June 7, 2026 • 7 mins
Record plasma donor numbers aren't enough to meet growing demand, and there's debate over whether compensation is needed to bring figures up.
It's National Blood Donor Week, and the Blood Service is looking to recruit another 4000 over the next year.
More than 25,000 New Zealanders have donated plasma in the past year - the most the service has ever recorded - and yet it's still not enough.
NZ Initiative expert Eric Crampton joined the Afternoons team to weigh in.
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Speaker 1 (00:09):
You're listening to a podcast from Newstalk zed be follow
this and our wide range of podcasts now on iHeartRadio.
Speaker 2 (00:16):
New Zealand is facing ongoing pressure on its blood and
plasma supply, but one idea keeps coming up. Should we
actually be paying downers? Utilizing research from Georgetown professor and
ethics Peter Jaworski, economist doctor Eric Crampton from the New
Zealand Initiative argues the current system isn't working, pointing out
that we rely on important plasma from countries like the
US where donors are paid. So is it time to
(00:38):
rethink the ethics and the economics of paying people for plasma?
Doctor Crampton joins us now, very good afternoon, Good afternoon.
Speaker 3 (00:46):
Hey, Just to start things off, just so we all
know where we stand on this. What's the difference between
plasma and whole blood.
Speaker 4 (00:54):
Plasma is the castracolored liquid that blood kind of floats
around in. Whole blood has plasma as well as red
blood cells, white blood cells, all the other bits that
are in blood. You'd have to find a different kind
of doctor to get you all the kinds of different
the specific diferences. But plasma is safe to donate more
frequently than blood. It regenerates far more quickly within the
body hold blood it takes a little bit longer for
(01:17):
that to come back up. And plasma also is really
important in manufacturing medicines. That gives us another difference between
blood and plasma because you can make plasma donations really
safe in ways that it's harder to do with blood.
When you process it for medicines, you can kill off
anything that's in there really that might be a problem
from the donor. With blood, you have to be a
(01:38):
little bit more careful.
Speaker 3 (01:39):
So when you give plasma, did you take all the
blood out and then then that they give back the
red blood cells?
Speaker 4 (01:46):
Is that outlooks the machines pull out of plasma, any
blood goes back into the person. They're always having technological
improvements in this, particularly in some of the paid centers
in the US. The machines are getting a lot more efficient,
and they've had increases in the amount of plasma that
they're able to get from a donor per donation, just
(02:07):
because the machines are getting a lot better at it.
Speaker 3 (02:09):
So why is it any plasma that save a tachan
never real there's not really many countries that will apply
for whole blood is there.
Speaker 4 (02:18):
Well, plasma is in shortage in any country that doesn't
allow compensation for donors winds up having shortages of plasma.
New Zealand had bucked that trend until about fourteen twenty fifteen.
Since then we've been reliant on increasing proportions of immuno globulin,
which is the product made from plasma, is one of
(02:38):
the products made from blood plasma, the most prominent one.
We have been importing increasing amounts of that. We used
to be self sufficient, now we're not. We're buying product
out of the United States, where donors are compensated. The
United States is responsible for about seventy percent of the
world's supply of blood plasma product, in part because they
allow compensation. They're not the only country that does. Germany, Austria, Hungary,
(03:03):
Czech Republic, and some Canadian province has allow compensation, but
others like New Zealand, Land Australia, we lined up with shortages.
We don't have a shortage of blood, we do have
shortages of plasma, and we wind up important because of it.
Speaker 3 (03:15):
So if someone had a moral problem with people being
paid for plasmas, then we are anyway, We're just outsourcing
it to another country.
Speaker 4 (03:25):
We are paying American donors for their plasma product. And
that's one of the things that worried me intensely during COVID.
So they were seeing sharp decreases in donation rates during
the early part of COVID because they were having all
of these rolling lockdowns across the US that were starting
to hinder some of their supply, and because we were
increasingly reliant on their product. I was worried that our
(03:45):
failure to allow compensation would result in worse shortages here
that could not be made up. Allowing compensation here would
allow us to be part of the solution. So rather
than outfitting poorer countries for immunoglobulin products from the United States,
we would be helping to supply them, which seems like
a good thing.
