Freakonomics what makes a donor donate

The fact that we can do something, does it mean that we should do something. Whose money is it, though? In the case of Jodi's story, would the kidney have gone to the first patient even if they did not have a partner willing to donate?

Is so, why would the first patients partner agree to donate? Does the algorithm favor longer and longer chains? Does being part of a longer chain improve your unos score? If you are C in this case, why bother having a partner, you would have gotten B's partner's kidney anyway. If you're B the Same thing holds. As a result, this system might suffer from free loader problem, where everyone would benefit from a thickening of the market, but each individual won't, so very few do.

There should be a limit to the length of a chain, for practical reasons. A transplant surgeon can only do one at a time, and even if you had hundreds in town for a convention, then having too many transplants in a single facility on the same day might result in worse care for the patients. Interesting show but one thing you kept bringing up was the "fact" that you have a spare kidney or that donors are unharmed by the operation. I donated a kidney last year and before that had a real hard look at the papers and this is completely unsupported by the data.

Aside from the 1 in chnce of death during the donation and a 1 in 20 chance of a serious complication during the operation tears to bowel, adrenal gland, spleen, nerve damage and a fair chance of post operative hernia or wound infection kidney donors are living with reduced kidney function through the rest of their lives as the other one doesn't pick up all the slack although it does its best.

The comparison they doctors make is that donors live as long or longer than the general population. Unfortunately that doesn't hold water - donors can't be overweight, have high blood pressure, are non smokers etc. And no-one has really done that comparison in a well controlled way despite the decades of living kidney donors. A show on the data supporting and ethics of living kidney, liver and other donations would be really interesting.

To the questions below about living donors going to the top of the list - in the UK you get priority for an organ if you donated while in the US you get additional points in the ranking system but you really don't want to have to rely on it.

After listening to this episode, I began to wonder how could we bring more donors to the market in order to save more lives. The idea that the algorithm can match those in need of a kidney with the donors and the effect of one kidney donor can be multiplied by starting a chain of multiple recipient and donor pairs is an amazing benefit to the system.

But my concern as a healthy individual that may be willing to become a non-directed donor in hopes of starting a chain that could have a positive effect on several lives is that one day someone close to me will need a kidney that I no longer have available. On top of the personal grief that I would feel knowing that I could have helped a loved one, I can imagine my mother-in-law chastising me because her daughter, my wife, is sick and "he already gave his kidney to some stranger 15 years ago".

In order to avoid this situation, is it possible for healthy non-directed donors to receive a "kidney credit" allowing that individual at some time in the future, if the need arises, to move a loved one to the top of the donor list. The problem that I see with this is that if a donor is issued a kidney credit, it seems more liquid and transferrable to the highest bidder than an actual kidney is.

Meaning that I as a person who has willingly given away one of my kidneys may now be swayed by a benefactor to suddenly claim that this person is a long-time family friend that I will allow to use my kidney credit. But then again, what measures are currently in place that keeps someone from paying a willing donor to make this claim and become a paired donor for a specified recipient? I would also like to hear what economists feel are the dangers, benefits, and uncertainties of having a free market for organs.

I am sure this podcast episode will generate a lot of responses, so hopefully we will get a follow-up episode. Your podcasts are great and the books are even better. I look forward to reading "When to Rob a Bank" during my 4th of July vacation weekend. I found this episode to have particularly low bandwidth.

While the interviews were cute, they were not as informative as an in depth discussion of the facts. And we never really heard Al Roth discuss his theories in any detail. All in all, the useful information could have been revealed in 5 minutes, rather than I don't have time for these "chatty" podcasts, although they seem to be increasingly popular. For more information on the people and ideas in the episode, see the links at the bottom of this post. For many years, Roth had taught economics at Harvard.

ROTH: We had just moved into our new apartment. We had moved to Stanford in September of We only had one phone at that point and it was in her office, which was downstairs. And she went down and got the phone and it started ringing again. And it was the Nobel Committee. So indeed, we had- we were asleep. We were not waiting for a call. ROTH: Exactly. Get ready. Are you ready? You said something a little odd. That this was a surprise and it was a Monday and I teach on Mondays.

He has helped people who need a kidney transplant find a donor. You should tell all your listeners they should complete high school. ROTH: I mean, my degrees are in engineering. ROTH: Market design is an ancient human activity. You know, when you look at a distribution of stone tools around the Middle East and Europe, you find that long before the invention of agriculture, stone tools were moving thousands of miles from where they were quarried and made. But the stone tools, which are very durable, are evidence that markets are older than agriculture.

But the Stone Age men who traded those stone tools and weapons had to make markets somehow. They had to make them safe. They had to feel confident that they could bring the things that they would trade for those stone tools and not be robbed by guys with stone axes who would take their stuff.

Today we think about fraud and identity theft and securing your credit card. So if I were the king of England and I wanted to have markets in England, I had to make sure that the roads were safe to get to the markets.

