11 ms·

Thousands of Low-Income Americans 'Donate' Blood Plasma to For-Profit Centers

80 points by Mz 10y ago

ErikVandeWater 10y ago
Although somewhat grotesque to many on the face of it, this seems like fundamentally a good thing. Poor people get money they need, and people with severe injuries get their lives saved. I find it unusual there always seems to be an aversion to companies making money on healthcare (the emphasis on for-profit). This is weird, because no one would suggest companies should only be allowed to make money on irrelevant or trivial things; shouldn't companies that save lives make _more_ money than companies that just make entertainment, or manufacturing equipment?
- DanBC 10y ago
  People desperate for money, who may not have blood suitable for donating, are incentivised to lie. Meanwhile, men can't donate if they've had sexual contact with men in the past 12 months. http://www.redcrossblood.org/donating-blood/eligibility-requirements/eligibility-criteria-topic http://www.redcrossblood.org/donating-blood/eligibility-requ...
  - zaroth 10y ago
    And if the alternative (not offering any payment) is simply not having enough plasma to manufacture the life saving treatments? It's almost as if people who are donating this frequently should be properly screened and truly compensated for the value they are providing...
    - awqrre 10y ago
      Around here they don't pay for blood, they give you things like movie tickets or restaurant gift cards... sure the recipients could sell them for cash but it's not as easy.
  - dbg31415 10y ago
    Before it can be distributed and used, the blood gets screened and tested. We shouldn't be too worried about people lying having any impact on the quality or safety of the blood supply. * Blood Donor Screening || http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/ApprovedProducts/LicensedProductsBLAs/BloodDonorScreening/default.htm http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts... > FDA has progressively strengthened the overlapping safeguards that protect patients from unsuitable blood and blood products. Blood donors are asked specific questions about risk factors that could affect the safety of the donation and are deferred from donation if risk factors are acknowledged. FDA also requires blood centers to maintain lists of unsuitable donors to prevent further donations from these individuals. After donation, the blood is tested for several infectious agents. All tests must be negative before the blood is suitable for transfusion. In addition to these safeguards, FDA has significantly increased its oversight of the blood industry. The agency inspects all blood facilities at least every two years, and "problem" facilities are inspected more often. Blood establishments are now held to quality standards comparable to those expected of pharmaceutical manufacturers.
    - Rasco 10y ago
      What about the window between an infection by the HIV and the production of antibodies ? Parent's argument doesn't seem to be irrelevant, otherwise, if the screenings were totally reliable why would we bother asking for risky behaviours ? Lying is one of the arguments against paid blood donations in France, the other being that poor people may be incentivized to put their health at risk by donating to often (donations are anonymous). The WHO seems to advocate for unpaid donations : > An adequate and reliable supply of safe blood can be assured by a stable base of regular, voluntary, unpaid blood donors. These donors are also the safest group of donors as the prevalence of bloodborne infections is lowest among this group. World Health Assembly resolution WHA63.12 urges all Member States to develop national blood systems based on voluntary unpaid donations and to work towards the goal of self-sufficiency.[1] [1]http://www.who.int/mediacentre/factsheets/fs279/en/ http://www.who.int/mediacentre/factsheets/fs279/en/
      - chimeracoder 10y ago
  - chimeracoder 10y ago
    For plasma donation, every individual is tested for blood-borne diseases. They draw an additional whole blood sample first for this test. This is even more rigorous than what we do for whole blood donation, in which blood samples are pooled and tested as a batch. Ironically, the reason we're able to do this is that we make a larger profit off of plasma donations, whereas we don't for whole blood, and have to use the cheaper testing methods for that.
- pkaye 10y ago
  What would be interesting is the relative profit made by the poor people vs the companies.
- gech 10y ago
  Is the share of the profit from this equitable though? Or do these companies take the lion's share?
  - zaroth 10y ago
    Equitable? The raw material is a far cry from the final product which required perhaps hundred of millions in R&D. If people are willing the give a unit of plasma for $7.50 and supply is meeting demand, it seems precisely equitable. The key question is that donating so frequently must be safe for the donor. If there's long term health implications then the firms have to coordinate if necessary to ensure donations are not made too frequently.
    - cloudsloth 10y ago
      Showing that people are willing to pay a price does not make it equitable. You have to account for power dynamics and market conditions. I believe the original question was whether there was a relatively even or fair split of 'profits' from the current setup. One could make a case for this being even, and also for it being somehow relational to investment (blood from the giver, r&d + logistics from the receiver). Your 'answer' glosses over all that.
      - peacetreefrog 10y ago
        You're welcome to "make the case" for whatever you want, but this comment suggesting it's something in anyone's control belies what's really going on. The price system and "profit" splits aren't something any one entity (plasma doner nor company) sets down and decides. It (like most prices) is an emergent phenomenon. You might as well "make the case" the morning commute from downtown Chicago up to Evanston should be less than 35 minutes, it's pretty much irrelevant as to how it turns out.
        cloudsloth 10y ago
        I think you misunderstood me entirely. I wasn't saying it was in someone's control. I was discussing analysis of the system as it is.