Speaker 3 (04:06):
How much did they pay in the stits. How much
would you imagine we would pay here in New Zealand
for pleasment.
Speaker 4 (04:13):
I don't have those numbers in front of me. You'll
have to talk with Peter sometime, because he is the
real expert on this. I just wrote the forward for
his report, but I note that in the Canadian paid
it's just this really neat outcome where at least in Canada,
the Canadian paid services can supply plasma at forty one
(04:35):
to eighty eight percent of the cost that faces the
Canadian blood services that don't compensate, so the paid donation
centers wind up being a lot more efficient, even though
about a third of the cost of plasma is what
they paid donors.
Speaker 3 (04:49):
Actually, just looking at this here a quick Google search
between thirty and eighty American dollars per donation. So I
just wonder if that's an because the difficult part of
giving blood is taking the time out of your day
going somewhere and the perceived tiredness that you get after it,
so you you can't have a lot on on that
(05:09):
given day.
Speaker 4 (05:10):
So it's a little different with plasma. So you wouldn't
get the same kind of right losing blood right you're
seeing plasma, there's a bit of a recovery time, but
you'd be able to donate plasma like every six days
or so if we had compensated donation here. That's one
of the other reasons that compensation can really make sense
with blood donations. You might go a few times a year,
(05:32):
right and getting like even a one off donation is
pretty good. With a paid compensation regime, you'd have someone
who's gone through the initial paperwork and then they show
up far more regularly, maybe once a fortnite. It's really
you get efficiencies in processing because it's the same person
coming back repeatedly. There's no harm in doing so, it's safe.
(05:53):
It happens all the time in the US. There aren't
adverse consequences. But you can get those efficiencies in donation
because you get the same person coming back repeatedly because
you're not asking them to give up huge amounts of
time for free.
Speaker 2 (06:07):
One of the big respects doctor, you know, from the
ethics standpoint, is that it could be turning parts of
the human body into a commodity. So if we were
to compensate for plasma donations, what would need to change
is that legislation that would need to be altered.
Speaker 4 (06:22):
It'd be in the Human Tissues Act, where there are
general prohibitions on compensation for these products in the human body.
So we've gotten a kind of exemptions for that for
compensation for time out of the workforce sometimes. So Minister
Bishop progressed legislation that passed unanimously through Parliament that allowed
compensation for life kidney donors. That's been helpful. We could
(06:46):
allow compensation here as well. I would prefer to allow
private centers to set up and pay compensation not you
see some of the efficiencies that result in the American
and the Canadian setups where they can drive down costs
while maintaining safety. It seems to really work well. If
we weren't prepared to go that far, you could just
(07:07):
have a stand compensation regime for the time that donors
are spending and pee enough to make them want to
come back repeatedly.
Speaker 2 (07:17):
Eric, It is a fascinating discussion. Thank you very much
for your time. Really appreciated it, and we will speak
to the Georgetown ethics professor maybe in the next couple
of weeks on his research as well. But it's an
interesting idea.
Speaker 1 (07:29):
For more from News Talks B listen live on air
or online and keep our shows with you wherever you
go with our podcasts on iHeartRadio.
You're listening to a podcast from Newstalk zed be follow
this and our wide range of podcasts now on iHeartRadio.
Speaker 2 (00:16):
New Zealand is facing ongoing pressure on its blood and
plasma supply, but one idea keeps coming up. Should we
actually be paying downers? Utilizing research from Georgetown professor and
ethics Peter Jaworski, economist doctor Eric Crampton from the New
Zealand Initiative argues the current system isn't working, pointing out
that we rely on important plasma from countries like the
US where donors are paid. So is it time to
(00:38):
rethink the ethics and the economics of paying people for plasma?
Doctor Crampton joins us now, very good afternoon, Good afternoon.
