Title: Customer Discrimination and Quality Signals: A Field Experiment with Healthcare Shoppers
Abstract: This paper provides evidence that customer discrimination in the market for doctors can be largely accounted for by statistical discrimination. I evaluate customer preferences in the field with an online platform where cash-paying consumers can shop and book a provider for medical procedures based on an experimental paradigm called validated incentivized conjoint analysis (VIC). Customers evaluate doctor options they know to be hypothetical to be matched with a customized menu of real doctors, preserving incentives. Racial discrimination reduces patient willingness-to-pay for black and Asian providers by 12.7% and 8.7% of the average colonoscopy price respectively; customers are willing to travel 100–250 miles to see a white doctor instead of a black doctor, and somewhere between 50–100 to 100–250 miles to see a white doctor instead of an Asian doctor. Further, providing signals of provider quality reduces this willingness-to-pay racial gap by about 90%, which suggests that statistical discrimination is an important cause of the gap. Actual booking behavior allows cross-validation of incentive compatibility of stated preference elicitation via VIC.
Alex Chan is a PhD candidate in Health Economics, and a Gerhard Casper Stanford Graduate Fellow. He has research interests in health economics, experimental economics, market design, and labor economics. His projects look at the causes and consequences of discrimination and diversity in medicine, U.S. Health Policy (especially organ transplantation), and market design in health policy and medicine. He holds an MPH from Harvard University. Before Stanford, he developed extensive experience in the healthcare industry starting as a McKinsey consultant, and most recently as Senior Vice President of Market Strategy with Optum/UnitedHealth before joining academia.
Associate Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School
His research focuses on the economics of health insurance markets with particular emphasis on understanding insurer behavior in those markets and designing optimal health plan payment systems.
Dr. Layton and his collaborators are using economic models of health insurer behavior to design payment systems that combat inefficiencies caused by adverse selection. In one project, he and his coauthors are deriving new methods for designing health plan payment systems that set payments to insurers in a way that discourages insurers from inefficiently rationing care used by sick individuals with multiple chronic conditions. This work focuses on designing payment systems for the state and federal Health Insurance Marketplaces, as well as the Dutch health insurance market and the Medicare Advantage program.
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Timothy J. Layton
Associate Professor
Department of Health Care Policy, Harvard Medical School
Associate Professor of Strategy at the Kellogg School of Management
Faculty Research Fellow at the National Bureau of Economic Research (NBER)
Professor Amanda Starc received her BA in Economics from Case Western Reserve University, and her PhD in Business Economics from Harvard University. Dr. Starc's research interests include industrial organization and health economics. Her research examines the Medicare Advantage, Medicare Part D, and Medicare Supplement ("Medigap") markets, as well as consumer behavior in insurance exchanges. Recent work measures the effectiveness of direct-to-consumer advertising of pharmaceuticals. Her work links models of consumer choice and supply side incentives, and uses a range of econometric techniques to analyze data.
This will be an in-person event: Encina Commons, Conference Rom 119, with a boxed lunch served.
Amanda Starc
Associate Professor
Northwestern University, Kellogg School of Management
Join us on October 19th for our weekly seminar from 12 PM - 1 PM PT featuring Genevieve Lakier, Professor of Law at University of Chicago's Law School and CPC Co-Director, Nate Persily. This series is organized by the Program on Democracy and the Internet, and the Cyber Initiative at the William and Flora Hewlett Foundation.
For years now, scholars have expressed alarm at the tendency of government officials to pressure—or “jawbone”—social media companies into taking down what the officials consider to be harmful or offensive speech, even when no law requires it. Scholars have worried, for good reason, that the practice of jawboning allows government officials to evade the stringent constraints on their power to regulate speech imposed by the First Amendment. But relatively little attention has been paid to the constitutional question of whether, or rather when, government jawboning itself violates the First Amendment. In fact, answering this question turns out to be quite difficult because of deep inconsistencies in the cases that deal with jawboning, both in the social media context and beyond. In this talk, I will explore what those inconsistencies are, why the case law is so unclear about where the line between permissible government pressure and unconstitutional governmental coercion falls, and what kind of jawboning rule might be necessary to protect free speech values in a public sphere in which both private companies and government officials possess considerable power to determine who can and cannot speak.
