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Fair Allocation of Vaccines, Ventilators and Antiviral Treatments: Leaving No Ethical Value Behind in Healthcare Rationing

Author

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  • Parag A. Pathak

    (Department of Economics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139; National Bureau of Economic Research, Cambridge, Massachusetts 02138)

  • Tayfun Sönmez

    (Department of Economics, Boston College, Chestnut Hill, Massachusetts 02467)

  • M. Utku Ünver

    (Department of Economics, Boston College, Chestnut Hill, Massachusetts 02467; Deakin University, Burwood, 3125 Victoria, Australia)

  • M. Bumin Yenmez

    (Department of Economics, Boston College, Chestnut Hill, Massachusetts 02467)

Abstract

A priority system has traditionally been the protocol of choice for the allocation of scarce life-saving resources during public health emergencies. COVID-19 revealed the limitations of this allocation rule. Many argue that priority systems abandon ethical values, such as equity, by discriminating against disadvantaged communities. We show that a restrictive feature of the traditional priority system largely drives these limitations. Following minimalist market design , an institution design paradigm that integrates research and policy efforts, we formulate pandemic allocation of scarce life-saving resources as a new application of market design. Interfering only with the restrictive feature of the priority system to address its shortcomings, we formulate a reserve system as an alternative allocation rule. Our theoretical analysis develops a general theory of reserve design. We relate our analysis to debates during COVID-19 and describe the impact of our paper on policy and practice.

Suggested Citation

  • Parag A. Pathak & Tayfun Sönmez & M. Utku Ünver & M. Bumin Yenmez, 2024. "Fair Allocation of Vaccines, Ventilators and Antiviral Treatments: Leaving No Ethical Value Behind in Healthcare Rationing," Management Science, INFORMS, vol. 70(6), pages 3999-4036, June.
    • Handle: RePEc:inm:ormnsc:v:70:y:2024:i:6:p:3999-4036
    DOI: 10.1287/mnsc.2022.00930
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    Citations

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    Cited by:

    1. Parag A. Pathak & Harald Schmidt & Adam Solomon & Edwin Song & Tayfun Sönmez & M. Utku Ünver, 2020. "Do Black and Indigenous Communities Receive their Fair Share of Vaccines Under the 2018 CDC Guidelines?," Boston College Working Papers in Economics 1019, Boston College Department of Economics.
    2. Parag Pathak & Govind Persad & Tayfun Sönmez & M Utku Ünver, 2022. "Reserve system design for allocation of scarce medical resources in a pandemic: some perspectives from the field," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 38(4), pages 924-940.
    3. Nikhil Vellodi & Joshua Weiss, 2021. "Optimal Vaccine Policies: Spillovers and Incentives," Working Paper 21-06, Federal Reserve Bank of Richmond.
    4. In'acio B'o & Li Chen, 2021. "Designing Heaven's Will: The job assignment in the Chinese imperial civil service," Papers 2105.02457, arXiv.org, revised Sep 2021.
    5. Avataneo, Michelle & Turhan, Bertan, 2021. "Slot-specific priorities with capacity transfers," Games and Economic Behavior, Elsevier, vol. 129(C), pages 536-548.
    6. Babus, Ana & Das, Sanmay & Lee, SangMok, 2023. "The optimal allocation of Covid-19 vaccines," Economics Letters, Elsevier, vol. 224(C).
    7. Tayfun Sonmez, 2023. "Minimalist Market Design: A Framework for Economists with Policy Aspirations," Papers 2401.00307, arXiv.org.
    8. Wei-Cheng Chen & Lin Chen & Yi-Cheng Kao, 2024. "Efficient mask allocation during a pandemic," Review of Economic Design, Springer;Society for Economic Design, vol. 28(2), pages 275-311, June.
    9. Liang Guo & Wendy Xu, 2023. "“We Are the World”: When More Equality Improves Efficiency and Antipandemic Consumptions Are Intervened," Marketing Science, INFORMS, vol. 42(2), pages 214-232, March.
    10. Scott Duke Kominers & Alex Tabarrok, 2022. "Vaccines and the Covid-19 pandemic: lessons from failure and success," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 38(4), pages 719-741.
    11. Almeer, Abdullah & Dur, Umut & Harris, Will & Hauser, Greg & Phan, William & Zhang, Yanning, 2024. "Increasing the representation of a targeted type in a reserve system," Mathematical Social Sciences, Elsevier, vol. 129(C), pages 34-41.
    12. Dur, Umut & Zhang, Yanning, 2023. "Fairness under affirmative action policies with overlapping reserves," Journal of Mathematical Economics, Elsevier, vol. 109(C).
    13. Muhammad Maaz, 2020. "Saturating stable matchings," Papers 2011.06046, arXiv.org, revised Mar 2021.
    14. Tayfun Sönmez & M. Bumin Yenmez, 2019. "Can Economic Theory be Informative for the Judiciary? Affirmative Action in India via Vertical and Horizontal Reservations," Boston College Working Papers in Economics 1026, Boston College Department of Economics, revised 23 Jun 2021.
    15. Haris Aziz & Florian Brandl, 2021. "Efficient, Fair, and Incentive-Compatible Healthcare Rationing," Papers 2102.04384, arXiv.org, revised Sep 2021.

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    More about this item

    Keywords

    crisis standards of care; triage; multiprinciple allocation framework; minimalist market design; reserve system; COVID-19;
    All these keywords.

    JEL classification:

    • D45 - Microeconomics - - Market Structure, Pricing, and Design - - - Rationing; Licensing
    • D47 - Microeconomics - - Market Structure, Pricing, and Design - - - Market Design
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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