- prmph 10y ago
  The grotesqueness is not about the donation itself, it is about people being so desperate under the current economic system that they have to resort to this
- ThrustVectoring 10y ago
  Relevant Churchill quote: >Some years ago in London there was a toll bar on a bridge across the Thames, and all the working people who lived on the south side of the river had to pay a daily toll of one penny for going and returning from their work. The spectacle of these poor people thus mulcted of so large a proportion of their earnings offended the public con-science, and agitation was set on foot, municipal authorities were roused, and at the cost of the taxpayers, the bridge was freed and the toll removed. All those people who used the bridge were saved sixpence a week, but within a very short time rents on the south side of the river were found to have risen about sixpence a week, or the amount of the toll which had been remitted! My inner cynical hardline communist says that this just gives rentiers more juice to squeeze from poor folks. If getting more stuff helps poor people, they'd have been helped by the mechanization of agriculture rather than continuing to get worked to the bone to barely survive. IMO what they need is negotiating power and better outside options to the exploitative traps they're in.
  - mindslight 10y ago
    If your inner communist wants to see reforms, it should think economically. One can't ignore incentives. The core intuition is that rents will go up, but not by the full six pence - perhaps only five. The landlords will be unable to extract the entire surplus. The people will have slightly more money, which they can save to gain that negotiating power you're talking about. However, the monetary policy of USD directly destroys this natural rising. Instead of accepting that slight deflation is natural [0], deflation has been cast as a bogeyman [1] and banished at all costs. The result is massive monetary base inflation to keep the CPI rising, which precisely affects the areas where new money is injected into the consumer economy - anything which can function as collateral and thus be financialized. So cheaper life necessities that should be a boon (eg Walmart) simply cause rents (landlord or bank) to rise fully in compensation as a matter of policy. [0] In the steady state, both technological progress and general market competition should lead to continually lower prices - a lower price is generally how one wins out in a market. [1] In the days when communication was slow, price signals were a comparatively large portion of all market coordination. A slowing down of purchasing meant also a slowing down of communication, causing a positive feedback loop as people doubled down on their expectations. Contrast with computing devices which have developed rapidly enough to even outpace the forced inflation - we've all delayed purchases of new devices for a year or two until new tech came out, but despite the promise of an even better deal, eventually our present utility function overrides future savings and we upgrade.
- mc32 10y ago
  I was acquainted with a couple from Ohio somewhere. At times the husband would 'donate' blood in order to afford gas money to be able to drive to an entry level job at some warehouse or something. It was a pretty sad sounding story. On the other hand, I can admire their will to do what it takes to earn some money the hard way.
DoodleBuggy 10y ago
Meanwhile, low-income Indians sell their kidneys https://www.youtube.com/watch?v=eny6D-7f_rc https://www.youtube.com/watch?v=eny6D-7f_rc The Red Market is an interesting/disturbing book on the organ trade, here's an NPR interview with the author http://www.npr.org/2011/06/10/136931615/blood-bones-and-organs-the-gruesome-red-market http://www.npr.org/2011/06/10/136931615/blood-bones-and-orga...
dbg31415 10y ago
I donate every 2 months. I also encourage everyone who can to donate as frequently as they can. It's an easy way for anyone to play it forward. * American Red Cross || http://www.redcrossblood.org/give/drive/driveSearch.jsp http://www.redcrossblood.org/give/drive/driveSearch.jsp I had a family member in a near-fatal car accident a little over 12 years ago. It took a lot of blood to keep her alive, and I'm thankful for everyone who donated and made saving her life possible. That said, donating blood takes time and effort, and some recovery time where you don't feel 100% for a day or so after -- so I have no problem with incentivized / compensated altruism.
- cylinder 10y ago
  This is not about donating blood to the Red Cross, this is about the plasma donation industry, which is only for-profit in the US and supplies much of the world. Only a few companies operate in this space, I've studied it closely. Baxalta runs a big chain, BioLife, as does CSL. If we accept that selling organs is prohibited and unethical then we should also accept the same for selling plasma.
  - kgwgk 10y ago
    What about hair, milk, sperm or oocytes?
    - x0137294744532 10y ago
      You can donate hair, milk, sperm or oocytes as frequently as you like without affecting your health. This is not the case for organs or plasma.
      - kgwgk 10y ago
        Could you donate sperm 100 times per day without affecting your health? I'm impressed! (Edit: assuming you're an sperm producing individual.(I was going to say 'man', but I don't want to risk offending anyone again.)) Seriously, egg donation seems to affect your health more than plasma donation. According to wikipedia: Birth control pills are administered during the first few weeks of the egg donation process to synchronize the donor's cycle with the recipient's, followed by a series of injections which halt the normal functioning of the donor's ovaries. These injections may be self-administered on a daily basis for a period of one to three weeks. Next, follicle-stimulating hormones (FSH) are given to the donor to stimulate egg production and increases the number of mature eggs produced by the ovaries. Throughout the cycle the donor is monitored often by a physician using blood tests and ultrasound exams to determine the donor's reaction to the hormones and the progress of follicle growth. Once the doctor decides the follicles are mature, he/she will establish the date and time for the egg retrieval procedure. Approximately 36 hours before retrieval, the donor must administer one last injection of HCG hormone to ensure that her eggs are ready to be harvested. The egg retrieval itself is a minimally invasive surgical procedure lasting 20–30 minutes, performed under sedation (but sometimes without any). A small ultrasound-guided needle is inserted through the vagina to aspirate the follicles in both ovaries, which extracts the eggs. After resting in a recovery room for an hour or two, the donor is released. Most donors resume regular activities by the next day.
