Selling Blood Is Big Business
RED GOLD! As the nickname implies, this is one highly valued substance. It is a precious fluid, a crucial natural resource that has been compared not only to gold but also to oil and coal. However, red gold is not mined from veins in the rocks with drills and dynamite. It is mined from the veins of people by much subtler means.
“Please, my little girl needs blood,” implores a billboard that looms over a busy avenue in New York City. Other advertisements urge: “If you’re a donor, you’re the type this world can’t live without.” “Your blood counts. Lend an arm.”
People who want to help others evidently do get the message. They line up in droves, worldwide. No doubt most of them, as well as the people collecting the blood and the people transfusing the blood, sincerely want to help the afflicted and believe that they are doing so.
But after blood is donated and before it is transfused, it passes through more hands and undergoes more procedures than most of us realize. Like gold, blood inspires greed. It may be sold at a profit and then resold at a larger profit. Some people fight over the rights to collect blood, they sell it at exorbitant prices, they make fortunes from it, and they even smuggle it from one country to another. The world over, selling blood is big business.
In the United States, donors were once paid outright for their blood. But in 1971 British author Richard Titmuss charged that by thus luring the poor and sick to donate blood for the sake of a few dollars, the American system was unsafe. He also argued that it was immoral for people to profit from giving their blood to help others. His attack prompted an end to the paying of whole-blood donors in the United States (although the system still thrives in some lands). Yet, that did not make the blood market any less profitable. Why?
How Blood Remained Profitable
In the 1940’s, scientists began to separate blood into its components. The process, now called fractionation, makes blood an even more lucrative business. How? Well, consider: When dismantled and its parts sold, a late-model car may be worth up to five times its value when intact. Similarly, blood is worth much more when it is divided up and its components are sold separately.
Plasma, which makes up about half of the blood’s total volume, is an especially profitable blood component. Since plasma has none of the cellular blood parts—red cells, white cells, and platelets—it can be dried and stored. Furthermore, a donor is allowed to give whole blood only five times a year, but he can give plasma up to twice a week by undergoing plasmapheresis. In this process, whole blood is extracted, the plasma separated, and then the cellular components are reinfused into the donor.
The United States still allows donors to be paid for their plasma. Moreover, that country permits donors to give about four times more plasma annually than the World Health Organization recommends! Little wonder, then, that the United States collects over 60 percent of the world’s plasma supply. All that plasma in itself is worth about $450 million, but it fetches much more on the market because plasma too can be separated into various ingredients. Worldwide, plasma is the basis for a $2,000,000,000-a-year industry!
Japan, according to the newspaper Mainichi Shimbun, consumes about a third of the world’s plasma. That country imports 96 percent of this blood component, most of it from the United States. Critics within Japan have called that country “the vampire of the world,” and the Japanese Health and Welfare Ministry has tried to clamp down on the trade, saying that it is unreasonable to profit from blood. In fact, the Ministry charges that medical institutions in Japan make some $200,000,000 in profits each year from just one plasma component, albumin.
The Federal Republic of Germany consumes more blood products than the rest of Europe combined, more per person than any country in the world. The book Zum Beispiel Blut (For Instance, Blood) says of blood products: “Over half is imported, mainly from the U.S.A., but also from the Third World. In any case from the poor, who want to improve their income by donating plasma.” Some of these poor people sell so much of their blood that they die from blood loss.
Many commercial plasma-centers are strategically located in low-income areas or along the borders of poorer countries. They draw the impoverished and the derelicts, who are all too willing to trade plasma for money and have ample reason to give more than they should or to conceal any illnesses they might harbor. Such plasma traffic has arisen in 25 countries around the world. As soon as it is stopped in one country, it springs up in another. Bribery of officials as well as smuggling is not uncommon.
Profit in the Nonprofit Realm
But nonprofit blood banks have also come under harsh criticism lately. In 1986 reporter Andrea Rock charged in Money magazine that a unit of blood costs the blood banks $57.50 to collect from donors, that it costs the hospitals $88.00 to buy it from the blood banks, and that it costs patients from $375 to $600 to receive it in a transfusion.
