6 ms·

Really interesting situation, and very frustrating that none of the rare blood donors costs can be paid for by hospitals. Seems like there should be some loop h

by sosuke 12y ago

Really interesting situation, and very frustrating that none of the rare blood donors costs can be paid for by hospitals. Seems like there should be some loop hole to get them compensated.

csdrane 12y ago
I would have guessed that the reason for prohibiting payment for blood would be the same as the reason prohibiting payment for organ donations. Interesting that in this case it is blamed on trying to minimize donations from people with HIV.
- niels_olson 12y ago
  It's not just HIV. It's any infectious disease (there is a thick book of reasons to disallow a donation). The problem is that these infectious diseases are socially disruptive, therefore these folk, unfortunately, tend to have less marginal income. Therefore, they are exactly the people who would respond to a small monetary incentive. This has been studied. If anyone is acutely aware of the problem, it's blood banks. So this issue is revisited routinely. Here is a recent review on the topic: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847338/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847338/
  - joezydeco 12y ago
    I'm advocating tax deductions as an incentive. If I give $350 in cash to the American Red Cross, I can take that charitable deduction from my annual filing. If I donate a unit of blood that gives ARC $350 in products, that's not deductible. The incentive side steps the donor-with-marginal-income problem, unless I'm missing something.
    - eru 12y ago
      That's a clever way to pay richer people progressively more for their blood.
    - zaroth 12y ago
      IRS Pub 526 on Charitable Contributions, Page 2: Not Deductible As Charitable Contributions: Cost of raffle, bingo, or lottery tickets Dues, fees, or bills paid to ... Tuition Value of your time or services *Value of blood given to a blood bank* It's amazing how many details the IRS pubs cover. I like your proposal though.
- gohrt 12y ago
  Organs don't regenerate like blood does. Blood is very valuable and blood is paid for all the time. The only restriction is on paying the original creator. Once the blood is extracted, it is sold and re-sold for high prices.
TheBeardKing 12y ago
I would think they could just screen frequent donors with rare blood types for infections. Once the donor is known safe, compensate however is needed to get their blood. I believe there are private industries doing this. This one will be opening soon in my town, though I guess just for plasma: http://www.biolifeplasma.com/become-donor/compensation.html http://www.biolifeplasma.com/become-donor/compensation.html
- davegardner 12y ago
  I'm a regular whole blood and plasma donor and I'm quite sure that I'd be much less likely to donate if I was being paid for it. I'm not really sure exactly why I feel that way, but I guess that if you put a dollar value on it I'd be calculating whether it really was worth my time. Right now, because there is no compensation (aside from a muffin and a cup of tea afterwards), I get the emotional benefits of having performed a purely altruistic deed.
  - DavidAdams 12y ago
    You're not alone. I listened to a podcast a while back on this subject, and the reason that the blood "market" runs solely and strictly on donations it's because earlier in history, when the medical establishment paid for blood, they were only able to get skid row types to contribute, and needless to say, the quality of the blood wasn't good. http://freakonomics.com/2013/06/05/is-paying-for-blood-a-good-idea-after-all/ http://freakonomics.com/2013/06/05/is-paying-for-blood-a-goo...
  - Osmium 12y ago
    Two other possibilities: * In the private health-care world, if you're getting paid, you might feel like someone else is profiting off your blood (how else could they pay you?) or * In the public health-care world, if you're getting paid you might feel like money is being ill-spent when it could/should be used to better pay healthcare workers etc. since people are typically willing to donate blood for free.
    - psykovsky 12y ago
gwern 12y ago
That's modern medical 'ethics' for you: damn the consequences, what matters is what it looks like and whether it offends anyone.
- niels_olson 12y ago
  No, it's about the safety of the blood supply. It's a weird quirk of human psychology and economics that paying for donations means fewer healthy people and more people with infectious diseases donate when it's fee-for-blood.
  - masklinn 12y ago
    For an example of that, HIV likely crossed into the US from Haiti via the blood trade[0][1] which acted as both amplifier and transport after haitians had to leave DRC, and some got infected in the time they spent there. And of course thousands of haemophiliacs in the 80s got infected with HIV and HepC because of contaminated Factor VIII: http://en.wikipedia.org/wiki/Contaminated_haemophilia_blood_products http://en.wikipedia.org/wiki/Contaminated_haemophilia_blood_... [0] http://www.onereads.org/spillover-david-quammen?page=0,208 http://www.onereads.org/spillover-david-quammen?page=0,208 [1] http://lambsbloodblog.wordpress.com/2013/01/11/hemo-caribbean-sold-more-than-3-million-worth-of-blood-plasma-siphoned-from-haitians/ http://lambsbloodblog.wordpress.com/2013/01/11/hemo-caribbea...
  - gwern 12y ago
    If you were designing based on consequences, would covering basic expenses for rare blood donors result in so many people signing up with infectious diseases that it exceeds the deaths from the Rube Goldberg scheme described in OP which limps along with just a few rare blood donors?
    - niels_olson 12y ago
      I get what you're saying. I'll ask our blood banker when she gets back from ASHI.
  - Confusion 12y ago
astrocat 12y ago
It's unclear to me why paying individuals with very rare blood types for the blood they provide to the medical industry would in any way alter the landscape of general blood donations. I understand why it's a bad idea to attempt to pay for regular blood donations in general, but rare blood is not a "regular donation" - the individual is in possession of an insanely lucrative product. It just happens to be their blood, instead of something more "normal" like artistic talent.
- danielweber 12y ago
  My wife knew a person in college who got paid for their blood, something like $500 a month. Not enough to retire on, but a nice second source of income.