kgwgk 10y ago
And thousands of men 'donate' sperm to for-profit centers. Which, truth be said, seems a convenient way to perpetuate your genes without all the hassle of the traditional mechanism. As long as your genes are 'desirable', of course.
- EliRivers 10y ago
  Selecting for men who jack off into a cup for money. Who wouldn't desire those genes.
njharman 10y ago
Is this really news, not known? I did it and so did most people I knew back in college (the ones who didn't were too heavy drug users). It was one of many sources for "minor money". Which when you have NO money, is pretty great. It's one of a host of shitty things we force poor people to do cause as a society we have this stupid fucking idea that you have to work for everything, that you don't deserve the necessities of existence unless you spend 40+ hours making someone else rich.
- QuercusMax 10y ago
  I sold my plasma for a semester or so in college for gas money, before I got a "real job" on campus. I was making around $60-75/wk, which wasn't bad at all. The people there were all either college students or super sketchy people; it was right next to university campus. I didn't (and still don't) feel like I was taken advantage of at all; it was better than flipping burgers.
fapjacks 10y ago
Hah there was a time, long ago, when I used to feed myself with money from blood and plasma donation.
Houshalter 10y ago
This reminds me of "The Copenhagen Interpretation of Ethics": http://web.archive.org/web/20160806191858/https://blog.jaibot.com/the-copenhagen-interpretation-of-ethics/ http://web.archive.org/web/20160806191858/https://blog.jaibo... Our culture has a very strange belief that you shouldn't benefit from the less fortunate. Even if you benefit them too. People that have never donated a dollar to charity in their lives, will come out of the woodwork and complain about "exploitation".
- kome 10y ago
  "People that have never donated a dollar to charity in their lives" is a particularly American, or let's say anglophone, way to approach social justice. Charities are based on good will, but "the less fortunate" do not need "good will": they need social rights. https://en.wikipedia.org/wiki/Social_rights https://en.wikipedia.org/wiki/Social_rights If you don't see "exploitation" when people need and they are willing to sell their blood, I have no idea what you mean by exploitation.
  - gravypod 10y ago
    Does that sentiment hold when your donations are to pro-bono legal firms?
    - aqme28 10y ago
      The "donations" in this case aren't really donations. They're being paid in exchange for their blood plasma. So I don't see the comparison to pro-bono legal firms.
      - gravypod 10y ago
        Trades of goods are equivalent to currency.
      - chimeracoder 10y ago
        > The "donations" in this case aren't really donations. They're being paid in exchange for their blood plasma. Which gets back to the question - what's wrong with that? The alternative is not to pay people for donating plasma, and we can see quite clearly that that doesn't work - every country that does not pay for blood plasma donations runs a shortage, and most of them end up importing plasma from the US. So, we have to pay for plasma, or else we won't have enough, which means people will literally die. Given that we have to pay for plasma, what's wrong with letting anyone who's medically eligible to donate do so? Most of the common arguments against tissue donation (safety, incentive to lie, etc.) either don't apply to plasma donation or are no longer relevant thanks to the cost and accuracy of modern testing methods. There is no medical or financial reason not to permit the practice, and I'm struggling to see a moral one that doesn't eventually result in people dying because we refuse to collect the life-saving tissue that people are perfectly capable of providing and willing to provide.
sandworm101 10y ago
The rules against paying donors in many countries can cause problems. Some people with very rare bloodtypes are in high demand. When someone needs that rare blood we could at least cover the traveling expenses needed to bring in the willing donor. But that just isnt allowed.
- chimeracoder 10y ago
  > The rules against paying donors in many countries can cause problems. Some people with very rare bloodtypes are in high demand. When someone needs that rare blood we could at least cover the traveling expenses needed to bring in the willing donor. But that just isnt allowed For plasma, most countries meet their unfulfilled demand in part by buying plasma from the US. That isn't allowed for all other forms of tissue, though, so the shortages for rare matches remain. This literally costs lives.
- k__ 10y ago
  I habe 0+ which isn't rare but still in high dem and.
  - sandworm101 10y ago
    I also have o+ but recentlu found out i will never be allowed to donate in canada because i lived in the middle east off and on as a kid (80s and 90s). The saudis imported beef from the uk. So i have been exposed to mad cow disease. 25 years later and i am symptom free. Lol. This rule bans so many soldiers, expats and immigrants that i am forced to conclude canada blood services has more than enough blood. The saudis happily took my blood at 15yo. They paid me for it.
than 10y ago
Radiolab had a fascinating segment on US blood banks and how cutthroat the blood economy can be. In many cases, your local blood bank might be arbitraging blood from different areas of the country. http://www.radiolab.org/story/308780-blood-banks/ http://www.radiolab.org/story/308780-blood-banks/
daviross 10y ago
