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Paying for Kidneys? A Randomized Survey and Choice Experiment

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  • Julio J. Elias
  • Nicola Lacetera
  • Mario Macis

Abstract

Legislation and public policies are often the result of competition and compromise between different views and interests. In several cases, strongly held moral beliefs voiced by societal groups lead lawmakers to prohibit certain transactions or to prevent them from occurring through markets. However, there is limited evidence about the specific nature of the general population’s opposition to using prices in such contentious transactions. We conducted a randomized survey with 2,666 American residents to study preferences for legalizing payments to kidney donors. We found strong polarization, with many participants supporting or opposing payments regardless of potential transplant gains. However, about 18 percent of respondents would switch to favoring payments for sufficiently large increases in transplants. Preferences for compensation have strong moral foundations; participants especially reject direct payments by patients, which they find would violate principles of fairness. We corroborate the interpretation of our findings with a choice experiment of a costly decision to donate money to a foundation that supports donor compensation.

Suggested Citation

  • Julio J. Elias & Nicola Lacetera & Mario Macis, 2019. "Paying for Kidneys? A Randomized Survey and Choice Experiment," NBER Working Papers 25581, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:25581
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    1. Smith, Adam, 1759. "The Theory of Moral Sentiments," History of Economic Thought Books, McMaster University Archive for the History of Economic Thought, number smith1759.
    2. Gary S. Becker & Julio Jorge Elías, 2007. "Introducing Incentives in the Market for Live and Cadaveric Organ Donations," Journal of Economic Perspectives, American Economic Association, vol. 21(3), pages 3-24, Summer.
    3. Roth, Alvin E. & Leider, Stephen, 2010. "Kidneys For Sale: Who Disapproves, and Why?," Scholarly Articles 5128483, Harvard University Department of Economics.
    4. Christian A. Vossler & Maurice Doyon & Daniel Rondeau, 2012. "Truth in Consequentiality: Theory and Field Evidence on Discrete Choice Experiments," American Economic Journal: Microeconomics, American Economic Association, vol. 4(4), pages 145-171, November.
    5. Roland Benabou & Jean Tirole, 2009. "Over My Dead Body: Bargaining and the Price of Dignity," American Economic Review, American Economic Association, vol. 99(2), pages 459-465, May.
    6. Roland Bénabou & Jean Tirole, 2011. "Identity, Morals, and Taboos: Beliefs as Assets," The Quarterly Journal of Economics, Oxford University Press, vol. 126(2), pages 805-855.
    7. Brian A. Jacob & Steven D. Levitt, 2003. "Rotten Apples: An Investigation of the Prevalence and Predictors of Teacher Cheating," The Quarterly Journal of Economics, Oxford University Press, vol. 118(3), pages 843-877.
    8. Uri Gneezy, 2005. "Deception: The Role of Consequences," American Economic Review, American Economic Association, vol. 95(1), pages 384-394, March.
    9. George A. Akerlof & Rachel E. Kranton, 2000. "Economics and Identity," The Quarterly Journal of Economics, Oxford University Press, vol. 115(3), pages 715-753.
    10. Alberto Alesina & Stefanie Stantcheva & Edoardo Teso, 2018. "Intergenerational Mobility and Preferences for Redistribution," American Economic Review, American Economic Association, vol. 108(2), pages 521-554, February.
    11. Scott Cunningham & Manisha Shah, 2018. "Decriminalizing Indoor Prostitution: Implications for Sexual Violence and Public Health," Review of Economic Studies, Oxford University Press, vol. 85(3), pages 1683-1715.
    12. Rajna Gibson & Carmen Tanner & Alexander F. Wagner, 2013. "Preferences for Truthfulness: Heterogeneity among and within Individuals," American Economic Review, American Economic Association, vol. 103(1), pages 532-548, February.
    13. Avraham Stoler & Judd B. Kessler & Tamar Ashkenazi & Alvin E. Roth & Jacob Lavee, 2017. "Incentivizing Organ Donor Registrations with Organ Allocation Priority," Health Economics, John Wiley & Sons, Ltd., vol. 26(4), pages 500-510, April.
    14. Björn Bartling & Yagiz Özdemir, 2017. "The limits to moral erosion in markets: social norms and the replacement excuse," ECON - Working Papers 263, Department of Economics - University of Zurich.
