Thousands of Low-Income Americans 'Donate' Blood Plasma to For-Profit Centers
abcnews.go.com
abcnews.go.com
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".
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
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.
So I don't see the comparison to pro-bono legal firms.
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.
Sure, right now we gave good tests for most diseases, but the next AIDS has no test making the long term risks real.
PS: Risks of AIDS are conservatively estimated at 1:1.5 million per transfusion, but some people get a lot of transfusions. Here is one example from 2008: https://www.cdc.gov/Mmwr/preview/mmwrhtml/mm5941a3.htm AIDS is also rapidly becoming drug resistant making reduced transmission even more important.
They do have the if there is any reason you suspect their might be an issue bar code because people still lie even without money simply because of social pressure.
Buying plasma doesn't hurt anyone. It doesn't make the poor worse off. It's certainly not "exploitation". And it's doing more to help the poor than the vast majority of people that don't do anything.
There is a problem in the world, that people are poor, desperate, or in need. But the plasma industry didn't cause poverty, and they aren't making it any worse. If anything they are making it better, if only slightly.
I am referring to my experience in the '90s and it may have been allowed more than 2xs a month, but that is all I was comfortable with. When the payout was reduced >50% I desisted.
Back on topic: Adjusting for inflation(stagflation), that's a hell of a lot less today than when I initially quit. In your opinion, what percentage of people donating are not indigent? Back then I would have said maybe 25%, and those were all hard-up students from the University 4 blocks away.
edit: changed 'starving' to 'hard-up'. Technically, indigent too.
If you want to make it out like these people are being 'exploited', then you can make the case just the same that all property is exploitation. Railing against poor people donating blood plasma, or organs for that matter, is profoundly misguided.
"Do you shoot up illicit drugs with shared needles?"
"Um... No. No I do not."
- Have you ever been charged with a criminal offence? - Do you use recreational drugs?
Etc. I don't think that the blood donation questionare is especially problematic on that regards.
As far as the "Low-Income Americans" from the article are concerned, all sorts of jobs give them an incentive to lie, why should donating blood be considered more exploitative because of it?
The question of whether buying blood has a net positive public health benefit is a very real one, but it's unrelated to darawk's ancestor post arguing that selling blood is just another form of work.
As a father this situation would be horrible if my only chance to provide things for my daughter was taken away to "help" me:
"he was giving plasma because his daughter had a birthday, and he needed $7.50 to buy her a bathing suit and money for a cake"
Sure, you can say it would be better if the dad had some other opportunity available, but that's changing the subject. This is what he has right now, that gives him more happiness than anything in his life.
In the US I've even heard people using this rational to avoid fuelling the military industrial complex. However a well functioning government that best served society would not have this problem. In principle it's the government's job to take care of society's needs, not the charities'.
I think the existence of Planned Parenthood is a case in point. Undoubtedly they provide a necessary service, but in what world should a pregnant teenager not have access to a doctor?
In practice charities act as a highly inefficient decentralised mechanism for providing basic needs to those that can't afford them. In some cases, the charities are stellar. In others, they come with a religious taint (e.g. access to a doctor through a church). In the worst case a charity can operate as a scam, see the untouchable tele-evangelists.
I disagree strongly. Concentrating responsibility concentrates power, which is dangerous. Governments should share power internally, share between levels (federal, state, local), and leave a lot of the power with the people (who may use it for private enterprises, NGOs, etc.).
You imply government policy does not follow trends and whims, which is observably false.
What I am implying is that, unfortunately (again), government is the one entity that the common person is given a say in. They aren't a member on any boards, they don't manage philanthropists' thoughts or funds and they own no capital from which to generate their own wealth.
What I am implying is that they can influence the government into addressing their needs, even if superficially.
You shouldn't use the less fortunate (or anybody, really) as a mere mean to an end. Paying the homeless a pittance to behave as moving antennas is about as close as you can get to treating someone as a mere mean. The same goes for paying the disadvantaged $40 for their plasma - we can all intuitively recognize that a minimal "solution" that treats the individual as a mean and not an individual (autonomous, self-legislating, etc) is not a "right" one.
The idea that recognizing this while not giving to charity makes you a hypocrite is puzzling. There's no conflict between the positive right to give to charity and the negative right to not be exploited.
The people who claim to care about these poor people, have done nothing to help them. Their revealed preferences show they don't actually care at all. They just want to signal how virtuous and moral they are. The policies they support would actually make them poorer. And they know that and don't care.
It is the worst kind of hypocrisy, and I believe it's responsible for many of the world's problems.
> "Do their actions make the world a better place?"
Do they? Is a "better" world a one in which people are forced to sell their plasma to survive? In your dimly utilitarian view, you've neglected to consider whether such a state of affairs is truly a good one (much less a maximally good one, as most utilitarians would actually demand).
