Is Paying for Blood a Good Idea After All?

(Photo: Howard Lake)

An article in Science by Nicola Lacetera, Mario Macis, and Robert Slonim summarizes their research on economic incentives and blood donation (abstract; PDF). Contrary to previous studies, the researchers found that various incentives, from gift cards to a day off, increased blood donation: 

Overall, 18 of the 19 distinct incentive items offered in observational and field experimental studies increased blood donations, and the effects were larger for items of higher monetary value; only one reward offer, a free cholesterol test, had no effect. When data were available (for 15 of the items), no effect on blood safety was detected. Finally, although temporary rewards might affect long-term motivations, no post intervention effects on donations were found, including any negative effects deriving from potential motivation loss. 

In Freakonomics, we mentioned Richard Titmuss‘s landmark 1970 study on blood donations, which found that offering money for  blood actually hurt donations. The new research urges a policy overhaul: 

The position and guidelines of the World Health Organization (WHO) and several national blood collection agencies for nearly 40 years have been based on the view that offering economic incentives to blood donors is detrimental to the quantity and safety of the blood supply. The guidelines suggest that blood should be obtained from unpaid volunteers only. 

However, whether economic incentives positively or negatively affect blood donations (and other prosocial activities) has remained the subject of debate since the positions were established.

Evidence consistent with the WHO position came originally from uncontrolled studies using nonrandom samples and, subsequently, from surveys and laboratory studies indicating that economic incentives can “crowd out” (decrease) intrinsic motivations to donate and can attract “worse” donors.

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  1. Tom Petrik says:

    I would gladly give blood for pay.

    The one time I offered o volunteer they wouldn’t let me, though. Meds for three different things, they just shook their ears and said “no, sorry”.

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    • Enter your name... says:

      The problem (which is much bigger with cash payments than with thank-you gifts) is that there are a significant number of people who are willing to tell lies for money. So you might be honest and say that you’re on meds for three different things, and it’s too bad that your health keeps you from getting the money, but the next guy might go in and tell a bunch of lies about how he’s never injected drugs and never visited prostitutes and doesn’t have any health risks or diseases at all, just to get the money.

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      • Esse says:

        I lie simply to be able to donate blood, particularly because I have blood that can be given to newborns. If I answer honestly that I’m a woman who had sex with a man who’s had sex with men, I’m barred from donating. However, I’ve never had a positive STI test of any sort, so I lied and donated and everyone was happy. I don’t donate now, simply because the nearest blood donation center is an hour away.

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  2. Derek Yuen says:

    The catch is: the rewards are material items (coupons, vouchers) rather than cash. As argued by J Heyman and D Ariely (2004) in “Effort for Payment”, when payments were given in the form of gifts, effort seemed to stem from altruistic motives and was largely insensitive to the magnitude of the payment. The study by Lacetera et al. will be more conclusive if cash is used for payment instead of material items.

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  3. Eric M. Jones says:

    It always amazes me that, e.g. the Red Cross begs for voluntary blood donations but only pays people who live in back alleys for it (Let’s hope this is an exaggeration). I know lots of people in great health who would be happy to sell you a pint of blood for $50.

    The Red Cross doesn’t do anything for free. Neither do hospitals. And the doctor needs another Mercedes.

    So why are they such tightwads? Because they CAN be.

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    • steve cebalt says:

      My daughter (college) did a paper in the style of Jonathan Swift’s “Modest Proposal” satire for a class on “Dangerous Ideas.” A person could auction off his heart, eyes, skin, kidneys, liver, etc., for delivery with 7 days, during which time the donor would be euthanized.

      Remember, the premise of the class is to expand students’ power of thinking by urging them to go (hypothetically) beyond all normal boundaries.

      The Prof glanced at her thesis and said it was “too radical,” and my daughter was very upset and thought she needed to do it over. I told her not to change a word; that the Prof’s comment was made in haste. She didn’t change it, and she got an A on the paper and in the class. Her paper is here if anyone is interested:

      I personally would CERTAINLY auction my organs for, let’s say, $2 million total. I’d be able to leave that money as a financial legacy for the people I love, and I would save any number of lives of rich sick people. Their money is no good if they’re dead; but I’d be happier with the money for my family. Saving lives and leaving a financial legacy for my loved ones is more than anything else I can hope to achieve in this lifetime.

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      • k says:

        Hidden due to low comment rating. Click here to see.

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      • Steve says:

        I’m curious now – I wonder what percent of organ donations come from suicides?

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    • Enter your name... says:

      In the US, nobody pays anyone for blood donations, regardless of whether they live in a back alley or a penthouse. It’s illegal.

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      • Brian says:

        Penn & Teller get away with it because they claim that their tickets can be subjectively viewed to have no value.

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      • Eric M. Jones says:

        Not quite. But Google: ” Are paid blood donations legal? ” Wiki has a good discussion too.

        Blood and plasma is paid for all the time. But my point is that markets that depend on donations show exactly what is wrong with communism, and why a market economy has great advantages.

        Complaints by anyone about a blood shortages while maintaining a system where the shortages are guaranteed is disingenuous. Although I understand the concerns that paying for blood will induce people to conceal their health problems, this seems to me idiotic. There are plenty of perfectly healthy people who would like to sell you their blood.

        BTW: Licensed aircraft pilots are discouraged (or prevented) from giving blood.

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      • Robb says:

        In the US, blood banks don’t pay for blood donations that are to be used for transfusion. However, they can pay for blood (usually plasma) donations that are to be used for research.

        Here arises the confusion:
        If you’re getting blood, it came from a volunteer donor.
        If you’re buying blood for your lab, it may have been purchased for money.

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      • Lassie says:

        Do you mean entities like RedCross paying donors? I have seen and been to plenty of centers that paid money. Usually it’s about $25 for a pint of blood, and I have seen as much as $60 for plasma. It isn’t illegal to play for blood donors in the U.S.

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  4. Brian says:

    Blood donors in Las Vegas can get free show tickets to Penn & Teller ($150 value)

    Prior to this annual promotion, their were blood shortages in Las Vegas, now they send blood to other states.

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  5. Jeff Kaufman says:

    I already give blood at work for a few pennies.

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  6. Caleb B says:

    There is no plasma shortage….bc they pay people for it. I think it has been pretty well established people respond more to “straight cash homie.”

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  7. pawnman says:

    What constitutes “worse blood” in an era where it is cheap and easy to screen the blood for pathogens before administering it?

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  8. Sylvia says:

    Where I live blood donation for money is not done.
    There is shortage of volunteers and shortage of blood.
    If someone is expected to need blood transfusion they need to find people to donate blood for them (not the specific blood they will be given, just same quantity).
    So, if you cannot find relatives or friends to donate blood there are people lurking around the blood center that would donate blood for you if you pay them.

    The whole process would be much easier on the sick and their families if blood donation could be officially done for money.

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