Where man's best friend also tastes good: the market for dog meat in Korea

The winter Olympics in Korea is bringing out stories about the restaurants there that have dog meat on the menu, and about how foreigners might not be charmed:

The Daily Mail headlines it this way (with lots of pictures):
The trade in dog meat South Korea doesn't want Olympics tourists to see is exposed at market where they are slaughtered, chopped up and served in bubbling red broth for just $8 a bowl
Here are their sub-headlines

• "Dogs and even puppies are sold openly for food in Moran market, Seongnam, outside of Seoul, South Korea, Dailymail.com reveals - showing claims it would be closed last May are false 
• The dogs are kept in freezing, dark cages until they are slaughtered, their fur burned off and their carcasses are put on display
• Up to 80,000 dogs are sold and slaughtered at the market a each year to be made into an $8 soup, which folklore claims boosts eaters' sex drive 
• But ahead of the Olympic Winter Games coming to PyeongChang on Friday, officials issued guidelines for when it comes to eating dog meat, urging citizens not to consume the animals during the Olympics 
• Two-month-old puppies fare little better, being sold for just $9.20 or £6.50 out of metal crates and cardboard boxes, with some saying they can be eaten too "

USA Today puts it this way:
Winter Olympics shines spotlight on dog meat trade in South Korea

"Eating dog meat is common and legal in Korea, as well as many parts of Asia, and is mainly eaten by older people. Dotted around the country are thousands of restaurants serving “gaegogi” dishes that, according to folklore, have strengthening and medicinal properties."

Altruistic kidney donation in Israel: Matnat Chaim (gift of life)

Matnat Chaim (gift of life) is an Israeli organization, led by a rabbi, that promotes living kidney donation.  It's been quite successful, but has also been the source of some controversy and suspicion.

Here's an academic article about them:

Altruism and Religion: A New Paradigm for Organ Donation
by Aviad RabinowichEmail authorAlan Jotkowitz, Journal of Religion and Health, February 2018, Volume 57, Issue 1, pp 360–365

Abstract: "Activity of NGO’s supporting living donor kidney donations can affect the shortage of kidneys. Matnat Chaim is a Jewish orthodox organization active in Israel since 2009. This is a voluntary organization with aims to shorten and eliminate the waiting list for kidneys. Since the beginning of its activity, it has said to play a key role in 379 kidney transplantations. In 2015, out of 174 live donor kidney transplantations that took place in Israel, Matnat Chaim had a key role in 88 of them (50.6%). We found some ethical issues concerning the organization's activity. The donor can restrict his or her donation to specific characteristics of recipient which can result in organs transplanted in a homogeneous group of the population. Another issue is the question of whether nudging people to kidney donation takes place and whether it is valid to do so. We found that Matnat Chaim does a great deal for promotion and intermediation of kidney donations in Israel. This form of promotion can be implemented by other organizations and countries."

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They earlier were the subject of some investigations, but I haven't heard that anything further has come of this. Here's an article from The Times of Israel in September 2017
Head of transplant organization arrested over ‘organs for donations’ scheme
Charity suspected of bumping potential recipients to top of waiting list in exchange for funding, paying illegal compensation to donors

"Police on Monday arrested the head of a charity that facilitates voluntary organ donations in Israel, and three of its employees, on suspicion that it illegally traded organs for donations.
"The suspicions include managing the waiting list so as to bump potential recipients to the top in exchange for donations to the organization, and paying compensation to potential organ donors, police said.
...
"A police spokesperson explained that the investigation was “particularly complex and sensitive” and officers have made an effort not to interrupt the continuing work of the organization “in order to allow its life saving services to continue regardless of the ongoing probe.”"

Laura Doval on kidney exchange in Argentina

Laura Doval, a market designer who teaches at Cal Tech and who hails from Argentina, has an article in FOCO ECONÓMICO about some of the market design issues facing kidney exchange in Argentina, including some issues addressed in her own research:

Trasplante cruzado: Argentina le abre las puertas al diseño de mercados
(Google translate: Cross transplant: Argentina opens the doors to market design)

"The new legal framework creates a system where patients with their non-compatible living donors can register and is responsible for finding compatible pairs. In our example, Ana and Barbara may not know each other (even live in different provinces) and even then the exchange could take place. In addition, the law removes the requirement to go through a judge and establishes the rules under which the exchange occurs.

