The American Blood Supply: Issues and Policies of Blood Donation

Most of us hear only bad things about the blood supply in the United States. We are told that the supply is chronically low, that most people won't donate, that we depend too much on paid and possibly unsafe donors, and that many other countries have more generous people and better blood supplies. The American Blood Supply examines these and other claims and, after a realistic consideration of the facts, its conclusions are "short on scandal and long on praise." The authors find that the blood collection agencies and the present number of blood donors (more than half the people eligible to donate whole blood, they estimate, have done so at least once) are producing efficiently, for most purposes and situations, a sufficient supply of blood components and blood-based pharmaceuticals. American plasma collections are adequate both to meet internal needs and to provide for considerable export. The book covers alternative blood collection ideologies, blood safety and disease transmission considerations, the nonprofit organizations that collect almost the entire whole blood supply, the pharmaceutical industry that collects and processes plasma (most of it from paid plasmapheresis donors), public attitudes and participation in the blood supply, comparisons with practices in other countries, and identification of important unresolved problem areas. The authors' concerns for the future of the blood supply include the governance and performance of regional blood supply monopolies and the integrity of blood collection messages delivered to the public. The three authors are faculty members at MIT. Alvin Drake's background is in operations research on the delivery of public services, Stan Finkelstein is a physician interested in medical innovation, and Harvey Sapolsky is a political scientist specializing in public organizations. This book is the fifth in the series Health and Public Policy, edited by Jeffrey Harris.