This was something I did twice a week myself, to help get through college. It worked well for being a way to get additional money in a way which worked with the rest of my schedule, though having income directly tied to health wasn't always great. (Have a minor cold? Now be knocked out of a week or two's deposits)
ensiferum 10y ago
Two other interesting news stories right next to this one http://abcnews.go.com/US/bus-drivers-working-alongside-silicon-valley-millionaires-struggle/story?id=44707434 http://abcnews.go.com/US/bus-drivers-working-alongside-silic... http://abcnews.go.com/US/working-fast-food-jobs-16-hours-day/story?id=44707695 http://abcnews.go.com/US/working-fast-food-jobs-16-hours-day... Is this the "american dream" ?
- gens 10y ago
  Wouldn't be a dream if it as real, now wouldn't it ?
  - ensiferum 10y ago
    touche
peacetreefrog 10y ago
Pretty basic economics. Quantity supplied generally == quantity demanded, as long as there's a functioning price system. It's why you can go to a gas station and (while the price certainly changes) count on them never being out of gas, despite whatever else is going on in terms of weather, OPEC or whatever. Paying people for plasma donation means there's plasma available for patients who need it. And it's not like these doners are coerced. Removing their option to do that (by outlawing paid donations) by definition can only make them worse off.
- jeffdavis 10y ago
  I agree because blood donation is safe. If it weren't, or we were talking about kidneys or something, it gets more complicated.
  - chimeracoder 10y ago
    > I agree because blood donation is safe. If it weren't, or we were talking about kidneys or something, it gets more complicated. Unsafe procedures provide even more justification for compensation. Otherwise, there's a shortage of people who will be willing to go through it for free, leading to even more exploitative incentives - peer pressure in the best case[0], or outright trafficking in the worst. Remember that you can't prevent market activity from happening; you can prevent it from happening out in the open, and hope that the inconvenience and other risks are enough of a deterrent (look at the war on drugs, or sex work). But for an individual, there is no situation in which the stakes are higher than being denied a lifesaving treatment. That's the point at which, in the extreme case, even kidnapping or organ harvesting seem like viable options (to them), because they are literally the only option, other than death. You might think I'm being hyperbolic, but this literally happens. But if you can ensure an adequate supply from people who are properly informed about the risks and capable of consenting, there is no incentive to engage in that sort of activity. [0] for example, pressure from an infertile relative who wants to use your eggs to conceive
- peacetreefrog 10y ago
  It is interesting how the (monetary) price for blood is basically $0, while for plasma it's > $0. Know nothing about blood or plasma, but I'd imagine this is because donating plasma takes longer and is more painful. Wouldn't be surprised if it was trickier to store/transport/use or if you generally got less plasma fluid out of a person vs blood, or people could donate less often or something. Also note while the monetary price for blood is $0, that's probably not the full price -- just ask anyone who has reluctantly donated blood because they didn't want to be the only person in their school or office not donating during a blood drive. There's often a social cost to NOT donating too. Also, even with these differences/caveats the lack of a price system for blood does lead to some mismatches between supply and demand. There's currently a big blood shortage as we speak (google it), leading some hospitals to cancel elective surgery.
WalterBright 10y ago
I donate blood now and then, and am an organ donor. I suppose technically I'm being exploited, but I don't mind.
RUG3Y 10y ago
I've donated plasma when I was really broke...only a couple of months ago. I would do it again except the phlebotomist perforated the vein in my left arm 6 or 7 times, digging around for what felt like an eternity. I'm a glutton for punishment but that definitely wasn't worth 40 bucks. I needed money for car parts though. The really interesting thing about the plasma center is all the oddball characters you get to see. It's worth a visit just to experience the weird vibe.
jrs235 10y ago
So it seems there is a lot of confusion here in the comments. [Blood] Plasma donation is not the same as blood donation. https://www.statnews.com/2016/01/22/paid-plasma-not-blood/ https://www.statnews.com/2016/01/22/paid-plasma-not-blood/
adentranter 10y ago
Aussie here. This is an interesting contrast to what the state of blood donation and healthcare here is. I have never seen a for profit blood bank here. It's mainly one non for profit that takes blood donations. I have often tried to donate blood but been turned away due to my height vs weight ratio ( im skinny and tall ). I think the desire to donate blood for nothing may come from the fact that we receive pretty much free healthcare ( you can pay for health insurance and get access to better doctors and shorter waiting lists ). I've read many things on HN about healthcare in the pass and it always amazes me how much I take my countries health system for granted. I have put on 10 kgs (22 lbs) since I last tried so maybe I will try again sometime.
- chimeracoder 10y ago
  > I think the desire to donate blood for nothing may come from the fact that we receive pretty much free healthcare ( you can pay for health insurance and get access to better doctors and shorter waiting lists ). Whole blood donations are (almost always) uncompensated in the US as well. This article is referring to plasma donations, which are different and take longer.
WhitneyLand 10y ago
So how come you can't "donate" a kidney and be paid for your time on the operating table?
- chimeracoder 10y ago
  > So how come you can't "donate" a kidney and be paid for your time on the operating table? Because one is explicitly illegal and the other is not. If you're asking for a justification behind that difference, the answer is that the laws are simply not consistent. Donating eggs, for example, can be compensated, and that's a relatively invasive procedure.