" Although Argentina is the first country in Latin America to approve kidney transplants as a transplant modality, this modality has a long time in the world: South Korea performed the first cross transplant in 1990; in 1999, Switzerland led the first in Europe; in 2000, it began in the United States, where it is estimated that 13% of kidney transplants occur according to this modality. In the United States, it was doctors and economists who promoted the creation of cross-transplant centers. In fact, the New England cross transplant center was founded by Dr. Delmonico and the economist Al Roth. The latter received the Nobel Prize in Economics in 2012, in part because of the practical implications of his work for the design of these systems.
...
"Given the incipient state of the project in Argentina, it is a good time to reflect on what we can learn from existing projects, both to imitate them and to innovate about them:

"Who can be donors? In Argentina, the law continues insisting that the recipient-donor pairs (in our example, Ana-Bernardo and Bárbara-Alejandro) have a family link to be able to enroll in the "Cross-Renal Donation Program". Although most of the times the recipient-donor couples have a family bond, this restriction limits the possibilities of finding a successful exchange. Among other things, this restriction does not foresee the possibility of altruistic donors: people who enroll in the system to be living donors but do not accompany a recipient. In practice, the presence of altruistic donors has allowed to implement, in addition to crossed transplants, also chains. In a chain, the altruistic donor gives his kidney to the recipient of an incompatible couple, whose donor then gives his kidney to another non-compatible partner, etc. The difference between the chains and the cross transplant is that it is not necessary to close the cycle. There are two types of chains.
"In the Domino Chain , the donor of the last couple donates their kidney to someone on the waiting list.

"In Never Ending Altruistic Donation , the donor of the last couple is recorded in the system. If it is necessary for the chain to continue (because someone who requires a living donor is listed) you will be required to donate your kidney.
 The reason for requiring the last recipient to have a potential donor is to avoid situations where someone is benefited without returning to the system.

"Compatible pairs : [3]The law provides that only donor-recipient couples that are incompatible can participate in the program. This does not take into account the benefit of including partners that are compatible. On the one hand, it would allow for more exchanges. As an example, think of Ana, a patient of blood type A, and Osvaldo, her donor, of blood type 0. Let's suppose that there is another patient, Oscar, of blood type 0, with his donor, Alejandra, of blood type A. In this case, Alejandra can not donate her kidney to Oscar (blood group A can not donate to blood group 0), while Ana and Osvaldo can not participate because they are compatible. Therefore, we could only carry out the transplant between Ana and Osvaldo. If Ana and Osvaldo could participate in the system, we could make two donations: Alejandra to Ana and Osvaldo to Oscar. Further, This could be beneficial for Ana: if Alejandra has better compatibility in age and weight with Ana than she has with Osvaldo, Ana's life expectancy is now better. To the extent that we design a system that does not harm patients in compatible pairs (for example, offering the patient to participate in exchanges with donors of better quality than theirs), the system can generate a greater number of donations and of better quality.

"Connection to the waiting list : In Argentina, the law allows couples enrolled in the cross-donation program to have their recipient also enrolled on the waiting list for a cadaveric transplant while waiting for another couple to be assigned to them. Suppose that a receiver enrolled in both systems receives a cadaveric transplant offer. As a living donor transplant is very superior in quality to a cadaverous one, it is possible that the recipient wants to decline this offer and keep their options open. On the one hand, we want to give you that freedom so you can get the best possible result and potentially use your donor for another operation; On the other hand, if there is no penalty for rejecting the offer, the waiting time of the patients in both lists increases.

"At the time of writing this article, the new law does not mention what happens in the event that a patient enrolled in both systems decline a cadaveric transplant offer. The rules we implement will determine the recipients' incentives to accept or decline these offers; these incentives then determine what kind of organ allocations we can implement. In fact, understanding this interaction between the rules that determine the allocation of offers on the waiting list after declining an offer and the assignments that we can implement both in the list and in the cross-donation program was the focus of the first chapter of my doctoral thesis. While there I study ways in which to design these rules, the main message is as follows:[4] This puts us before the following dilemma. One option is to rethink the transplant system, both cadaverous and crossed, jointly rather than as two independent systems. The second option is to think about how to determine the priority within the waiting list of cadaveric transplants of patients who are in both systems. Since these patients have more options than those only on the waiting list, treating them in the same way implicitly harms those with fewer options. When there are multiple lists to assign similar objects, economists know very little about how to design the priorities of the participants annotated in multiple lists in order to guarantee the efficiency in the allocation. This is one of the topics that my current research occupies."
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See my earlier post

Wednesday, November 8, 2017

Kidney exchange authorized in Argentina

Uneven playing fields in school choice: the consequences of manipulability

 Here's a study of a school choice system using the manipulable (not strategy proof) immediate acceptance ("Boston") algorithm for school choice, in the Wake County Public School System in North Carolina, the 15th largest in the U.S. (The authors are all market design economists at North Carolina State University.)

Identifying the Harm of Manipulable School-Choice Mechanisms
By Umut Dur, Robert G. Hammond, and Thayer Morrill
American Economic Journal: Economic Policy , February 2018, 10(1): 187–213
https://doi.org/10.1257/pol.20160132

Abstract: An important but under-explored issue in student assignment procedures is heterogeneity in the level of strategic sophistication among students. Our work provides the first direct measure of which students rank schools following their true preference order (sincere students) and which rank schools by manipulating their true preferences (sophisticated students). We present evidence that our proxy for sophistication captures systematic differences among students. Our results demonstrate that sophisticated students are 9.6 percentage points more likely to be assigned to one of their preferred schools. Further, we show that this large difference in assignment probability occurs because sophisticated students systematically avoid over-demanded schools.

