Blood money: blood donors' attitudes to changes in the New Zealand blood transfusion service

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Abstract
Blood is an unusual product in a market economy: donors give it freely to strangers. Titmuss concluded that if this gift was commercialised, donors would feel less inclined to donate blood without payment and would face incentives not to disclose diseases.1 The opposing view is that the most efficient way of rationing a scarce product like blood is to put a price on it and let a market develop in which it can be traded.2 In 1993 a purchaser-provider split was introduced into the New Zealand health service. The Blood Transfusion Service was embedded in the new hospital organisations, crown health enterprises, which were required to be profit driven.3 A National Blood Transfusion Trust was set up to preserve the gift relationship and to ensure that there is no …