A Nobel winning economist will tell you why you can buy heroin on any corner, but you can't hire a killer. And why that same logic means people are dying who don't have to.
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The INTO THE IMPOSSIBLE Podcast
Nobel Economist: The Market That Lets People Die | Al Roth
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Brian Keating
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Al Roth
Nobel Prize-winning economist Al Roth explores why some markets, like buying drugs or hiring hitmen, have different societal impacts. He discusses kidney exchanges, surrogacy laws, bans, black markets, and moral dilemmas in controversial transactions, revealing complex consequences of regulations and market bans on health and society.
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“A Nobel winning economist will tell you why you can buy heroin on any corner, but you can't hire a killer. And why that same logic means people are dying who don't have to.”
“And the natural decision is, why don't we send her home with her parents, and how should we do that? And the answer is, in Western Europe, the family courts have. Have pioneered ways for surrogate parents to adopt their own children so that they become the legal parents in a place where surrogacy is illegal.”
“The Unforgivable Burden of Student Debt: "it's the only form of debt that can't be discharged in bankruptcy, as I understand it. What about the moral and ethical issues raised by that? It's like singled out.”
“Why We Ban Unusual Foods: "They're really sharp tests that when you see horse meat being banned, like you said, I, you know, I've never come across my, you know, my neighbor's horse and, you know, coveted it for lunch. Right. But there must be people that do or else it wouldn't be needing to be banned.”
“I think sports have lots of reasons to ban performance enhancing drugs of various sorts because they want competition to be on a level playing field.”
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Why is it so easy to buy drugs, but so hard to hire a hitman? We forbid, as most countries do, any effort to pay kidney donors. In Canada and in Britain, surrogacy isn't illegal, but it's illegal to pay a surrogate. People who need surrogacy service come to California, but they have no trouble bringing their babies back because parental rights in surrogacy are recognized. Recognized.
My guest today won the Nobel Prize in Economics for designing the systems that match kidney donors to patients. What he told me about the markets we're not allowed to have is going to make some of you uncomfortable and quite frankly, angry.
You're the first person I've ever had on the podcast who has been called an organ trafficker. But explain how that came about.
Well, I talk about controversial transactions. And one of the things that my colleagues and I have helped medical professionals do is organize what's called kidney exchange. And kidney exchange, which we can talk about more, is a way of getting more living donor transplants than could otherwise be gotten. And that's important because there's a real shortage of transplants. The rate of kidney failure in the United States is at about 130,000 people a year, but we do fewer than 30,000 transplants a year. So it's important to get more transplants. And we do this in a way that the US Congress didn't find repugnant. They unanimously amended the National Organ Transplant act to affirm that kidney exchange is legal in the United States, but not everyone is equally happy with it.
And one of the funny things about transplant dogma in the world is that countries should be self sufficient in transplantation. And one of the things about kidney exchange is it needs big groups of patient donor pairs to work efficiently. And so, for example, I went to the United Arab Emirates for the first kidney exchange between the UAE and Israel. But the lady who calls me an organ trafficker thinks that countries should be self sufficient in transplants.
One of the things that I never really appreciated as explicitly as you make it in the book is sort of the unintended consequences of many economic actions that then have both political and economic and social ramifications. Can you explain the relationship between bans and black markets?
So one of the themes of the book is that to work well, markets need social support, and to work well, bans on markets also need social support. So often what I'm talking about in the book are transactions that some people would like to engage in and other people think shouldn't be allowed. And when you ban something that some people would like to engage in, often you're going to find that they try to find ways to work around the ban. And one way to work around the ban is to find a another jurisdiction where the transaction you want to engage in is legal. A different way to work around a ban is to find people who are willing to violate the ban and commit criminal acts in order to further the kind of transaction that you're interested in.
If you have a ban that protects moral purity, but then it creates a black market, I mean, that ends up hurting people, how do we judge if that's truly moral?
Well, one of the themes in the book is I think we have to judge the morality of the bans we make and the markets we support, not just by our intentions, but by the consequences. So one of the questions I ask in the book is why is it so easy to buy drugs but so hard to hire a hitman? And what I mean by that is we have in the United States, we have bans on commercial murders. When we find hitmen, we put them in prison for as long as we can, and when we find heroin dealers, we put them in prison for as long as we can. But those two bans have had very different effects. There's almost no commercial killing in the United States. It doesn't make it into the national crime statistics. But heroin is readily available in the United States. And we have not only lots of dealers and addicts, but many overdose deaths every year, many more than we have homicides of any sort.
So the two very similar kinds of bans catch them and imprison them, have very different effect. So I think we're doing fine on hitmen. We should. We should keep it up. We don't need hitmen, and we don't have them. But we're not doing fine on heroin. We have a lot of heroin, and we ought to be experimenting with ways to reduce the harm that it does. If we can't, even if we can't ban it as thoroughly as we would like to.
And of course, the United States has some experience with this from Prohibition. In the 1920s and early 30s, we tried to ban the production and sale of most alcoholic beverages, and that didn't work well. And so after amending the constitution to institute prohibition, we re amended it to end prohibition. And ending prohibition on alcohol hasn't solved the problem of alcohol. There are still alcoholics and drunk drivers, but you can't buy whiskey from gangsters anymore. The legal market has out competed the organized crime organizations that grew up in order to sell illegal alcohol.
You're the second economist to come on who's written a book that has, you know, brothel or prostitution in the title. Allison playing on her, her last name. But, but she wrote a book called An Economist Walks into a Brothel. And it makes me think that in America we prohibited the sale and, and, and manufacture of alcohol. That was nationwide. But we have a lot of, you know, cantons and you know, kind of broken up districts and, and not just purely federal law. We have, you know, legal prostitution in, in Las Vegas, as I understand. I don't have any walked into a brothel.
My, you know, physicists don't walk into brothels maybe as much.
So just incidentally, prostitution isn't legal in Las Vegas, but it is legal in some rural counties in Nevada.
Ah, okay, good, good. Okay, so Vegas. That's right. Okay. So it shows you how little I know about prostitution.
Now, the fact that it's not legal doesn't mean that there's no prostitution in Las Vegas.
Exactly. That, that is certainly the case. So. But my bigger point is that like with taxes, like estate taxes here in California we have, you know, billionaires tax that's being proposed. I'll get your impression about that maybe later. But you can move to Florida, right? So you can move to Texas. You can do all sor sorts of things in contradistinction to the ban on alcohol, which is nationwide, as I recall. So is that possibly enforceable when morality can vary from jurisdiction to jurisdiction to have an effective ban that will actually work in the real world, if ever?
Well, it's hard to ban things that some people very much want to have. So during Prohibition, fat in the hall, there was production in the United States. There were illegal stills. And nascar, the, the Stock Car Racing association in their museum has a still because some of their folk heroes are people who had cars that looked ordinary but were tricked out to carry alcohol and go very fast so that they could outrun policemen. And also Canada used to continue to export spirits. So it was very hard to both stop the import from Canada and the production in the hills by the light of the moon of moonshine whiskey. And that's true. Generally.
The, you know, one of the markets that I write about is the market for surrogacy. Right. So, so in California, where you and I live, and throughout the United States, it's legal to hire someone to bear a baby for you. And in California, if you and your spouse, say, need the help of a surrogate, the California birth certificate will list you as the mother and father on the. On the birth certificate. And there's no problem bringing the baby home or anything like that. But in most of Western Europe, surrogacy is illegal. And it's illegal because when you read the statements that go along with the laws that make it illegal, they think it's undignified and inappropriate for women to be treated as commodities, which they think surrogacy does.
So surrogacy is banned in most of Western Europe. But of course, when you have a ban that is porous, when you have a ban that people are looking for ways around, they may find them. And in the case of surrogacy, when you have a ban that doesn't work as well as you would like, it means they're going to be babies and the babies have to be brought home. So while the constitutional courts in Germany and Spain and France say surrogacy is illegal, the family courts have to do the thing that family courts always do, which is decide with whom should this baby go home? And the natural decision is, why don't we send her home with her parents, and how should we do that? And the answer is, in Western Europe, the family courts have. Have pioneered ways for surrogate parents to adopt their own children so that they become the legal parents in a place where surrogacy is illegal. So, you know, the laws against surrogacy are often phrased as, we're trying to protect vulnerable people, and the vulnerable people are women who might be tempted to become surrogates. But of course, no one is more vulnerable than a newborn baby. So if you're interested in protecting vulnerable people, you have to take account of the fact that this ban is going to be porous.
So you ask a lot of uncomfortable questions in this book, but they're done in a very provocative and endearing way, I have to say. It's very easy to read this book, but it's not the topic selection you talk quite frequently. And the core of this book is about repugnant transactions. So first, could you define that for us, please?
I talk about controversial markets generally, but one kind of controversial market is one that involves repugnant transactions, by which I mean transactions that some people want to engage in, other people think shouldn't be allowed and have the property that the harms to the people who think it shouldn't be allowed aren't easily Measurable. So often the objections to a repugnant transaction are based on moral or religious arguments. So for example, same sex marriage is that kind of repugnant transaction in the sense that some people very much want to engage in it. Other people who aren't involved directly in any way don't think it should be allowed. And it's a transaction that the people who object to it can't even tell has happened unless someone tells them. That's why people wear wedding rings to let you know that they're married, because you can't tell by looking at people whether they're married or not.
When I think about things that are repugnant versus disgusting, like I hate fish, if it were up to me, we'd ban gefilte fish and herring and all sorts of things that many of my friends engage in or driving slow in the left lane. Al, if you had a magic wand, what kind of thing that's disgusting maybe, but not repugnant. What would you like to ban and just wipe away?
Well, so disgusting things we don't have to worry about banning normally, because disgust. One way of thinking about disgust is it's a more or less universal reaction to, maybe to things that could cause you to have infections. So, you know, human fluids and things like that. There's no law against serving drinks in, in California restaurants that are made of spit. But there is a law in California against serving horse meat for people to eat. Because in 1998 we passed a referendum making it a felony to, to sell horse meat for human consumption. And, and of course it's not because no one wants to eat horse meat. On the contrary, it's precisely because some people want to eat horse meat and other people don't want them to.
So what would I ban? The things that I don't like often don't have to be banned, right? There's no law against eating cockroaches, but no one's eating cockroaches. People driving slowly in the left lane has a negative externality, right? They interfere with traffic. So that's not what I'm worried about in this book. Those are markets that economists know a lot about. If I built a discotheque next to your house that partied all night, that would harm your enjoyment of your house. And that's why we have zoning laws that probably say that you live in a neighborhood zoned for residences. But it's easy to understand why you don't want a discotheque next to your house. It would harm you.
It's harder to Understand, but needs to be understood why some people don't like same sex marriage or don't like plasma donors to be paid or don't like surrogates to be paid. Right. So I already mentioned that in Western Europe surrogacy is illegal. But in Canada and in Britain surrogacy isn't illegal, but it's illegal to pay a surrogate. So there aren't so many surrogates in, in Britain and Canada. And people who need surrogacy service from Canada and Britain come to also come to California. But they have no trouble bringing their babies back because parental rights in surrogacy are recognized in, in Canada and Britain. But that's a case where something that's legal becomes illegal when you add money.
And that's an interesting category of repugnant transactions.
So it made me think of the famous paradox in physics as experimental physicist, I think of everything through physics, but sort of Schrodinger's cat. It's sort of this observer dependent phenomenon. And so I ask you who does it matter that the transaction be repugnant to the participants or the observer society?
So again, I'm using repugnance in sort of a technical way. So the participants in a repugnant transaction want the transaction. They're not repulsed by it. They, they are eager for it. Like same sex marriage, like surrogacy, incidentally, prostitution is one of those transactions that adding money to the transaction, that's what turns sex into prostitution.
Well, how do we wait and balance a democratic process? Do we vote on it? Do we rely on religious figures to decide for us?