80 points by Mz 10y ago

Although somewhat grotesque to many on the face of it, this seems like fundamentally a good thing. Poor people get money they need, and people with severe injuries get their lives saved. I find it unusual there always seems to be an aversion to companies making money on healthcare (the emphasis on for-profit). This is weird, because no one would suggest companies should only be allowed to make money on irrelevant or trivial things; shouldn't companies that save lives make _more_ money than companies that just make entertainment, or manufacturing equipment?

DanBC 10y ago
People desperate for money, who may not have blood suitable for donating, are incentivised to lie. Meanwhile, men can't donate if they've had sexual contact with men in the past 12 months. http://www.redcrossblood.org/donating-blood/eligibility-requirements/eligibility-criteria-topic http://www.redcrossblood.org/donating-blood/eligibility-requ...
- zaroth 10y ago
  And if the alternative (not offering any payment) is simply not having enough plasma to manufacture the life saving treatments? It's almost as if people who are donating this frequently should be properly screened and truly compensated for the value they are providing...
  - awqrre 10y ago
    Around here they don't pay for blood, they give you things like movie tickets or restaurant gift cards... sure the recipients could sell them for cash but it's not as easy.
- dbg31415 10y ago
  Before it can be distributed and used, the blood gets screened and tested. We shouldn't be too worried about people lying having any impact on the quality or safety of the blood supply. * Blood Donor Screening || http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/ApprovedProducts/LicensedProductsBLAs/BloodDonorScreening/default.htm http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts... > FDA has progressively strengthened the overlapping safeguards that protect patients from unsuitable blood and blood products. Blood donors are asked specific questions about risk factors that could affect the safety of the donation and are deferred from donation if risk factors are acknowledged. FDA also requires blood centers to maintain lists of unsuitable donors to prevent further donations from these individuals. After donation, the blood is tested for several infectious agents. All tests must be negative before the blood is suitable for transfusion. In addition to these safeguards, FDA has significantly increased its oversight of the blood industry. The agency inspects all blood facilities at least every two years, and "problem" facilities are inspected more often. Blood establishments are now held to quality standards comparable to those expected of pharmaceutical manufacturers.
  - Rasco 10y ago
    What about the window between an infection by the HIV and the production of antibodies ? Parent's argument doesn't seem to be irrelevant, otherwise, if the screenings were totally reliable why would we bother asking for risky behaviours ? Lying is one of the arguments against paid blood donations in France, the other being that poor people may be incentivized to put their health at risk by donating to often (donations are anonymous). The WHO seems to advocate for unpaid donations : > An adequate and reliable supply of safe blood can be assured by a stable base of regular, voluntary, unpaid blood donors. These donors are also the safest group of donors as the prevalence of bloodborne infections is lowest among this group. World Health Assembly resolution WHA63.12 urges all Member States to develop national blood systems based on voluntary unpaid donations and to work towards the goal of self-sufficiency.[1] [1]http://www.who.int/mediacentre/factsheets/fs279/en/ http://www.who.int/mediacentre/factsheets/fs279/en/
    - chimeracoder 10y ago
- chimeracoder 10y ago
  For plasma donation, every individual is tested for blood-borne diseases. They draw an additional whole blood sample first for this test. This is even more rigorous than what we do for whole blood donation, in which blood samples are pooled and tested as a batch. Ironically, the reason we're able to do this is that we make a larger profit off of plasma donations, whereas we don't for whole blood, and have to use the cheaper testing methods for that.
pkaye 10y ago
What would be interesting is the relative profit made by the poor people vs the companies.
gech 10y ago
Is the share of the profit from this equitable though? Or do these companies take the lion's share?
- zaroth 10y ago
  Equitable? The raw material is a far cry from the final product which required perhaps hundred of millions in R&D. If people are willing the give a unit of plasma for $7.50 and supply is meeting demand, it seems precisely equitable. The key question is that donating so frequently must be safe for the donor. If there's long term health implications then the firms have to coordinate if necessary to ensure donations are not made too frequently.
  - cloudsloth 10y ago
    Showing that people are willing to pay a price does not make it equitable. You have to account for power dynamics and market conditions. I believe the original question was whether there was a relatively even or fair split of 'profits' from the current setup. One could make a case for this being even, and also for it being somehow relational to investment (blood from the giver, r&d + logistics from the receiver). Your 'answer' glosses over all that.
    - peacetreefrog 10y ago
      You're welcome to "make the case" for whatever you want, but this comment suggesting it's something in anyone's control belies what's really going on. The price system and "profit" splits aren't something any one entity (plasma doner nor company) sets down and decides. It (like most prices) is an emergent phenomenon. You might as well "make the case" the morning commute from downtown Chicago up to Evanston should be less than 35 minutes, it's pretty much irrelevant as to how it turns out.
      - cloudsloth 10y ago
        I think you misunderstood me entirely. I wasn't saying it was in someone's control. I was discussing analysis of the system as it is.
prmph 10y ago
The grotesqueness is not about the donation itself, it is about people being so desperate under the current economic system that they have to resort to this
ThrustVectoring 10y ago
Relevant Churchill quote: >Some years ago in London there was a toll bar on a bridge across the Thames, and all the working people who lived on the south side of the river had to pay a daily toll of one penny for going and returning from their work. The spectacle of these poor people thus mulcted of so large a proportion of their earnings offended the public con-science, and agitation was set on foot, municipal authorities were roused, and at the cost of the taxpayers, the bridge was freed and the toll removed. All those people who used the bridge were saved sixpence a week, but within a very short time rents on the south side of the river were found to have risen about sixpence a week, or the amount of the toll which had been remitted! My inner cynical hardline communist says that this just gives rentiers more juice to squeeze from poor folks. If getting more stuff helps poor people, they'd have been helped by the mechanization of agriculture rather than continuing to get worked to the bone to barely survive. IMO what they need is negotiating power and better outside options to the exploitative traps they're in.
- mindslight 10y ago
  If your inner communist wants to see reforms, it should think economically. One can't ignore incentives. The core intuition is that rents will go up, but not by the full six pence - perhaps only five. The landlords will be unable to extract the entire surplus. The people will have slightly more money, which they can save to gain that negotiating power you're talking about. However, the monetary policy of USD directly destroys this natural rising. Instead of accepting that slight deflation is natural [0], deflation has been cast as a bogeyman [1] and banished at all costs. The result is massive monetary base inflation to keep the CPI rising, which precisely affects the areas where new money is injected into the consumer economy - anything which can function as collateral and thus be financialized. So cheaper life necessities that should be a boon (eg Walmart) simply cause rents (landlord or bank) to rise fully in compensation as a matter of policy. [0] In the steady state, both technological progress and general market competition should lead to continually lower prices - a lower price is generally how one wins out in a market. [1] In the days when communication was slow, price signals were a comparatively large portion of all market coordination. A slowing down of purchasing meant also a slowing down of communication, causing a positive feedback loop as people doubled down on their expectations. Contrast with computing devices which have developed rapidly enough to even outpace the forced inflation - we've all delayed purchases of new devices for a year or two until new tech came out, but despite the promise of an even better deal, eventually our present utility function overrides future savings and we upgrade.
mc32 10y ago
I was acquainted with a couple from Ohio somewhere. At times the husband would 'donate' blood in order to afford gas money to be able to drive to an entry level job at some warehouse or something. It was a pretty sad sounding story. On the other hand, I can admire their will to do what it takes to earn some money the hard way.