Here's the operational definition of a sophisticated student:
" In their application procedure, students have a two-week window during which they must log into a website and submit their preferences. A student is free to change her ranking as many times as she wishes. Moreover, upon each visit, a student learns how many students have ranked each school first. Therefore, a sophisticated student benefits from logging into the website multiple times or logging in closer to the deadline. On the other hand, a student submitting her true preferences needs only to log into the website once.
"Following this logic, our classification of sincere and sophisticated students is drawn from the number of logins to the application website. Specifically, we classify students who log in once as sincere and those who log in more than once as sophisticated. We then show a series of results to demonstrate that our login proxy for sophistication is capturing important, systematic differences across students. For instance, some students who visit the application website multiple times change their rankings near the end of the selection period by removing popular (i.e., over-demanded) schools from the top of their rankings. More generally, we demonstrate that sophisticated students avoid over-demanded schools by not ranking them as their first choice. As a result, sophisticated students are more likely to receive an assignment but, conditional on receiving an assignment, are less likely to be assigned to a highly over-demanded school."

A landmark market design paper, on school choice in NYC, by Abdulkadiroglu, Agarwal, and Pathak

When market design was young, it was a game played by game theorists.  As it matured, and we wanted market designs be adopted, implemented, and maintained, it became a kind of economic engineering. But for market design to become a fully mature part of economics, not only must designs move into practice, and be monitored and maintained, they must also be evaluated.*

So I find myself thinking again about this paper from the December AER that I already blogged about:

Abdulkadiroglu, Atila, Nikhil Agarwal, and Parag A. Pathak, “The WelfareEffects of Coordinated Assignment: Evidence from the New York City High SchoolMatch,”American Economic Review, 107(12), December 2017, 3635–3689.

I think of it as the third of three papers: the first two were about the engineering aspects of the NYC high school match, the first school choice design of its kind:

Abdulkadiroglu, Atila , Parag A. Pathak, and Alvin E. Roth, "The New York City High School Match," American Economic Review, Papers and Proceedings, 95,2, May, 2005, 364-367.

and

Abdulkadiroglu, Atila , Parag A. Pathak, and Alvin E. Roth, "Strategy-proofness versus Efficiency in Matching with Indifferences: Redesigning the NYC High School Match,'' American Economic Review, 99, 5, Dec. 2009, pp1954-1978. 

Now, in this third paper, two of the original designers (Abdulkadiroglu and Pathak) together with one of the new generation of market design investigators  (Agarwal) evaluate the impact on students of the current centralized school choice system (it uses a deferred acceptance algorithm) in comparison to the decentralized ("uncoordinated") system it replaced.  

The new system produces a stable matching, which good evidence suggests is helpful in keeping the system healthy in the long term in a school system like NYC, in which the school principals are also strategic players.  But aside from being long lasting, how good is the system for students?

Using the (ordinal) rank order lists submitted by students in the new system, the paper measures welfare by estimating a cardinal random  utility model, with (cardinal) tradeoffs among school attributes being measured in terms of the additional distance a student is willing to travel to be at a more preferred school.

The uncoordinated system suffered from congestion, with many students having to be placed administratively in a school for which they had expressed no preference.  They find that these schools were by and large significantly less desirable.

They find that the new system improves welfare over the old by 80% of the gains that could be achieved by a utility-maximizing allocation made independent of other constraints. They further find that changes in the algorithm (e.g. choosing a different stable matching, among the multiple that arise from random tie-breaking) would have very little effect on welfare.

The biggest difference is that under the old system, only about half the students were placed in the "main round" (now occupied by the deferred acceptance algorithm), whereas in the new system this number immediately climbed to over 80% (with some additional subsequent gains). So students who used to be administratively assigned are now largely assigned instead to a school over which they have expressed a preference. That turns out to be very good for them.

Market design is coming of age...
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* Of course, not all steps in the market design process have to be accomplished by the same individuals, but in this case that's an extra plus.  And of course other  school choice markets have been investigated by these and other investigators, but in most cases those markets were not designed by economists, so that's another extra bonus here too, especially since features of the design (which encourage truthful reporting of preferences) add to the ability to estimate welfare gains. 

Cadavers and the slave trade

The NY Times has an article on the intersection of the slave trade in the United States with the market for cadavers for anatomy classes in medical schools:

Beyond the Slave Trade, the Cadaver Trade, By Daina Ramey Berry

"One shocking fact that’s recently come to light: Major medical schools used slave corpses, acquired through an underground market in dead bodies, for education and research.

"Yes, there was a robust body-snatching industry in which cadavers — mostly the bodies of black people, many of whom had been enslaved when they were alive — were used at Harvard, the Universities of Maryland, Pennsylvania and Virginia, and other institutions.
...
"Body snatchers like Grandison Harris of Georgia and Chris Baker of Virginia collected specimens for dissection for the benefit of medical colleges. While they received room, board and modest wages for the bodies they collected, they were also enslaved African-American men themselves, listed as “janitors” or “porters” in the medical schools’ records."
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See some of my earlier posts on the cadaver trade:

Monday, July 3, 2017

Cadavers and the teaching of anatomy

Saturday, February 18, 2012

Markets for cadavers

Thursday, June 30, 2011

Medical education in Paris in the 1830's--cheap cadavers

Super bowl thought by Kim Krawiec: football players are paid, why not kidney donors?