Well, so in the United States we vote on some of these things. We elect legislators who create legislation about some of these things. And many, many of the morally contested transactions that I talk about in my book have made their way to the Supreme Court. Same sex marriage, interracial marriage. Whether contraception can be banned in the state of Connecticut, that was the case of Griswold versus Connecticut in the 1960s. I'm anticipating that we're going to see a Supreme Court appeal to the, to the many states that are now allowing medical aid and dying. So as a democracy with courts, we, we do things politically and legally.
Can religious kind of overtones, can they corrupt markets? Is it possible to have something that both buyer and seller are interested in? Society is sort of okay with. But some religious phenomena maybe baked into the, you know, overarching DNA or framework of the country or principality that can supersede is ultimately the halo on your book cover is that the final arbiter?
Well, I think the halo was designed to show that we're on the side of the angels. But religion affects certainly what people think should be allowed and not so. I mentioned medical aid in dying, which come September when legal medical aid in dying goes into effect in Illinois and in New York, more than a third of Americans are going to live in states that have legal medical aid and dying. But of course that's especially when we think about death. Americans also bring up religious thoughts of various sorts. And so many, many of the objections to medical aid and dying, by no means all of them, but many of the objections are phrased in terms of religious objections. I think the same thing was true of same sex marriage. Abortion is a subject that many people rely on, on religious intuitions about human life and when it begins.
So yeah, I think that religious intuitions inform a lot of what we're talking about when we talk about morally contested markets.
And now Professor Roth is about to turn that same scalpel on something closer to home for both of us, the university system.
Let's take a brief detour into a favorite subject of mine and possibly yours, academia. I want to talk about the morality, moral issues that come up in academia. So the first one is I was a postdoc at Stanford in 1999, but I remember the tuition then was about, I think it was about 12 or $13,000 a year and I think it's now 40. Yeah, tuition's outpaced inflation you dramatically so. And the students there get a lot of financial aid. Sanford's one of the, you know, finest educational institutions in the world. And they also are quite generous, but they're not completely generous.
Right.
I mean, there is sort of a moral question that I have is, is it okay that you charge such high tuitions knowing that so many people will get a tuition reimbursed, but that it's outpacing inflation for the families that can quote unquote afford it? Is that a moral transaction that parents really have no choice with? I mean, if my kid gets into Stanford, it's going to be hard to convince him or her not to not to go there. So what, what are the moral around academia today?
You and I will agree on moral issues, but I'm not sure that pricing is one of them. Let's think not about Stanford, but about University of California, which is a taxpayer supported institution. So that starts to get more into these questions of democracy and equality. And I don't know what the tuition is at University of California. I'm sure, it's cheaper than Stanford cheap,
but out of state it's not.
But also, I'm sure that they give lots of financial aid. So. So let's consider the alternative, which is that the University of California should decide to be free. If University of California were free, then we taxpayers would be paying for the education of everyone who goes to the University of California when it's not free. So that would be a subsidy for the rich, because the rich are the ones now paying the full tuition and less prosperous families get lots of financial aid. So the question is, do we want to use our tax dollars to subsidize the rich, and is it immoral not to. I'm rephrasing your question in a tough way. And there's part of our current political establishment in the United States that seems to believe that it is immoral not to subsidize the rich and we should use tax policy to subsidize the rich.
And I'm not sure that that's the only moral position about taxes. So when you look at University of California and you say they charge a lot to people who can afford it, I'm not sure that's a bad thing. I mean, having people who can afford it pay for what they want and subsidizing people who can't afford it seems like it might to me, like it might be a good use of our tax policy.
Now, obviously, there's, I think, one of the biggest sources of debt, you know, in the country is student debt. So it's not all free. And also it's the only form of debt that can't be discharged in bankruptcy, as I understand it. What about the moral and ethical issues raised by that? It's like singled out. If there was a, you know, there's a tax on golf clubs, and if you spend too much on golf balls like I do, I lose too many to my son, which will hopefully go to Stanford and play in the golf team there. And I can't discharge it. And if I don't pay it, it's 30% interest rate, like vigorous. So what about that, that you can't discharge it in bankruptcy? What does that do to young people who are scarcely really able, in many cases, to understand the contract they're entering into at age 18?
Okay, so those are two separate questions. The question about being able to understand contracts and what it means to have informed consent. I think there are a lot of things we could talk about there, but I'm not an expert on bankruptcy law. And so I'm neither licensed to practice law in California, nor is that the part of economics that I study. But my understanding is that after you declare bankruptcy, there's some period of time in which you can't declare bankruptcy again. And that's not meant to penalize you. That's meant to make you credit worthy. That is, if you're someone who declared bankruptcy, you might find that you have trouble getting a loan to restart your business, to start a different business.
But your creditors are protected from that by the bankruptcy law, which says you'll have to repay these debts at least for a while. And I think that's the thought behind making student loans not subject to bankruptcy. People who are 18 years old and about to go to college don't have great credit ratings. So you can easily imagine that they would find loans unavailable if on graduating from college, they could discover that they were bankrupt. All they had was debts. But I think the intention of making student loans not bankruptible is to allow people to get student loans even when they don't have any collateral.
And that's part of the spine of the book. You talk about how these, you know, exceptions aren't really exceptions or taboos necessarily alone. They're diagnostics. They're really sharp tests that when you see horse meat being banned, like you said, I, you know, I've never come across my, you know, my neighbor's horse and, you know, coveted it for lunch. Right. But there must be people that do or else it wouldn't be needing to be banned. But before we move back to the, to the spine of the book, again, there's another phenomenon that relates to college, which is differential preparation before you go to college. So California banned the SAT as admission.
And part of the rationale was, well, poor families can't spend time in preparation and go to the Princeton Review or any of these things that, that parents use. It remind me of the, the Varsity Blue scandal from about eight or nine years ago, where these Hollywood families, some of which were married to hedge fund, you know, and, and venture capitalists, you know, paid, paid a lot of money for college coaching that got them into the school. That wasn't the kid's choice. The kid wanted to go to some, you know, like art school, and the parents wanted her to go to usc, and that's where she ended up going. But there was a great controversy about the legitimacy or morality of these, these college coaches and so forth. And it made me think of what just happened recently. There was a athletic competition called the Enhanced Games. Did you hear about that? So what do you make of that, because you talk about performance enhancement and now they've kind of taken it to this extreme, you know, now you can only participate if you're doing RO or whatever they're doing.
So what did you make of this competition? Did it fascinate you as it did me as an economist?
Well, I think it evolved a lot into something very different than it may have originally been intended to be, because I think it ended up being a marketing platform for nutritional supplements and things like that. So it was pretty shady in the end. And indeed, they didn't get the athletes who with the help of drugs, could break world records. They had a swimmer who used a full body suit that's disallowed in the sport as being maybe a too expensive barrier to entry for many, many swimmers. But let's talk a little about performance enhancement because I think sports have lots of reasons to ban performance enhancing drugs of various sorts because they want competition to be on a level playing field. So if you watch the Tour de France, you have the opportunity to each year see the first clean Tour de France, the first Tour de France that hasn't used any drugs. And we just had Batlon, the first. And in previous years we had the first until the drug testing regimes caught up with the performance enhancing regimes.
And then we discovered that some of the medalists had used performance enhancing drugs that they weren't allowed to. So I have no quarrel with sports making the rules that it wants. That's what you know. You can't bring a tennis racket to a ping pong tournament. But in general, performance enhancement is something that we should be interested in as progress in medicine. Right? So this morning I had a cup of coffee and no one thinks poorly of me for that. Every now and then I don't drink coffee for a day or two and I have slight withdrawal effects. But it helps me start the day, it helps keep me alert.
And a lot of science goes on over coffee. I think we wouldn't have any science if we didn't have coffee. And it's a performance enhancing drug, but we, we treat it as part of our nutrition, not a way to get ahead of your other physicists. So I'd be glad to have more safe performance enhancing drugs. One thing I see in the world when I talk to undergraduates, I ask them, do they know anyone who uses Adderall or Ritalin when they're studying for exams? And to a man and a woman, they say, well, they don't use it themselves, but they know lots of people who do. Adderall is a drug prescribed for children who have attention deficit disorder. And it's gone through clinical trials and it's pretty safe. We give it to 9 year olds so that they don't fidget in class.
So I'm guessing that some part of that it's a cocktail of amphetamines of some sort might be useful for you doing your work or me doing my work. And it's one thing to say when you're about to get on your bicycle for a bicycle race, you're not allowed to use it. But it's another thing to say that we would reject a new subatomic particle if it had been discovered by someone who was on Adderall, or a new mathematical theorem, or a cancer cure, or peace negotiations in the Middle east if it had been done after 36 hours of unslept negotiation. And of course, truck drivers and other people use amphetamines in ways that may or may not be harmful for their health. So I regret that a lot of medical science associated with performance enhancing drugs is devoted to making them undetectable in athletic contests rather than to fully exploring, can you take these things when you're young and not have congestive heart failure when you're middle aged? Things like that that would help us bring more performance enhancement into our nutrition?
No.
It is funny that you mentioned the coffee and then also drugs. There's a famous mathematician you might know, Erdos, who said that a mathematician is a machine that converts coffee to theore. But he also was addicted to methamphetamine. And one day his colleague, not Terry Tao, who I had on the podcast not too long ago, but an older colleague of his implored and begged him, you got to stop doing amphetamines. He said, I can stop anytime I want. And then his colleague said, okay, fine, so stop for a month. And he did. He stopped for a month and he came back to his colleague's door and knocked on it at Princeton and said, congratulations, you've set back mathematics for a month.
He couldn't prove theorems as well when he wasn't on meth. I gave a talk in Hungary and I, I mentioned Erdos and coffee, and they corrected me. They said that that quote is attributed to Erdos, but it's actually due to Renyi. Right? A lot of mathematics was Erdos and Renyi. And apparently the coffee comment is due to Reni.
Also, I wonder what people's Reny number is, because it's the Erdos number that gets all. And then there's the Erds Bacon number. If you've been in a movie about, you know, with Kevin Bacon, I found fascinating that, you know, doing some research. I think it's true that you trained as an operations in operations research, which is more akin to, we used to call that industrial engineering or operations engineering. And that's very different from, say, Guido Mbens or other people that I've talked to on the podcast in Economics, in that it's sort of more experimental physics like my audience might be used to. So when you're doing the type of work that you do, what do you view as your lab and what do you view as an experiment? Is there sort of that notion from your operations research?
So I've been associated with market design, but also with experimental economics, and economists now do experiments. So just incidentally, my most recently published experiment in PNAS also drew some repugnance. It was an experiment with a field experiment with the economics job market, the job market for new PhDs. And we had noticed that lots of people who have social media accounts tweet the job market papers of their students. And one question was, does this have an effect on the job market success of their students? And does it have therefore an uneven effect on the job market? If your advisor is a social media influencer, does that help your job market? We invited everyone on the job market, all the new PhDs on the job market, to come to a Twitter site that they organized to tweet their job market papers. And then we did an experiment where some of them and not others were retweeted. And we looked at the different effect on the job market. And we found that to be tweeted and retweeted was good for women candidates.
And women are sort of underrepresented in the economic academic market. But some people objected to our doing that because they said, you're, you're helping these women, it turns out. But truly that comes at the cost of someone else. And our feeling is, is complicated about that. I mean, we, we thought about it a lot beforehand and we talk about it a lot in the published paper. First of all, it's that job markets and other markets aren't zero sum. When you make good matches, you can make the market work better and make people better off. Also, so many jobs aren't filled in a given season.
It's hard to find the people who you want and interview them and make offers to them that they accept because often a lot of attention is focused on the same people. So the people you make offers to get other offers and might accept the other offers. So we think that there's lots of positive gains, not just redistribution of jobs. That's an experiment. That is, we had randomized controls, we could measure the effects. And it had some moral objections to it. Some people thought you shouldn't be experimenting on economists, and other people thought you shouldn't be experimenting in a job market. But in fact, economists do a lot of experiments now.
