Iranian Kidney Donors
Iran is one of the few countries in the world to have eliminated the shortage of kidneys. A useful new paper looks at what donors are like,
First some background:
The adoption of a regulated market mechanism for kidney procurement in Iran started in 1988 in the absence of sufficient posthumous donations (Ghods and Savaj, 2006). The mechanism allows living unrelated Iranian individuals to donate kidneys to Iranian patients with end stage renal disease (ESRD) for financial gains. The program was successful in eliminating the renal transplant waiting list within a decade of its implementation (Mahdavi-Mazdeh, 2012). In addition, the Organ Transplant Act legalized brain-stem death donations in 2000. Both ESRD patients and potential kidney donors are referred to and registered with The Association for Supporting Renal Patients, a non-profit organization (NGO) which conducts a primary medical evaluation and facilitates the market exchange. Upon successful completion of the test, a formal consent is acquired and the potential donor and the recipient are introduced to each other. At this stage both the patient and the donor are referred to a nephrologist for further evaluation, cross-match, and angiography. If the patient-donor pair is compatible, in the next step the pair negotiate the terms and conditions of the exchange. All terms within the price-cap are guaranteed and enforceable by the NGO. The price-cap is frequently adjusted for inflation and during the course of our study was set at 180 million Iranian Rial (US$4700 in August 2017). However, the negotiation is private and the pair can agree any terms they wish. The donor also receives a “gift of altruism” and 1 year of insurance from the government through the Charity Foundation for Special Diseases. Transplant surgery is carried out free of charge in public university hospitals. The Iranian Ministry of Health and Medical Education introduced further procedural changes in July 2019. In particular, they established a center for organ transplant and procurement at the ministry which acts as the matching centre and provides oversight and overall control of the process.
Are the donors irrational, risk-loving, impatient? No, they are normal people making the best of sometimes limited opportunities:
The overall picture is of individuals who were in financial need, often unemployed but with a family to support and where alternatives sources of financial support were grim. However, despite their financial position, these individuals were typically patient and not especially prone to risk-taking. They were no less rational than the average, but those who ended up completing the process might be characterized as more altruistic than those who did not….More broadly our findings indicate that even in situations of extreme poverty we should not assume lower levels of rationality will be pervasive.
Given that donation saves lives and that kidney donation is not especially risky (much less risky than driving a motorcycle, for example) the tradeoff seems positive and well within ordinary bounds.
Turning to the US, here is Sally Satel on a proposed tax credit for kidney donation:
What if we could solve the organ donor shortage with a simple tax credit? That is the idea behind the End Kidney Deaths Act (EKDA) (HR 9275).
The bill, advanced by the Coalition to Modify NOTA (NOTA stands for the National Organ Transplant Act passed in 1984) would provide a $50,000 refundable tax credit—$10,000 per year for five years—to any living donor who gave a kidney to the next person on the waiting list. The tax credit would be a 10-year pilot program.
The credit would save 10,000 to perhaps as many as 100,000 lives over ten years.
FYI, I am a supporter of Modify NOTA (along with Al Roth, Steve Levitt, and Mario Macis, to name just a few of the economists, joined by surgeons, nephrologists and others).
Hat tip: Kevin Lewis.
Fluoride revisionism?
I am usually skeptical of such efforts, but Journal of Health Economics is quite a serious outlet:
Community water fluoridation has been named one of the 10 greatest public health achievements of the 20th century for its role in improving dental health. Fluoride has large negative effects at high doses, clear benefits at low levels, and an unclear optimal dosage level. I leverage county-level variation in the timing of fluoride adoption, combined with restricted U.S. Census data that link over 29 million individuals to their county of birth, to estimate the causal effects of childhood fluoride exposure. Children exposed to community water fluoridation from age zero to five are worse off as adults on indices of economic self-sufficiency (−1.9% of a SD) and physical ability and health (−1.2% of a SD). They are also significantly less likely to graduate high school (−1.5 percentage points) or serve in the military (−1.0 percentage points). These findings challenge existing conclusions about safe levels of fluoride exposure.
That new article is by Adam Roberts. Via the excellent Kevin Lewis.
