Shortages, Bloody Shortages
Mihai Sarbus writes that in Romania — the home of Vlad Dracula — their hospitals are running out of blood. The number of people volunteering to donate blood has declined steadily in recent years. Health-care professionals fear that joining the European Union will bring crisis-level blood shortages. Why? European regulations forbid any kind of remuneration for this service. Socialism and blood donation are not a good mix. FULL ARTICLE
Comments (19)
When the EU finally enforces "the prohibition on making the human body and its parts as such a source of financial gain," it's going to have quite a tangle, determining who is merely a "gold digger" and who is a whore.
Published: October 31, 2006 9:30 AM
I dont get why he says that price of blood will fall in the free market. There is already shortage at current price in Romania, so obviously the price needs to rise to clear the demand.
Published: October 31, 2006 9:57 AM
I've heard the same arguments used with regard to paying for transplant parts. I do agree with the author that government should stay out of the blood business.
I've always wondered though if in times of deparate need I'd be tempted to sell a kidney to save my home (or even put my child through college).
Published: October 31, 2006 10:12 AM
Hospitals evidently have no problem commodifying blood when it comes time to bill patients for same. True they add value by processing, however, the fact is that blood has a price per unit.
Published: October 31, 2006 10:25 AM
The author isn't claiming that the price of blood will fall from its current level, which is zero, but that it will initially rise precipitously, but then fall again as the market begins to diversify. It seems quite sensible to me.
Published: October 31, 2006 10:54 AM
Wonderful and succinct piece. Sometimes I think they'll never get it. ;-(
Published: October 31, 2006 11:53 AM
"Money does not express value. It is only a tool for facilitating exchange."
Exactly! Money is a credit slip, a universal IOU. Also functions as a common unit of conversion between other assets.
Published: October 31, 2006 12:03 PM
Excellent job, Mihai! I've been interested in the organ shortage issue (and peripherally, the blood shortage issue) for more than a decade, and I've never seen anyone tackle head-on the question of "degradation" and commodification (really, they should say "commoditization") as fully and as well as you have. Not only will I send this around to colleagues interested in the organ shortage, but also to my Romanian friends.
Published: October 31, 2006 2:32 PM
Mike,
Good point. It raises the question of the real value of the food ticket and the two days(?!?) off. Sounds pretty sweet to me, but who's handing out the time off? Is it mandatory on employers to let you take off two days? I'd be surprised if there weren't employment contracts forbidding you to give blood if you're gone from work for two days!
Mr. Sarbu, great article. Would you kindly elaborate on the remuneration scheme?
Published: October 31, 2006 2:46 PM
"In the fields of medicine and biology the following must be respected in particular: the prohibition on making the human body and its parts as such a source of financial gain."
Stretch the words a little (biology => sexual reproduction) and you can outlaw prostitution. Stretch them a little more, and you can outlaw physicians and nurses from being remunerated for their services ... Ain't laws wonderful?
Published: October 31, 2006 2:51 PM
Let me throw some science into the stew--I'm not certain exactly how it fits in, but it is surely relevant to this discussion. In the 1960's, before the Nobel-prize winning discovery of the "Australia antigen," it was impossible to screen blood donors for Hepatitis B, the then major cause of transfusion-associted hepatitis. This disease was a scourge, sometimes causing chronic liver disease or even death in previously healthy patients. Sound epidemiological studies at the time showed conclusively that blood obtained from commercial sources caused substantially higher rates of transfusion-associated hepatitis compared to blood obtained from volunteers. Offering money for blood donorship presumably attracted more hepatitis carriers than those who would volunteer, e.g., intravenous drug addicts who would not admit their addiction before they donated. These findings caused considerable prejudice among physicians against the use of blood purchased from donors and, and essentially killed the commercial blood-donor market in the U.S. The situation today, of course, is different technologically and many, but not all, transmissible diseases can be screened out of the blood donor pool. For example, there is a brief window of time, after acauiring infection but before a patient turns HIV positive, during which the patient can transmit HIV. Thus, blood banks generally ask prospective male donors whether they are homosexual and will refuse them regardless of their blood-test findings. I think even today, therefore, that physicians would still be reluctant to use blood obtained from commercial sources.
Published: October 31, 2006 3:27 PM
Glenn,
A very interesting comment, and it makes a lot of sense that the very people you would not want to donate blood are those most likely to be enticed to do so for monetary compensation.
This is something to think about. Thank you.
Published: October 31, 2006 4:20 PM
Great Article. Also may I add there is a quality control issue here. Because of the artificial shortage created by government, there is an incentive for doctors and bureaucrats to ignore checking for bad blood transfusions and altruistic donors with "bad" blood. There's no competition for blood, so some ill willed freak with aids could just as easily donate as some high quality donor.
Some might argue the government may impose regulations to enforce proper blood through altruistic bureaucrats, but without the profit or loss test, there's isn't any way for bureaucrats to assess the risk vs the benefit to blood recievers.
Seems like the EU wants their citizens to (involuntarily) gamble with their lives
Published: October 31, 2006 4:30 PM
Thank you for your comments and questions. I will try to respond to them to the best of my abilities in the next couple of days.
If you have a question or comment please put it on the blog, don’t e-mail me. Let’s have a public discussion. But for questions about the history of Romania, Transylvania, vampires and the like an e-mail is fine.