Genevieve Lakier teaches and writes about freedom of speech and American constitutional law. Her work examines the changing meaning of freedom of speech in the United States, the role that legislatures play in safeguarding free speech values, and the fight over freedom of speech on the social media platforms.
Genevieve has an AB from Princeton University, a JD from New York University School of Law, and an MA and PhD in anthropology from the University of Chicago. Between 2006 and 2008, she was an Academy Scholar at the Weatherhead Center for International and Area Studies at Harvard University. After law school, she clerked for Judge Leonard B. Sand of the Southern District of New York and Judge Martha C. Daughtrey of the Sixth Circuit Court of Appeals. Before joining the faculty, Genevieve taught at the Law School as a Bigelow Fellow and Lecturer in Law. She will serve as the Senior Visiting Research Scholar at the Knight Institute at Columbia University for the 2021-2022 school year, where she will be supervising a project exploring the relationship between the First Amendment and the regulation of lies, disinformation and misinformation.
A major bill with bipartisan support in Congress would reward farmers for an unusual harvest. The Growing Climate Solutions Act(link is external) promises billions of dollars for climate-smart agriculture practices, such as planting cover crops to reduce erosion and sequester carbon. The bill highlights farming’s potential as a climate change solution, as well as the challenge of controlling the sector’s growing greenhouse gas emissions. Below, Stanford Earth scientists Inês Azevedo, David Lobell and Rob Jackson discuss the surprising amount of greenhouse gases emitted by farming, how farmland conservation programs can help reverse the trend and what the federal government can do to promote more climate-friendly agriculture, among other issues.
Azevedo is an associate professor in the Department of Energy Resources Engineering at Stanford’s School of Earth, Energy & Environmental Sciences (Stanford Earth). Her research examines the role of food systems in reaching de-carbonized economies. Lobell is the Gloria and Richard Kushel Director of the Center on Food Security and the Environment. He uses unique datasets to study rural areas; his research has shown how reduced soil tillage can increase yields while nurturing healthier soils and lowering production costs. Jackson is the Michelle and Kevin Douglas Provostial Professor of Energy and Environment in Stanford Earth. His work has shown that global emissions of nitrous oxide increased by 30 percent over the past four decades due mostly to large-scale farming with synthetic fertilizers and cattle ranching, and that well-managed soil’s ability to trap carbon dioxide is potentially much greater than previously estimated.
What might the average person be surprised to learn about greenhouse gas emissions from America’s agricultural lands?
Lobell: First, I think people are surprised that the food system actually uses a very small share of fossil fuels, even when you include all the fertilizer production. Second, people are surprised by how many things they think are good, like eating organic or local foods, have very little effect on emissions and can even be worse than conventional alternatives.
Jackson: Many people are aware that fossil fuel use drives most carbon dioxide emissions, but they might not know that more than half of methane and nitrous oxide emissions attributable to human activities come from agriculture.
Azevedo: I think the average person would be surprised to learn agriculture – including livestock, agricultural soils and agricultural production – accounts for about 10 percent of total U.S. greenhouse gas emissions and, in contrast to some other sectors of the economy, they have increased over time.
Does the Growing Climate Solutions Act go far enough to mitigate and reduce emissions? How could it be stronger?
Lobell: I worry that there isn’t enough emphasis on the main greenhouse gases that agriculture contributes to – nitrous oxide and methane – where progress could probably be made a lot faster than for carbon dioxide. Soil carbon is like motherhood and apple pie – nobody is against it – but I wish that half the energy I see going into how to get more carbon into soil was going into how to reduce emissions of the other gases.
How can programs that reward farmers for certain conservation practices help?
Jackson: The world’s soils contain far more carbon than the atmosphere, but agricultural activities such as plowing have released two hundred billion tons of carbon dioxide to the atmosphere from soils. Conservation programs can help us put some of that carbon back where it belongs, making our soils more fertile and better at retaining water.
Lobell: On one level, these programs can help start the process of making agriculture carbon neutral or even carbon negative. This is important if we want to meet aggressive climate goals. On another level, they can help build a broader political coalition devoted to solving climate change. This might be even more important for climate goals, especially given the disproportionate role of rural states in our federal government.
How should such programs be designed for maximum efficiency and cost-effectiveness?
