Monday, May 21, 2018

Safe injection sites in New York City? Learning from Canada...

The NY Times has two recent stories, one perhaps a reaction to the other.  First this:
De Blasio Moves to Bring Safe Injection Sites to New York City

"Mayor Bill de Blasio is championing a plan that would make New York City a pioneer in creating supervised injection sites for illegal drug users, part of a novel but contentious strategy to combat the epidemic of fatal overdoses caused by the use of heroin and other opioids.
"Safe injection sites have been considered successful in cities in Canadaand Europe, but do not yet exist in the United States. Leaders in San Francisco, Philadelphia and Seattle have declared their intention to create supervised sites, although none have yet done so because of daunting obstacles. Among them: The sites would seem to violate federal law.
"The endorsement of the strategy by New York, the largest city in the country, which last year saw 1,441 overdose deaths, may give the movement behind it impetus.
"For the sites to open, New York City must still clear some significant hurdles. At minimum, the plan calls for the support of several district attorneys, and, more critically, the State Department of Health, which answers to Gov. Andrew M. Cuomo. The city sent a letter on Thursday to the state, asserting its intention to open four injection centers.

"The most serious obstacle to the safe injection sites may be the federal government. A section of federal law known as the crack house statute makes it illegal to own, rent or operate a location for the purpose of unlawfully using a controlled substance.
The enforcement of the statute in the case of safe injection sites, however, would be up to the discretion of federal authorities. While it is unclear how the Trump Justice Department will respond to the city’s proposal, the attorney general, Jeff Sessions, has taken a hard line on drug policy.
“We don’t believe a president who has routinely voiced concern about the national opioid epidemic will use finite federal law enforcement resources to prevent New York City from saving lives,” Eric F. Phillips, the mayor’s press secretary, said in a written statement.
Advocates for the sites point out that needle exchanges were considered illegal when they began, and they are now commonplace; in 2015, for example, when Mike Pence was governor of Indiana, he put aside his moral opposition to needle exchanges and allowed a program to stem the flood of H.I.V. cases."
And, today, this:
Opioid Crisis Compels New York to Look North for Answers
Supervised injection sites for heroin users have prevented overdose deaths in Canada. But is New York City ready for the scenes that come with them?

"As Mayor Bill de Blasio has come out in support of supervised injection centers in New York, his stance has been shaped by Canada’s lead.
The country has been a pioneer; its first supervised injection facility, where heroin can be used under supervision, opened in Vancouver in 2003. A decade of political and legal wrangling followed, culminating with the Canadian Supreme Court ruling in favor of the approach in 2011."

Sunday, May 20, 2018

A quick look back at the politics of electricity markets

This, from the RTO Insider, which bills itself as "Your Eyes and Ears on the Organized Electric Markets."

Former FERC Chairs Reminisce, Sound Off at EBA

"The Energy Bar Association closed its annual meeting last week with a panel discussion with five former FERC chairs whose terms collectively spanned two decades. The former chairs offered entertaining anecdotes about the past while expressing pride over the growth of competitive markets — and frustration over forces they said threaten them."

Saturday, May 19, 2018

Afshin Nikzad defends (x2)

Defense 2, (Offense 0).
Afshin Nikzad defended twice in eight days, to qualify for two Ph.D.s, one from Management Science and Engineering, in Operations Research, and one from Economics (in economics:).  Here are photos from his Economics defense.

Afshin Nikzad and some of his admirers: Philip Strack, Fuhito Kojima, Daniela Saban, Niloufar Salehi, Al Roth, Afshin, Paul Milgrom, and Itai Ashlagi

The papers he presented for his Economics defense were
Thickness and Competition in Ride-sharing Markets 
Financing Transplant Costs of the Poor: A Dynamic Model of Global Kidney Exchange 

The papers he presented for his MS&E defense were 
Approximate Random Allocation Mechanisms 
What matters in tie-breaking rules? How competition guides design 

Welcome to the club(s), Afshin

Friday, May 18, 2018

Eric Budish on (expensive) blockchain technology

The Economic Limits of the Blockchain
by Eric Budish
May 3, 2018

Abstract: The amount of computational power devoted to blockchains such as Bitcoin’s must simultaneously satisfy two conditions in equilibrium: (1) a zero-profit condition among miners,who engage in a rent-seeking competition for the prize associated with adding the next block to the chain; and (2) an incentive compatibility condition on the system’s vulnerability to a“majority attack”, namely that the computational costs of such an attack must exceed the benefits. Together, these two equations imply that (3) the recurring, “flow”, payments to miners for running the blockchain must be large relative to the one-off, “stock”, benefits of attacking it. The constraint is softer (i.e., stock versus stock) if both (i) the mining technology used to run the blockchain is both scarce and non-repurposable, and (ii) any majority attack is a “sabotage” in that it causes a collapse in the economic value of the blockchain; however, reliance on non-repurposable technology for security and vulnerability to sabotage each raise their own concerns, and point to specific collapse scenarios. Overall the results place potentially serious economic constraints on the applicability of the Nakamoto (2008) blockchain innovation. The anonymous, decentralized trust enabled by the blockchain, while ingenious, is expensive.

