Dynamic Incentives in Wait List Mechanisms

摘要

Many scarce public resources are allocated through a wait list. A particularly salient example is the kidney wait list in the United States, which now has almost 100,000 patients waiting for a lifesaving transplant.While the design of such systems has garnered significant research attention, most theoretical results yield answers that depend on the primitives of the market (compare Su and Zenios 2004; Leshno 2017; Bloch and Cantala 2017). Moreover, the state of the art empirical methods used to prospectively evaluate wait list designs do not incorporate the dynamic incentives that are central to the theoretical literature. Perhaps the most prominent example of an empirically guided redesign is the 2014 reform of the deceased donor kidney allocation system. The kidney committee used the Kidney-Pancreas Simulated Acceptance Module (KPSAM) to predict the transplants that would result from various organ allocation rules. KPSAM allowed the committee to experiment with the priority system, evaluate outcomes and make an informed decision. However, this decision tool simplifies patient acceptance behavior by assuming that it is invariant to priority rules and therefore ignores patients' dynamic incentives.