> The people who claim to care about these poor people, have done nothing to help them. Their revealed preferences show they don't actually care at all.
Sure, if you think voting and advocacy count for nothing. Charity and philanthropy are good, but they're general obligations not directed at any individual or group of individuals. Whether or not people choose to give to your pet injustice (there are many of them, after all) is not indication that they passively abide by it.
>Do they? Is a "better" world a one in which people are forced to sell their plasma to survive? In your dimly utilitarian view, you've neglected to consider whether such a state of affairs is truly a good one
You twist my words. Is the world optimal? Of course not. Does that have anything to do with the plasma industry whatsoever? Again, the plasma industry did not create poverty. They are not "forcing" anyone to sell plasma. They are not making the world any worse than it otherwise was. The people who sell plasma are better off - otherwise they wouldn't continue to do it voluntarily.
>Whether or not people choose to give to your pet injustice (there are many of them, after all) is not indication that they passively abide by it.
If you want to know what someone really believes - what they really value - you need to look at their actions, not their words. People lie about their beliefs and values, even to themselves.
And people that profit off of child labor are helping hungry kids eat.
This is an absurd metric.
The main objection against child labor is that it is extremely detrimental for the children. If you literally believe the children benefit from it, then I can not understand your objection.
Slaves work because if they don't, the slave master will beat or kill them. The plasma industry isn't going to beat or kill you if you don't sell them blood.
You may have problems in your life that make you so desperate, you need to sell your blood. But the plasma industry didn't create those problems, and they aren't making your life any worse.
No, I just see the metric as a particularly weird line to draw.
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?
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-requ...
It's almost as if people who are donating this frequently should be properly screened and truly compensated for the value they are providing...
* Blood Donor Screening || 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.
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]
> 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.
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.
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.
I wasn't saying it was in someone's control. I was discussing analysis of the system as it is.
The US actually provides 50% of the world's plasma supply, because there are more people in the US willing to donate under the current system than there is a need for it, whereas most of the world (which does not pay for plasma donation) has an ongoing shortage.
Plasma, like whole blood, also has a relatively short shelf life and cannot be donated on an as-needed basis, so it's preferable to have more than you need, since you never know when there will be a natural disaster, etc.
I've donated plasma. I think the whole process, from the moment I walked in the door to the moment I left, was about two hours. I read a book the whole time and they paid me about $100 (I don't remember exactly how much). It was pretty easy, and I'd do it again if I could.
>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.
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.
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.
I didn't (and still don't) feel like I was taken advantage of at all; it was better than flipping burgers.
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-orga...
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.
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
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.
It's not. In the US compensation for donating blood is illegal but not plasma. Most charities that take blood donations sell it.
Not really: https://www.statnews.com/2016/01/22/paid-plasma-not-blood/
http://abcnews.go.com/US/bus-drivers-working-alongside-silic...
http://abcnews.go.com/US/working-fast-food-jobs-16-hours-day...
Is this the "american dream" ?
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.
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.
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.
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.
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.
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.
* American Red Cross || 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.
If we accept that selling organs is prohibited and unethical then we should also accept the same for selling plasma.
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.
Yes, for a healthy individual, the act of donating plasma is about as risk free as you can get. Perhaps sperm donation is the only less risky live tissue donation. The reason we pay for it is that, if we didn't, we wouldn't have enough, and people would die. That's not speculative - countries which don't pay for plasma donation end up buying it from the US.
Donating eggs can have really serious complications even for healthy individuals - its not a trivial procedure, and even when performed correctly, it carries a small risk of infertility.
That's not to say you shouldn't do it, but there's another reason that we shouldn't expect women to do it for free - that actually becomes a lot more exploitative than providing up-front compensation and a full explanation of the risks, which we do.
Do we agree that selling organs is a bad idea though?
* The Sale of Human Organs (Stanford Encyclopedia of Philosophy) || https://plato.stanford.edu/entries/organs-sale/
* Why Legalizing Organ Sales Would Help to Save Lives, End Violence - The Atlantic || https://www.theatlantic.com/health/archive/2011/11/why-legal...
* Cash for Kidneys: The Case for a Market for Organs - WSJ || http://www.wsj.com/articles/SB100014240527023041494045793225...
* Most people are okay with 'selling' organs — and it might be wise - Business Insider || http://www.businessinsider.com/can-you-sell-organs-2016-9
And... it's not like the rich aren't already buying organs... why not legalize, make transparent, and regulate the process for all?
* Liver Transplant for Steven Jobs of Apple Raises Questions - The New York Times || http://www.nytimes.com/2009/06/23/business/23liver.html
* Steve Jobs' liver transplant: Did he game the system? || http://www.slate.com/articles/health_and_science/human_natur...
At the one I go to it is about 45 minutes between walking in the door and walking out the door.
https://www.google.com/search?q=blood+centers
I suppose adding a city name to that search will be useful.