal medical transaction in some states, but is illegal in others.

"When we have those knee-jerk reactions and our gut repels us from considering something apparently icky, economics asks us to look a little more closely.

"Today on the show, we have three recommendations of things that may feel kinda wrong but economics suggests may actually be the better way. First: Could the matching process of organ donation be more efficient if people could buy and sell organs? Then: should women seek revenge more often in the workplace? And finally, what if insider trading is actually useful?"

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*In their enthusiasm, they mis-state how few kidney exchanges were done before my colleagues and I got involved. (There weren't many, but more than two...)

As it happens, earlier this week I blogged about another interview, in the NYT, by Peter Coy (in print, not audio) that focused on kidney exchange:

Tuesday, February 6, 2024

Update (5pm): now I see that on the Planet Money site there's a transcript.  Here's the part that I participated in:

SYLVIE DOUGLIS, BYLINE: This is PLANET MONEY from NPR.

(SOUNDBITE OF COIN SPINNING)

MARY CHILDS, HOST:

A couple decades ago, Al Roth was working on solving this problem - people who needed kidneys weren't getting matched effectively with people who had kidneys to donate.

AL ROTH: Part of the kind of work I do is called matching theory.

GREG ROSALSKY, HOST:

Al helped create this, like, beautiful, elegant algorithm that would match kidney donors with recipients.

CHILDS: You obviously won a pretty big prize for this work.

ROTH: I did. I recommend it.

CHILDS: OK. Yeah (laughter). You like the prize. It's a good prize.

ROTH: Yeah.

CHILDS: That's good to know.

ROTH: A week long of parties.

CHILDS: The prize he won? - it was the Nobel Prize in economics.

ROSALSKY: As you might know, Al's matching work vastly improved the way people get kidneys and saved literally thousands of lives. Like, in the year 2000, before Al's work, there were only two paired kidney transplants - two. Thanks to Al's algorithm, there are now about a thousand per year.

CHILDS: But, Al says, his Nobel Prize-winning algorithm - it isn't even the best way to get people kidneys. Technically, he says, the best way is to grow kidneys in a lab, so it's not even the second-best way.

I'm just envisioning you doing all this matching work knowing that this is, like, a little goofy. Like...

ROTH: Oh.

CHILDS: ...There's a easier way.

ROTH: I hope it's a lot goofy...

CHILDS: (Laughter).

ROTH: ...The work I'm doing, anyway.

CHILDS: (Laughter).

ROTH: No, no. That's right. So could we figure out a way to have more donors to have fewer deaths? I bet we could.

ROSALSKY: OK, so there is a much easier, more efficient way to get people kidneys. It's the way people get most things - with money. Like, what if we could just buy and sell organs?

ROTH: Oh, we'd have a lot more organs. That's how we get most of our stuff. There's a famous passage quoted from Adam Smith, which I'm going to paraphrase, but it says something like, it's not through the generosity of the butcher and the baker that you get your food. You buy it from them. It's how they - that's how they sustain their families - is by selling you food. And that's how you get food, and that's why there's enough food.

CHILDS: Right. The kidney market already has supply and demand. It just doesn't have prices to balance them because buying and selling kidneys is illegal in basically the entire world. So here we are. We don't have enough kidneys. We desperately need more, and yet, we refuse to pay more than $0 for them.

ROSALSKY: And as Al saw while working on kidneys, people had moral objections to the idea of paying for organs. They had concerns that just didn't really make sense to him as an economist.

ROTH: But when I started to look, it turns out there are lots of markets like that.

CHILDS: Lots of markets where people just don't want to allow a market. They feel icky about putting a price on something. Al has a list - for example, surrogacy - a legal and flourishing industry in much of the U.S., not in much of the rest of the world; assisted end of life - perfectly fine medical transaction in Oregon, illegal where I am in Virginia.

ROSALSKY: Al is actually working on a book about all of this.

ROTH: Its working title is "Repugnant Transactions And Controversial Markets." And the idea is that sometimes economists have perfectly good ideas that other people don't think are perfectly good.

ROSALSKY: Al has sort of made his own little subdiscipline in economics about this.

ROTH: "Ickonomics" (ph), "Yuckonomics" (ph) - you know, I trade in book titles. I'm open to suggestions.

CHILDS: You can email Al with your book title suggestions, though honestly, that's kind of hard to beat. In the meantime, when we have those knee-jerk reactions and our gut repels us from considering the icky thing, economics would like to humbly submit that maybe we should.

(SOUNDBITE OF JORDACHE V. GRANT AND SKINNY WILLIAMS' "OLDER HEADS")

CHILDS: Hello, and welcome to PLANET MONEY. I'm Mary Childs.

