Bargaining Fools

The unusual days project with Andrew Leigh took a different twist today. Andrew and I completed our latest paper — “Bargaining over Labor: Do Patients have any Power?” By the way, the answer is ‘yes.’ However, this will require some explanation.

Before getting to that some context is useful. This paper looks at birth timing (like our earlier one on The Millennium Bub). One thing we document is that there are fewer births on weekends (and public holidays) than on weekdays. This is consistent with findings in the US. But what is more fascinating is that there are fewer births on inauspicious days like April 1, February 29 and Friday 13th. The first two have twice the magnitude in decline as the last one. So parents are really worried about the consequences of funny birthday dates for their children; enough to want to move that day if they can. [As an example, I have a brother born by planned C-section on 2nd April; which is a shame for me as I would have really exploited a 1st April birthday. But I guess that is the point].

That is interesting and qualifies for some unusual day activity. But we don’t stop there. There is another issue that concerns us. Most medical associations profess that medical considerations come first. That would suggest that non-medical considerations would only carry weight when there is no medical issue. So if 1st April or 29th February fall mid-week or on a weekend; no problem. But if they fall on a Friday or Monday, then parents’ desires may well conflict with those of doctors and hospitals. In this situation the doctors should win out.

Well, we use our data to estimate precisely this. And we find that three quarters of the time, the doctors win; there are more 1st April births on Fridays and Mondays than 1st April births on other days. But a quarter of the time, on average, the patients get their way. This means that they do have some bargaining power.

A day here or a day there perhaps isn’t of much consequence. But it is a far cry from the picture of ‘doctors in charge’ and that should give us some pause for thought.

Of course, if patients care about missing weekends too much then we may be over-estimating this. We don’t think that is plausible but perhaps the writers of The West Wing do?

LEO
What is it, two weeks?

TOBY
In ten days, we can pick a day on the calendar and they’ll induce.

LEO
You can pick a day?

TOBY
Yeah.

LEO
That’s great, so you can do it on a Friday, let the kids get their feet wet over the weekend.

TOBY
Yeah.

LEO
Let me tell you something… you know what I’d do? I’d check into the hospital today. You can’t do it too soon. Mallory was very nearly born at Exit 322 on the Long Island Expressway.

[Update: Andrew Leigh also has a discussion on his blog.]