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Gaming the Liver Transplant Market

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  • Jason Snyder

Abstract

The liver transplant waiting list is designed to allocate livers to the sickest patients first. Before March 1, 2002, livers were allocated to patients based on objective clinical indicators and subjective factors. In particular, a center placing a prospective transplant recipient in the intensive care unit (ICU) leads to a higher position on the liver transplant waiting list. After March 1, 2002, a policy reform mandated that priority on the liver transplant waiting list no longer be influenced by whether the patient was in the ICU. I show that after the reform, ICU usage declined most precipitously in areas with multiple transplant centers. I find no evidence that pervasive manipulation in the most crowded liver transplant markets distorted the allocation of livers away from the intended prioritization of the sickest patients first. It appears that centers in areas with multiple competitors manipulated the waiting list to ensure that the sickest patients received a liver. The Author 2010. Published by Oxford University Press on behalf of Yale University. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org, Oxford University Press.

Suggested Citation

  • Jason Snyder, 2010. "Gaming the Liver Transplant Market," The Journal of Law, Economics, and Organization, Oxford University Press, vol. 26(3), pages 546-568.
    • Handle: RePEc:oup:jleorg:v:26:y::i:3:p:546-568
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    File URL: http://hdl.handle.net/10.1093/jleo/ewq003
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    Citations

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    Cited by:

    1. Lamar Pierce & Jason Snyder, 2015. "Unethical Demand and Employee Turnover," Journal of Business Ethics, Springer, vol. 131(4), pages 853-869, November.
    2. Wiltermuth, Scott S. & Bennett, Victor M. & Pierce, Lamar, 2013. "Doing as they would do: How the perceived ethical preferences of third-party beneficiaries impact ethical decision-making," Organizational Behavior and Human Decision Processes, Elsevier, vol. 122(2), pages 280-290.
    3. Osmis Areda Habte & Håkan J. Holm, 2022. "Competition Makes Inspectors More Lenient: Evidence from the Motor Vehicle Inspection Market," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 61(1), pages 45-72, August.
    4. Janssen, Aljoscha & Zhang, Xuan, 2020. "Retail Pharmacies and Drug Diversion during the Opioid Epidemic," Working Paper Series 1373, Research Institute of Industrial Economics.
    5. Simon, Daniel H. & Prince, Jeffrey T., 2016. "The effect of competition on toxic pollution releases," Journal of Environmental Economics and Management, Elsevier, vol. 79(C), pages 40-54.
    6. Vanessa C. Burbano & John Mamer & Jason Snyder, 2018. "Pro bono as a human capital learning and screening mechanism: Evidence from law firms," Strategic Management Journal, Wiley Blackwell, vol. 39(11), pages 2899-2920, November.
    7. Bradford Baker & Rellie Derfler-Rozin & Marko Pitesa & Michael Johnson, 2019. "Stock Market Responses to Unethical Behavior in Organizations: An Organizational Context Model," Organization Science, INFORMS, vol. 30(2), pages 319-336, March.
    8. Victor Manuel Bennett & Lamar Pierce & Jason A. Snyder & Michael W. Toffel, 2012. "Competition and Illicit Quality," Harvard Business School Working Papers 12-071, Harvard Business School, revised May 2012.
    9. Paarsch, Harry J. & Segre, Alberto M. & Roberts, John P. & Halldorson, Jeffrey B., 2011. "Competition and Post-Transplant Outcomes in Cadaveric Liver Transplantation under the MELD Scoring System," CIS Discussion paper series 522, Center for Intergenerational Studies, Institute of Economic Research, Hitotsubashi University.
    10. John, Leslie K. & Loewenstein, George & Rick, Scott I., 2014. "Cheating more for less: Upward social comparisons motivate the poorly compensated to cheat," Organizational Behavior and Human Decision Processes, Elsevier, vol. 123(2), pages 101-109.
    11. Pierce, Lamar & Rogers, Todd & Snyder, Jason A., 2015. "Losing Hurts: The Happiness Impact of Partisan Electoral Loss," Working Paper Series rwp14-051, Harvard University, John F. Kennedy School of Government.
    12. Victor Manuel Bennett & Lamar Pierce & Jason A. Snyder & Michael W. Toffel, 2013. "Customer-Driven Misconduct: How Competition Corrupts Business Practices," Management Science, INFORMS, vol. 59(8), pages 1725-1742, August.
    13. Burbano, Vanessa C. & Ostler, James, 2021. "Differences in consumer-benefiting misconduct by nonprofit, for-profit, and public organizations," Organizational Behavior and Human Decision Processes, Elsevier, vol. 166(C), pages 117-136.
    14. Kejia Hu & Sunil Chopra & Yuche Chen, 2021. "The Effect of Tightening Standards on Automakers’ Non‐compliance," Production and Operations Management, Production and Operations Management Society, vol. 30(9), pages 3094-3115, September.
    15. Sara Parker‐Lue & Marvin Lieberman, 2020. "The impact of diversification on task performance: Evidence from kidney transplant centers," Strategic Management Journal, Wiley Blackwell, vol. 41(7), pages 1169-1190, July.

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