DoodleBuggy 10y ago

Meanwhile, low-income Indians sell their kidneys https://www.youtube.com/watch?v=eny6D-7f_rc https://www.youtube.com/watch?v=eny6D-7f_rc The Red Market is an interesting/disturbing book on the organ trade, here's an NPR interview with the author http://www.npr.org/2011/06/10/136931615/blood-bones-and-organs-the-gruesome-red-market http://www.npr.org/2011/06/10/136931615/blood-bones-and-orga...

dbg31415 10y ago

I donate every 2 months. I also encourage everyone who can to donate as frequently as they can. It's an easy way for anyone to play it forward. * American Red Cross || http://www.redcrossblood.org/give/drive/driveSearch.jsp http://www.redcrossblood.org/give/drive/driveSearch.jsp I had a family member in a near-fatal car accident a little over 12 years ago. It took a lot of blood to keep her alive, and I'm thankful for everyone who donated and made saving her life possible. That said, donating blood takes time and effort, and some recovery time where you don't feel 100% for a day or so after -- so I have no problem with incentivized / compensated altruism.

cylinder 10y ago
This is not about donating blood to the Red Cross, this is about the plasma donation industry, which is only for-profit in the US and supplies much of the world. Only a few companies operate in this space, I've studied it closely. Baxalta runs a big chain, BioLife, as does CSL. If we accept that selling organs is prohibited and unethical then we should also accept the same for selling plasma.
- kgwgk 10y ago
  What about hair, milk, sperm or oocytes?
  - x0137294744532 10y ago
    You can donate hair, milk, sperm or oocytes as frequently as you like without affecting your health. This is not the case for organs or plasma.
    - kgwgk 10y ago
      Could you donate sperm 100 times per day without affecting your health? I'm impressed! (Edit: assuming you're an sperm producing individual.(I was going to say 'man', but I don't want to risk offending anyone again.)) Seriously, egg donation seems to affect your health more than plasma donation. According to wikipedia: Birth control pills are administered during the first few weeks of the egg donation process to synchronize the donor's cycle with the recipient's, followed by a series of injections which halt the normal functioning of the donor's ovaries. These injections may be self-administered on a daily basis for a period of one to three weeks. Next, follicle-stimulating hormones (FSH) are given to the donor to stimulate egg production and increases the number of mature eggs produced by the ovaries. Throughout the cycle the donor is monitored often by a physician using blood tests and ultrasound exams to determine the donor's reaction to the hormones and the progress of follicle growth. Once the doctor decides the follicles are mature, he/she will establish the date and time for the egg retrieval procedure. Approximately 36 hours before retrieval, the donor must administer one last injection of HCG hormone to ensure that her eggs are ready to be harvested. The egg retrieval itself is a minimally invasive surgical procedure lasting 20–30 minutes, performed under sedation (but sometimes without any). A small ultrasound-guided needle is inserted through the vagina to aspirate the follicles in both ovaries, which extracts the eggs. After resting in a recovery room for an hour or two, the donor is released. Most donors resume regular activities by the next day.

kgwgk 10y ago

And thousands of men 'donate' sperm to for-profit centers. Which, truth be said, seems a convenient way to perpetuate your genes without all the hassle of the traditional mechanism. As long as your genes are 'desirable', of course.