While checking up on the super bowl, I'm reminded that Kim Krawiec posted this:
 Super Bowl Week OpEd

"As the Super Bowl approaches, Phil Cook and I have an OpEd running in the Raleigh News & Observer and a few other publications:

Why ban payment to kidney donors but not football players?

BY PHILIP J. COOK AND KIMBERLY D. KRAWIEC 

February 01, 2018 01:06 PM

Super Bowl week rivets national attention on America’s most popular and lucrative sport, professional football. If stories of concussion and permanent injury to players make some fans uneasy, there is always the reassuring fact that the players volunteer for the job and are well compensated – so well compensated that there are untold thousands of young men who would gladly take their place.

Football is so ingrained in our culture that we generally accept this situation without much scrutiny. However, our research got us thinking about the stark contrast with another risky but valuable activity – kidney donation.

About 6,000 people per year donate one of their two kidneys. This selfless act has some risk to the donor, both from the surgery and years later when there is a chance the remaining kidney will fail. In return, kidney donors are rewarded with the knowledge they helped save the life of a loved one. They receive nothing tangible. Indeed, federal law bans compensation for kidney donors, as do the laws of all other countries except Iran (really).

So, why do we pay football players to entertain the public, but are unwilling to pay kidney donors to save lives?

The stakes in both cases are high, but much higher in kidney donation. The total value of NFL teams is about $60 billion. If, in some unlikely future, the risk of serious permanent injury to players led to a ban on professional play, that value would be destroyed.

Meanwhile, the ban on compensation for living kidney donation currently costs thousands of lives and billions of dollars in taxpayer money every year. The waiting list for a kidney now includes 100,000 patients, who for the most part are kept alive by renal dialysis at federal government expense. If they survive long enough, typically more than five years, in this debilitated state, they may hope to rise to the top of the list and receive a kidney from a deceased donor.

Deceased donors are a limited resource: few people die under conditions that permit donation and the United States already procures a large percentage of healthy kidneys from deceased donors. What is needed are many more living donors. Current estimates suggest an offer of $50,000 per living donation would be adequate to recruit sufficient numbers to meet the needs of all transplant-eligible renal patients. This would eliminate the waiting list and prevent thousands of unnecessary deaths and years of unnecessary disability. Given standard value-of-life estimates, the present value of the public benefit of converting to a system of compensated donation would exceed $1 trillion – many times the value of professional football.

It should be noted that the alternative to the current ban on compensation is not a laissez-faire free market. Rather, the current system for regulating the allocation of available kidneys could be readily expanded. A nonprofit or government organization could offer a fixed payment to living donors who were screened to be physically and mentally sound, and then fully informed of the risks. To avoid “impulse” donations, there could be a mandatory waiting period.

And it should be noted that the medical risks to kidney donors are far less than the risks of a football career; most donors lead normal lives, while most NFL veterans are, to some degree, disabled.

Inevitably the chance to sell a kidney for $50,000 would be most attractive to people who are struggling financially. Some ethicists opine that a compensated system would exploit the poor. Yet, more than a few NFL players also come from poor homes and 70 percent are black, causing many to view the concussion crisis as another example of racial inequality. In our view, the risk of exploitation is not a legitimate reason for forbidding compensation to kidney donors, thus denying the poor full use of one of their potential assets.

Millions of Americans, not just NFL players, work in occupations that have a substantial risk ofserious injury. Loggers, fishermen and others accept these risks in exchange for compensation. Extending that list to include kidney donors is just common sense.

PHILIP COOK IS TERRY SANFORD PROFESSOR EMERITUS OF PUBLIC POLICY AND PROFESSOR OF ECONOMICS AND SOCIOLOGY AT DUKE UNIVERSITY’S SANFORD SCHOOL OF PUBLIC POLICY. KIMBERLY KRAWIEC IS THE KATHRINE ROBINSON EVERETT PROFESSOR OF LAW AT DUKE LAW SCHOOL."

Changing of the guard at Management Science (but papers on market design are solicited)

Here's an email announcement from Yan Chen and Axel Ockenfels about the recent change of editors at Management Science:

"We would like to update you on some recent development regarding behavioral economics at Management Science. As you may have heard, the new Editor-in-Chief, David Simchi-Levi, has decided to merge behavioral economics, judgment and decision making, and decision analysis into the newly expanded Decision Analysis Department (DA). The two of us will be the Department Editors handling behavioral economics papers within DA.