And a Nobel Prize a few years ago went to Michael Kramer and Abhijit Banerjee and Esther Duflo for experiments in development policy. That is, if you're trying to get insecticide treated mosquito nets distributed in some country in Africa, you can't distribute them at the same time to all the villages. So you can randomize which ones you try to distribute them to one way and which one some other way and then see which works better. So that won a Nobel Prize. I mean, the idea of using experiments to help evaluate policy not just by their intentions, but by their outcomes.
Yeah, it brought up a lot of questions in my mind. Some of these issues in the book that reminded me of, like, different types of equilibria and stability in matching. How does that come about? And you could be technical, talk about the different forms of equilibria and stability and perturbations that arise in the types of matching experiments that you talk about in the book. So could you explain the role that these concepts from thermodynamics or from Nash or other domains, how do they come into play in the research that you do?
Okay, so economists talk a lot about equilibrium, but not as much as we should about equilibration, about how we get to equilibrium. Physicists probably have that problem a little bit too. You know, you can tell when something is stable when you drop a ball into a hole. It's stable when it comes to rest at the bottom of the hole. But there's a lot of motion beforehand if it's a bouncy ball. So often we have some idea what a good equilibrium would look like, but not how to get there. And one of the things we're seeing, and we're going to see again with AI, but one of the things we're seeing, say with computerization of markets, is that it becomes cheaper to make applications for jobs for college positions, college admissions. It becomes cheaper to make applications faster than it becomes cheaper to evaluate those applications.
So lots of job ads get many, many responses, and it's hard to decide who to interview. Lots of college admissions offices get many, many applications, and it's hard to decide who to admit, who to make offers to, who to put on the waiting list. And so that's a problem common to many markets that we call congestion. There's more things you have to evaluate than time. You have to evaluate it. And so one of the ways we can sometimes deal with that in this age of computerization is we can try to make it cheaper, not just to make applications, but to process them. I've done work of that sort of in the labor market for new doctors, done work of that sort in trying to promote kidney transplants through kidney exchange. So we're now in a world before AI.
This is we're now in a world of smart markets, markets where the marketplace itself can do some computations to help the market reach equilibrium. So that's a little bit how market design interacts with equilibration.
What is the role of the non experimentally subjectible quantities like trust or belief, things that you really can't quantify. What are the roles of trust play in markets?
Well, a lot of markets involve a great deal of trust. If you sell me 5,000 bushels of wheat, I have to expect that they'll arrive if they have a date of arrival, or that I can sell them on a market if I want to sell them before they arrive. If we were dealing in a futures market when the Berlin Wall fell, it was a little hard to spark commerce between Western Europe and Eastern Europe, because in Western Europe, as in the United States, lots of contracts were payable 60 days after the invoice. So I want to buy a ton of ball bearings from you, you send me the ball bearings and an invoice and then 60 days later I pay you. But in Eastern Europe it was customary that I pay you first and then you send me the ball bearings. And so there were these questions of trust. Can we really send you money for ball bearings before we've seen if your ball bearings are round enough? Can you really send us ball bearings without knowing we're really going to pay you? Those different concepts had built up across the two sides of the Berlin Wall, made it very hard to start commerce going, because trust had different features on the two sides.
I remember people saying that the euro is going to fail because even in east and West Germany, these are relatives and they didn't trust each other. Not just from West Europe and East Europe. Actually German, they were all Germans and they were artificially divided from.
But the divide in Germany was a pretty serious divide. They had reason not to trust each other.
Were you surprised that the euro has so far Succeeded?
No, I'm not a monetary economist, so I don't have a deep professional insight into that. It makes a lot of sense. It has some drawbacks, but we have the dollar throughout the United States and it succeeds. And it has some drawbacks. When there's high unemployment in Mississippi, they can't devalue the Mississippi dollar to make Mississippi products cheaper. They're stuck with having the same dollar as the rest of us. On the other hand, when you cross into Mississippi or out of it, you don't have to change money. So commerce goes smoothly throughout the United States.
So we already had examples of continent wide currencies and it was a little funny for Europe to always have very different currencies wherever you went.
Have you ever seen something that seemed elegant with respect to market design but that society rejected?
Well, you know, we can talk about organ trafficking again. We have a real shortage of kidneys for transplant. I think I mentioned that there's 130,000 new cases of kidney failure each year in the US but fewer than 30,000 transplants. About 22,000 of those transplants come from deceased donors and about not quite 7,000 of them come from living donors. Kidneys are a little bit special in that that living donors have two kidneys and can remain healthy with one. So if someone you love was dying of kidney failure, you might be able to save their life, but there aren't enough donors. So if you potentially have kidney disease yourself, you might not be able to donate to who you want. One question that economists ask when you see thousands and thousands of people waiting for a deceased donor kidney is when you see long lines.
Maybe prices aren't being used to increase supply. And that's definitely the case in the U.S. we forbid, as most countries do, any effort to pay kidney donors. But it seems to me, and to many people that we should try to be flexible on that score because there are thousands and thousands of deaths every year because there's a shortage of kidneys.
Yeah, what about the converse were something that society accepted, but that was horribly inelegant and hideous to you? As a professional economist, I'm a great believer in evidence.
You see what works and you try to judge your policies on their consequences and not just their intents. So we talked earlier about heroin and there are lots of efforts to eliminate heroin, but those haven't been successful. And there are efforts to reduce its harm. And part of the harm that heroin does has to do with the fact that it's a crime and that people get arrested and communities get disrupted. And so some American cities and then some Western European countries have started to experiment with decriminalizing the use of small amounts of all sorts of drugs, you know, including heroin. And that has a certain elegance to it. But it turns out that, you know, not only are we losing the war on drugs, but it won't even accept our surrender. In cities like Portland, Oregon, where they briefly decriminalized open air use of drugs, they discovered that that has bad effects on the city, that having hypodermic needles on the ground near where your children play is not a good thing.
So they've started to recriminalize some of that. And I don't think we have any good answers yet about how to reduce the harms that we're suffering from illegal drug use. But that's all the more reason why we should be experimenting. And in the United States and Canada and elsewhere, often the cities have been the laboratories of democracy. So one harm reduction adaptation that has, has now come into wide use despite being vigorously opposed, is clean needle exchange. That is one of the problems with intravenous drug use is not just addiction and crime, but hepatitis and aids. And when you make available clean needles, the transmission of AIDS and hepatitis goes way down. So I think that's been a success.
That is, we hate drug use. We wish there were none, but we also hate overdose deaths and hepatitis deaths and AIDS deaths. So I think that's been a good thing. And there are other experiments going on, like safe injection sites that people can inject their drugs with someone watching them, you know, a nurse on duty, so that if they lose consciousness they won't die. And similarly, you know, a lot of drugs accessed from criminals are laced with fentanyl, which is cheaper than heroin, but it means you have no idea what dose you're getting. So if you're a heroin user who is used to injecting a certain amount, you can kill yourself. So there are cities where you can test your drugs for fentanyl. These are illegal drugs, but you should know maybe whether there's fentanyl, whether it's relatively safe for you to take.
And these are real half measures. That is, they don't satisfy our urge that there should be no heroin. But we've worked really hard for a long time that there should be no heroin and there's still heroin. So. So I'm in favor of thinking about harm reduction.
Thomas Sowell says something like, there's no solutions, there's just trade offs. And in the book, you describe this very interesting style of really philosophical and intellectual debate which is called a McCormick style trade off statement. What is that? And how could it improve the public debate around contentious issues?
Okay, so Frank McCormick is someone who's done a lot, an economist who's done a lot of work, work on the costs of transplantation versus dialysis and on the savings that would be accrued from making transplants more available. That is not just the lives saved, but the fact that we could afford to save these lives even if it were expensive, because dialysis is so expensive and Medicare pays for most dialysis. So end stage kidney disease is, is 7% of the Medicare budget and $55 billion a year. And almost all of that is on dialysis. But when you transplant someone, they come off dialysis. So McCormick, a lot of his work, McCormick's work is not only might it be the right thing to pay kidney donors, but we could afford it. But what he says is, he says, of course some people disagree with that, but mostly they disagree by saying, I think it's wrong, let's not do it. And, and what he would like them to make is what I called in the book, a McCormick statement, which says, although I understand that tens of thousands of people are dying each year in the United States, nevertheless I think that paying kidney donors is so wrong that we should accept that death toll.
And here are my reasons. And so what he wants is that people should acknowledge that there are trade offs for prostitution.
I mean, how would that work? I mean, would you say I acknowledge that men will go ungratified or something like, yes, you can say there'll be women that will have money, maybe, perhaps. And it should be noted there are male prostitutes as well. So maybe I shouldn't restrict myself only to a female. But how could that be employed in this McCormick like style?
So prostitution is complicated. It's against the law in many places, not in every place. I once gave a talk in Germany about morally contested transactions and I used three examples. Prostitution, kidney exchange and surrogacy. And the reason that was a good thing for an American to talk about in Berlin is the German laws are exactly the opposite of the American laws. The only one of those three that is legal in Germany is prostitution. Surrogacy and kidney exchange were illegal when I spoke kidney exchanges. Presently they're trying to push forward a law that would allow that.
But the problem with prostitution is multiple. And partly it has to do with the fact that there are both voluntary sex workers engaged in prostitution and trafficked women and children who are also objects of the prostitution market. But aren't willing objects. So let's think about those separately. We're not helping voluntary sex workers by making them criminals. It turns out that outdoor prostitution, outdoor sex work, street walking, it's one of the most dangerous jobs in the world. At the level of homicides, it's dangerous to be a prostitute. And so there are places like the Netherlands where they've licensed prostitutes, legal prostitutes, but by licensing them, they're trying to make sure that they're not trafficked, that they're voluntary sex workers.
They check their immigration status, status, they check various things in different cities in the Netherlands. So that's one set of experiments. Now, if you were to legalize prostitution, you would enlarge the market for prostitution. The risk of patronizing a prostitute would be less. And so there's the question of is legalizing prostitution a complement or a substitute for trafficked women and children? You wouldn't want to increase the scope of trafficking in women and children. One of the things I talk about in the book is a proposal by my colleague Petra Pearson, who says, let's try, try, maybe let's experiment with a combination of what they do in the Netherlands, which is licensing prostitutes, and in the Nordic countries, Norway and Sweden, where they've shifted the criminal burden. They've legalized the selling of sex, but criminalized the buying of sex. And that turns out not to be that popular among people who represent sex workers in Sweden, because as I said, sex work is dangerous, especially on the street sex work and the way way sex workers try to cope with the danger and mitigate it is by flirting.
That is, you know, someone stops the car, rolls down the window and starts a conversation about maybe you'd like to get in my car and deliver sexual services at wherever we go. When you have a customer and by talking to the driver, they can try to determine whether he's a crazy person. But if it's a crime for the driver to be talking to them, the drivers don't want to flirt, they don't want chit chat. They want, you know, to get in the car right away. And that makes the job more dangerous. Petra Pearson's proposal, which I like, I'd like to see it experimented in Las Vegas, for example, is why don't we license voluntary sex workers and have them. Part of that is discussions with social workers to make sure they're voluntary sex workers and health inspections and all those good licensing things and make it a crime to engage with an unlicensed prostitute. And the idea there is to make the voluntary part of sex work Safer and to shrink the trafficking part.
And I don't know if that would work, but I could easily see how it could be implemented in Las Vegas, where, although prostitution isn't now legal in Las Vegas county, it is legal in other counties in Nevada. So it shouldn't be a tremendous reach for the Nevada legislature to allow that.
There's a portion where you mentioned that we can agree to disagree. And it made me think of a colleague or, you know, a fellow Nobel laureate named Oman, I think. Is his name Bob Omah?