EliRivers 10y ago
Selecting for men who jack off into a cup for money. Who wouldn't desire those genes.

njharman 10y ago

Is this really news, not known? I did it and so did most people I knew back in college (the ones who didn't were too heavy drug users). It was one of many sources for "minor money". Which when you have NO money, is pretty great. It's one of a host of shitty things we force poor people to do cause as a society we have this stupid fucking idea that you have to work for everything, that you don't deserve the necessities of existence unless you spend 40+ hours making someone else rich.

QuercusMax 10y ago
I sold my plasma for a semester or so in college for gas money, before I got a "real job" on campus. I was making around $60-75/wk, which wasn't bad at all. The people there were all either college students or super sketchy people; it was right next to university campus. I didn't (and still don't) feel like I was taken advantage of at all; it was better than flipping burgers.

fapjacks 10y ago

Hah there was a time, long ago, when I used to feed myself with money from blood and plasma donation.

Houshalter 10y ago

This reminds me of "The Copenhagen Interpretation of Ethics": http://web.archive.org/web/20160806191858/https://blog.jaibot.com/the-copenhagen-interpretation-of-ethics/ http://web.archive.org/web/20160806191858/https://blog.jaibo... Our culture has a very strange belief that you shouldn't benefit from the less fortunate. Even if you benefit them too. People that have never donated a dollar to charity in their lives, will come out of the woodwork and complain about "exploitation".

kome 10y ago
"People that have never donated a dollar to charity in their lives" is a particularly American, or let's say anglophone, way to approach social justice. Charities are based on good will, but "the less fortunate" do not need "good will": they need social rights. https://en.wikipedia.org/wiki/Social_rights https://en.wikipedia.org/wiki/Social_rights If you don't see "exploitation" when people need and they are willing to sell their blood, I have no idea what you mean by exploitation.
- gravypod 10y ago
  Does that sentiment hold when your donations are to pro-bono legal firms?
  - aqme28 10y ago
    The "donations" in this case aren't really donations. They're being paid in exchange for their blood plasma. So I don't see the comparison to pro-bono legal firms.
    - gravypod 10y ago
      Trades of goods are equivalent to currency.
    - chimeracoder 10y ago
      > The "donations" in this case aren't really donations. They're being paid in exchange for their blood plasma. Which gets back to the question - what's wrong with that? The alternative is not to pay people for donating plasma, and we can see quite clearly that that doesn't work - every country that does not pay for blood plasma donations runs a shortage, and most of them end up importing plasma from the US. So, we have to pay for plasma, or else we won't have enough, which means people will literally die. Given that we have to pay for plasma, what's wrong with letting anyone who's medically eligible to donate do so? Most of the common arguments against tissue donation (safety, incentive to lie, etc.) either don't apply to plasma donation or are no longer relevant thanks to the cost and accuracy of modern testing methods. There is no medical or financial reason not to permit the practice, and I'm struggling to see a moral one that doesn't eventually result in people dying because we refuse to collect the life-saving tissue that people are perfectly capable of providing and willing to provide.

sandworm101 10y ago

The rules against paying donors in many countries can cause problems. Some people with very rare bloodtypes are in high demand. When someone needs that rare blood we could at least cover the traveling expenses needed to bring in the willing donor. But that just isnt allowed.

chimeracoder 10y ago
> The rules against paying donors in many countries can cause problems. Some people with very rare bloodtypes are in high demand. When someone needs that rare blood we could at least cover the traveling expenses needed to bring in the willing donor. But that just isnt allowed For plasma, most countries meet their unfulfilled demand in part by buying plasma from the US. That isn't allowed for all other forms of tissue, though, so the shortages for rare matches remain. This literally costs lives.
k__ 10y ago
I habe 0+ which isn't rare but still in high dem and.
- sandworm101 10y ago
  I also have o+ but recentlu found out i will never be allowed to donate in canada because i lived in the middle east off and on as a kid (80s and 90s). The saudis imported beef from the uk. So i have been exposed to mad cow disease. 25 years later and i am symptom free. Lol. This rule bans so many soldiers, expats and immigrants that i am forced to conclude canada blood services has more than enough blood. The saudis happily took my blood at 15yo. They paid me for it.

