Thursday, November 19, 2009

Blood, Drugs, and Greed

Greed is considered a bad thing and in many cases is equated with capitalists like myself. Yet, it is that very greed that not only allows a home computer possible, but then also allows those who profited from it (i.e. Bill Gates) to dispense the largesse which they couldn't possibly spend themselves. One of the greatest philanthropists in the world, Andrew Carnegie became incredibly wealthy through steel, a product which has greatly enriched our lives. Acquiring wealth by force has never been a secure way to maintain it. Many of the rich nobles of the European middle ages and renaissance were actually deeply in debt to the bankers who financed their operations. The bankers were rich, the nobles just had the airs of wealth.

In spite of the proven track record that greed has in benefiting people, we still don't embrace it in many aspects of our lives. Drugs and blood are two areas where we just have not gotten it in this country.

The FDA regulates blood donations in this country. Blood can be donated by people, it cannot be sold. Is it any wonder that we have shortages all the time? Meanwhile, plasma (a component of blood), can be sold. I looked on line for stories of plasma shortages and the most recent one I found was from 1995. How much money can you get from plasma? Looking on the internet it appears that somewhere in the neighborhood of $20 to $35 per visit. And you can go twice a week, every week of the year. So between $2000 and $3600 per year. Suprisingly, prices have not gone up significantly over the last 20 years. So why not pay people for blood? What is the hangup we have in this country? Hospitals charge you somewhere in the neighborhood of $250 for a pint of blood that is used during surgery. So would the price of blood charged change if we started paying donors for the blood?

Not necessarily. The majority of blood is used in large urban centers. Unfortunately, these are also the places that have the lowest rates of donation. So, the urban centers have to buy their blood from an outlying area that takes in more blood than they need (you didn't think these non-profits would just give them the blood did you?) . In some cases, blood that is donated in Bismark, ND may be sold to Tulsa, OK and then to Memphis, TN, and then to Atlanta, GA, and finally provided to a hospital in Tallahassee, FL. Just like with any product, each stop gets an increase in price. So, if people were paid $50 (or $100) for a pint (which takes about 1 hour), there would be an increase in the supply of people. Whereas before, blood banks rely on people donating their blood (and time) out of their generosity, now, they can lure in the segment of population that is driven by a profit motive. Most people in this country don't make anywhere near $50 an hour, so in deciding whether to work a few extra hours or lie on a bed and read a book and get the same amount of money, I'll choose the lieing on the bed option.

Statistically, city dwellers are less generous monetarily than rural folks. That may be why cities take in less blood than they use. However, if now it wasn't a matter of generosity, but greed, cities which have a much higher percent of non-generous people than the rural areas will see an immediate increase in the amount of blood brought in. Hence, no need to buy from somewhere else. Which means that the four or five markups (from $50 to $200) is available to pay the people giving the blood.

Now, I wouldn't regulate the compensation at all. And what you would find is in less than six months, the market would be normalized. Sure AB- blood in New York City may command a premium of $200 to the person, while common types like A+ in Des Moines, IA were only paying $35. Shortages would vanish. Blood banks would get to become more choosy (thereby putting downward pressure on prices) because the number of people willing to sell their blood is much higher than those willing to donate their blood.

Does this work in real life? Yeah, there is no shortage of plasma. Another example would be sperm and eggs. You can get them in any variety you want, and the market has made it such that you can choose the socioecomomic background, intelligence, and athletic ability of the sperm or eggs. If the free market was allowed to control the blood supply, you would be able to choose to have blood that only came from non-smoker females who breast fed their kids if that is your desire. Government mandated generosity can't even keep up with the demand. We should be allowed to sell organs to. Since we don't there is and always will be a shortage. By the way, I still give blood, although it would be a lot easier to remember every two months if there was a financial incentive.

Drugs are another aspect that the government goes schizophrenic on. There are drugs that are herbs, non-drugs (alcohol, tobacco, caffiene, etc), good drugs (tylenol, advil, etc), strong good drugs (prescription drugs), and bad drugs (marijuana, cocaine, heroin, etc.).