In this regard, the invention of money was a big breakthrough. ROTH: Barter is very hard because you need a double coincidence of wants.

You need to find someone who has what you want and who wants what you have. ROTH: Right. Well, so finding the third party starts getting you involved in other things. And, of course, money is a great market-design invention for helping you find third parties because you can sell what you have for money and then go look for what you want. But there are some transactions — entire realms of transactions, really — where money cannot do what it does in a typical market.

Where, for whatever reason, supply is not allowed to naturally meet demand with price as the arbiter. The economist as engineer. Because these atypical markets have to be set up differently, they have to be helped along. So job markets are like that, getting into college is like that. Or think about this problem, which Al Roth has worked on directly: what is the best way for hospitals to hire newly minted doctors, and for those doctors to find the most appropriate hospital for them to work in?

The current system is called the National Resident Matching Program :. But you have to go back to the s to understand how doctors get jobs. And the s is around the time when the medical degrees as we know them, the MD degree, became the dominant medical degree. ROTH: The first job — the standard first job — for medical graduates became what was called an internship, and is today called a residency.

As Roth tells it, there was an arms race between hospitals for the best future doctors. They began grabbing medical students earlier and earlier — sometimes two years before graduation. And what that form was…you go on interviews and you find out the salary and the working conditions of the various jobs that you might be offered and then, instead of working the phones and maybe getting an offer that says you have to take it — yes or no right now on the phone — what you do is you consider in advance which jobs you would like and you submit a rank order preference.

And the jobs do the same thing, the hospital residency programs do the same thing. And then a match is made in a centralized clearinghouse. By the s, this system was showing strain. Some people thought the hospitals had too much leverage over the residents.

Also: by now, there were a lot more female medical students, some of whom had a significant other who was also a medical student — and such a couple typically wanted to get a residency in the same hospital, or at least the same region. So those candidates might opt out.

In , Al Roth was asked to help write an algorithm that could fix these problems. The algorithm worked well and it now matches more than 20, applicants each year. Most people involved in this scenario are pretty happy with how it works, correct? ROTH: Well, labor markets are stressful for everyone. So I think you are overstating how happy people are with the labor market. But I think it works pretty well.

Or at least an improvement over what was before? If we consider the medical residency matching program relatively successful to what preceded it, at least, why is it not used more widely in the labor markets? ROTH: Well, the medical market is an easier one to coordinate than many markets because just about everyone becomes available at the same time when they graduate from medical school and they all start their jobs therefore about the same time in July.

Whereas many markets, think about the market for journalists, they might be hired at different moments and jobs might become available and need to be filled and not be able to wait for you to consider many jobs. I would think you could deal with rolling admissions, is that right? I mean, hiring practice has become more and more complicated it seems as one way to address the matching problem.

But it seems as though your complicated mathematical foundation might provide, ironically, a simpler way to address that problem. And one of the things that we do in the medical match is we make all the jobs available at the same time that allows you to consider them, to have preferences over them.

ROTH: Well, the markets for new lawyers might fall into that category and certainly the most- the fanciest job that top graduates of elite law schools get is a lot like a medical residency.

That market is presently in the kind of situation that the doctor market was around , where jobs are being contracted far before law school graduation. Judges are a law unto themselves, and they break the rules. They cheat. You know, so the middle of their second year and a half before they are ready to graduate. ROTH: Well the question is, is there a desire for judges to coordinate in a way that would control the market? As complicated as it may seem to match future lawyers or doctors with their employers, consider an even more complicated match: a person who will die unless they can get a kidney transplant.

According to the National Kidney Foundation, out of the roughly , people awaiting an organ transplant, more than , of them, roughly 80 percent, need a kidney. And so the list is ever-growing, but the number of kidneys available for transplant is pretty stagnant.

Why is that? It is my honest belief that stopping any kind of public wellfare and demanding taxes for it, would lead to in fact more money being given to the poor. Not to mention many proven positive side-effects.

On one hand, some people would start to donate, to avoid being socially punished. On the other hand however, probably an equal or even higher number of people would stop what little the already donate or stop thinking about starting to donate.

Just as it is with bringing up kids: Reward beats punishment. So "outing" and honoring people to a great and public extend which engage themselves in charity would accomplish much more imho. How do we have any idea what Rupert Murdoch gives?

Maybe he does things anonymously. It is unfair and mean to pick on an individual when we do not know what they really do. Maybe Jobs gave a lot away anonymously but maybe because he started poor he had different thoughts about his fortune and used it a different way. Who are we to judge? What is the research behind offering raffles as an incentive to give? Have any studies actually found an increase in donations because of the raffles? Interesting thought.

I wonder if there is any source where I could go deeper into the findings made by the Freakonomics team? How likely is it that this conversation is happening in more than one universe? Should we worry more about Covid or about nuclear war? Is economics a form Every year, thousands of people in the U.