Yes, sir.
Who said that you actually can't agree to disagree. And so if you can't agree to disagree, because no rational agent with the same Bayesian priors can come to a disagreement rationally. Okay, we're not all rational actors, I'm sure. But how does that, you know, complicate the search for the pot of gold at the end of the McCormick rainbow? I mean, is that not going to really throw a spanner in the works, as they say?
Saying, that's a great paper that Bob Ollman wrote, but it depends, as mathematical theorems do, on its assumptions. And the assumptions are that we have common knowledge of the same prior beliefs and that we're just updating our beliefs based on new information as Bayesian decision makers do. So, in fact, the reason that's a great title for the paper is it's got this very counterintuitive conclusion because we all know that we can disagree. What he meant is under very idealized circumstances about very special kinds of disagreement, we wouldn't be able to disagree. There's another paper in that line called we can't disagree forever, but we can disagree for a long time and maybe forever. And so what I say in the book is these are issues on which we're not going to reach consensus. Right. There are some people whose objection to prostitution is that they object to sex outside of marriage of any sort, and maybe they think.
Think that God disapproves of that. And if that's what they think, then they're never going to vote for legislation that might make sex work less dangerous for voluntary sex workers. But it used to be, it maybe still is in many places, that the people who see themselves as representing the interests of voluntary sex workers often feel like they're opposed by the people who feel they're representing the interest of trafficked women and children, because on one side they're willing to tolerate that the market would get bigger if it got safer, and on the other hand, they're not willing to tolerate that it should get bigger. But the nice thing about this hybrid Dutch, Swedish proposal is it could potentially gather support from both parts. That is, it's intended to make voluntary sex work safer while shrinking the role of trafficked women and children. And so you can start to think about forming political coalitions, doing what democracies do to make sex work less dangerous. Since we've failed pretty much everywhere in the world at go away, we can make it illegal. But I don't know of any society that is completely free of prostitution.
You open the book with another fellow laureate, Danny Kahneman, who chose medical aid and Dying two years ago. Exactly. I think in March you use that to kind of examine autonomy and law and the different roles of morality and variability with geography. But I want to ask you, what do you think? Who should control the end of a life? Who should have the most say over it? The individual, the state, the church? Where do you think come to them?
I don't want to tell you who should have final authority on your life, but I think I would like to have some autonomy about the end of life. This is incidentally an old controversy. You know, some of the controversies I talk about, like, about surrogacy, have to do with new technologies. You couldn't have gestational surrogacy without in vitro fertilization. And that just happened in the 1970s. But Hippocrates, the ancient Greek physician who had his students swear an oath. One part of the oath, it wasn't just first do no harm. One part of the oath was I prescribe a life ending medicine.
Which means that even in the time of Hippocrates, around 3,000 years ago, medical aid in dying was controversial. People dying in pain and suffering wanted help to make a quick exit. And Hippocrates didn't think his students should help supply it. So it's an old controversy, not one that comes about with new technology. But new medical technology has allowed us to extend the dying process quite a bit. So it's complicated. And of course, like other things that are illegal in many jurisdictions, there's covert medical aid in dying. I believe there's quite a bit of COVID medical aid in dying because the same medicines that relieve pain can shorten life.
It's a question of dosage. There's an American Medical association of palliative doctors. I forget their exact name, but these are the doctors who man hospices. They have a position statement as a professional organization that says they're studiously neutral, neutral about medical aid and dying. And they acknowledge that there's covert medical Aid in dying. But their concerns, they say, and I thought it was a nice statement of one of the common concerns when we talk about bans. Their concerns is that allowing doctors to aid in death and not just preserving life would disrupt the delicate equilibrium between patients and doctors. And loosely speaking, I think that's true of many people who don't want to relax the guardrails around certain bands.
They worry that as a society we're in a complicated equilibrium that's not so bad, but if we relax the guardrails too much, we might slide down a slippery slope towards a less sympathetic society than we would want to live in. And I think the converse sort of progressive position is we're in a complicated social equilibrium that's not as good as it could be. And if we relaxed some of the guardrails, we could climb up that welfare gradient to get to a better society. So a lot of the disagreement has to do with not necessarily just the subject at hand, but what would follow from that. And of course, economists think about not just about trade offs more than other people do, but about equilibrium more than most other people do. And so I think economists are sympathetic to both points of view.
You know, you see a book, an economics book, if you're a layperson, you think, oh, do I really need to? It's not homework. Why should I read this book? But it is so enjoyable. It's such a romp through all these really pertinent questions, not just for the economically minded in the audience, but for everyone in society that thinks, thinks clearly, rationally and morally. And I wonder if you could do what you're not supposed to be done. But we love to judge a book by its cover. Hey, book lovers, we're judging books by the covers. We know we're not supposed to do it, but into the impossible. There's nothing to it.
Let's take a look and judge some books. Could you take us through the title, the subtitle and the artwork on this wonderful new book?
So the title, when I finished the book and sent to the, you know, the draft to my publisher, the title was something closer to Controversial Markets and Morally Contested Transactions. And that describes what the book is about. But my publisher didn't think that was a good title. So he proposed Moral Economics. And the trouble with that as a title is it wouldn't clue you into the fact that I'm not talking about capitalism versus socialism, I'm talking about morally contested transactions. So that's where the subtitle came. From Prostitution to Organ Markets or what we Learn from controversial markets and contested transactions.
I'm going to give a warning and a spoiler alert. We're going to talk about the Torah. We're going to talk about the Nobel Prize in the remaining 15 minutes or so that Al's generously given us. So that's not your thing, I understand, but I can't resist when I have an intellect like Al's to grapple with and to discuss as a Havrusa and do some holochic interloquit. So, you know, the book has many different religious kind of aspects to. It discusses Jehovah's Witnesses and Islamic law, but it deals with a lot of day to day practical sorts of issues. I wonder, as an economist, you know, looking at the Talmud or the Torah, do you see things that are, you know, just prescient or do you see things that are really antiquated? Let me take a couple examples. One is indentured servitude, you know, which would have a provision that you could work for somebody to discharge your debts.
Was that an immoral thing? Leaving aside the fact that some claim it led to chattel slavery, which most rabbinical scholars, including me, I'm not a rabbinical scholar, but I've thought about this a lot. It's clear the Torah eventually says that no, all slaves go free in the jubilee year. Is there a morality to slavery? How does a professional economist look at questions raised in these ancient texts?
Well, so. So debt slavery is much more modern than that. It's not confined to biblical history. There were debtors prisons 200 years ago in England and there were debtors prisons in the American colonies when we were British colonies. And by and large we moved away from thinking of debt, of failing to pay your debts as sin, to thinking of it as maybe bad luck. So we have bankruptcy laws now that allow you to reorganize your business, which might be profitable if only you didn't have the big debts that you'd assume. So we've changed our view of that, which is related incidentally to a whole long religious discussion about interest on loans. Should debts come with interest? Is it okay to make money from your money? Aristotle thought it was present.
And it's not clear in the Torah what they think, but maybe they think you shouldn't be charging your lancement interest. But indeed, in much of medieval Europe, when the Catholic Church thought that it was wrong to charge interest on loans, but when sovereigns and other people needed loans, Jews and Lombards, communities that allowed themselves to do finance, did finance and lent money Often with moral opprobrium. But we'd hardly have the global capitalist economy that we have in the world today if you couldn't charge interest on capital. So mostly even the Catholic Church, which has been very opposed to interest on loans, allows mortgages and all the nice financial instruments that make it easy for people to, to trade over time to look forward to their future prosperity and buy a house. Now, incidentally, Islamic law still doesn't like interest on loans, but there are things called Islamic mortgages, where instead of borrowing money from a bank, paying interest on it and using it to buy your home, the bank buys the house and charges you rent. And when you've paid enough rent, you own the home. So those have very similar on the equilibrium path outcomes. And finance is an important part of the world economy.
That's the story about bankruptcy. We used to have debtors prisons in the American colonies and we don't anymore. We still worry about high interest loans. There are payday loan services that give loans to people who live paycheck to paycheck. And when they have an emergency like a car breaks down, they, they might take a loan at a pretty high interest rate, a regulated but high interest rate that might take them several paychecks to pay back. In the United States, we pay for blood plasma, which is why there's not a shortage of blood plasma in the world. We're the Saudi Arabia of blood plasma, and we export tens of billions of dollars of blood plasma products each year, which is why there aren't massive medical deaths in Western Europe, where many countries forbid paying plasma donors. But a couple of economists did a study where they looked at new plasma donation facilities in the United States, new places where you can get paid for plasma.
And they found that the incidence of payday loans goes down when a plasma facility opens up. So the same people who might have to live paycheck to paycheck can support their income in different ways.
If you were around during the writing of the Ten Commandments, you were back at the source code meeting when Moses was receiving the Torah, would you have been surprised? I mean, all these things still have relevance. You talk about Leviticus, about their prohibition on incest and blood and the, you know, blood, the dam is the Nephesh, it is the soul. That's why we can't eat it. And those of us that keep kosher, you talk about reproduction. Onan, are you shocked that these things, which were surely in equilibrium back then, are really important back then, are still so relevant to today? If you were around back then, when you say, come on, guys, we don't got to put this in.
It's not.
No one's going to care about, like, onanism and surrogacy or eating blood. I mean, would you have been shocked that it's persevered for 3,000 years, approximately?
Well, so blood seems a little arcane in some ways. But adultery and reproduction, those are very common concerns. You know, putting them in the Ten Commandments didn't ban adultery, incidentally. I mean, it didn't make it disappear. It banned it without making it disappear. When you talk to rabbis who do a lot of pastoral work, one of the things I've heard is the main problem in my congregation is adultery. There are things are hard to ban. And thinking about reproduction here is still very hot item.
The supreme court just overturned 50 years of Roe v. Wade and sent the permission to ban abortions back to the states, as opposed to saying it's a right of individual women to decide whether to terminate a pregnancy, incidentally, reproduction. When I talk about repugnant transactions, the whole reproductive chain has been in front of the Supreme Court at some point. You know, whether contraception can be banned. That was a 1960s Supreme Court decision that it couldn't. The state of Connecticut couldn't ban the sale of contraception. Well, surrogacy hasn't been in the Supreme Court yet, but it might. Abortion obviously is.
These are questions about do women have the right to prevent a pregnancy, to initiate a pregnancy, ivf, to terminate a pregnancy. All of those are controversial. If Hashem had had a longer table, he could have had some more relevant commandments.
Well, Mel Brooks, you know, and he comes down from the mountain. I bring to you these 15. He drops on tablet 10 commandments. You know, the good news is, you know, I got them down to 10. But the bad news is adultery still is prohibited.
Right, Exactly. You know, but you ask, are there any things that surprise me in this? So not quite biblical, but in my career, the study of matching markets has become very important and become more and more central to economics. And that wasn't always the case. When I sent a paper years ago in the early 1980s on the economics of matching to a famous economics journal edited by someone who later that year won a Nobel Prize, he sent it back to me with a note that said, your paper, the Economics of Matching, obviously worked very hard. It's got very interesting results. But the only economics is in the the title. And what he meant was the markets I was looking at had had to do with building relationships much more than they had to do with using prices to clear the market. But you know, when you read in the Talmud, when you read Vayikra Raba, the commentary on Leviticus, there's a wonderful story about Rabbi Yossi Barafta who has a conversation with a Roman matron, a matronita.
And she says to him, how long did it take Hashem to. To create the universe? And he says, six days. And he rested on the seventh. And scholar that he is, he gives her the citation. And then she asks, what has he been doing since then? And the answer is, he's been making matches.
That's funny. Speaking modern incarnations, maybe, of what Hashem, you know, could only dream of, perhaps. What's your take on the unintended moral consequences of prediction markets? I'm thinking about Kalshi, the poly market. People are betting on people living and dying. And what are some of the moral concerns as you have about these new markets?