We have a terrific group of Associate Editors (AEs), including Al Roth and Richard Thaler who serve as our honorary AEs, and Björn Bartling (University of Zurich), Gary Bolton (University of Texas at Dallas), Peter Cramton (University of Cologne), Dan Friedman (University of California at Santa Cruz), Tanjim Hossain (University of Toronto), Scott Kominers (Harvard University), Dorothea Kübler (Berlin Social Science Center WZB), Katherine Milkman (University of Pennsylvania), Tanya Rosenblat (University of Michigan), Dirk Sliwka (University of Cologne), Matthias Sutter (Max Planck Institute for Research on Collective Goods, Bonn), and Stephanie W. Wang (University of Pittsburgh).

We hope that you will continue to submit your best papers to Management Science. Please

​​

do check the new Editorial Statement for Decision Analysis

​​

, and note the new emphasis on (1) mechanism and market design at DA; and (2) relevance to the science and/or practice of management at the journal level.

In closing, we would like to thank Uri Gneezy and John List for bringing behavioral economics into Management Science. We hope to continue their excellent work and publish the best papers in our field.

Sincerely,

Yan ​​and Axel

--

Yan Chen

http://yanchen.people.si.umich.edu/

Axel Ockenfels
ockenfels.uni-koeln.de/aoc-seb.de

Risks of living kidney donation: a meta-analysis

Better information is accumulating on the risks of living kidney donation. A meta-analysis has just been published January 30 in the Annals of Internal Medicine. It reports what the authors consider to be very moderately increased risk of kidney failure, and of pregnancy complications.

Mid- and Long-Term Health Risks in Living Kidney Donors
A Systematic Review and Meta-analysis
by Linda M. O’Keeffe, PhD*; Anna Ramond, DPharm*; Clare Oliver-Williams, PhD; Peter Willeit, MD; Ellie Paige, PhD;Patrick Trotter, MBChB; Jonathan Evans, MBChB; Jonas Wadstrom, MD; Michael Nicholson, MD; Dave Collett, PhD; and Emanuele Di Angelantonio, MD

From the Abstract:
"Although living kidney donation is associated with higher RRs  [relative risks] for ESRD and preeclampsia, the absolute risk for these outcomes remains low. Compared with nondonor populations, living kidney donors have no increased risk for other major chronic diseases, such as type 2 diabetes, or for adverse psycho-social outcomes."

And from the concluding discussion:
"Findings from this review may have implications for policies and practices related to living kidney donation. For example, donors should be informed that, although nephrectomy is associated with a higher RR for ESRD,the absolute risk is still low for most donors (that is, those not from known high-risk populations [39]). Thus, risk prediction tools for ESRD may better approximate the risks involved for prospective donors (43). Guidelines that do not contain information about pregnancy for living kidney donors should instead include relevant information for women of childbearing age in the informed consent process. Furthermore, this review supports the need for long-term follow-up of donors to monitor their health and mitigate possible increases in disease risks associated with kidney donation (44). In conclusion, compared with nondonor populations, living kidney donors have no increased risk for several major chronic diseases, with the exception of ESRD. However, the absolute risk for this disease remains low. Female donors who become pregnant after nephrectomy also seem to be at increased risk for preeclampsia, but more data are needed to confirm this finding."

San Francisco Will Clear Thousands of Marijuana Convictions

What happens when a formerly repugnant transaction goes from being illegal to being legal?
The NY Times has the story:
San Francisco Will Clear Thousands of Marijuana Convictions

"Thousands of people with misdemeanor convictions for marijuana possession dating back 40 years will have their criminal records cleared, the San Francisco district attorney’s office said Wednesday. San Diego is also forgiving old convictions.

"Recreational marijuana became legal in California this year, and the law allowed those with prior low-level offenses to petition for expungement, a process that can be costly.

"But in San Francisco and San Diego, people need not ask. George Gascón, San Francisco’s district attorney, said his office would automatically erase convictions there, which total about 3,000.

"An additional 4,900 felony marijuana charges will be examined by prosecutors to determine if they should be retroactively reduced to misdemeanors.

"San Diego has identified 4,700 cases, both felonies and misdemeanors, that will be cleared or downgraded."
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See my earlier posts on Turing's Law, named for Britain's 2003 posthumous pardon of Alan Turing who had been convicted of a crime when homosexual acts were illegal.

Colleges that get a lot of applications read each one quickly (WSJ)

How to deal with congestion?  Move fast...  Here's the story from the WSJ:

Some Elite Colleges Review an Application in 8 Minutes (or Less)
With so many applying, fewer schools have one person read a whole application; plowing through 500 files in a day

"As application numbers surge, admissions officers at some elite colleges say they don’t have time to read an entire file.

"Instead, staffers from more schools—including the Georgia Institute of Technology, Rice University and Bucknell University in Pennsylvania—now divvy up individual applications. One person might review transcripts, test scores and counselor recommendations, while the other handles extracurricular activities and essays.

"They read through their portions simultaneously, discuss their impressions about a candidate’s qualifications, flag some for admission or rejection, and move on. While their decision isn’t always final, in many cases theirs are the last eyes to look at the application itself.

"The entire process can take less than eight minutes.
...
"Efficiency is crucial, since more students are using the Common Application, which allows them to submit material to multiple schools. Nearly 902,000 students used it last year. As of Jan. 15 this year, the number was already 898,000 students submitting to an average of 4.8 schools.

