Bad Blood

With unwonted hoopla, the New York State Medical Society announced last week a new gimmick in blood banking. Under its "blood assurance program," the head of a family can sign up at one of the member blood banks and, in return for one pint of blood each year, get a certificate entitling him and each member of his family to a maximum of four pints of transfusion blood. A single individual is assured of all the blood he may need. A family in which nobody is qualified to give blood can get in on the plan if a friend or relative deposits the premium pint. No cash is involved.

On its face the plan looked good, but it had many hidden shortcomings which emphasized that in New York and throughout the U.S., the whole system of blood banking is in bad shape. New York State's Blood Banks Association has about 100 members, but only 22 have joined its clearinghouse, an essential and appealing feature of the program. This means that a subscriber who is ill or injured away from home has only a 20% chance of landing in a hospital whose blood bank will honor his guarantee of four free pints. Outside the state, his chances are even less. The organizers hope to enlist more member banks in New York State and to work out exchange agreements with similar doctor-sponsored setups in such states as Florida, Texas and California.

No Monopoly. Wholesale blood donations and widespread blood banking got off to a flying start in World War II. The American Red Cross, as the U.S. Government's official collecting agency, did itself proud and drained off 13 million pints. During the cold war, the Red Cross had to do a balancing act: while it could not keep its monopoly in blood (and flatly denied that it wanted one), it sought compromise measures to insure a supply of freely given blood for the armed forces, for civil defense and for disasters. Trying to work with organized medicine, it agreed not to set up any local blood bank without the approval of the county medical society.

Meanwhile, many a plain citizen who wanted to give a patriotic pint for Korea, and also protect his family against being bled financially white for hospital blood, has felt that he was getting a raw deal. In many communities he would find that he had no blood credit, would have to pay up to $35 a pint for the blood or replace it at the rate of two pints for one, and still pay a service charge which might run to $25. (For safety's sake, better hospitals retype all blood and carefully match it with the patient's. For this, a reasonable charge would be $7 to $10 a pint.)

Free for All? The Red Cross insists that no charge ever be levied for blood which it has collected from volunteer donors, or for serum albumin and gamma globulin derived from such blood. But the A.M.A. and state medical societies claim that free blood--for any patients other than charity cases--is "socialism." In public statements some officials of county and state societies have shown that they are determined to wrest control of blood from "lay" groups.

Some blood banks are already making a profit (which may help to pay other hospital costs). The New York State plan is open to abuse because it is proposed to collect three times as much blood as subscribers will need, on the basis of past experience, and the surplus could be sold.

Even the quality of blood is not standardized: licensed blood banks which meet the exacting federal standards may not accept blood in exchange from substandard banks.

Late this month, spokesmen for the Red Cross and the American Hospital Association will sit around a table in Washington with members of the A.M.A. and the Association of American Blood Banks, to see whether they can agree on a nationwide program. Before they do, they will have to get a lot of bad blood out of their systems.

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