    15. Daniel J. Benjamin & Ori Heffetz & Miles S. Kimball & Nichole Szembrot, 2014. "Beyond Happiness and Satisfaction: Toward Well-Being Indices Based on Stated Preference," American Economic Review, American Economic Association, vol. 104(9), pages 2698-2735, September.
    16. A. Alesina & P. Giuliano., 2016. "Culture and institutions," VOPROSY ECONOMIKI, N.P. Redaktsiya zhurnala "Voprosy Economiki", vol. 10.
    17. Richard T. Carson, 2012. "Contingent Valuation: A Practical Alternative When Prices Aren't Available," Journal of Economic Perspectives, American Economic Association, vol. 26(4), pages 27-42, Fall.
    18. Ilyana Kuziemko & Michael I. Norton & Emmanuel Saez & Stefanie Stantcheva, 2015. "How Elastic Are Preferences for Redistribution? Evidence from Randomized Survey Experiments," American Economic Review, American Economic Association, vol. 105(4), pages 1478-1508, April.
    19. Daniel J. Benjamin & James J. Choi & Geoffrey Fisher, 2016. "Religious Identity and Economic Behavior," The Review of Economics and Statistics, MIT Press, vol. 98(4), pages 617-637, October.
    20. Leonardo Bursztyn & Georgy Egorov & Stefano Fiorin, 2017. "From Extreme to Mainstream: How Social Norms Unravel," NBER Working Papers 23415, National Bureau of Economic Research, Inc.
    21. César Martinelli & Susan W. Parker & Ana Cristina Pérez-Gea & Rodimiro Rodrigo, 2018. "Cheating and Incentives: Learning from a Policy Experiment," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 298-325, February.
    22. Alvin E. Roth, 2007. "Repugnance as a Constraint on Markets," Journal of Economic Perspectives, American Economic Association, vol. 21(3), pages 37-58, Summer.
    23. Sen, Amaryta, 1999. "On Ethics and Economics," OUP Catalogue, Oxford University Press, number 9780195627619.
    24. Björn Bartling & Roberto A. Weber & Lan Yao, 2015. "Do Markets Erode Social Responsibility?," The Quarterly Journal of Economics, Oxford University Press, vol. 130(1), pages 219-266.
    25. A Falk & T Neuber & N Szech, 2020. "Diffusion of Being Pivotal and Immoral Outcomes," Review of Economic Studies, Oxford University Press, vol. 87(5), pages 2205-2229.
    26. Richard Carson & Theodore Groves, 2007. "Incentive and informational properties of preference questions," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 37(1), pages 181-210, May.
    27. Kaushik Basu, 2007. "Coercion, contract and the limits of the market," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 29(4), pages 559-579, December.
    28. Daniel J. Benjamin & Ori Heffetz & Miles S. Kimball & Alex Rees-Jones, 2014. "Can Marginal Rates of Substitution Be Inferred from Happiness Data? Evidence from Residency Choices," American Economic Review, American Economic Association, vol. 104(11), pages 3498-3528, November.
    29. Wagner, Alfred, 1891. "Marshall's Principles of Economics," History of Economic Thought Articles, McMaster University Archive for the History of Economic Thought, vol. 5, pages 319-338.
    30. Dan Ariely & George Loewenstein & Drazen Prelec, 2003. ""Coherent Arbitrariness": Stable Demand Curves Without Stable Preferences," The Quarterly Journal of Economics, Oxford University Press, vol. 118(1), pages 73-106.
    31. Daniel J. Benjamin & Ori Heffetz & Miles S. Kimball & Alex Rees-Jones, 2012. "What Do You Think Would Make You Happier? What Do You Think You Would Choose?," American Economic Review, American Economic Association, vol. 102(5), pages 2083-2110, August.
    32. James Andreoni & Charles Sprenger, 2012. "Risk Preferences Are Not Time Preferences," American Economic Review, American Economic Association, vol. 102(7), pages 3357-3376, December.
    33. Judd B. Kessler & Alvin E. Roth, 2012. "Organ Allocation Policy and the Decision to Donate," American Economic Review, American Economic Association, vol. 102(5), pages 2018-2047, August.
    34. Bénabou, Roland & Ticchi, Davide & Vindigni, Andrea, 2015. "Forbidden Fruits: The Political Economy of Science, Religion, and Growth," CEPR Discussion Papers 10548, C.E.P.R. Discussion Papers.
    35. Marina Agranov & Pietro Ortoleva, 2017. "Stochastic Choice and Preferences for Randomization," Journal of Political Economy, University of Chicago Press, vol. 125(1), pages 40-68.
    36. Rachel Croson & Uri Gneezy, 2009. "Gender Differences in Preferences," Journal of Economic Literature, American Economic Association, vol. 47(2), pages 448-474, June.
    37. Satz, Debra, 2010. "Why Some Things Should Not Be for Sale: The Moral Limits of Markets," OUP Catalogue, Oxford University Press, number 9780195311594.
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    1. Chris Sampson’s journal round-up for 19th August 2019
      by Chris Sampson in The Academic Health Economists' Blog on 2019-08-19 11:00:02

