As you may have read, the Rhode Island Blood Center has put out a call for blood donations – and it is extremely important that you donate if you can. Lives literally depend on these donations, for which there is no effective substitute. AI can’t donate. You can. Please consider it.
That said, understanding how much blood costs, and why, may help us understand why all our health care is so damned expensive.
First fact – all blood starts out free. All the blood in the United States is donated. No one can sell their blood. People can sell plasma, but not red blood cells. This was per order of the FDA years ago, something FDA thinks protects the blood supply, because it prevents people who might have a dread disease from having an incentive to cover that up, in order to sell their blood.
Most people donate one unit, or 500 milliliters of blood, each time they donate. That’s about 10 percent of your circulating blood volume, and for most of us, that isn’t a problem. The body makes blood cells quickly – regenerating the lost blood cells in 4 to 8 weeks, and the plasma that carries those cells in one to two days.
But if you got blood in 2021, your hospital charged your insurer $867 to $4452 per unit of transfused blood. Insurers paid $1087 to $1911. Medicare paid $926. And that doesn’t include the process of typing and screening, which has to be done for each unit to make sure it is safe to transfuse.
All for a substance which you or someone in your community donated. For free.
That seems analogous to going to the bank, depositing $100, and then being charged $1000 to withdraw what you deposited. That’s far from a perfect analogy, however: blood has to be tested, carefully stored, and processed, all of which has costs. But the magnitude of the charge for blood remains troublesome.
In most of Europe, patients are generally not billed themselves for blood, but the cost to their health systems in 2021were estimated to be €110 to €300 — or something like one seventh to one tenth of what it costs here.
Why does blood cost so much more here? I don’t know in precise detail.
Here’s what I do know. All outpatient donation in Rhode Island appears to be controlled by a single non-profit entity, as far as I can tell. That entity paid its president something like $1.8 million in 2019, the last year for which I can find data. It paid two other employees over $600,000 in that year. Those highly paid and very accomplished, well-trained staff appeared to work in New York, not in Rhode Island. The non-profits that used to do this work in Rhode Island appear to have merged with a New York non-profit in about 2017. In 2019, there appeared to be only one board member who lived in Rhode Island – a very accomplished lawyer.
It’s 2026, and all of that may have changed.
But this kind of corporatization of health care, which we see again and again, in hospitals, nursing homes, physician practices, imaging centers, urgent care centers, home health, physical therapy offices, insurance companies and even hospice care, is associated, at least in time, with the mushrooming cost of health care. These corporate processes, both for- and not-for-profit, seem to have outpaced and out-foxed governments’ ability to keep our health care affordable.
And these costs are all crazy.
All that said, please go to donate blood today. There is a critical shortage. But then let’s roll up our sleeves, so to speak, and work together to find a way to make a health care system that’s for people, not for millionaires.
Before they bleed us dry.
Thanks to my mentor, friend and colleague Dr. Ed Iannuccilli, whose column on blood donation got me thinking about this. You can read it at https://edwrites.net/subscribe?utm_source=email&utm_campaign=email-subscribe&r=trd3i&next=https%3A%2F%2Fedwrites.net%2Fp%2Fa-long-time-mission-of-donating-blood&utm_medium=email
You can find Michael Fine’s commentaries and short stories on
https://michaelfinemd.substack.com/and on http://www.michaelfinemd.com