ROSALSKY: And I'm Greg Rosalsky. Today on the show, we apply an elegant economic framework to Al's market, the trading of human organs, to whether or not we should exact revenge on our enemies, and to whether or not we should trade on inside information.

(SOUNDBITE OF JORDACHE V. GRANT AND SKINNY WILLIAMS' "OLDER HEADS")

CHILDS: When we face difficult situations that don't have an absolutely clear right answer, economist Al Roth says borrowing tools from economics can be useful.

ROTH: Economists deal in trade-offs, and one of the things about trade-offs is you have to say to yourself, supposing there's something we really don't like, what will happen if we ban it? And if the answer is it won't go away, but it'll go underground or become criminalized or become very irregular, then you might prefer to regulate it rather than ban it.

ROSALSKY: And there are real problems with banning things. For example, remember that time we tried to ban alcohol, like, in the 1920s and 1930s?

ROTH: We discovered that it gave rise to a big criminal economy and didn't completely wipe out alcohol at all. So we legalized it. And the legal market for alcohol, with all its problems, is a lot nicer in many ways, a lot more socially useful than the criminal market - you know, Al Capone and the Saint Valentine's Day massacre and, you know, Eliot Ness.

CHILDS: Alcohol, as you may know, is legal today. Selling kidneys - no, not legal - with kidneys, we are in our Prohibition era.

ROTH: There is a black market for kidneys. And often it's pretty terrible because the almost-universal laws against compensating kidney donors have driven that market underground. And what underground often means is out of the hospitals and into hotel suites and apartments...

CHILDS: Eugh (ph).

ROTH: ...And - yes, so medically very bad, as well as, you know, not just illegal but dealing with criminals - medically very bad, bad for the donors, bad for the recipients.

CHILDS: And that's what we have today. That's the market we have chosen. We have the black market with money and the legal market with no money.

ROSALSKY: So Al has been thinking about solutions to this. Like, what can we do realistically to incentivize more kidney donations? How else could we go about creating a market for kidneys to be, as Al likes to put it, more generous to kidney donors?

CHILDS: And when Al thinks about how to design a market, he prioritizes investigating what exactly it is that we're objecting to so he can build a market that fixes or avoids those problems. And in the case of kidneys...

ROTH: There are metaphysical objections. You know, it's just wrong. But the objections that seem to touch on the world seem to say that you can't do this without exploiting poor people because poor people are so vulnerable that just offering them money takes away their agency.

CHILDS: The first reaction is just a gut reaction, which doesn't help inform Al on design. The second reaction is that money can be coercive, that if people have no money and you offer them money to participate in a study, they might have to do the study, especially if you offer a huge amount, like a life-changing amount of money. It's just too compelling. They wouldn't have a choice.

ROSALSKY: This argument does strike Al as unreasonable.

ROTH: There's lots of jobs that we pay people to do because otherwise no one would do them. And you can earn a decent living being a meatpacker. But that's one of the things that bothers people. They say, why should we allow a market that will be mostly - most of the participants will be in the lower parts of the income range? And of course, that isn't very sympathetic to people who are lower income, right? In other words...

CHILDS: Right.

ROTH: ...We need jobs that people with lower income can get. That's why they have some income - is that there are jobs.

CHILDS: Luckily, there is a really obvious, easy solution to this objection - just solve poverty.

ROTH: There'd be a lot less repugnance to monetary transactions if there was no income inequality.

CHILDS: (Laughter).

ROTH: If you wanted to sell me your kidney, but we all had the same income and the same prospects, it just might not be a big thing.

CHILDS: OK, failing that, Al mentioned another way to create a kidney market, a way to get kidneys only from people who aren't that poor - a tax break.

ROTH: People who are wealthy enough to benefit from tax credits on income tax aren't the poorest of the poor. So it might be that the way to start paying kidney donors is to say, we will give you a tax break on everything after the first $10 million of income in the year that you - you know, and then only hedge fund managers would donate kidneys, and that would be repugnant.

CHILDS: But there's a twisted logic to it because at least they could - like, should something go awry in the surgery or in the...

ROTH: Yeah, they'd be fine. They'd be fine. Yeah.

ROSALSKY: Perfect. Like, now we have a few ideas of how to make this happen without paying people for kidneys. We could resolve income inequality, or we could just, you know, do a tax credit and receive only hedge fund manager kidneys. And - right? - there's something a little goofy about all this because these solutions are trying to account for objections that are just hard to design around 'cause those objections are at least partly stemming from some messy human feeling or intuition that just won't let us exchange things in the normal way.

CHILDS: So do you think there'll ever be a U.S. market for kidneys?

ROTH: Well, I think we're not doing a good job yet and that we ought to find a way to be more generous to donors so that we have more of them.

CHILDS: And what that looks like - you're open to suggestion?