***
Posted by: Jim Scanlan at October 31, 2006 10:12 AM
I've heard the same arguments used with regard to paying for transplant parts. I do agree with the author that government should stay out of the blood business.
I've always wondered though if in times of deparate need I'd be tempted to sell a kidney to save my home (or even put my child through college).
An audio recording on this topic
The Economics of Organ Donations
June 05, 2006, Featuring Richard Epstein
Russ Roberts and Richard Epstein, law professor at the University of Chicago, discuss the market for kidneys. Should people be allowed to buy and sell kidneys? How might a market for kidneys actually work in practice? Should mercenary motives be allowed to trump altruism? Epstein deals with these questions and more.
http://www.econtalk.org/archives/2006/06/the_economics_o_4.html
the transcript is here:
http://www.econlib.org/library/Columns/y2006/Epsteinkidneys.html
Professor Epsein makes the case for a free market for organs far better then I could. Unfortunately I discovered this talk after I sent the article, but I’m sharing it with you now.
Posted by: Ike Hall at October 31, 2006 2:46 PM
Mike,
Good point. It raises the question of the real value of the food ticket and the two days(?!?) off. Sounds pretty sweet to me, but who's handing out the time off? Is it mandatory on employers to let you take off two days? I'd be surprised if there weren't employment contracts forbidding you to give blood if you're gone from work for two days!
Mr. Sarbu, great article. Would you kindly elaborate on the remuneration scheme?
Ike,
You make an excellent point. If I would be an employer facing this problem I would certainly put that in the contract. In practice only those employed by the state do take the two days off. Private firms de facto refuse to let their employees to take that vacation. This was one of the complaints of the Health-care professionals against those evil capitalists. It may seem strange for a westerner, but here in the east people do not stand up for their rights (real or perceived), but simply rely on the government to do everything, while complaining constantly. So private firms can afford not to let go for a couple of days their employees without being sued by them.
The remuneration scheme worked like this: you go to the collection center to donate blood. It is strictly forbidden to give money to the donors, so what you receive is a piece of paper with which you go to a food-store that has a contract with a government agency. You put in your bag whatever you want for the value stated on that piece of paper, excluding alcohol and cigarettes. When leaving they verify the amount of products that you put in you bags and the take the ticket. They present the ticket at the government agency that gives them the money.
Was this your question?
***
Article on the same topic on my private blog
http://transylvanialibertarian.blogspot.com/2006/10/great-blood-sucking-contest-eurocrats.html
My blogs:
http://transylvanialibertarian.blogspot.com/
and
http://libertarian-answers.blogspot.com/
Published: October 31, 2006 5:02 PM
Posted by: Glenn Goodhart at October 31, 2006 3:27 PM
Sound epidemiological studies at the time showed conclusively that blood obtained from commercial sources caused substantially higher rates of transfusion-associated hepatitis compared to blood obtained from volunteers. Offering money for blood donorship presumably attracted more hepatitis carriers than those who would volunteer, e.g., intravenous drug addicts who would not admit their addiction before they donated. (…)
I think even today, therefore, that physicians would still be reluctant to use blood obtained from commercial sources.
This is indeed, Glen, an issue that needs to be addressed by those who, like myself, want to make the case for a free market solution to medical problems such as this one. I don’t think that what you described can be used against a free market solution. One of the key distinctions between a free market solution and a political one is that the free market permits both a commercial and a non-commercial response to the needs of patients. What the state does is to eliminate altogether the commercial solution. On the long term the politically enforced solution has unforeseen and disastrous consequences, that I will not restate here. The free market, instead, has a place for both commercial and non-commercial entities and doctors can make a choice. Unlike now, when there is no choice at all. That is why we have a shortage.
But what about the quality of the blood if we let those greedy capitalists to lay their hands on the market? (I had some e-mails to that effect, so it is not you, Glen, that I’m addressing now with this tone.) Well, guess what? In the long run, the free market is the only mechanism that can solve the problem of quality, and for that we only have to see how the free market works in other sectors. Private firms that make a living by collecting and reselling blood to Hospitals cannot afford to disregard quality. For them is a question of life and death. State run collection centers, though, can afford to be a little more careless. So on the free market, because of the competition, quality of the blood will become in time more and more important. Also, alongside the private firms there will be charitable associations that will give blood for free, so firms can only out compete them by higher quality standards. It might be that in the short run blood obtained from commercial sources is less reliable, qualitatively, then the blood obtained from volunteers. But in time the mechanism of the free market will change that.
Thank you for your thought provoking comment, Glen. I appreciate it very much.
Published: October 31, 2006 6:02 PM
If companies were able to charge for blood usage I suspect we'd see more research into artificial blood, techniques to reduce wastage and ways to stretch existing stocks. Also, people would be able to choose from more options, for example pig blood platelets for a cheaper alternative.
Published: November 1, 2006 1:22 AM
An interesting program on the kidney market in Iran, where buying and selling kidneys is legal but regulated
http://news.bbc.co.uk/1/hi/programmes/this_world/6080328.stm
Published: November 1, 2006 7:54 AM
Actually this might be a better link, short story on the program http://news.bbc.co.uk/1/hi/programmes/this_world/6090468.stm
Published: November 1, 2006 7:59 AM
Cookies and T shirts.
Published: November 1, 2006 4:11 PM