So my main concern about prediction markets is the fact that it seems to be crossing a lot of borders between what's public and what's private. And so people are trying to make money by having inside information on what is going to be tweeted on truth, social, things like that. And that just suggests to me a breakdown of public order in Washington. And it's not just particular prediction markets. I don't think I have a particular concern with prediction markets as such. One thing closely related that I talk about in the book is sports gambling. And sports gambling, when it was illegal or even in places where it was legal, often involved placing a bet before the beginning of a game on what the outcome of the game was going to be. But when gambling is available on your phone and you can bet on who will make the next point or will the next attempt at a basket go in, it's addictive, apparently, for some people.
So just as there are organizations like Alcoholics Anonymous, there's an organization called Gamblers Anonymous now, and it also causes gamblers to try to influence particular athletes to make bets come out. So that threatens the integrity of some sporting contests. Both of those are things we should worry about a little. I wouldn't mind seeing some consumer protection regulations of gas, gentle nudges of the sort that say on your gambling app, before the game begins, you can put in if you wish a limit. Say, once I've lost $100, I want the app to go blank. I don't want to bet anymore once I've lost $100. And I think that might help some people. For example.
Yeah, gambling Is supposedly one of the hardest addictions to break. Cause it seems completely innocuous on the surface. If someone has a heroin addiction, it's pretty easy to spot them going downhill. But a gambling, it's pretty hard to keep that close to the, the illusion
that you know, I'm down $100, but if I just bet some more, I'll get, I'll get even again.
The gambler's fallacy. Yes, yes. I think I could win a Nobel Prize for that. I want to get back just briefly to academia before we segue to the end with the Nobel Prize. Kind of very venally self interested questions on my part. But let's, let's talk about academia. It's full of different markets, it's full of zero sum games. I mean undergraduate getting into college, you know, getting into graduate school grades, tenure.
Once you get a faculty job, if you can get a faculty job job, then the prestige chaired loans, AI, you know, faculty poaching, tenure, startup. What is the most repugnant market, you know, sub field in academia and what's driving it? Is it knowledge, status, credentials, prestige, who gets what?
So let me first take issue with calling all those things zero sum. Some of them are distributive. Right. There's a job that you could have that I could want and only one of us could have. But that doesn't mean it's zero sum. That if neither of us had that job, the world might be worse off. There'd be less physics or less economics. So I don't think those things are zero sum, but they're distributive.
There's competition. I think the thing that's most worrisome is when the competition leads to scientific fraud. Because the thing that isn't zero sum is we're doing science, we're learning things. I mean for STEM fields at least, we're trying to make progress. We're not just conserving the past and passing it on to future generations the way maybe a Shakespeare scholar does. You don't make New Shakespeare. But I'm more worried about the people who do make New Shakespeare. That is, I discover an ancient manuscript which I've now washed in my washing machine and buried in my garden to make it look ancient.
And I say here's a Shakespeare play that you never read and it turns out not to be a real Shakespeare play. That's probably a crime. But every now and then in science and in other parts of academia, we see the pressures for promotion and tenure and publication lead to things like that. And that's of course, very disturbing and works against what the productive parts of academia.
I want to close with maybe a connection between Judaism and the Nobel Prize, which I've been fascinated with. You're the 26th Nobel laureate I've been honored to speak with. It's just such a treat because I do think that you're kind of members of society's intellectual seal team six and we need people like you. And of course, criticized the Nobel Committee, but not the Nobel laureates. I've never done that. Many of them are good friends, have written forwards to my books, and I hope you will be included in my next volume of interviews with Nobel laureates. We'll discuss that when it comes down in a year or two. But before I go too much further, I have to take issue with one of the main things that disturbed me most about the Nobel Prize, which is that if you look at what Alfred Nobel wrote, it's what we call in Hebrew, a zava? A.
It's an ethical one will. And it said. Basically, I distilled it into three major categories. It said, the prize shall go to the person who contributed the greatest benefit to mankind. He said, mankind. And then the Swedish Academy changed it to humankind recently. But I want to talk about the morality of changing someone's will, but before we get there. So he said to the person, meaning a singular person, who in the preceding year contributed the most to the benefit of mankind.
And by the way, he also didn't include economics, as you know. Do you find any of these to be, you know, kind of troubling? You know, from a Judaic standpoint, the wishes of the dead are sacrosanct, right? We're not supposed to even leave a dead person alone. We're supposed to escort them and be with them and bury them immediately. So what do you make of this? That we. That the Nobel committee, what they've changed, modified, added to it? Are those benign? Am I making too much of it? Or is there some moral concern that we should have?
So. So along with not being licensed to practice law in California, I'm also not licensed to practice law in Sweden, nor do I read Swedish. And I don't know what the Swedish law about starting foundations is, but one of the things Alfred Nobel did is he didn't direct who should win prizes. He founded a foundation, and he wanted this to last forever. And he gave the foundation lots of discretionary. Now, I don't know exactly what the Swedish law says about the nonprofit Nobel foundation, but when you found a nonprofit in The United States, it has a charter, and the charter typically is for producing some public good, and that allows it to be tax exempt. You have to apply for tax exempt status, and it gives the foundation discretion to carry that charter into the future. So although Nobel wrote about giving the prize to that person who the previous year conferred the most benefit.
You're a physicist. Think about the Higgs boson. Is that the right word for the particle? Higgs predicted a particle, but we didn't know that that was an important advance in physics until someone verified that the particle existed. And of course, that didn't, didn't happen in the previous year. And his discovery wasn't in the previous year to when the particle was observed. And it was more than one person who did it. I can well imagine that the foundation is in good faith trying to fulfill Nobel's wishes. But it turns out that particle physics didn't exist when Nobel wrote his will.
But he had the foresight to delegate the responsibility for fulfilling his wishes to a foundation. So. So I don't think there's necessarily anything immoral about the fact that you can't read from the simple words that are in the public declaration. I bet the documents founding the Nobel foundation are much longer.
There's so much death associated with the Nobel Prize. I just put a video out called the Only Near Death Experience. I believe in the headline that he saw in Paris. That was actually his brother's death that called him or associated him with being a merchant of death. And actually it led to the wording of the betterment of mankind. Because editorial doesn't say the merchant of death is dead. It says that a person who can hardly be said to have benefited mankind died yesterday in Cannes. And it was really his brother Ludwig.
But of course, you know, his youngest brother died because he was trying to experiment with nitroglycerin. And then Nobel himself made. Made his money, his vast fortune from dynamite and other weapons of war, like his, like his father, Emmanuel. But there's so much death, you know, and you got the prize on December 10, which is not his birthday, but his death day. Right. So. And the flowers come from his mausoleum, him in San Remo, not from local Swedish Stockholm flower fields, although December, that's pretty hard. But the one thing that kind of puzzled me always for a prize that's so saturated in death, is that the posthumous prohibition that you can't win it.
And that was Only instituted in 1974 by the Nobel committee, who meets every now and then. But that was actually the most recent time. 52 years ago now, and so many people who surely could have won it if they weren't dead, like Vera Rubin. She discovered the best evidence we have for dark matter, and she d long after the evidence for dark energy. In 2011, she was still alive. She could have won it easily. And so there are many people in that camp. So I guess, is this a market? Can we look at this as a market? What is the Nobel trying to do? And then how in concert is it with its stated goals or implied goals?
The area I work in is called market design, and I'm partly responsible for spreading that word. But a word I prefer is marketplace design. And because marketplaces are small parts of large environments and you have to think how the marketplace contributes to the market, how it interacts with the market. So I don't think of the Nobel foundation as a market, but it's certainly a kind of marketplace in the large market for science. And that market has lots of parts to it and is very complicated. A lot of science is open source. When you discover something, you write a paper, and you might even have to pay a publication fee depending on the journal you send it to. But you, your object is to make that discovery widely available.
But of course, it's not just altruism that makes scientists do that. I'm employed by a university and they are glad when I publish papers and they raise my salary, or they give me tenure, or they don't take it away. So there's no question that prizes are part of the ecology of science and therefore part of the economy of science also.
And within market design is marketing, this notion of marketing. And I guess I want to close with, maybe it's uncomfortable, but I think I can tell you're a very good spirited person and you won't be offended by these questions, But Peter Nobel died on 26 May, just a couple of weeks ago, and he called the economics prize a cuckoo's egg in the Nobel nest, and he called it a marketing PR coup by economists. So first, how do you react to that? Is it a marketing stunt? And as a marketplace designer, what do you look at it as? The Nobel in Economics, The Reese bank guys?
Yeah.
Yeah.
So I actually didn't know that Peter Nobel had died until you sent me an email the other day saying that you wanted to ask me about that. And I looked him up in Wikipedia and what his Wikipedia entry says is, he's principally known as an opponent of the Nobel Prize in economics.
He was a lawyer. He was a Swedish lawyer.
He was a Swedish lawyer. And he was the great grandson not of Alfred Nobel, but of his brother who predeceased him. So I can imagine that as in many estates, the family that didn't get Nobel's inheritance, instead he gave a big portion of it to a foundation which he started multiple generations later. They can have strong feelings about that. But Nobel wanted a professional foundation to be the custodian of the prize and not the great grandson of his deceased brother. But I can see that his name is Nobel, he lived in Sweden, so that every year there was a giant week long celebration that featured his name. I can see that that could be annoying to him.
The final thing I want to bring up is fellow Nobel laureate Milton Friedman, who's sort of supernatural to many of us and, or at least it's. But he said he was a little bit embarrassed. He said he was uneasy with it and he said eventually with this gun arm Myrdal, who I don't know who it is, but he sort of regretted accepting it because they felt like it wasn't science. But tell me now, you're clearly doing science. Your research breaches every boundary between what good empirical epistemology and rigorous academic research to be. Has economics progressed? Should we make sense of their comments in their time? And has, has economics really become a science more thanks to work by you and your colleagues in more recent decades? Was it reasonable for Friedman to be embarrassed back then, but not so now?
Well, economics is an early stage science. There's lots more we don't know about economies than that we do. But you know, chemistry was once an early stage science. When Archimedes did physics, it was a pretty early stage science. But looking back at Archimedes, we can see the science in what he did. Although there may have been other things too. And you know, the early, early alchemists, you know, they tried to transmute lead into gold, but they also figured out how to make dyes that would survive washing, you know, steady dyes. So they did real chemistry also.
So the alchemists weren't scientists, but we can see the science that emerged chemistry from their work. So I think that economics is an early stage science. We're learning more and we're becoming more scientific and I hope to see continued progress.
Al Roth, congratulations on this wonderful new book. I encourage everybody to read it. I listened to it. The audiobook is fantastic. It's an easy read, which I can't believe I'm saying about an economics book. Thank you so much for spending this time with us and I can't wait till we finally meet in person someday.
Okay, well, thank you for having me.
Nobel Prize winner Alvin Roth just argued that letting people die to keep a market pure is a moral choice we're making by default. If that reframed how you think about markets, subscribe and turn on notifications too, please. Then let me know in the comments. Would you let someone sell a kidney to someone, save a life and go deeper into the morality of modern life? My conversation with Sam Harris, it's three hours long and it's linked right here.