The Political Transformation of Corporate America, 2001-2022
This article reconciles conflicting views about the political landscape of corporate America with new data on the revealed political preferences of 97,469 corporate directors and executives at 9,005 different U.S. companies. I find that average ideology for these individuals has shifted meaningfully to the left over time, changing from modestly conservative in 2001 to roughly centrist by 2022. This finding supports a middle-ground position between conventional wisdom casting “big business” as a conservative stronghold and revisionist views holding the opposite. Counterfactual simulations and a difference-in-differences design suggest multifaceted causes for these changes, and hand-collected data on corporate stances on LGBTQ-related legislation coupled with an instrumental variables design indicate that individual ideology has large effects on firm-level political activity. Overall, this transformation has profound implications for American politics, as the individuals comprising one of the most powerful interest groups—corporate elites—appear to be fracturing ideologically and to some degree even switching sides.
That is from a new paper by Reilly Steel.
Saudi claim of the day
The Neom giga-project in Saudi Arabia is currently using one fifth of all the steel produced in the world, an official said on Monday.
The futuristic city will be the world’s largest customer for construction materials for several decades, said Manar Al Moneef, Neom’s chief investment officer.
She told the Global Logistics Forum in the King Abdullah Financial District in Riyadh that the $500 billion project would be one of the world’s leading drivers of the global logistics sector in coming years.
“Neom is going to be the largest customer over the next decade. If you look at our demand in logistics it’s 5 percent of the global logistics market,” she told the forum, in rare public comments.
Here is the full story, via Mike Doherty.
Friday assorted links
1. Choose the right status hierarchies. An excellent short essay.
2. How to solve America’s housing crisis.
3. Hugh Grant sides with Schelling and rebels against Adam Smith.
4. The new Sienese painting show at the Met (New Yorker).
6. AI in Africa (FT).
Noah Smith on the vibe shift
My values haven’t become more conservative — my desire for a more economically egalitarian and socially tolerant society has not diminished an iota. You won’t see me bellowing “I didn’t leave my party, my party left ME!!” and storming over to the GOP in a huff. But I have to say that I now doubt the practical effectiveness of some of the policies I embraced in previous years. Others still seem like good ideas, but I’ve been dismayed at their botched implementation where they were tried. And many progressive ideas simply don’t seem like they’ll be able to win majority political support in the near future. It’s looking more and more likely that America is headed for a more conservative decade.
I’m not the only person to have noticed the shift. Dave Weigel recently wrote a post detailing all the ways that Kamala Harris’ campaign is to the right of Biden’s 2020 run, both in terms of tone and rhetoric and in terms of actual policy. Harris and other Dems have touted their tough stances on the border, abandoned big new spending programs, stopped talking about a public option for health insurance, trumpeted their support for Israel, embraced oil drilling, and gone tough on crime. Harris’ policy agenda includes plenty of pro-business and deregulatory ideas. She even brags about owning a gun and being willing to shoot intruders.
Here is the full post. And this, from later on, past the gate:
The sheer range of issues where progressivism seems adrift and directionless leaves me pensive and morose. I believe in the power of wonky technocrats to implement incremental policy tweaks to accelerate the energy transition, fix the immigration system, and make police more effective and less violent. But what’s left to fight for? Other than defending America against the depredations of Trump and the right, what big political goal can mobilize the masses to get out there and vote for left-of-center politicians?
I do see two big bright spots here. The first is industrial policy, which promises not just to restore American manufacturing, but to revitalize whole areas of the country. The second is the abundance agenda and YIMBYism, which promises to provide cheap housing, energy, and transportation for all.
Recommended.
Will Trumpian tariffs attract more foreign direct investment?
That is the theme of my latest Bloomberg column, here is one excerpt:
In the debates over Brexit almost a decade ago, it was periodically suggested that Britain’s higher trade barriers with the EU could lead to a beneficial upsurge in foreign direct investment, to serve the British market. So far Britain continues to languish in stagnation, and foreign direct investment into the country has fallen. To the extent a nation is not part of the world’s free-trade system, it may be less desirable to invest there.
Now consider the US. It is a much bigger market than Britain, yet a Trumpian trade war will not in every way reassure foreign investors. “America First” is a big part of the core Trump message, and foreign investors may fear their longer-term rights will not be fully respected under such a regime. In contrast, Ronald Reagan’s threat to Japanese automakers four decades ago was one small part of a broader commitment to the US as a (mostly) free-trading nation.
Trump, it is fair to say, does not share that commitment. Under Trump’s plans for tariff hikes, the US would repudiate all of its previous trade agreements, including with neighbors and major trade partners Canada and Mexico. Would anyone be surprised if Trump’s next step was to impose a higher corporate tax rate on foreign-owned capital in the US?
Countries that have been successful at attracting foreign capital, such as Singapore and Ireland, have tended to follow a similar strategy: They are credible, predictable and keep their word.