ROTH: I'm open to suggestions.

Thursday, July 13, 2023

Laurie Lee interviews me about kidney exchange, repugnance, and more (podcast)

 Laurie Lee interviews me in her podcast Donor Diaries.

https://www.buzzsprout.com/1748941/13094958?t=35 (You don’t have to log in; just click on “Listen Now”.)

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Here is her written description:

"Exchanging kidneys is a complicated process that involves multiple collaborations between kidney patients, living donors, transplant centers, insurance companies, airlines and more.  It’s truly remarkable if you stop to think about the number of people and organizations that need to come together to make 1 paired exchange possible.  We only started exchanging kidneys between non-compatible pairs a little over 20 years ago, so it’s a somewhat new process.  Have you ever wondered how this was made possible?

"Meet Nobel Laureate Al Roth who is an economist and Stanford University professor.  Al designs markets.  He’s one of the prominent players who has made kidney exchange possible.  In a nutshell, his work has revolutionized kidney exchange around the world by using economic theory to make kidneys more available.

"In October 2012, Al was the co-recipient of the 2012 Nobel Memorial Prize in Economic Sciences, together with Lloyd S. Shapley, for “ the theory of stable allocations and the practice of market design."

"Al Roth is well known for his application of economics to real world problems.  In this podcast episode we touch a wide range of topics ranging from paired exchanges, prostitution, surrogacy, and more.  All of these markets are examples of repugnant markets.  Kidney Donation can be characterized as a repugnant market, and Al will tell us all about it! 

Links:

Thursday, April 14, 2022

#122 Game Theory and Market Design. "Unsiloed" podcast about Who Gets What and Why

I'm interviewed by Greg La Blanc, on market design generally, using my book Who Gets What and Why as a takeoff point.

  

Friday, February 4, 2022

Kim Krawiec interviews me about repugnance on her podcast Taboo Trades

 Kim Krawiec interviews me on her podcast Taboo Trades:

She writes "Al Roth and I discuss hitmen, drugs, kidneys, paid sex, and other repugnances. We’re joined by co-hosts Madison White and Alex Leseney (both UVA 3Ls), with appearances from UVA 3Ls Thalia Stanberry, Caitlyn Stollings, Jackson Bailey, and Autumn Adams-jack. A good time was had by all!"

The podcast starts with a cold open, drawn from the body of the interview, in which I ask her co-hosts to help me hire a hitman to rub out a negative referee.  But mostly we talk about transactions that have no easily measurable negative externalities, yet that third parties nevertheless object to.


Monday, December 27, 2021

Overcoming taboos concerning organ donation: a BBC broadcast

 Here's a BBC broadcast on generational change that talks about how young people are helping to overcome taboos regarding organ donation. (They chat with me about organ exchange, including a liver lobe for a kidney, and about having hairdressers talk to customers about deceased donation.)

Listen now

"Generation change: Part two, The Documentary

"BBC presenter Babita Sharma and correspondent Megha Mohan meet the young people from India, Nigeria, the United Kingdom, the United States and the United Arab Emirates fighting to change taboos around organ donation and for greater diversity in the critical fields of science, technology, engineering and maths. We also speak to Nobel Prize awarded contributors including kidney transfer campaigner and economist Alvin Roth as well as astronomer and Physics Laureate Andrea Ghez."

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Earlier: 

Monday, May 6, 2019

Tuesday, November 16, 2021

Freakonomics MD on deceased donor organs for transplants

 Freakonomics MD has a podcast focusing on the scarcity of deceased donor kidneys for transplant, and why recovered organs are sometimes discarded. They interview (separately) Dr. Sumit Mohan at Columbia, and me. (I was in fact interviewed by Jessica Wapner, not by the narrator, Dr. Bapu Jena, using a fancy microphone which they FedExed to me beforehand and I FedExed back to them afterwards...so my snippets probably sound like me...)

You can listen to it right below, or at the link...

x


Why Do So Many Donated Kidneys End Up in the Trash? (Freakonomics, M.D. Ep. 11)

LISTEN NOW:

Every year, thousands of people in the U.S. die while they’re waiting for a new kidney, yet thousands of available organs get thrown away. Bapu talks to a kidney doctor and an economics Nobel laureate about why this happens and how the system could improve.

Follow Freakonomics, M.D. on Apple PodcastsSpotifyStitcher, or wherever you get your podcasts.

Saturday, October 9, 2021

Peter Lorentzen interviews me about market design (podcast)

 Peter Lorentzen interviews me about market design, and my book Who Gets What and Why. (We have an interesting conversation on market design and my career, not closely related to the book...)