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🔖 Titles
Nobel Economist Al Roth on Markets, Morality, and the Cost of Letting People Die
The Deadly Logic of Banned Markets with Nobel Laureate Al Roth
Why Banning Kidney Sales Lets People Die: Nobel Economist Al Roth Explains
The Morality of Markets We Forbid: Al Roth on Black Markets and Human Suffering
When Markets Kill: Al Roth Discusses Repugnant Transactions and Unintended Consequences
Saving Lives or Saving Morality? Nobel Laureate Debates the Price of Market Bans
Al Roth on Repugnant Markets: The Deadly Cost of Prohibitions
Markets That Let People Die: The Economic and Moral Dilemma Explored
The Price of Prohibition: Nobel-Winning Economist Al Roth on Life, Death, and Markets
Can Morality Kill? Nobel Economist Al Roth Examines Bans, Black Markets, and Human Life
💬 Keywords
kidney exchange, organ donation, black markets, surrogacy, drug prohibition, ban consequences, repugnant transactions, moral dilemmas, social support for markets, prostitution laws, performance enhancement, sports doping, academic tuition, student debt, financial aid, bankruptcy law, plasma donation, SAT ban, college admissions scandal, gambling addiction, harm reduction, safe injection sites, religious influence, medical aid in dying, autonomy, discrimination in markets, market design, matching markets, trust in commerce, Nobel Prize economics, marketplace regulation
ℹ️ Introduction
Episode Introduction
The conversation focused on the moral complexities underlying the markets we allow—and those we forbid. At the center is a Nobel Prize-winning economist whose groundbreaking work on kidney donation systems has forced society to confront uncomfortable truths: why is it so easy to buy heroin, yet so difficult to hire a hitman, or even pay a kidney donor? One concept discussed was “repugnant transactions”—exchanges some people wish to engage in, but others find morally objectionable, from surrogacy to same-sex marriage to prostitution.
A key theme that emerged was the unintended consequences of bans: when a market is prohibited, black markets often surface, sometimes causing more harm than the activities themselves. The discussion explored provocative questions: how should we weigh the harms created by black-market activity against the perceived moral purity of a ban? Should society judge bans—and the markets we sanction—not just by their intentions, but by their real-world effects?
Several points were raised, including the role of social norms, religion, and politics in shaping what transactions are deemed morally acceptable. The conversation also delved into the ethical quandaries of academia, the thorny debates around performance-enhancing drugs, the evolution of matching markets, and the impact of trust and belief on economic interactions. Ultimately, this episode challenges listeners to reconsider the balance between morality, legality, and human welfare in the markets that shape our world.
📚 Timestamped overview
00:00 The author argues that the effectiveness of bans should be judged by their consequences, noting the stark contrast between the successful suppression of commercial murders and the widespread availability and impact of heroin in the United States.
08:10 Despite surrogacy bans in most of Western Europe, family courts in countries like Germany, Spain, and France have developed ways for surrogate parents to legally adopt their children, highlighting the practical challenges of enforcing such bans and the need to protect vulnerable newborns.
14:50 The section discusses the influence of religion on public opinion regarding medical aid in dying, noting that many objections are framed in religious terms, similar to issues like same-sex marriage and abortion.
18:27 The section discusses the issue of student debt being a major source of debt in the country, highlighting concerns about its inability to be discharged in bankruptcy and the impact on young people who may not fully comprehend the financial agreements they enter into at a young age.
20:55 The text discusses the disadvantages faced by poor families in college preparation compared to wealthier families using expensive coaching, referencing the Varsity Blues scandal and recent developments like the Enhanced Games, which involve performance enhancement in athletics.
27:00 The section discusses an experimental study on the influence of social media activity on the job market success of new PhDs, specifically finding that being tweeted and retweeted positively impacted women candidates.
32:39 The differing trust-related practices in Western and Eastern Europe regarding payment and delivery terms complicated post-Berlin Wall commerce, as Western contracts typically involved payment after receipt, whereas Eastern contracts required prepayment.
39:41 Frank McCormick's work highlights the economic feasibility and potential life-saving benefits of increasing kidney transplants over dialysis by paying donors, despite ethical objections from some who prioritize the moral stance against paying donors over the lives lost annually.
46:35 The discussion focuses on the potential of a hybrid Dutch-Swedish proposal to garner political support from both advocates of voluntary sex workers and those against trafficking, by making sex work safer while reducing trafficking, in contrast to failed attempts to eliminate prostitution through illegality.
52:26 The section discusses plans to cover the Torah, the Nobel Prize, religious aspects of a book, and how economic perspectives interpret both prescient and antiquated concepts from religious texts like indentured servitude.
54:20 The section discusses how religious views on charging interest have evolved, highlighting that while medieval Europe and Islamic law typically opposed it, modern financial systems, including those influenced by Catholic and Islamic perspectives, have adapted with instruments like mortgages and Islamic financing to accommodate economic growth.
59:23 The speaker reflects on how the study of matching markets has gained prominence in economics, sharing an anecdote about a paper they submitted in the 1980s that was initially criticized for lacking economic focus despite its interesting results.
01:06:41 The speaker, who is not licensed to practice law in California or Sweden, discusses Alfred Nobel's creation of a foundation intended to last indefinitely with discretionary powers and contrasts it with the U.S. process of founding nonprofits which requires a charter and tax-exempt status.
01:13:01 The section discusses Milton Friedman's mixed feelings about winning the Nobel Prize, his perception that it wasn't fully scientific, and questions whether economics has since evolved into a genuine science due to recent advances, implying increased legitimacy in contemporary economic research.
01:13:47 The text discusses how economics is in its early stages as a science, akin to the early stages of chemistry and physics, noting that early scientists, like alchemists, made significant contributions despite their incomplete understanding.
📚 Timestamped overview
00:00 Comparing bans on drugs and hitmen
08:10 Surrogacy bans and legal workarounds
14:50 Religion and medical ethics debate
18:27 Student debt and bankruptcy issues
20:55 College admissions scandals and performance enhancement
27:00 Social media impact on job market
32:39 Trust issues in East-West trade
39:41 Frank McCormick on transplant savings
46:35 Balancing sex work safety and trafficking
52:26 Discussing Torah and Nobel Prize
54:20 Historical views on charging interest
59:23 Early career insights on matching markets
01:06:41 Nobel Foundation's Legal Structure
01:13:01 Discussion on Milton Friedman's Nobel Prize
01:13:47 Early stage of economics science
❇️ Key topics and bullets
Sequence of Topics Covered
1. Introduction to Market Morality and Prohibited Transactions
Paradox of easy access to drugs vs. prohibition of hiring a hitman 00:00:00
Illegality and restrictions on kidney donation and surrogacy payments 00:00:14
International differences in surrogacy laws and rights
2. Nobel Prize Achievement and Organ Transplant Systems
Designing kidney matching systems 00:00:32
Legal and social acceptance of kidney exchanges
Criticism and controversy around cross-national organ exchanges 00:01:35
Notion of national self-sufficiency in transplants
3. Bans, Black Markets, and Unintended Consequences
Relationship between bans and black market formation 00:02:20
Social support required for both markets and bans 00:02:25
Methods of circumventing bans with different jurisdictions/criminal action
4. Morality of Bans: Intentions vs. Consequences
Judging bans by outcomes, not just intentions 00:03:22
Comparison of bans on hitman services vs. drug dealing 00:03:34
Success of banning murder for hire vs. failure in banning heroin
5. Lessons from Prohibition and Regional Variations in Law
U.S. history of alcohol prohibition and repeal 00:04:43
Differences between local and national bans (e.g., alcohol, prostitution) 00:05:23
Variability of enforcement and effectiveness due to local governance
6. Porous Bans: Case Study of Surrogacy
Legality and acceptance in different states/countries 00:07:21
Parental rights and adaptation in family courts despite illegality 00:08:10
Tension between protecting vulnerable populations (surrogates, babies) and porous effectiveness
7. Repugnant Transactions: Definitions and Examples
Technical definition of repugnant transactions 00:09:44
Same sex marriage, paid plasma donors, surrogacy as key examples 00:10:12
Distinction between disgust (e.g., eating cockroaches) and moral repugnance (e.g., horse meat laws) 00:11:01
8. Moral Objections and Social Decision-Making
Bans on payments for legal acts (e.g., paying surrogates in Canada/Britain) 00:12:18
Observer society versus participant perspectives 00:13:04
Democratic and religious influences in legislating market restrictions 00:13:51
Courts as arbiters in contested moral markets 00:14:06
Religious influences on contested markets (aid in dying, same-sex marriage, abortion) 00:15:00
9. Morality and Pricing in Academia
Moral questions around rising tuition and financial aid in higher education 00:16:03
University of California as a public institution, implications for subsidies and fairness 00:16:55
Student debt and bankruptcy law; informed consent for financial contracts 00:18:27
Differential college preparation and admissions scandals (Varsity Blues, SAT bans) 00:20:21
10. Performance Enhancement: Sports and Academia
Enhanced Games and the issue of doping in sports 00:21:51
Societal reasons for banning performance-enhancing drugs 00:22:23
Nuanced use of stimulants in academic and professional settings (Adderall, coffee) 00:23:35
Risks and benefits of broader access to performance enhancers
11. Market Design, Experiments, and Academic Morality
Role of experiments in economics and market design 00:27:00
Moral objections to experimental studies in job markets 00:28:13
Broader application in development economics and randomized control trials 00:29:29
Concepts of equilibrium, equilibration, and congestion in modern markets 00:30:36
12. Trust in Markets and Cultural Differences
Importance and mechanics of trust in long-term and international transactions 00:32:39
Different customs in credit/trust post-Berlin Wall 00:33:15
The euro & continent-wide currency trust 00:34:09
13. The Limits of Market Design: Elegance vs. Social Acceptance
Organ trafficking and the shortage of kidney transplants 00:34:59
Restrictions on paying organ donors and consequences
Social acceptance of uneconomic but popular policies (e.g., heroin bans and harm reduction) 00:36:27
14. Harm Reduction, Trade-offs, and McCormick Statements
Real-world examples of half measures (clean needle exchange, safe injection sites) 00:38:13
McCormick style statements for explicit trade-off discussions 00:39:41
Application of McCormick reasoning to prostitution and regulatory complexities 00:41:02
15. Complexities of Regulatory Experiments: Prostitution as Case Study
Comparative analysis of prostitution, surrogacy, kidney exchange in the U.S. and Germany 00:41:20
Experiments with combined regulations to reduce harms and trafficking 00:41:55
Perspectives on agreeing to disagree, rational actors, and durable disagreement 00:45:07
16. Autonomy, Morality, and End-of-Life Decision-Making
Medical aid in dying: autonomy, legal, moral, and equilibrium concerns 00:47:41
Historical perspective from Hippocrates to modern medical law 00:48:06
Slippery slopes and societal equilibrium in relaxing bans 00:50:13
17. Ancient Texts, Economics, and Moral Law
Economic interpretations of Torah, Talmud, and religious prohibition (indentured servitude, charging interest) 00:52:26
Historical debt slavery and evolution of bankruptcy laws 00:53:36
Comparative perspectives on religious and secular lending practices (Islamic finance) 00:55:47
Market explanations for modern inequalities and adaptations (e.g., plasma donation) 00:56:42
18. Relevance and Longevity of Ancient Moral Questions
Persistence of taboos and regulations across millennia (adultery, reproduction, incest) 00:57:55
Current legal and moral controversies: contraception, surrogacy, abortion 00:58:54
19. Matching Markets and Relationship Economics
Academic resistance to matching models in economics 00:59:23
Jewish texts and matchmaking as economic metaphor 01:00:26
20. Modern Prediction Markets and Gambling Concerns
Ethics and risks of prediction markets and inside information 01:01:06
Sports gambling, technology, and addiction concerns 01:01:33
Consumer protection proposals for gambling apps
21. Repugnant Markets in Academia
Competition and zero-sum vs. distributive outcomes in academic careers 01:03:43
Scientific fraud as the most worrisome outcome
Value of science as a non-zero-sum endeavor
22. The Nobel Prize: Origins, Morality, and Evolution
Explicit intentions in Nobel’s will and the Foundation’s role 01:05:46
Challenges in fulfilling Nobel’s original criteria (timing, singularity, disciplinary limits) 01:06:15
The morality of altering interpretations and criteria over time 01:06:15
Death, legacy, and the prohibition of posthumous awards 01:09:48
The Nobel Prize as a marketplace and part of the scientific ecosystem 01:10:23
23. Critiques and Perceptions of the Nobel in Economics
Peter Nobel’s criticism: the economics prize as a “cuckoo’s egg” 01:11:27
Nobel family inheritance and institutional legacy
24. Economics as Science and Disciplinary Progress
Milton Friedman’s unease and evolution of economic science 01:13:47
Parallels drawn with the history of chemistry and alchemy
Hope for continued progress toward scientific rigor in economics
25. Conclusion and Book Recommendation
Host’s endorsement of the book’s value for all audiences 01:14:35
Final thoughts and encouragement to engage with the topics discussed
👩💻 LinkedIn post
🚨 Just listened to a thought-provoking episode of the INTO THE IMPOSSIBLE Podcast featuring Nobel-winning economist insights on markets that are forbidden—sometimes with mortal consequences.
