Experimental Design Details
CASE 1: PAYMENTS FOR HUMAN ORGANS FOR TRANSPLANTATION
About 5,200 respondents will be recruited online and through professional survey firms.
PILOT N. 1
Each subject will be presented with three (3) possible systems of procurement and allocation of organs among the following eleven (11) systems (more details are provided in the Docs & Materials)
System A: unpaid donors, government agency recruits donors, allocation of organs based on priority rules based on urgency, waiting time, etc. Efficiency = 20% of demand satisfied.
System B1: $20,000 cash paid to donors, individual purchases or organs, market-based allocation of organs; Efficiency = 80% of demand satisfied
System B2: $20,000 cash paid to donors, individual purchases or organs, market-based allocation of organs; Efficiency = 40% of demand satisfied
System C1: $20,000 cash paid to donors, government agency, government agency recruits donors, allocation of organs based on priority rules based on urgency, waiting time, etc.; Efficiency = 80% of demand satisfied
System C2: $20,000 cash paid to donors, government agency, government agency recruits donors, allocation of organs based on priority rules based on urgency, waiting time, etc.; Efficiency = 40% of demand satisfied
System D1: donors' expenses reimbursed, government agency recruits donors, allocation of organs based on priority rules based on urgency, waiting time, etc.; Efficiency = 80% of demand satisfied
System D2: donors' expenses reimbursed, government agency recruits donors, allocation of organs based on priority rules based on urgency, waiting time, etc.; Efficiency = 40% of demand satisfied
System E1: donor given $20,000 in-kind (e.g. housing subsidy), government agency recruits donors, allocation of organs based on priority rules based on urgency, waiting time, etc.; Efficiency = 80% of demand satisfied
System E1: donor given $20,000 in-kind (e.g. housing subsidy), government agency recruits donors, allocation of organs based on priority rules based on urgency, waiting time, etc.; Efficiency = 40% of demand satisfied
System F: unpaid donors, opt-out ("presumed consent") system for donor registry managed by a government agency; allocation of organs based on priority rules based on urgency, waiting time, etc.; Efficiency = 40% of demand satisfied
System G: unpaid donors, government agency recruits donors, allocation of organs based on urgency, waiting time, etc. + priority list for registered donors; Efficiency = 40% of demand satisfied
Subjects will be randomly assigned to one of the following TEN experimental conditions:
Group 1: Systems A, B, C. No efficiency mentioned; Systems ratings elicited first; Morality elicited next.
Group 2: Systems A, B, C. No efficiency mentioned; Morality ratings elicited first; Systems ratings elicited next.
(Comparison of 1 and 2 will let us know whether the overall rating of the systems is affected by whether the subjects have been asked to think about morality first)
Group 3: Systems A, Bh, Ch. Efficiency mentioned (high); Systems ratings elicited first; Morality elicited next
Group 4: Systems A, Bh, Ch. Efficiency mentioned (high); Morality ratings elicited first; Systems ratings elicited next.
(Comparison of 1 and 3 and of 2 and 4 will let us know whether the morality judgments are affected by the efficiency of the systems or whether they are independent of outcomes)
Group 5: Systems A, Bl, Cl. Efficiency mentioned (low); Morality ratings elicited first; Systems ratings elicited next.
(Comparison of 4 and 5 will further inform us of whether the morality judgments are affected by the efficiency of the systems or whether they are independent of outcomes)
Group 6: Systems A, Dh, Eh. Efficiency mentioned (high); Morality ratings elicited first; Systems ratings elicited next.
Group 7: Systems A, Dl, El. Efficiency mentioned (low); Morality ratings elicited first; Systems ratings elicited next.
Group 8: Systems Ch, Dh, Eh. Efficiency mentioned (high); Morality ratings elicited first; Systems ratings elicited next.
Group 9: Systems Cl, Dl, El. Efficiency mentioned (low); Morality ratings elicited first; Systems ratings elicited next.
(Results from groups 6, 7, 8 and 9 will tell us whether the morality judgments differ depending on whether organ donors are offered cash, expenses reimbursement, or in-kind payments)
Group 10: Systems A, F, G. Efficiency mentioned; Morality ratings elicited first; Systems ratings elicited next.
(results from group 10 will inform us of how morality judgments of systems based on "presumed consent" and giving priority to persons on the registry compare to systems where donors are compensated/reimbursed for expenses)
PILOT N. 2
Respondents will be presented with two systems, A and B, varying in the way organs are procured and allocated to recipients, and in their efficiency, i.e. in the expected number of organs procured and thus in the percentage of patients who obtain an organ transplant.
There are three systems:
System A: unpaid donors, government agency recruits donors, allocation of organs based on priority rules based on urgency, waiting time, etc.
System B: $20,000 cash paid to donors, individual purchases or organs, market-based allocation of organs
System C: $20,000 cash paid to donors through a government agency; allocation of organs based on priority rules based on urgency, waiting time, etc.
And five possible levels of “efficiency as follows:
N organs procured % of patients who obtain a transplant
0 12000 10
1 30000 25
2 60000 50
3 90000 75
4 120000 100
Respondents are randomly assigned to one of twenty-six possible pairs of systems as follows:
A1B1, A1B0, A1C0, A1C1, A1B2, A1C2, A1B3, A1C3, A1B4, A1C4: Here we compare A1 (the actual level of efficiency of the current system) with all other system-efficiency possibilities).
A2B2, A2B1, A2C1, A2C2, A2B3, A2C3, A2B4, A2C4: Here we do the same as above, but assuming that the unpaid donor system has higher efficiency (A2). The trade-offs could be different if the unpaid donor system was more efficient.
B4C4, B3C3, B4C3, B3C4, B4C2, B3C2, B4C1, B3C1: Here we compare the free market and the regulated market systems. We do so assuming high levels of efficiency (3 or 4) for the free market. The goal is to see whether people are willing to choose the free market when it helps more patients than the regulated market.
The structure of the survey is as follows:
a. Respondents are shown a screen with two systems (26 possible pairs randomly assigned; see below)
b. For each system, respondents are asked to give their morality judgments
c. Choice: respondents are asked to choose which of the two systems they would prefer
d. Overall rating: respondents are asked to rate each system from 0-100
e. Elicitation of minimum efficiency required to switch to the other system
f. Demographics
More details about the survey are provided in the Documents and Materials section.