"Applications to Georgia Tech jumped by 13% for the coming academic year, to 35,600. The current freshman class has roughly 2,800 students."

Drug trafficking via the U.S. mail

A recent Senate report (which I haven't seen) has generated a lot of news coverage to the effect that fentanyl, a Schedule II controlled substance (i.e. a drug that may not be legally sold without a prescription in the U.S.) that is implicated in the current opioid crisis in the U.S., is widely available from internet sites that will send it to you in the mail.

Here's the WSJ story:

Stamp Out Easy Mail Access to Deadly Fentanyl, Senate Report Urges


"A U.S. Senate report raises fresh concerns about how easy it is to buy illicit, mail-order opioids from China, a source federal authorities say has fueled a nationwide addiction crisis claiming tens of thousands of lives.

The new Senate report, issued ahead of a hearing Thursday, is the latest to focus on how international mail has become a major conduit for these drugs.

Investigators for the Senate’s Permanent Subcommittee on Investigations posed as would-be online buyers, entering terms like “fentanyl for sale” into Google..."

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Try it yourself: https://www.google.com/search?q=fentanyl+for+sale

Science talent search finalists (and some alumni)

The  Regeneron Science Talent Search, which was sponsored by Westinghouse when I was in high school, has announced  its finalists this year, who compete for college scholarships by submitting the results of their scientific investigations.

Here's the story from CNN:
Could these students provide the science breakthroughs of the future?

I participated when I was in high school, but without progressing very far in the competition.

There are more science competitions for high school students than there used to be. I already blogged about one of the finalists (you can find them all here):

Komo, Andrew
Montgomery Blair High School, Silver Spring, Maryland
Cryptographically Secure Proxy Bidding in Ascending Clock Auctions

He came in first in another competition:

Saturday, December 23, 2017

Auction design wins a national high school science prize

Italy recommends Global Kidney Exchange to the World Health Organization

Global Kidney Exchange (GKE) was presented last week  in the executive session of the World Health Organization (WHO), the UN agency concerned with public health policy.   

Among the Statements submitted by Member States and other participants of the 142th session of the Executive Board  was this Statement from Italy, which encourages the WHO to include  in the 2019-2023 program the development of kidney transplantation  in low and middle income countries through cooperation, assistance and GKE, and proposes that the WHO should consider and implement a pilot project GKE program.  

  Here's the statement in full (points 6-10 are the action items):

Statement from Italy

Italy fully aligns with the statement carried out by Malta on behalf of European Union and its Member States.

Italy commends the DG and the Secretariat for the refined version of the Draft General Programme.

In particular Italy appreciates the additional attention given to migrants’ health in the new version of the programme of work.

In this session we would like to echo Spain’s remark and raise the EB and Member States’ attention to the problem of kidney transplantation globally.

In the past and in the current draft programme considerable attention has been correctly paid by WHO to TB, HIV and malaria,

However:

1. According to reliable international data, 2-7 million people die annually from kidney failure - more than from TB, HIV, and malaria combined. Transplantation is by far the most cost-effective treatment for kidney failure, particularly in low/middle income countries (LMIC)
2. Non-communicable diseases such as heart disease, diabetes, and kidney disease have replaced communicable diseases as the most common causes of premature death worldwide. An estimated 80% of this burden occurs in LMIC.
3. Billions of dollars are spent in LMIC to reduce the burden of communicable diseases, but significantly less is spent on non-communicable diseases. Consequently, the gap in healthcare between High Income Countries (HIC) and LMIC has become particularly large for noncommunicable diseases such as kidney failure.
4. Transplantation is preferable to dialysis as a treatment for kidney failure. Transplant patients live on average 10 years longer, and have better quality of life than those on dialysis. In some LMIC, as many as 75% of patients who start dialysis die within one year. Moreover, transplantation is much less expensive than dialysis over time. This is very much limited by the limited availability of organs that can be addressed with kidney exchange.
5. Kidney exchange extends the reach of living donation because some healthy living donors are not able to give a kidney to a loved one for reasons outside of their control. However, they could exchange their kidney with another such pair so that both patients are able to receive a living donor kidney transplant. Kidney exchange is practiced routinely in HIC and preliminary clinical experience indicates it could be expanded globally to increase access to living donor kidney
transplantation. Kidney exchange is equitable, mutually beneficial, and has been carefully developed to be ethical, legal, and transparent.
6. We encourage WHO to include organs and in particular kidney transplantation in its programme as we believe that oversight, cooperation and assistance of the WHO to carry out a pilot program with strong international governance that is consistent with the highest ethical and legal standards, and that carefully approves participating countries, facilities, healthcare providers, and patient-donor pairs should be conceived and implemented.
7. Given that transplantation is more cost effective than dialysis, the savings attained in HIC from transplantation affords LMIC patients the opportunity to participate in kidney exchanges with HIC patients. We refer to this as Global Kidney Exchange (GKE).
8. Consider the figure: the LMIC mother wishes to donate to her daughter, and the HIC brother wishes to donate to his sister, but neither pair is able to proceed. Without transplantation, the LMIC daughter will die and the HIC sister will remain on dialysis. However, through GKE each patient receives a compatible kidney from the other patient’s donor. Furthermore, the savings attained in the HIC can also support long-term care of the LMIC donor and recipient in their home country.
9. Preliminary clinical experience in a small sample of exchanges between LMIC and HIC pairs has achieved 100% patient and graft survival as well as donor safety with up to 3 years of follow-up.
10. The pilot program would establish a technical working group to develop a self-sustaining and scalable GKE program that will:
a. Execute planning meetings to carefully develop the criteria for participating countries, physicians and patient-donor pairs;
b. Design, create, and implement an international governance protocol; and
c. Perform and test Global Kidney Exchanges.