"In our interview, we range far beyond the examples from the book to discuss the implications of his work for the design of tech’s market-making “platform” businesses like Airbnb, Amazon, Lyft, or Uber, the challenges he faces when countries or people view some kinds of transactions as “repugnant” or morally unacceptable, and the reasons why San Francisco’s school district (unlike Boston’s or New York’s) chose not to implement the un-gameable school choice plan his team devised for them.

"Host Peter Lorentzen is an Associate Professor in the Department of Economics at the University of San Francisco, where he leads a new digital economy-focused Master's program in Applied Economics."

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Friday, December 18, 2020

Allocating vaccines while they're still scarce--I'm interviewed by Stacy Vanek Smith on the Indicator from Planet Money

 Here's a podcast in which I'm interviewed by Stacey Vanek Smith about how vaccines might be allocated while still scarce:

Who Gets A Vaccine? A Conversation With Alvin Roth

The Indicator from Planet Money, December 15, 2020

("9-Minute Listen")



And here's the transcript.

Below is the latter part of the interview, about vaccines (edited by me to take out excess "you know's," you know?):

SMITH: What are - when you're looking at the vaccine situation now, there are a limited number of COVID vaccines available, at least at this moment. What do you see when you look at that market right now? Not that it's a market per se but you know what I mean.

ROTH: Any time we're allocating scarce resources,  I think it's fair to talk about that as the marketplace. It's waiting for a scarce resource to become available. So what we do with [deceased donor] organs is we form waiting lists and each organ has a different kind of waiting list. So that's a little bit like what we're going to see with a vaccine. Different states are going to have different rules of how to get vaccines. They also have different supply and demand. It might be that lots of people in New York will want to have a vaccine. And it's possible - and I'm purely speculating - that a smaller percentage of people in Tennessee will want it, right? We have a lot of vaccine hesitancy in the United States.

SMITH: Yeah.

ROTH: So one thing that reminds me of kidney exchange a little bit is exchange. Supposing it turns out that we allocate to the states proportional to population, which I think we may be doing this morning. And suppose it turns out that in New York, there's a giant shortage, that there are lots of health care workers, and they're eager to get it. And then after that, there are lots of old people and vulnerable people of various sorts. And New York will develop a priority list.

At the same time, they might discover that in Tennessee, they've gotten more vaccines than they can get rid of on the first day because of vaccine hesitancy or maybe people aren't eager to try it out so early. So you could imagine an exchange, that we'll send you 100,000 doses today and call them in two months when we think we'll need them.

SMITH: What would - like, what do you think is sort of an ideal way for states and I guess - and countries to start approaching this? Because it is complicated, and everybody wants this vaccine, right? A lot of people want this vaccine right now. The demand is greater than the supply. Like, what would you I guess like to see happen or like to see start happening for countries and states kind of making this decision?

ROTH: One thing that people have said is, health care workers are important because they help us contain the disease. But they're also vulnerable to it  - especially if we talk about the health care workers who are treating people who are ill with COVID. So it might make sense to prioritize them so that the hospitals don't shut down, things like that.

But then you might also say, people who are at risk in various ways should get a high priority because getting a vaccine might save their life. But then we might want to go in a different direction. We might want to say - who is likely to be a superspreader? Who  is exposed by the nature of their work? Maybe the essential workers who drive the trucks and deliver the goods and coming to your door and maybe getting your signature.

SMITH: Right, right 'cause this is a little different than a kidney because we're talking about a virus that can spread. So that's in there, too. Like, people who are more likely to - 'cause if we can vaccinate, let's say, like, people who do deliveries, then that could pay sort of exponential dividends.

ROTH: Right. And then we could also think about what's costly to us about the precautions we're taking. One of those things, of course, is child care. If you have school-age children and they're now at home and especially if they're quite young, so they can't even really do Zoom classes without your help, well, then someone in your household is not working very hard 'cause they're providing a service that teachers used to provide. So we might think about what set of vaccinations would be required to open up schools again 'cause that would be a big weight lifted off the economy.

SMITH: Oh, right. That would be - that would help in, like, other ways because then it could help people go back to work, yeah.

ROTH: You'd like there to be the biggest multiplier effect you can get for each vaccine that not only does good for the person getting the jab, you know, the needle in his upper arm but that jab should also do the most good for the most other people.

SMITH: Dr. Alvin Roth is a professor of economics at Stanford University and winner of the 2012 Nobel Prize in Economics.

This episode of THE INDICATOR was produced by Nick Fountain, fact-checked by Sean Saldana. THE INDICATOR is edited by Paddy Hirsch and is a production of NPR.

Copyright © 2020 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
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A quick note on interviews.  These 9 minutes came from a one hour interview, so lots of decisions about what to include were made by NPR. (That’s why I come off as a solitary hero in the initial discussion of kidney exchange.)  But, aside from that, the editors did a pretty good job on this one, imho...)