Herbs are labeled as "food supplements" to avoid the regulation as a drug, but sold as "remedies" for all kinds of things that normally one would associate with good drugs. All said, the actual ingredients of herbs are rarely known or labeled and any doseage is unscientific at best - two plants growing next to each other could have drastically different levels of desired chemicals. The herbal market is big in the United States and periodically companies get in trouble when they cross the line between "food supplement" (little to no regulation) and good drugs (which require regulations that the herbal companies haven't met).

Non drugs are the most ridiculous things we have. They run the gamut of caffiene which isn't regulated and freely available to everyone, to alcohol which is restricted but still allowed to advertise, to tobacco which is legal to buy but has become a scarlet letter if you use it. Our country tried banning alcohol once, with disasterous results. We're slowly progressing to a tobacco ban (which guess what...will have disasterous results). We don't like to call these drugs because they are substances that millions of people use (and are dependent on) every day. It doesn't change the fact that they are indeed drugs.

Good drugs are here to stay. Although sometimes we get a little too hysterical when one of them (Sudafed) is used to make a bad drug (Methamphetamine). Then we start doing stupid things like writing down your name and address everytime you buy a box. Do we do that for all of the other ingredients needed to make Meth? No, just Sudafed. What irks me most about it is then they have to come out with pseudoephedrine free Sudafed. That stuff is another drug that doesn't work as well or last as long. Just let me buy the good drugs in peace so I don't have to let my nose run all over your store. Another part of where we get a little goofy is when we let the government say what is good for us. Claritin was a prescription drug that was moved to over the counter because it was so effective. Did it cut into the profits of the company that made it, you bet.

Finally there are the bad drugs. These are still used in research and even in medicine in controlled manners, but the government has decided that the average person should not get their hands on them. So we have a ban. And guess what, it isn't working out to well. You might even say that it is a disaster.

All things are subject to supply and demand. Bans merely exacerbate the problem on certain things. The first thing that bans do is attempt to limit the supply. Since demand hasn't decreased, prices go up. When prices go up, there is more potential for profit and all sorts of undesirable people get into the business. So the "businessmen" find ways to meet the demand. As with any business, disagreements will come up. In the legal business world, these would be solved through mediation and litigation processes. In the illegal world, those options are not available, so disputes are settled by coercion and force.

If drugs were legalized, the crime associated with them (between the gangs and cartels) would go down, because the profit margins would decrease since the costs of smuggling would no longer be part of the street price. Would there still be people robbing stores or breaking into homes to get their money for their fix? Of course, but it wouldn't be any more than it is now. We already have a 200 year history of regulation for alcohol and tobacco. We know that banning them doesn't work but actually creates more problems. So why do we do this with marijuana, cocaine, and heroin?

If you believe that making drugs legal would somehow cause a bunch of people to start using them, you're delusional. Prohibition did nothing to decrease the number of people drinking, it only changed the location where they obtained their alcohol and where they drank it. Repeal of prohibition did not increase the number of drinkers, they just did it in the open. The consequences of drug use are known. More people die from alcohol and tobacco than all of the other drugs (illegal and legal) combined. This is probably a result of the government trying to tell us that alcohol and tobacco are not as bad, so some people act stupid and use them to excess.

Let me make one thing clear. I think recreational use (and definitely unecessary dependent use) of any kind of drug (from caffiene on up to Meth) is stupid. I think the US is even more stupid for trying to blur the lines as to what drugs are OK and not OK. Its OK to ban heroin right now, because Sam Adams didn't cook some up in his home. Maybe instead of focusing on trying to limit the supply of some drugs (which isn't working), the US should focus on addiction recovery for those that want it for all drugs. In the end, you have to admit that there will always be some small segment of the population that are willing to destroy themselves to get a high. No amount of bans or legislation or intervention are going to prevent that. Greed won't allow it. (It also is the reason bans don't work for anything.)

1 comment:

  1. I have always thought the blood shortage was strange and I agree that allowing people to sell their blood would increase the supply.