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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 inju

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
      First of all, we're talking about plasma and not whole blood - the difference is important. > An adequate and reliable supply of safe blood can be assured by a stable base of regular, voluntary, unpaid blood donors. An adequate and reliable supply of plasma cannot be assured by a stable base of unpaid plasma donors - countries that pay for donations run a surplus and end up supplying it to countries that don't, because the latter don't produce enough. > if the screenings were totally reliable why would we bother asking for risky behaviours ? Because it saves time (and money) to be able to rule out people who are ineligible for blood donation before they ever get their blood drawn. You might think, "how could a person who has had Hepatitis A not know that they are ineligible to give blood?", but the answer is that this happens all the time. Screening questions are there as a cost-saving measure; they're not intended to catch anything that blood testing wouldn't, and they're already arguably overly conservative in the screening stage as it is. > What about the window between an infection by the HIV and the production of antibodies ? > (A) For plasma, you don't test for antibodies - you test for viral load. (B) The window is incredibly short. The chance of someone donating plasma within a few days of being infected with HIV and having a viral load high enough to transmit HIV but also not test positive is minuscule. At that point, there are far bigger risks to worry about, like the many things that you can't test for (and which the patient may not know they have). Risk management isn't about eliminating risk; it's about systematically and contextually evaluating the appropriate levels of risk.
- 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.

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
    First of all, we're talking about plasma and not whole blood - the difference is important. > An adequate and reliable supply of safe blood can be assured by a stable base of regular, voluntary, unpaid blood donors. An adequate and reliable supply of plasma cannot be assured by a stable base of unpaid plasma donors - countries that pay for donations run a surplus and end up supplying it to countries that don't, because the latter don't produce enough. > if the screenings were totally reliable why would we bother asking for risky behaviours ? Because it saves time (and money) to be able to rule out people who are ineligible for blood donation before they ever get their blood drawn. You might think, "how could a person who has had Hepatitis A not know that they are ineligible to give blood?", but the answer is that this happens all the time. Screening questions are there as a cost-saving measure; they're not intended to catch anything that blood testing wouldn't, and they're already arguably overly conservative in the screening stage as it is. > What about the window between an infection by the HIV and the production of antibodies ? > (A) For plasma, you don't test for antibodies - you test for viral load. (B) The window is incredibly short. The chance of someone donating plasma within a few days of being infected with HIV and having a viral load high enough to transmit HIV but also not test positive is minuscule. At that point, there are far bigger risks to worry about, like the many things that you can't test for (and which the patient may not know they have). Risk management isn't about eliminating risk; it's about systematically and contextually evaluating the appropriate levels of risk.
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.