by sosuke 12y ago

Really interesting situation, and very frustrating that none of the rare blood donors costs can be paid for by hospitals. Seems like there should be some loop hole to get them compensated.

csdrane 12y ago

I would have guessed that the reason for prohibiting payment for blood would be the same as the reason prohibiting payment for organ donations. Interesting that in this case it is blamed on trying to minimize donations from people with HIV.

niels_olson 12y ago
It's not just HIV. It's any infectious disease (there is a thick book of reasons to disallow a donation). The problem is that these infectious diseases are socially disruptive, therefore these folk, unfortunately, tend to have less marginal income. Therefore, they are exactly the people who would respond to a small monetary incentive. This has been studied. If anyone is acutely aware of the problem, it's blood banks. So this issue is revisited routinely. Here is a recent review on the topic: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847338/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847338/
- joezydeco 12y ago
  I'm advocating tax deductions as an incentive. If I give $350 in cash to the American Red Cross, I can take that charitable deduction from my annual filing. If I donate a unit of blood that gives ARC $350 in products, that's not deductible. The incentive side steps the donor-with-marginal-income problem, unless I'm missing something.
  - eru 12y ago
    That's a clever way to pay richer people progressively more for their blood.
  - zaroth 12y ago
    IRS Pub 526 on Charitable Contributions, Page 2: Not Deductible As Charitable Contributions: Cost of raffle, bingo, or lottery tickets Dues, fees, or bills paid to ... Tuition Value of your time or services *Value of blood given to a blood bank* It's amazing how many details the IRS pubs cover. I like your proposal though.
gohrt 12y ago
Organs don't regenerate like blood does. Blood is very valuable and blood is paid for all the time. The only restriction is on paying the original creator. Once the blood is extracted, it is sold and re-sold for high prices.

TheBeardKing 12y ago

I would think they could just screen frequent donors with rare blood types for infections. Once the donor is known safe, compensate however is needed to get their blood. I believe there are private industries doing this. This one will be opening soon in my town, though I guess just for plasma: http://www.biolifeplasma.com/become-donor/compensation.html http://www.biolifeplasma.com/become-donor/compensation.html

davegardner 12y ago
I'm a regular whole blood and plasma donor and I'm quite sure that I'd be much less likely to donate if I was being paid for it. I'm not really sure exactly why I feel that way, but I guess that if you put a dollar value on it I'd be calculating whether it really was worth my time. Right now, because there is no compensation (aside from a muffin and a cup of tea afterwards), I get the emotional benefits of having performed a purely altruistic deed.
- DavidAdams 12y ago
  You're not alone. I listened to a podcast a while back on this subject, and the reason that the blood "market" runs solely and strictly on donations it's because earlier in history, when the medical establishment paid for blood, they were only able to get skid row types to contribute, and needless to say, the quality of the blood wasn't good. http://freakonomics.com/2013/06/05/is-paying-for-blood-a-good-idea-after-all/ http://freakonomics.com/2013/06/05/is-paying-for-blood-a-goo...
- Osmium 12y ago
  Two other possibilities: * In the private health-care world, if you're getting paid, you might feel like someone else is profiting off your blood (how else could they pay you?) or * In the public health-care world, if you're getting paid you might feel like money is being ill-spent when it could/should be used to better pay healthcare workers etc. since people are typically willing to donate blood for free.
  - psykovsky 12y ago

gwern 12y ago

That's modern medical 'ethics' for you: damn the consequences, what matters is what it looks like and whether it offends anyone.

niels_olson 12y ago
No, it's about the safety of the blood supply. It's a weird quirk of human psychology and economics that paying for donations means fewer healthy people and more people with infectious diseases donate when it's fee-for-blood.
- masklinn 12y ago
  For an example of that, HIV likely crossed into the US from Haiti via the blood trade[0][1] which acted as both amplifier and transport after haitians had to leave DRC, and some got infected in the time they spent there. And of course thousands of haemophiliacs in the 80s got infected with HIV and HepC because of contaminated Factor VIII: http://en.wikipedia.org/wiki/Contaminated_haemophilia_blood_products http://en.wikipedia.org/wiki/Contaminated_haemophilia_blood_... [0] http://www.onereads.org/spillover-david-quammen?page=0,208 http://www.onereads.org/spillover-david-quammen?page=0,208 [1] http://lambsbloodblog.wordpress.com/2013/01/11/hemo-caribbean-sold-more-than-3-million-worth-of-blood-plasma-siphoned-from-haitians/ http://lambsbloodblog.wordpress.com/2013/01/11/hemo-caribbea...
- gwern 12y ago
  If you were designing based on consequences, would covering basic expenses for rare blood donors result in so many people signing up with infectious diseases that it exceeds the deaths from the Rube Goldberg scheme described in OP which limps along with just a few rare blood donors?
  - niels_olson 12y ago
    I get what you're saying. I'll ask our blood banker when she gets back from ASHI.
- Confusion 12y ago

astrocat 12y ago

It's unclear to me why paying individuals with very rare blood types for the blood they provide to the medical industry would in any way alter the landscape of general blood donations. I understand why it's a bad idea to attempt to pay for regular blood donations in general, but rare blood is not a "regular donation" - the individual is in possession of an insanely lucrative product. It just happens to be their blood, instead of something more "normal" like artistic talent.

danielweber 12y ago
My wife knew a person in college who got paid for their blood, something like $500 a month. Not enough to retire on, but a nice second source of income.