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    1. Johanna Catherine Maclean & John Buckell, 2021. "Information and sin goods: Experimental evidence on cigarettes," Health Economics, John Wiley & Sons, Ltd., vol. 30(2), pages 289-310, February.
    2. Niu, Xiaofei & Li, Jianbiao, 2020. "Incentivizing organ donation by swearing an oath: The role of signature and ritual," EconStor Preprints 203243, ZBW - Leibniz Information Centre for Economics.
    3. Riehm, Tobias & Fugger, Nicolas & Gillen, Philippe & Gretschko, Vitali & Werner, Peter, 2021. "Social norms and market behavior: Evidence from a large population sample," ZEW Discussion Papers 21-017, ZEW - Leibniz Centre for European Economic Research.
    4. Zawojska, Ewa & Gastineau, Pascal & Mahieu, Pierre-Alexandre & Cheze, Benoit & Paris, Anthony, 2021. "Measuring policy consequentiality perceptions in stated preference surveys," 2021 Annual Meeting, August 1-3, Austin, Texas 313977, Agricultural and Applied Economics Association.
    5. Viola S. Ackfeld, 2020. "The Aversion to Monetary Incentives for Changing Behavior," Working Paper Series in Economics 100, University of Cologne, Department of Economics.
    6. Stith, Sarah S. & Li, Xiaoxue, 2021. "Does increasing access-to-care delay accessing of care? Evidence from kidney transplantation," Economics & Human Biology, Elsevier, vol. 41(C).
    7. Vecchi, Martina & Jaenicke, Edward C., 2021. "Local food in times of crisis: the impact of Covid-19 and two reinforcing primes," 2021 Annual Meeting, August 1-3, Austin, Texas 313958, Agricultural and Applied Economics Association.
    8. Yokoo, Hide-Fumi & 横尾, 英史, 2020. "Ethics of randomized field experiments: Evidence from a randomized survey experiment," Discussion Papers 2020-07, Graduate School of Economics, Hitotsubashi University.

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    More about this item

    JEL classification:

    • D01 - Microeconomics - - General - - - Microeconomic Behavior: Underlying Principles
    • D47 - Microeconomics - - Market Structure, Pricing, and Design - - - Market Design
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • D64 - Microeconomics - - Welfare Economics - - - Altruism; Philanthropy; Intergenerational Transfers
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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