Has the situation changed since then? In September 1989 reporter Gilbert M. Gaul of The Philadelphia Inquirer wrote a series of newspaper articles on the U.S. blood-banking system.* After a yearlong investigation, he reported that some blood banks beg people to donate blood and then turn around and sell as much as half of that blood to other blood centers, at a considerable profit. Gaul estimated that blood banks trade about a million pints [half a million liters] of blood every year in this way, in a shadowy $50,000,000-a-year market that functions somewhat like a stock exchange.
A key difference, though: This blood exchange is not monitored by the government. No one can measure the exact extent of it, let alone regulate its prices. And many blood donors know nothing about it. “People are being fooled,” one retired blood banker told The Philadelphia Inquirer. “Nobody is telling them that their blood is going to us. They would be furious if they knew about it.” A Red Cross official put it succinctly: “Blood bankers have for years fooled the American public.”
In the United States alone, blood banks collect some 13.5 million pints [6.5 million L] of blood every year, and they sell over 30 million units of blood products for about a thousand million dollars. This is a tremendous amount of money. Blood banks don’t use the term “profit.” They prefer the phrase “excesses over expenses.” The Red Cross, for instance, made $300 million in “excesses over expenses” from 1980 to 1987.
The blood banks protest that they are nonprofit organizations. They claim that unlike big corporations on Wall Street, their money does not go to stockholders. But if the Red Cross did have shareholders, it would be ranked among the most profitable corporations in the United States, such as General Motors. And blood-bank officials do have handsome salaries. Of officials in 62 blood banks surveyed by The Philadelphia Inquirer, 25 percent made over $100,000 a year. Some made more than twice that much.
Blood bankers also claim that they do not “sell” the blood they collect—they only charge processing fees. One blood banker retorts to that claim: “It drives me crazy when the Red Cross says it doesn’t sell blood. That’s like the supermarket saying they’re only charging you for the carton, not the milk.”
The Global Market
Like the plasma trade, the trade in whole blood encircles the globe. So does criticism of it. The Japanese Red Cross, for instance, stirred a furor in October 1989 when it tried to elbow its way into the Japanese market by giving large discounts on products extracted from donated blood. Hospitals reaped huge profits by claiming on their insurance forms that they had bought the blood at standard prices.
According to Thailand’s newspaper The Nation, some Asian countries have had to clamp down on the market in red gold by ending paid donations. In India as many as 500,000 sell their own blood to make a living. Some, haggard and impoverished, disguise themselves so they can donate more than is allowed. Others are deliberately overbled by the blood banks.
In his book Blood: Gift or Merchandise, Piet J. Hagen claims that the shady doings of blood banks are at their worst in Brazil. The hundreds of Brazilian commercial blood banks operate a $70 million market that draws the unscrupulous. According to the book Bluternte (Blood Harvest), the poor and unemployed stream to the countless blood banks in Bogotá, Colombia. They sell a pint [half a liter] of their blood for a meager 350 to 500 pesos. Patients may pay from 4,000 to 6,000 pesos for the same pint of blood!
Clearly, at least one global reality emerges from the foregoing: Selling blood is big business. ‘But so what? Why shouldn’t blood be a big business?’ some may ask.
Well, what makes many people uneasy about big business in general? It is greed. The greed shows, for example, when big business persuades people to purchase things they don’t really need; or worse, when it continues to foist on the public some products known to be dangerous, or when it refuses to spend money to make its products safer.
If the blood business is tainted with that kind of greed, the lives of millions of people the world over are in great danger. Has greed corrupted the blood business?
In April 1990, Gaul’s exposé won a Pulitzer Prize for Public Service. It also sparked a major congressional investigation into the blood industry late in 1989.
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Probably very few women who have just given birth wonder what happens to the placenta, the mass of tissue that nourishes the baby while it is in the womb. According to The Philadelphia Inquirer, many hospitals save it, freeze it, and sell it. In 1987 alone, the United States shipped some 1.7 million pounds [0.8 million kg] of placentas overseas. A firm near Paris, France, buys 15 tons of placentas every day! The placentas are a ready source of maternal blood plasma, which the company processes into various medicines and sells in some one hundred countries.
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The Main Components of Blood
Plasma: about 55 percent of the blood. It is 92 percent water; the rest is made up of complex proteins, such as globulins, fibrinogens, and albumin
Platelets: about 0.17 percent of the blood
White Cells: about 0.1 percent
Red Cells: about 45 percent