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Here's a link to the whole meeting:

142nd session of the WHO Executive Board

WHO/V. Martin

22 January 2018 – This week the WHO Executive Board is setting the agenda for the World Health Assembly, and determining how to best promote health, keep the world safe, and serve the vulnerable. The session takes place on
22–27 January 2018 in Geneva, Switzerland.

• Provisional agenda
• All documentation
• Live webcast
• Speech by WHO Director-General

Update: you can watch the Italian representative, Professor Walter Ricciardi, deliver the statement  in the live webcast, afternoon session part 2 (in the links on the right), at minute 57 for about 3 minutes.
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Here are all my posts on GKE, which tell of its clinical success so far, and of some highly politicized opposition that it attracted. However as transplant professionals have had an opportunity to hear directly about the proposal, calmer, more practical discussions are taking place, and GKE is gaining support.  This most recent recommendation from Italy to the WHO seems like a responsible way to move forward.

I support the call for action in point 10 of the Statement of Italy, and I think that the need to establish careful rules around the issues included in point 6 are well considered. I'm cautiously optimistic that this will mark a turning point towards practical, evidence-based exploration of ways to extend the very considerable benefits of kidney exchange, transparently, ethically, and without undue delay.
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(Here are some pictures from our meeting in Rome, two weeks ago...)

How banks support payday lenders and check cashing services by dissing their low income customers

Here's a story from the WSJ that I found disturbing (and which helps explain why many people choose to be "unbanked" and to patronize high-priced non-bank financial services):

Bank of America: No More Free Checking for Customers With Low Balances
eBanking customers switched into accounts that typically require direct deposit or a minimum balance to avoid $12 monthly fee

"Bank of America Corp. has eliminated a free checking account popular with some lower-income customers, requiring them to keep more money at the bank to avoid a monthly fee.

"This month, all remaining eBanking customers with the Charlotte, N.C., lender were switched into accounts that charge a $12 monthly fee unless the customer has a direct deposit of $250 or more or a minimum daily balance of $1,500. Some eBanking customers were switched over as early as 2015.

"Banks have long grappled with how to charge customers for basic checking services. The accounts are costly for banks to maintain, though they do bring in revenue through overdraft and other fees."
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Some previous posts about the other part of this market:

Friday, November 3, 2017

Payday lending and check cashing

Thursday, January 22, 2015

Payday loans

2018 Tsinghua Conference on Behavioral, Experimental and Theoretical Economics (Tsinghua BEAT)

Here's the call for papers with a Feb 1 deadline:

Call for Papers : Tsinghua BEAT 2018

Dear Colleagues, 

We are pleased to announce the call for papers for the 2018 Tsinghua Conference on Behavioral, Experimental and Theoretical Economics (shortened as Tsinghua BEAT). The conference will be held on the campus of Tsinghua University, at the School of Economics and Management, in Beijing on July 9-10, 2018. 

Plenary speakers at Tsinghua BEAT include:


Jacob Goeree, University of New South Wales; 

Ed Hopkins, University of Edinburgh; 

Muriel Niederle, Stanford University; 

Alvin Roth, Stanford University. 

The conference has a single track. Please consider submitting a paper in the areas of behavioral, experimental and theoretical economics to the conference by February 1, 2018. Papers should be sent as email attachments to tsinghua.beat@gmail.com, with the subject line: [2018 Tsinghua BEAT submission]. Extended abstracts will not be accepted. Members of the organizing committee will put together the program and notify the participants by March 1, 2018. The acceptance rate for submitted papers for the 2017 conference was 50%. We look forward to welcoming you in July at Tsinghua. 

Sincerely,

Chong-En Bai 

Yan Chen 

Ming Gao 

Audrey Hu 

Tracy Xiao Liu 

Alex White 

Jie Zheng 

Xiaohan Zhong 

Programs from Previous Years:

2017 Tsinghua BEAT conference

Link to Conference Website:

http://tinyurl.com/tsinghuabeat

Vermont legalizes marijuana

The Washington Post has the story:

Vermont is the first state to legalize marijuana through legislature

"Gov. Phil Scott (R) signed a bill Monday legalizing marijuana for adults over 21. It allows for the possession of an ounce or less of marijuana, two mature and four immature plants. Vermont is the ninth state to legalize recreational marijuana for adults. The other states did so through ballot initiatives.