Lobell: I’m concerned there is a lot of hype out there now on what specific practices can deliver, for example by companies trying to raise large funding rounds on the idea of selling carbon credits. I think it’s important that the programs have a strong system of verification and ability to adjust over time as we learn about what is truly effective.
Jackson: Rather than focusing primarily on carbon dioxide, agricultural incentives would be well served to reduce emissions of methane and nitrous oxide through practices such as better fertilizer and manure management. Methane’s warming potential is 30 times higher than carbon dioxide’s over a century, and nitrous oxide’s warming potential is nearly 300 times higher. Reducing them is a great bang for our climate buck.
From a global perspective, how important is agriculture’s role as a potential climate change solution, and how can policymakers better quantify and track it?
Azevedo: One of the recent things our recent research has shown is that although reducing emissions from fossil fuels is essential for meeting the Paris Agreement goals, other sources of emissions may also preclude its attainment. Specifically, even if all fossil fuel emissions were immediately halted, the achievement of the agreement’s 1.5 degree Celsius maximum temperature increase target would likely not be feasible if global food systems continue along their current trends.
Lobell: I think accelerating public research in this area will be critical, particularly for ways to accurately measure carbon accumulation or emissions reductions on individual farms. If this had been a well-funded area, we might be in a much better position in terms of leveraging all of the private sector enthusiasm for it. Since food is a traded commodity, it will also be important to monitor global land-use change and the extent to which our domestic policies might be having unintended consequences elsewhere.
The disclosures made by whistleblower Frances Haugen about Facebook — first to the Wall Street Journal and then to “60 Minutes” — ought to be the stuff of shareholders’ nightmares: When she left Facebook, she took with her documents showing, for example, that Facebook knew Instagram was making girls’ body-image issues worse, that internal investigators knew a Mexican drug cartel was using the platform to recruit hit men and that the company misled its own oversight board about having a separate content appeals process for a large number of influential users. (Haugen is scheduled to appear before a Congressional panel on Tuesday.)
Facebook, however, may be too big for the revelations to hurt its market position — a sign that it may be long past time for the government to step in and regulate the social media company. But in order for policymakers to effectively regulate Facebook — as well as Google, Twitter, TikTok and other Internet companies — they need to understand what is actually happening on the platforms.
Former Facebook product manager Frances Haugen appears on “60 Minutes.” Haugen has been revealed as the source behind tens of thousands of pages of leaked internal company research. (Robert Fortunato for CBSNews/“60 Minutes") (Photo by Robert Fortunato/CBSNews/60MINUTES)
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The social media company shouldn’t be able to hide information about whether and how it harms users (from the Washington Post)
Join us at the weekly Cyber Policy Center (CPC) seminar on Tue, October 12th from 12 PM - 1 PM PST featuring Soojong Kim, postdoctoral fellow at the Program on Democracy and the Internet. This session will be moderated by Co-Director of the CPC, Nate Persily. This is part of the fall seminar series organized by the Program on Democracy and the Internet, and the William and Flora Hewlett Foundation’s Cyber Initiative.
There has been growing concern about online misinformation and falsehood. It has been suspected that the proliferation of misleading narratives is especially severe on Facebook, the world’s largest social media site, but there has been a lack of large-scale systematic investigations on these issues. This talk will introduce a series of ongoing research projects investigating online groups promoting misleading narratives on Facebook, including anti-vaccine groups, climate change denialists, countermovements against racial justice movements, and conspiracy theorists. The presentation will discuss the prevalence, characteristics, ecosystem of misleading narratives on Facebook, and implications for potential interventions.
Soojong Kim is a postdoctoral fellow, jointly affiliated with the Program on Democracy and the Internet (PDI) and the Digital Civil Society Lab (DCSL) at Stanford University. He received his Ph.D. at the Annenberg School for Communication, University of Pennsylvania. His research centers around digital media, social networks, and information propagation. As a former computer scientist, he is also interested in developing and applying computational methods, including online experiments, large-scale data analysis, and computational modeling.
*For fall quarter 2021, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone.