The conversation focused on why some markets, like organ donations or surrogacy, are considered too "repugnant" for society to allow—even if the cost is lives lost or opportunities missed. One key theme that emerged was the powerful tension between our moral intentions and the real-world outcomes of the bans we create.
Here are three key takeaways for anyone working at the intersection of economics, policy, or ethics:
Bans Have Unintended Consequences: Prohibiting certain transactions (like paid organ donation) doesn't eliminate demand. Instead, it often drives activities into black or gray markets, creating inefficiencies and sometimes harming vulnerable groups.
Morality Needs a Consequences Check: The discussion explored the necessity of evaluating not just the intention behind bans, but their actual societal outcomes. In some cases, “protecting moral purity” comes at the very real cost of human lives or increased suffering.
Markets Reflect Social Values—For Better or Worse: Several points were raised, including how social norms and religious beliefs shape what is considered acceptable or repugnant. This impacts everything from kidney donation, surrogacy, and prostitution to college admissions and end-of-life decisions.
If you engage with policy, ethics, or market design, this episode is a must-listen—it challenges us to reconsider where our good intentions may be doing harm, and where better-designed markets could actually save lives.
#Economics #Policy #PodcastTakeaways #EthicsInMarkets
🧵 Tweet thread
🚨 Why can you buy heroin on any corner, but you can’t hire a hitman? A conversation with a Nobel-winning economist about forbidden markets, moral trade-offs, and why our bans often backfire:
1️⃣ The conversation focused on why some “repugnant” markets are regulated so differently. For example, it's easy to find illegal drugs, but almost impossible to hire a hitman in the U.S. Both are banned—so why does one black market thrive, while the other barely exists? 00:03:41
2️⃣ One concept discussed was the unintended consequence of bans: prohibiting something doesn’t necessarily make it go away. Instead, it pushes demand underground or to other jurisdictions. Think of people traveling to California for surrogacy, then returning home with their babies because local courts recognize parental rights—even if paying surrogates is illegal in their home country. 00:00:14 00:08:21
3️⃣ A key theme that emerged was the difference between intentions and outcomes. Should we judge morality based on what we hope to achieve, or on the actual consequences of our actions? For instance, banning heroin hasn't rid the streets of it—but it has created a deadly, unregulated black market and countless overdose deaths. 00:04:03
4️⃣ The discussion explored repugnant transactions—deals that some want to make, but others find morally unacceptable (think: paying for organs, surrogacy, or same-sex marriage). Often, objections rely more on “ick” or religious discomfort than measurable harm. 00:10:05
5️⃣ Several points were raised, including how black markets adapt: bans on surrogacy in Europe force courts to create creative legal workarounds so children can go home with their parents anyway. Laws might claim to protect “vulnerable” women, but it’s often the babies who are most vulnerable to the unintended consequences. 00:09:03
6️⃣ There’s historical precedent: Prohibition didn’t end alcohol use in the U.S.—it just strengthened organized crime. Once alcohol was re-legalized, the unsafe, criminal element faded. The lesson? Legal, regulated markets can outcompete criminal ones. 00:05:14
7️⃣ If we judge policies only by their intentions and ignore the disaster of their consequences, we fail those we claim to protect. Why not use evidence to shape policy, instead of moral wishful thinking? Would you allow someone to sell a kidney if it could save a life? 00:03:34 00:35:56
8️⃣ Maybe it’s time for more McCormick statements: “Although I understand that tens of thousands of people are dying each year, nevertheless I think paying kidney donors is so wrong that we should accept that death toll. Here are my reasons…” 00:40:38
Let’s be honest about the costs we’re willing to pay for our moral comfort.
💡 What “repugnant” markets do you think society gets wrong? Should morality trump saving lives? Join the debate 👇
🗞️ Newsletter
INTO THE IMPOSSIBLE Podcast Newsletter
Episode Highlight: Nobel Economist: The Market That Lets People Die | Al Roth
Dear INTO THE IMPOSSIBLE Community,
This week, we dive into one of our most provocative and challenging episodes yet. The conversation focused on markets that society deems “repugnant”—transactions some people want, while others think they should be banned—and the moral consequences of those decisions.
What’s in this episode?
Life-or-Death Market Design:
One concept discussed was the paradox of markets in life-saving contexts. Why can you buy heroin almost anywhere, but you can’t legally pay someone for a kidney to save a life? The discussion explored how bans on certain markets—like organ sales—lead to unintended and often deadly consequences, such as black markets and needless death on waiting lists.Repugnant Transactions Explained:
A key theme that emerged was the idea of “repugnant transactions”—cases where the mere existence of a market offends some people, even if they’re not directly harmed. These include paying surrogates, organ donors, and the broader debates around prostitution and same-sex marriage.Morality vs. Outcomes:
Several points were raised, including whether our bans on certain transactions are truly moral if they lead to more harm than good. Should morality be measured by intention, or by consequence?Experiments in Harm Reduction:
The episode looks at past and current attempts to reduce harm rather than simply ban behavior—such as needle exchanges to prevent disease among drug users, or the experiments with regulated brothels and surrogacy.Academia Under Scrutiny:
The discussion also turned to the moral dimensions of higher education costs, student debt, and fairness in college admissions—exploring how market rules affect who gets access and who is left out.
Questions to ponder:
If a ban creates a thriving black market and more harm, is it still moral?
Should people be allowed to sell a kidney to save a life if they want to?
What’s the role of religious and cultural values in shaping our laws about who can do what, even when the risks and benefits are clear?
Listen in for an eye-opening look at the hidden logic guiding which markets are allowed, which aren’t, and who pays the price.
Don’t miss this episode!
Listen Now on Your Favorite Platform
Would you allow someone to sell a kidney if it meant saving a life?
Reply to this email—we’d love to hear your thoughts.
Stay curious,
The INTO THE IMPOSSIBLE Team
P.S. For even deeper moral explorations, check out our conversation with Sam Harris—linked at the end of the episode!
❓ Questions
Discussion Questions
The conversation focused on the unintended consequences of banning certain markets, such as organ sales and surrogacy. What examples from the episode illustrate how prohibitions can lead to black markets or harm to vulnerable populations, and how should societies weigh intended morality against actual outcomes?
One concept discussed was the idea of "repugnant transactions," where a transaction is forbidden not because of measurable harm but due to collective moral or religious discomfort. How can societies fairly navigate such subjective objections when creating laws?
A key theme that emerged was the contrast between effective and ineffective bans, using heroin and hitmen as examples. What factors contribute to the practical enforceability of bans, and how do these play out in real-world scenarios?
The discussion explored the role of financial incentives in organ donation, particularly kidney transplants. Is it ethical to pay organ donors if it could save thousands of lives, or should certain moral boundaries remain absolute, even at the cost of lives?
Several points were raised regarding how bans in one jurisdiction can be circumvented by moving transactions elsewhere, like surrogacy in California for residents of Europe or Canada. What challenges do these cross-border inconsistencies present for both individuals and lawmakers?
The episode delved into the role of religion and deeply held beliefs in shaping market laws (e.g., same-sex marriage, medical aid in dying, prostitution). To what extent should religious or cultural values influence market regulation in pluralistic societies?
The conversation highlighted examples where legal changes attempted to reduce harm from prohibited behavior, such as needle exchange for drug users. Are harm reduction policies a pragmatic concession, or do they undermine broader moral objectives?
The speakers questioned whether markets like college admissions or academic jobs are truly zero-sum or if they can offer collective gains. How might a better understanding of these dynamics inform reforms in academia?
The discussion examined the evolution of economic science and its recognition through the Nobel Prize, including the controversy around its legitimacy. How should non-traditional or emerging fields be recognized when their contributions don’t fit historical definitions?
When balancing competing interests—such as the autonomy of individuals versus societal norms (e.g., in the case of medical aid in dying)—what frameworks should be used to decide who ultimately has authority or veto power over morally contested choices?
curiosity, value fast, hungry for more
✔️ Why can you buy drugs on any corner, but can’t pay someone to save a life?
✔️ Nobel-winning economist Al Roth joins Brian Keating on the INTO THE IMPOSSIBLE Podcast to reveal the hidden logic—and deadly consequences—behind the markets society forbids.
✔️ From kidney exchanges to surrogacy, prostitution to heroin bans—discover why some “repugnant” markets persist, and others remain taboo.
✔️ Challenging what’s moral versus what actually helps people might just change how you see every rule we live by.
Conversation Starters
Conversation Starters for Facebook Group Discussion
The episode explores "repugnant transactions"—markets that many find morally objectionable, like paid organ donation or surrogacy. Which repugnant transaction discussed in the podcast challenged your own views the most, and why?
The discussion compared bans on heroin with bans on hiring hitmen, highlighting their very different real-world effects. What do you think explains why one ban (on hitmen) works and the other (on heroin) doesn’t? Should this influence how we make laws?
Is it ever justified to ban a market if the ban itself leads to greater harm (like black markets or preventable deaths)? Where should the line be drawn between upholding social values and minimizing suffering?
The conversation examined the morality of charging high university tuitions and the resulting impact on different social groups. Do you think it is fair for elite universities to charge high fees to those who can afford it while offering aid to the less wealthy? Why or why not?
Should society allow people to sell their kidneys to save lives, as suggested in the episode? Does the potential to save thousands of lives outweigh moral objections to creating such a market? What are the risks?
When discussing surrogacy and other controversial markets, the podcast raised the issue of "who decides"—the state, religious influences, or individuals. Who do you think should have the most say in these matters, and why?
Academia and performance enhancement were discussed, from Adderall in exams to banned substances in sports. Should all forms of performance enhancement be treated the same way, or are there key distinctions? Where do we draw the line?
Trust was described as essential in markets and commerce, with the fall of the Berlin Wall as a historical example. In today’s world, how important is trust for new markets (like prediction markets) to function ethically and effectively?
The episode mentioned that some bans, such as those on horse meat or paid plasma donation, may tell us more about our social values than about practical concerns. What bans in your country do you think are more about symbolism than actual harm reduction?
A theme from the episode was that unintended consequences often outweigh the intentions behind laws and bans. Can you think of a real-world example—outside those discussed—where this has played out? How could policymakers do better?
🐦 Business Lesson Tweet Thread
Why is it easy to buy heroin but illegal to pay for a kidney? Let’s talk about the markets we forbid — and the price we pay. 🧵
1️⃣ Some bans work. Others just create black markets. You can’t hire a hitman. You can buy heroin on any corner.
2️⃣ Bans don’t always protect. Sometimes, they harm: Thousands die every year waiting for kidneys because we ban paying donors.
3️⃣ Morality often drives these bans. But is it moral to let people suffer to avoid “repugnant” transactions?
4️⃣ Markets thrive or die on what we, as a society, decide to support. When bans leak, desperate people find workarounds or travel for what they need.
5️⃣ The real lesson: Judge laws not by intent, but by outcome. When purity comes before pragmatism, people pay the price—sometimes with their lives.
6️⃣ Progress isn’t about loving every market. It’s about asking: Are our choices saving or costing lives?
7️⃣ Sometimes, the most controversial experiments—like kidney exchanges—save the most people.