"But Vermont’s law is notable for what it does not do: create a state marketplace for the sale of marijuana.

Instead, it directs a marijuana advisory board to study what a legal marketplace where marijuana is taxed and regulated would look like in Vermont and report to the governor by Dec. 15.
...
"The measure creates a number of new marijuana laws, including stronger penalties for selling marijuana to people under 21 or enabling their consumption of the drug and makes it a crime to use marijuana in a vehicle where there is a child. It also makes the consumption of marijuana in public illegal.

"Scott said the commission must create education campaigns around marijuana and ways to keep the state’s roads safe.

“To be very direct: There must be comprehensive and convincing plans completed in these areas before I will begin to consider the wisdom of implementing a commercial ‘tax and regulate’ system for an adult marijuana market,” Scott wrote.

The law will take effect in July."

Legal marijuana and crime reduction

The Guardian channels an academic paper from the EJ:

Here's the Guardian story:
Legal marijuana cuts violence says US study, as medical-use laws see crime fall
Murder and violent crime found to have decreased most in states bordering Mexico as drug cartels lose business to regulation

And here's the paper:

Is Legal Pot Crippling Mexican Drug Trafficking Organizations? The Effect of Medical Marijuana Laws on US Crime  

Evelina Gavrilova

Takuma Kamada

Floris Zoutman 

Forthcoming in Economic Journal 

Abstract: We examine the effects of medical marijuana laws (MMLs) on crime. We exploit theintroduction of MMLs as quasi-experimental variation. Using data from the UniformCrime Reports, we show that the introduction of MMLs lead to a decrease of 12.5 percentin violent crime, such as homicides, aggravated assaults and robberies in states that borderMexico. We also show that the reduction in violent crimes is strongest for counties closeto the border (less than 350km), while there is no significant impact of MMLs on crimefor counties located further inland. Analysis from the Supplementary Homicide Reportsdata reveals that the decrease in homicides can largely be attributed to a drop in drug-lawrelated homicides. We find evidence for spillover effects. When an inland state passesa MML, this results in a decrease in crime in the nearest border state. Our results areconsistent with the theory that the introduction of MMLs reduces activity by Mexicandrug trafficking organizations and their affiliated gangs in the border region. MMLs exposedrug trafficking organizations (DTOs) to legitimate competition, and substantially reducetheir profits in one of their most lucrative drug markets. This leads to a decrease in drug-related crime in the Mexican border area. Our results indicate that decriminalization ofthe production and distribution of drugs may lead to a reduction in violence in marketswhere organized drug criminals meet licit competition.

Ninth Circuit rules that laws against prostitution are not unconstitutional

The Washington Post has the best headline:
They argued that prostitution is a constitutional right. Nice try, said federal court.

"The Supreme Court’s 2003 ruling in the case Lawrence v. Texas is one of its best-known in recent memory. In a 6-3 decision, the justices invalidated every remaining sodomy law in the United States, rendering the country’s archaic and largely unenforced bans on same-sex sexual activity unconstitutional. “Intimate conduct” between consenting adults was a fundamental right protected by the Constitution’s due process clauses, the high court found.
...
"The Erotic Service Provider Legal Education and Research Project, or ESPLERP, filed a lawsuit in federal court in 2015 claiming that, under the Supreme Court’s ruling, California’s anti-prostitution law violates the constitutional rights of prostitutes and clients to engage in consensual sexual activity. They even went so far as to say that the ruling barred laws criminalizing prostitution among adults and that paying for sex was a form of protected commercial speech.
...
"On Wednesday, the San Francisco-based court threw out the lawsuit, ruling that paying for sex didn’t count as the type of “intimate conduct” that Supreme Court justices had in mind.

“There is no constitutional rights to engage in illegal employment, namely, prostitution,” Judge Jane A. Restani wrote for the three-judge panel."
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Here's the story in the SF Chronicle:
Sex for sale is not a constitutional right, court rules

"Three former prostitutes, a would-be client and the Erotic Service Providers Legal, Educational and Research Project had argued that the high court, in striking down state laws against gay or lesbian sexual activity, recognized an adult’s right to engage in consensual sex without state interference. They maintained that the ruling extended to adults who consent to sex for a price.

"A panel of the Ninth U.S. Circuit Court of Appeals in San Francisco seemed receptive to that argument at a hearing in October, suggesting that the 1872 state ban might need closer scrutiny.

"One panel member said prostitution had been historically subjected to the same sort of moral disapproval that had once condemned gay sex, and might be more acceptable under the Supreme Court’s current view of individual rights. Another asked why it should be “illegal to sell something that it’s legal to give away.”

"But in a 3-0 ruling Wednesday, the panel ruled that the Supreme Court had not legalized prostitution with its 2003 decision.

"Although the scope of the ruling was not clear, the Supreme Court specified that the gay sex case “does not involve ... prostitution,” Jane Restani, a judge of the U.S. Court of International Trade temporarily assigned to the appeals court, wrote in the panel’s decision."