Thursday, May 17, 2018

Liver exchange in the U.S.?

 From  Liver Transplantation 24 677–686 2018 

Liver paired exchange: Can the liver emulate the kidney?
Ashish Mishra  Alexis Lo  Grace S. Lee  Benjamin Samstein  Peter S. Yoo Matthew H. Levine  David S. Goldberg  Abraham Shaked  Kim M. Olthoff Peter L. Abt

Abstract: Kidney paired exchange (KPE) constitutes 12% of all living donor kidney transplantations (LDKTs) in the United States. The success of KPE programs has prompted many in the liver transplant community to consider the possibility of liver paired exchange (LPE). Though the idea seems promising, the application has been limited to a handful of centers in Asia. In this article, we consider the indications, logistical issues, and ethics for establishing a LPE program in the United States with reference to the principles and advances developed from experience with KPE. 

"The potential number of donor and recipient pairs that might be suitable for LPE in the United States is unknown and is dependent on numerous factors. However, the Asan Medical Center experience from South Korea provides some perspective; among 2182 LDLT patients, 26 involved LPE.3 In the United States, most donors selected for LPE will likely be those where the donor is appropriate to donate with regard to the usual anatomical, medical, and psychosocial dimensions, but for 1 reason or another not appropriate for his or her intended recipient. Centers that evaluate living liver donors follow a stepwise approach to determining eligibility for donation. Some donors are rejected early in the evaluation process for obesity or other comorbidities, age, or being psychosocially unfit to proceed with donation.16, 17 Those who pass the initial screening process are assessed further for blood type, liver volumes, and other anatomical considerations, as well as general medical and psychosocial concerns. The donors who are rejected at this stage in the evaluation are the ones who could be considered for LPE. It is estimated that 3.5%‐17.0% of donors are rejected for ABOi, 4.1%‐14.0% for inadequate hepatic mass to support the recipient, and 1.5%‐6.0% due to vascular or biliary anatomic variations.17-20 There is considerable variation of these estimates based on the order of tests and the screening processes used to evaluate potential donors based on transplant center‐specific donor criteria. These barriers to donation represent opportunities for a variety of exchanges between donor and recipient pairs, such that the total number of lives saved through LDLT could be increased."

Examples of Potential LPE

In the following section, we provide some examples of potential LPE. If the history of KPE serves as a guide for the trajectory of LPE, the number of pairs involved, the indications for participation, and the complexity of exchanges are likely to increase (Fig. 2).
  1. Two‐way swap: ABOi pair and a pair where the estimated weight of the donor lobe is inadequate for the intended recipient (Fig. 2A).
  2. Three‐way swap: ABO compatible pair where the remnant volume is too small for the donor; ABOi donor to small child where the left lateral segment (LLS) is also too large for the child; and an ABOi pair (Fig. 2B).
  3. Nondirected donor starts a chain (Fig. 2C).
  4. Patient with familial amyloid polyneuropathy (FAP) receives a deceased donor organ or LDLT and starts a chain with a domino liver (Fig. 2D).

Wednesday, May 16, 2018

"Economics that works" in Bloomberg, celebrates Parag Pathak as a reply to some critics of economics

A Top Econ Prize for a Theory That Works
This economist figured out a better way to assign students to public schools.
By Noah Smith, May 15

Here are the opening lines:

"What do people think economic theorists do? The pundits who regularly criticize the profession, particularly in the pages of British magazines, seem to think that they spend all their time making abstruse, unrealistic theories about how free markets are the best of all possible worlds. And it's true that there are still a few economists out there who are essentially doing that. But a lot of theorists are doing something much more humble and practical work on small-bore theories that can be immediately applied to make the real world a little more efficient.

Parag Pathak is a theorist of this latter type. "

And here are the closing lines (what's in between is well worth reading too:)

"In an age when bashing economics is in vogue, the critics should pay attention to researchers like Pathak. Their theories are not as grandiose as the macroeconomic ideas that appear in the press — but they really work, and every day they improve people’s lives."

Tuesday, May 15, 2018

Dick Thaler reflects on nuts to nudges--The economist as story teller

Some Thaler stories, from the horse's mouth

Behavioral economics from nuts to ‘nudges’
A bowl of cashews led to a research breakthrough
by Richard H. Thaler

"People think in stories, or at least I do. My research in the field now known as behavioral economics started from real-life stories I observed while I was a graduate student at the University of Rochester. Economists often sneer at anecdotal data, and I had less than that—a collection of anecdotes without a hint of data. Yet each story captured something about human behavior that seemed inconsistent with the economic theory I was struggling to master in graduate school. Here are a few examples:..."