We’re all trading off values. The question is: Whose pain are we willing to ignore?
✏️ Custom Newsletter
🚀 Into the Impossible Podcast: "Nobel Economist: The Market That Lets People Die | Al Roth" – Now Live!
Hey Podcast Family,
Get ready for a mind-bending episode! We just dropped a brand new conversation featuring Nobel Prize-winning economist Al Roth, and trust us—this one will have you re-examining everything you think you know about markets, morality, and the rules that shape our lives.
Al Roth takes us on a journey through the “repugnant transactions” that society sometimes tries to wish away—think organ markets, surrogacy, and even job applications. Buckle up for an exploration of the tough questions: What makes a market acceptable? When do our attempts to ban something only make things worse? Why do some bans save lives, while others let people die?
🎯 5 Keys You’ll Learn in This Episode
Why Some Markets Are Allowed—and Others Are Forbidden: The discussion explored why you can easily buy drugs on a street corner, but can’t (thankfully) hire a hitman, and what that says about the effectiveness of certain bans 00:03:00.
The Real-World Consequences of “Moral” Bans: One concept discussed was that intentions aren’t enough—bans on things like organ donation can lead to more suffering and unnecessary deaths than if payment were allowed 00:04:00.
Black Markets, Workarounds, and Social Support: Several points were raised, including how efforts to restrict or ban disliked transactions (like paying for surrogacy or plasma donation) often just push these activities across borders or underground, without really stopping them 00:02:53.
How Trust and Culture Shape Commerce: The conversation focused on how deeply held beliefs, religious or otherwise, influence what transactions a society will tolerate, and the trust required to make any market work—whether it’s kidneys or coffee beans 00:33:39.
Why Bans Aren’t Always the Solution: A key theme that emerged was the idea that some “half-measures”—like clean needle exchanges or regulated sex work—might actually help reduce harm, even if they aren’t perfect 00:38:13.
🤓 Fun Fact
Did you know that coffee is technically a performance-enhancing drug? The episode even dives into why no one looks down on scientists and mathematicians for chugging espresso to crank out theorems...but performance enhancement becomes “repugnant” when it takes other forms (looking at you, Erdos and amphetamines!) 00:25:37.
🚦 Outtro
It’s not every day you get to hear a Nobel laureate break down the economics—and morality—of markets with this much candor and honesty. Whether you’re curious about kidney exchanges, what makes prostitution legal in one country but not another, or want to debate the fuzzy lines society draws around “acceptable” markets, there’s something in this episode for you.
👉 Call to Action
Ready to have your mind changed...or at least challenged? Listen to "Nobel Economist: The Market That Lets People Die | Al Roth" now, and let us know in the comments what markets you think should be allowed—or banned for good. And don’t forget to subscribe so you never miss an episode!
Stay curious,
The Into the Impossible Team
🎓 Lessons Learned
1. Morality and Market Design
Evaluating markets and bans requires considering both intentions and real-world consequences, not just moral aspirations. 00:03:22
2. Repugnant Transactions Defined
Some transactions are banned because they offend societal morals, even if not directly harming others involved. 00:09:39
3. Effects of Market Bans
Bans can create black markets or shift activity to other jurisdictions, often with unintended negative outcomes. 00:02:25
4. Kidney Donation Shortage
Legally prohibiting compensation for kidney donors causes unnecessary deaths due to donor shortages. 00:01:10
5. The Role of Trust
Markets rely profoundly on trust; differences in expectations can prevent commerce and cooperation. 00:32:39
6. Religion Shapes Market Acceptance
Religious beliefs strongly influence which markets or transactions a society will accept or prohibit. 00:15:00
7. Performance Enhancement Ethics
The acceptability of performance enhancements varies widely with context, intention, and safety. 00:23:35
8. Academic Market Morality
Issues like student debt and tuition raise complex moral questions about fairness and access in higher education. 00:16:30
9. Prostitution Policy Complexity
Legalizing or banning prostitution involves difficult tradeoffs between safety, trafficking, and societal values. 00:41:02
10. Pragmatism Over Perfection
Societal solutions require trade-offs; rarely are there perfect answers, only better or worse practical outcomes. 00:39:23
10 Surprising and Useful Frameworks and Takeaways
Ten Most Surprising and Useful Frameworks & Takeaways
1. Repugnant Transactions as a Technical Economic Category
The discussion explored how markets that society finds morally or culturally objectionable—such as paid surrogacy, prostitution, or kidney sales—are categorized not merely by illegality or disgust, but specifically as “repugnant transactions.” These are deals some people want, while others think should not be allowed, often for reasons impossible to quantify or resolve through standard economic harm measures 00:09:44.
2. Intention vs. Consequence in Market Morality
A key theme that emerged was the necessity to judge the morality of both markets and bans not by intention, but by actual consequences. For example, banning heroin and banning murder-for-hire are similar in law but produce very different results—the latter is nearly completely effective, the former not at all 00:03:22.
3. Porous Bans Create Black or Grey Markets
The conversation focused on unintended outcomes from bans: if people truly want something, bans don’t eliminate the activity, but instead push it into grey or black markets or different jurisdictions. Surrogacy bans in Western Europe, for example, just drive people to California, and similar back-channels exist for kidney donation and drugs 00:02:53.
4. The McCormick Trade-Off Statement
One concept discussed was the “McCormick statement,” which reframes contentious debates: “Although I understand tens of thousands die each year, I think paying kidney donors is so wrong we should accept those deaths—and here are my reasons.” This format surfaces actual trade-offs, moving arguments away from vague moralizing toward explicit balancing of consequences 00:39:41.
5. Legal vs. Voluntary vs. Harm
Several points were raised, including the way legality and payment can shift a transaction from mundane to “repugnant.” For instance, surrogacy is permissible in Canada/Britain if unpaid, illegal if compensated. Likewise, prostitution turns only into a crime when money changes hands 00:12:29.
6. Experimentation in Policy Design
The discussion highlighted how markets (and market bans) should be treated as areas for ongoing experimentation—adjusting laws, running field experiments, and measuring real outcomes. The history of prohibition, clean needle exchanges, and drug decriminalization shows that strict bans can fail, so ongoing experimentation is vital 00:37:39.
7. Equilibrium and Equilibration
A key framework distinguished between equilibrium (the state a system rests in) and equilibration (the process of getting there), borrowing from physics and applying it to economics: solutions are one thing, but getting there is another, and congestion in modern markets—like job applications or school admissions—highlights this process 00:30:36.
8. Marketplace Design vs. Market Design
A useful distinction emerged between "market design" and "marketplace design." While market design addresses rules and incentives, the broader context (marketplace design) considers the entire ecosystem—legalities, social norms, cultural context, and technological infrastructure 01:10:23.
9. Harm Reduction over Prohibition
The conversation focused on real-world strategies that mitigate harm when outright prohibition fails. Clean needle exchanges and supervised injection sites, though controversial, save lives and reduce disease, suggesting that policies should sometimes focus less on eliminating vice and more on reducing its consequences 00:38:13.
10. Cross-Cultural and Legal Patchwork
One of the most surprising frameworks was the exploration of how different societies tolerate or ban the same behaviors (prostitution, surrogacy, kidney exchange) and how those attitudes shape not only access but public health outcomes and individual autonomy, highlighting the crucial interplay of law, culture, and practical workarounds 00:15:21.
These frameworks encapsulate the episode's big ideas: from how morality and economics interface, to the importance of designing systems that acknowledge messy realities over pure ideology, and the constant need to test, iterate, and recognize trade-offs.
Clip Able
Clip 1
Title: Why Some Markets Are Illegal—and People Die Because of It
Timestamps: 00:00:10 – 00:03:12Caption:
The conversation focused on why certain markets are forbidden, such as the sale of organs or surrogacy services, and the consequences of these bans. One concept discussed was how prohibitions can lead to black markets and unintended harm. The discussion explored why it’s so easy to buy drugs yet so hard to hire a hitman, with both legal and moral implications. Several points were raised, including that bans on markets must be judged not just by intent, but by their real-world outcomes—sometimes leading to unnecessary suffering or death.
Clip 2
Title: The Moral Complexity of Bans: Prohibition, Surrogacy, and Social Harm
Timestamps: 00:04:43 – 00:08:13Caption:
A key theme that emerged was how well-intentioned bans can have harmful side effects. The discussion explored the history of alcohol prohibition, and drew parallels to current bans on surrogacy and drug use. Several points were raised, including examples where bans create underground markets and fail to eliminate the activity. The conversation focused on surrogacy laws in Western Europe, showing how legal contradictions can force family courts to improvise and sometimes undermine the original intent of a ban.
Clip 3
Title: Defining Repugnant Transactions and Society’s Double Standards
Timestamps: 00:09:25 – 00:13:03Caption:
The discussion explored the idea of “repugnant transactions”—deals that some people wish to make, but society finds morally objectionable. Several points were raised, including how money can turn a legal act into an illegal one, such as paying for surrogacy or prostitution. One concept discussed was the distinction between what society finds disgusting versus what it deems repugnant, and how this shapes our laws. The conversation focused on the moral and democratic processes for deciding which transactions to allow.
Clip 4
Title: Morality, Markets, and Higher Education: Is Charging High Tuition Just?
Timestamps: 00:16:03 – 00:19:44Caption:
The conversation focused on moral questions around academia, specifically tuition costs and student debt. A key theme that emerged was whether charging high university tuition is ethical, especially when it outpaces inflation and burdens families with debt they cannot discharge in bankruptcy. The discussion explored the tradeoff between making education free versus targeting financial aid, and the impact of student loan structure on young people’s futures. Several points were raised about the fairness of subsidizing education for the wealthy and the risks inherent in student debt policies.
Clip 5
Title: Performance Enhancement, Competition, and Fairness in Academics and Sport
Timestamps: 00:21:51 – 00:25:25Caption:
A key theme that emerged was the debate about performance-enhancing drugs, not just in athletics but in academia. The discussion explored the blurred lines between nutrition and enhancement, examining examples from the Tour de France to students using Adderall. Several points were raised about the extent to which rules regarding performance enhancement should be shaped by concerns about fairness, risk, and progress in broader society. The conversation focused on whether society is missing opportunities by devoting scientific effort to enforcing bans rather than investigating potential benefits.
💡 Speaker bios
Al Roth is known for his groundbreaking work on organizing kidney exchanges to address the critical shortage of donor organs. Recognizing that traditional transplant methods left many patients waiting, Roth and his colleagues developed kidney exchange programs, allowing more living donor transplants than previously possible. This innovative approach helped increase the number of transplants each year despite the high rate of kidney failure in the United States. Roth’s efforts were so significant that the US Congress unanimously amended the National Organ Transplant Act to affirm the legality of kidney exchanges—a controversial yet vital change that not everyone embraced, but one that saved countless lives.
💡 Speaker bios
Brian Keating, intrigued by the intersections of economics, society, and law, found himself reflecting on how certain taboos—like alcohol and prostitution—are addressed in America. He noted that while alcohol prohibition once swept the nation through federal mandate, other taboos, such as prostitution, are handled in a patchwork of local regulations, pointing to places like Las Vegas where it is legal. Inspired by economists like Allison who explore unconventional markets in their books, Brian leverages these observations to engage audiences in thought-provoking conversations about how societal values and economics intertwine in unexpected ways.
💡 Speaker bios
Al Roth is known for tackling controversial issues, particularly in the world of organ transplantation. With his colleagues, he pioneered the organization of kidney exchanges—a novel system that pairs living donors and recipients to maximize the number of kidney transplants. This work addresses the urgent shortage of transplants, as around 130,000 Americans face kidney failure annually, yet fewer than 30,000 receive transplants each year. Roth's efforts were instrumental in convincing the US Congress to amend the National Organ Transplant Act, making kidney exchange explicitly legal, though his innovations have not been without their critics.
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