Note also that capital inflows strengthen the dollar, which is not in every way consistent with Trump’s other objectives…
The best fesenjan I’ve had in years
Toranj
10861 Lindbrook Dr, Los Angeles, CA 90024
Via Jeff Holmes. And a little space birdy tells me that the best sandwich in LA is Roma Market, in Pasadena.
Thursday assorted links
1. Would a time machine make you a great investor? (WSJ)
2. Trialogues!
3. Valentina Goncharova song. And the subversive music of Soviet Ukraine (NYT).
4. Paul Baran. And Noah on AJR. And Dylan Matthews.
The early history of peer review
By the 1950s, the Royal Society was asking reviewers to respond to standardized questions, including whether a study contained “contributions to knowledge of sufficient scientific interest” and simply whether the society should publish it.
These questions could prompt brief responses even to significant pieces of work. Chemist Dorothy Hodgkin wrote barely 50 words when asked to review the full manuscript of the structure of DNA by Francis Crick and James Watson in 1953, which was published in Proceedings of the Royal Society in April 19541. (A shorter paper announcing the discovery had already appeared in Nature2.)
In her sole comment, beyond a series of yes and no answers, Hodgkin suggests the duo should “touch up” photographs to eliminate distracting reflections of “chairs in the perspex rod” — a technical fix that modern cameras perform routinely. Crick and Watson seemed to follow the advice.
The archive is also littered with long reports, many in handwritten scrawl. In 1877, reviewer Robert Clifton finished a 24-page report on two related papers on optics, with an apology: “How you will hate me for bothering you with this tremendously long letter, but I hope before we meet time will have softened your anger.”
Ferlier says that the introduction of the standardized referee questions significantly reduced the amount of time and effort put in by reviewers. “There’s really this understanding in the nineteenth century and very early twentieth century that the peer review is a real discussion,” she says. “After that, it becomes a way of managing the influx of papers for the journal.”
The article, by David Adam in Nature, is interesting throughout. Via Mike Rosenwald.
My Conversation with Musa al-Gharbi
I am a big fan of Musa’s work, most of all his new book We Have Never Been Woke: The Cultural Contradictions of a New Elite. As for the podcast, here is the video, audio, and transcript. Here is the episode summary:
Tyler and Musa explore the rise and fall of the “Great Awokening” and more, including how elite overproduction fuels social movements, why wokeness tends to fizzle out, whether future waves of wokeness will ratchet up in intensity, why neuroticism seems to be higher on the political Left, how a great awokening would manifest in a Muslim society, Black Muslims and the Nation of Islam, why Musa left Catholicism, who the greatest sociologist of Islam is, Muslim immigration and assimilation in Europe, and more.
Excerpt:
COWEN: Let me give you an alternate theory of the Great Awokening, and tell me what’s wrong with it. It’s not really my view, but I hear it a lot.
So on the Left, there’s some long-term investment in teaching in America’s top universities. You produce a lot of troops who could become journalists, and they’re mostly left-leaning. Then 2011, 2012 — there’s something about the interaction of social media and, say, The New York Times and other major outlets, where all of a sudden they have a much bigger incentive to have a lot of articles about race, gender, Black Lives Matter, whatever. When those two things come together, wokeness takes off based on a background in Christianity and growing feminization of society.
By the time you get to something like 2021, enough of mainstream media has broken down that it’s simply social media out there going crazy. That just gives us a lot of diversity of bizarre views rather than just sheer wokeness — and besides, Elon is owning Twitter, so wokeness ends.
What’s wrong with that account?
AL-GHARBI: For one, I do think that some of the factors that you identified are important for contextualizing the current moment. For instance, a lot of the symbolic professions, like law and consulting, academia, journalism — they are being feminized. I do talk a bit in the book about how this matters for understanding the dynamics in a lot of these institutions. Not just over the last 10 years, but over the last several decades, in part because women and men tend to engage in very different forms of status-seeking and competition and things like that. So that does matter.
Things like social media obviously do change the way interactions play out. But you can see, actually, that things like social media or changes in the media landscape after 2010 — one limitation for using those kinds of explanations to explain the current moment is that it becomes hard, then, to understand how or why it was the case that . . .
There were three previous episodes like this, one in the 1920s through the early ’30s, one in the mid-1960s to the late ’70s, and then one in the late ’80s through early ’90s. In all cases where we didn’t have social media, where the structure of media enterprises was importantly different than it is today, and before you had Gen Z “kids these days” with their idiosyncratic attitudes, or before a lot of these professions were as feminized as they were today.