than 10y ago

Radiolab had a fascinating segment on US blood banks and how cutthroat the blood economy can be. In many cases, your local blood bank might be arbitraging blood from different areas of the country. http://www.radiolab.org/story/308780-blood-banks/ http://www.radiolab.org/story/308780-blood-banks/

daviross 10y ago

This was something I did twice a week myself, to help get through college. It worked well for being a way to get additional money in a way which worked with the rest of my schedule, though having income directly tied to health wasn't always great. (Have a minor cold? Now be knocked out of a week or two's deposits)

ensiferum 10y ago

Two other interesting news stories right next to this one http://abcnews.go.com/US/bus-drivers-working-alongside-silicon-valley-millionaires-struggle/story?id=44707434 http://abcnews.go.com/US/bus-drivers-working-alongside-silic... http://abcnews.go.com/US/working-fast-food-jobs-16-hours-day/story?id=44707695 http://abcnews.go.com/US/working-fast-food-jobs-16-hours-day... Is this the "american dream" ?

gens 10y ago
Wouldn't be a dream if it as real, now wouldn't it ?
- ensiferum 10y ago
  touche

peacetreefrog 10y ago

Pretty basic economics. Quantity supplied generally == quantity demanded, as long as there's a functioning price system. It's why you can go to a gas station and (while the price certainly changes) count on them never being out of gas, despite whatever else is going on in terms of weather, OPEC or whatever. Paying people for plasma donation means there's plasma available for patients who need it. And it's not like these doners are coerced. Removing their option to do that (by outlawing paid donations) by definition can only make them worse off.

jeffdavis 10y ago
I agree because blood donation is safe. If it weren't, or we were talking about kidneys or something, it gets more complicated.
- chimeracoder 10y ago
  > I agree because blood donation is safe. If it weren't, or we were talking about kidneys or something, it gets more complicated. Unsafe procedures provide even more justification for compensation. Otherwise, there's a shortage of people who will be willing to go through it for free, leading to even more exploitative incentives - peer pressure in the best case[0], or outright trafficking in the worst. Remember that you can't prevent market activity from happening; you can prevent it from happening out in the open, and hope that the inconvenience and other risks are enough of a deterrent (look at the war on drugs, or sex work). But for an individual, there is no situation in which the stakes are higher than being denied a lifesaving treatment. That's the point at which, in the extreme case, even kidnapping or organ harvesting seem like viable options (to them), because they are literally the only option, other than death. You might think I'm being hyperbolic, but this literally happens. But if you can ensure an adequate supply from people who are properly informed about the risks and capable of consenting, there is no incentive to engage in that sort of activity. [0] for example, pressure from an infertile relative who wants to use your eggs to conceive
peacetreefrog 10y ago
It is interesting how the (monetary) price for blood is basically $0, while for plasma it's > $0. Know nothing about blood or plasma, but I'd imagine this is because donating plasma takes longer and is more painful. Wouldn't be surprised if it was trickier to store/transport/use or if you generally got less plasma fluid out of a person vs blood, or people could donate less often or something. Also note while the monetary price for blood is $0, that's probably not the full price -- just ask anyone who has reluctantly donated blood because they didn't want to be the only person in their school or office not donating during a blood drive. There's often a social cost to NOT donating too. Also, even with these differences/caveats the lack of a price system for blood does lead to some mismatches between supply and demand. There's currently a big blood shortage as we speak (google it), leading some hospitals to cancel elective surgery.

WalterBright 10y ago

I donate blood now and then, and am an organ donor. I suppose technically I'm being exploited, but I don't mind.

RUG3Y 10y ago

I've donated plasma when I was really broke...only a couple of months ago. I would do it again except the phlebotomist perforated the vein in my left arm 6 or 7 times, digging around for what felt like an eternity. I'm a glutton for punishment but that definitely wasn't worth 40 bucks. I needed money for car parts though. The really interesting thing about the plasma center is all the oddball characters you get to see. It's worth a visit just to experience the weird vibe.

jrs235 10y ago

So it seems there is a lot of confusion here in the comments. [Blood] Plasma donation is not the same as blood donation. https://www.statnews.com/2016/01/22/paid-plasma-not-blood/ https://www.statnews.com/2016/01/22/paid-plasma-not-blood/

adentranter 10y ago

Aussie here. This is an interesting contrast to what the state of blood donation and healthcare here is. I have never seen a for profit blood bank here. It's mainly one non for profit that takes blood donations. I have often tried to donate blood but been turned away due to my height vs weight ratio ( im skinny and tall ). I think the desire to donate blood for nothing may come from the fact that we receive pretty much free healthcare ( you can pay for health insurance and get access to better doctors and shorter waiting lists ). I've read many things on HN about healthcare in the pass and it always amazes me how much I take my countries health system for granted. I have put on 10 kgs (22 lbs) since I last tried so maybe I will try again sometime.

chimeracoder 10y ago
> I think the desire to donate blood for nothing may come from the fact that we receive pretty much free healthcare ( you can pay for health insurance and get access to better doctors and shorter waiting lists ). Whole blood donations are (almost always) uncompensated in the US as well. This article is referring to plasma donations, which are different and take longer.

WhitneyLand 10y ago

So how come you can't "donate" a kidney and be paid for your time on the operating table?

chimeracoder 10y ago
> So how come you can't "donate" a kidney and be paid for your time on the operating table? Because one is explicitly illegal and the other is not. If you're asking for a justification behind that difference, the answer is that the laws are simply not consistent. Donating eggs, for example, can be compensated, and that's a relatively invasive procedure.