In person only. Only those with an active Stanford ID with access to William J Perry Conference Room in Encina Hall may attend in person. This event will not be livestreamed
About the Event: With the counter-recovery and countervailing nuclear-targeting strategies, the United States embraced a massive expansion of the roles for nuclear weapons. Simultaneously, however, an accuracy revolution has quietly imbued conventional weapons with vastly improved target-killing capability. This raises the question: how many targets in the nuclear-war plan could just as effectively be dealt with using conventional weapons? In the last decade, the Russian security establishment has expressed concern about emerging U.S. conventional capabilities while the U.S. military has downplayed their strategic import. In this talk I will report on the early stages of a new project to investigate exactly how and if conventional forces might execute a strategic strike akin to the U.S. nuclear war plan and, conversely, whether an adversary could threaten the United States with unacceptable damage without ever escalating to nuclear use. I will discuss several target categories, the expected performance of conventional weapons, system considerations, and the consequences that “conventional strategic strike” may have for the future of deterrence.
About the Speaker: R. Scott Kemp is the MIT Class of '43 Associate Professor of Nuclear Science and Engineering, and director of the MIT Laboratory for Nuclear Security and Policy. His research combines physics, politics, and history to help create more resilient societies. His work has focused primarily on problems arising from weapons of mass destruction. His current research includes securing vulnerabilities in U.S. critical infrastructure and the redefining of strategic defense. In 2010, Scott served as Science Advisor in the U.S. State Department's Office of the Special Advisor for Nonproliferation and Arms Control where he was responsible for developing the technical framework for what became the Iran Nuclear Deal. Scott received his undergraduate degree in physics from the University of California, Santa Barbara, and his Ph.D. in Public and International Affairs from Princeton University. He is a Fellow of American Physical Society and recipient of the Sloan Research Fellowship in Physics.
Only those with an active Stanford ID with access to William J Perry Conference Room in Encina Hall may attend in person. This event will not be livestreamed.
For fall quarter 2021, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone.
Only those with an active Stanford ID with access to William J Perry Conference Room in Encina Hall may attend in person. This event will not be live-streamed.
About the Event: In January 2017 and again during his presidential campaign, then-Vice President Biden said that “I believe that the sole purpose of the U.S. nuclear arsenal should be deterring—and, if necessary, retaliating against—a nuclear attack.” The Biden Administration is now undertaking its Nuclear Posture Review (NPR), in which it is possible that the United States would, for the first time, formally adopt such a “sole purpose” or perhaps even “no first use” policy for its nuclear weapons. Yet some former government officials, as well as press accounts, have publicly reported that the possibility of a biological weapons attack that might cause casualties comparable to a nuclear attack blocked the adoption of a no-first-use or a sole-purpose policy in previous administrations’ NPRs. Should it do so again? I will present a technical and policy analysis of this question, with the aspiration of helping to bring systematic attention to this issue in the ongoing Nuclear Posture Review.
About the Speaker: Christopher Chyba is a professor of astrophysical sciences and international affairs at Princeton University, and past director of the Program on Science and Global Security. As an associate professor of geological sciences at Stanford University before coming to Princeton, he co-directed the Center for International Security and Cooperation and held the Sagan Chair at the SETI Institute. He has been a Marshall Scholar and a MacArthur Fellow.
During President Clinton’s first term, Chyba served on the staffs of the National Security Council and Office of Science and Technology Policy at the White House, entering as a White House Fellow. He served for a decade as a member of the National Academy of Sciences' Committee on International Security and Arms Control, and on President Obama’s Council of Advisors on Science and Technology (PCAST) from April 2009 through January 2017, on which he co-chaired the working groups on antibiotic resistance and on biodefense. In late 2020 to early 2021, Chyba served on the national security and foreign policy team for the Biden-Harris transition. His current policy-relevant research focuses on possible pathways to nuclear weapons use (for the past two years, he has co-chaired a project of the American Academy of Arts and Sciences on this topic), nonproliferation and strategic arms control issues, and biodefense -- including as a member of the OPCAST pandemic response group.
Chyba's scientific research ranges across planetary science and exobiology, as well as work in classical electrodynamics. His published work has included dynamical modeling of the Neptune-Triton system, the role of impacts on the origin of life on Earth, the Tunguska atmospheric explosion and planetary defense, radar, seismic, and magnetometer sounding of Europa's ice shell, bioenergetic models for possible ecosystems on Europa, electromagnetic heating of planetary satellites, and planetary protection.
Only those with an active Stanford ID with access to William J Perry Conference Room in Encina Hall may attend in person. This event will not be livestreamed.