I think all of those factors you said actually do matter, and they matter in the sense — because each of these episodes, there’s so much in common, an insane amount. When you read the book and I walk through some of these — I think a lot of readers will be troubled, maybe, by how similar these episodes are. But they’re also importantly different. They don’t play out identically. They are importantly different: The role that symbolic capitalists occupy in society changed immensely over the last century. The constitution of these fields has changed immensely. There are a lot more women; there are a lot more nonwhite people in these professions than there were in the past, and so on and so forth.
All of those factors you described: I think they actually do matter, especially for understanding the ways in which this period of awokening might differ from previous episodes, but I don’t think they explain why awokenings happen at all.
COWEN: If “woke” recurs, do you think there’s a ratchet effect where it comes back bigger and stronger each time, a bit like the destructiveness of war? Or is it more of a random walk? Like, the next wave of woke in 37 years might be half as strong as the one we just had. What’s your model?
AL-GHARBI: I think it’s random; that depends a little bit on . . .
What I argue in the book is that the — for instance, when we look at the last period of awokening in the late ’80s and early ’90s, it was much less — that was the last time we had these struggles over what they call political correctness, or the PC culture, which we call wokeness today. As I argue in the book, it didn’t last as long, that awokening. It was shorter than most of the others, actually. Shorter than the one in the ’60s, shorter than the one after 2010. It was a little shorter, and it also wasn’t quite as dramatic.
I think there are these kind of contextual factors that significantly inform how severe it is or how long it lasts, how long it’s able to sustain itself or how long it is until the frustrated elites get — enough of them get satisfied that they disengage. My guess is that it’s more of a random walk, but I’m open to persuasion.
Definitely interesting.
Rick Rubin podcasts with me
Recorded in August in Europe, here is the link. One hour, forty-five minutes, mostly Rick asking me questions about what he would like to hear about from the worlds of economics and politics. We do have I think also another one about music coming up…
Wednesday assorted links
“Life in India is a series of bilateral negotiations”
By Rohit Krishnan:
Life in India is a series of bilateral negotiations conducted a thousand times a day. And that drives the character of life here.
Now, I am seeing the country properly after several years. And it’s a major change.
Visible infrastructure has gotten much better. Roads are good, well maintained, and highways are excellent. They built 7500 miles last year, just as the year before. And they’re fantastic…
But:
Living in a country built off of bilateral negotiations for everything is simultaneously the libertarian dream and an incredibly inefficient way to do most collective things. Ronald Coase told us this in 1960.
“if property rights are well-defined and transaction costs are low, private parties can negotiate solutions to externalities without the need for government intervention”
But Indian life is dominated by transaction costs. Every time a driver pokes his car into a turn when the signal’s not for him it creates friction that ripples through the entire system. Every time someone has to spend effort doing a 1:1 negotiation they lose time and efficiency. Horribly so.
…The reason this isn’t an easy fix is that the ability to negotiate everything is also the positive. When every rule is negotiable you get to push back on silly things like closing off a section of a parking garage with rubber cones by just asking. Life in the West feels highly constricted primarily because of this, we’re all drowning in rules.
Here is the full essay.
How should strong AI alter philanthropy?
That is the theme of my latest Bloomberg column, and here is one bit:
One big change is that AI will enable individuals, or very small groups, to run large projects. By directing AIs, they will be able to create entire think tanks, research centers or businesses. The productivity of small groups of people who are very good at directing AIs will go up by an order of magnitude.
Philanthropists ought to consider giving more support to such people. Of course that is difficult, because right now there are no simple or obvious ways to measure those skills. But that is precisely why philanthropy might play a useful role. More commercially oriented businesses may shy away from making such investments, both because of risk and because the returns are uncertain. Philanthropists do not have such financial requirements.
And this oft-neglected point:
Strong AI capabilities also mean that the world might be much better over some very long time horizon, say 40 years hence. Perhaps there will be amazing new medicines that otherwise would not have come to pass, and as a result people might live 10 years longer. That increases the return — today — to fixing childhood maladies that are hard to reverse. One example would be lead poisoning in children, which can lead to permanent intellectual deficits. Another would be malnutrition. Addressing those problems was already a very good investment, but the brighter the world’s future looks, and the better the prospects for our health, the higher those returns.
The flip side is that reversible problems should probably decline in importance. If we can fix a particular problem today for $10 billion, maybe in 10 years’ time — due to AI — we will be able to fix it for a mere $5 billion. So it will become more important to figure out which problems are truly irreversible. Philanthropists ought to be focused on long time horizons anyway, so they need not be too concerned about how long it will take AI to make our world a fundamentally different place.
Recommended, interesting throughout.