The nature of blood as an economic good

 

For a product or service to be classified as an economic good, it is essential that it has the two fundamental qualities of being desirable yet scarce. The idea of being desirable suggests that consumption of this good has a welcome effect on the utility of the typical person, where he would prefer to have some positive quantity of it rather than none at all. Meanwhile, scarcity implies that the consumer would, in general, prefer to receive more of the good than is currently available to him to use, even though his utility rises by a diminishing amount for each additional unit consumed. If a good is not scarce, then there is usually no valid reason why it cannot be consumed free, as there is no limit to the quantity that can be provided (and thus wasted) of it. If, however, there is some restriction on supply (due to either natural or artificial factors), then the good is scarce, in which case it should not be provided free, but should rather be charged for, as some limit must be imposed on the quantity available per consumer. In such an event, the only way that a consumer can obtain more of one scarce economic good is if he limits his consumption of another economic good – the sacrifice of a less valued economic good can allow him to either exchange it for greater quantities of the good he values more with someone who has what he wants, or else permit him to produce what he wants himself (if this is possible).

 

In essence then, “an economic good is a desirable thing of which there is not enough to satisfy the desires of those who want it” [1], and which can, by implication, be successfully rationed, usually by means of the price mechanism. This is since the price mechanism not only has the ability to force people to conserve their use of such goods so that they are used in the optimum manner possible, but it also provides an incentive for further quantities to be supplied. It is thus obvious that every economic good has some intrinsic price attached to it, even if the person who actually consumes it does not pay for it, as is the case with gifts (which are paid for by a donor) or publicly provided goods (whose costs are borne by the taxpayer). While the range of economic goods is immense, covering everything from guns to butter, the number of real life items that do not, to some extent, display the characteristics of an economic good is minimal [2]. Even air, which has been presented as the classic example of a non-economic good due to its apparently limitless and hence non-scarce nature can, in fact, be traded on a market like an economic good. This is possible because if we are to narrow our definition of air to mean only that type of clean, oxygen rich gas that we desire for breathing purposes, then transactions involving payments can be made between parties to secure ever scarcer supplies of this economic good [3].

 

If we now apply the aforementioned criteria to blood, we can conclude that it too has the properties required for consideration as an economic good. First, while most people usually do not need more blood than they already have within their bodies to survive, should they, for any reason, suffer from blood loss or be unable to produce specific blood components, then the situation concerning their needs changes markedly. Now, blood becomes highly desirable, as they may wish to have some positive quantity of it transfused into them when they previously desired none. Furthermore, we can discern that blood becomes a scarce item, as the recipients may want to receive more blood than may be available to them, especially during incidents of uncontrolled bleeding, where transfusions must continue for as long as outflows of their own blood continue unabated. The idea of scarcity is most evident when blood shortages result in the implementation of rationing, where blood recipients, directly as patients or indirectly via their agents, namely hospitals and physicians, either have to reschedule surgery or must compete for whatever is available by showing that they need (or desire) more blood than is currently being received [4].

 

Altruism dependent blood banks may assert that as their donors voluntarily forego payment for their blood, any economic attributes that may exist are limited to only the final consumption side, and are in now way present at the point of acquisition. This is said to be the case because from the perspective of donors, while blood is admittedly desirable, they are more than willing to part with some of what they have, as they feel that they have enough for all their own needs. In addition, they may feel that their blood is not really scarce, as their good health enables them to produce sufficient quantities to meet all their own requirements. This is, unfortunately, an incorrect interpretation, since the production of an economic good is indeed taking place, using what is often perceived to be the scarcest and most desirable commodity available to any human being, namely time. By spending however long it takes to give blood, donors must incur an opportunity cost measured in lost time, since their restricted position means that they are unable to engage in other activities while donating. Now, while donating may provide donors with more utility than any other activity that could be performed during the relevant amount of time spent, this cannot detract in any way from the fact that they are literally paying for such utility by giving up some of their precious, and ever dwindling, time [5]. In addition to lost time, donors may suffer from a decreased availability in other things of value to them, with the greatest loss probably being the earnings and education they must forgo when they give blood freely.

 

Having conclusively demonstrated that blood is an economic good, we can go further and consider an argument by Titmuss that “the gift of blood has certain unique attributes which distinguish it from other forms of gift”[6]. If we examine some of these alleged attributes, we can see that in the world in which we live, there are economic goods with similar features to blood that are also provided in life saving circumstances, yet which can just as easily be traded as commodities as they can be given altruistically as gifts. Among the propositions made about blood that can be refuted are the following:

 

-“The gift of blood takes place in impersonal situations, sometimes with physical hurtful consequences to the donor”[7]. All blood donors, regardless of whether they are paid or not, are informed beforehand about the potential risks they face when giving blood, even though most risks are of a relatively trivial nature. This is in contrast to some other altruistic acts, where the donor is not aware of the risks that are being faced even though they may be of a much greater magnitude, including possible death. This occurs, for example, when people rush into blazing buildings to save others even though the intensity of the flames, and thus the risks, being faced are always changing – at such times, the rescuer could just as easily be a fireman, who is a professional in this field, as it could be a volunteer at the scene of the action, who is simply an unpaid amateur;

 

-“No givers require or wish for corresponding gifts in return. They do not expect or would not wish to have a blood transfusion” [8]. An initial reading would suggest that this statement appears to be based on the mistaken assumption by Titmuss that all gifts other than blood are provided according to the principle of gift reciprocity, where the donor expects, sometime in the future, to himself be the recipient of a similar gift. While it is true that few donors would have any wish to be ill and themselves require a transfusion of blood, the same logic can be applied to the people mentioned in the fire fighting example above, who, although they save other people’s lives, are unlikely to have any desire to be trapped in an inferno and need to be rescued either[9];

 

-“In most systems, there is no obligation imposed on the recipient himself to make a corresponding gift in return” [10]. Once again, we return to the assumption of gift reciprocity, although in this case we must look at the issue from the perspective of the recipient. While altruists may sometimes be pleased if they do get something in return (even a simple “thank you”), there are many types of gift that in no way require repayment by the recipient, especially if that person is unable to return the favour. For example, people who have just been saved from a fire are under no obligation to return to the building to help their rescuer if he himself has started having trouble while in the burning building, especially if they are injured.

 

From this analysis, it is clear that there is very little that can be said about blood that cannot be said in exactly the same way about many other goods in the world. This is hardly a surprising observation, for there are no intrinsic features about blood that make it unique or out of the ordinary, except, possibly, for the fact that it can be extracted from our bodies. If anything, blood is only special if we make it appear so, in which case we would simply be guilty of applying our own values and beliefs to something that can be rationalised and which may be seen in a different light by others. Having clarified the true economic nature of blood, we can move on to examine how best it can be acquired, with a comparison being performed in the following section of the features of the two main systems of blood collection that are available for use, namely free "altruistic" donation and compensated "selfish" blood extraction.

 

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