Speaker 3 (00:46):
Hey, Just to start things off, just so we all
know where we stand on this. What's the difference between
plasma and whole blood.
Speaker 4 (00:54):
Plasma is the castracolored liquid that blood kind of floats
around in. Whole blood has plasma as well as red
blood cells, white blood cells, all the other bits that
are in blood. You'd have to find a different kind
of doctor to get you all the kinds of different
the specific diferences. But plasma is safe to donate more
frequently than blood. It regenerates far more quickly within the
body hold blood it takes a little bit longer for
(01:17):
that to come back up. And plasma also is really
important in manufacturing medicines. That gives us another difference between
blood and plasma because you can make plasma donations really
safe in ways that it's harder to do with blood.
When you process it for medicines, you can kill off
anything that's in there really that might be a problem
from the donor. With blood, you have to be a
(01:38):
little bit more careful.
Speaker 3 (01:39):
So when you give plasma, did you take all the
blood out and then then that they give back the
red blood cells?
Speaker 4 (01:46):
Is that outlooks the machines pull out of plasma, any
blood goes back into the person. They're always having technological
improvements in this, particularly in some of the paid centers
in the US. The machines are getting a lot more efficient,
and they've had increases in the amount of plasma that
they're able to get from a donor per donation, just
(02:07):
because the machines are getting a lot better at it.
Speaker 3 (02:09):
So why is it any plasma that save a tachan
never real there's not really many countries that will apply
for whole blood is there.
Speaker 4 (02:18):
Well, plasma is in shortage in any country that doesn't
allow compensation for donors winds up having shortages of plasma.
New Zealand had bucked that trend until about fourteen twenty fifteen.
Since then we've been reliant on increasing proportions of immuno globulin,
which is the product made from plasma, is one of
(02:38):
the products made from blood plasma, the most prominent one.
We have been importing increasing amounts of that. We used
to be self sufficient, now we're not. We're buying product
out of the United States, where donors are compensated. The
United States is responsible for about seventy percent of the
world's supply of blood plasma product, in part because they
allow compensation. They're not the only country that does. Germany, Austria, Hungary,
(03:03):
Czech Republic, and some Canadian province has allow compensation, but
others like New Zealand, Land Australia, we lined up with shortages.
We don't have a shortage of blood, we do have
shortages of plasma, and we wind up important because of it.
Speaker 3 (03:15):
So if someone had a moral problem with people being
paid for plasmas, then we are anyway, We're just outsourcing
it to another country.
Speaker 4 (03:25):
We are paying American donors for their plasma product. And
that's one of the things that worried me intensely during COVID.
So they were seeing sharp decreases in donation rates during
the early part of COVID because they were having all
of these rolling lockdowns across the US that were starting
to hinder some of their supply, and because we were
increasingly reliant on their product. I was worried that our
(03:45):
failure to allow compensation would result in worse shortages here
that could not be made up. Allowing compensation here would
allow us to be part of the solution. So rather
than outfitting poorer countries for immunoglobulin products from the United States,
we would be helping to supply them, which seems like
a good thing.
Speaker 3 (04:06):
How much did they pay in the stits. How much
would you imagine we would pay here in New Zealand
for pleasment.
Speaker 4 (04:13):
I don't have those numbers in front of me. You'll
have to talk with Peter sometime, because he is the
real expert on this. I just wrote the forward for
his report, but I note that in the Canadian paid
it's just this really neat outcome where at least in Canada,
the Canadian paid services can supply plasma at forty one
(04:35):
to eighty eight percent of the cost that faces the
Canadian blood services that don't compensate, so the paid donation
centers wind up being a lot more efficient, even though
about a third of the cost of plasma is what
they paid donors.
Speaker 3 (04:49):
Actually, just looking at this here a quick Google search
between thirty and eighty American dollars per donation. So I
just wonder if that's an because the difficult part of
giving blood is taking the time out of your day
going somewhere and the perceived tiredness that you get after it,
so you you can't have a lot on on that
(05:09):
given day.
Speaker 4 (05:10):
So it's a little different with plasma. So you wouldn't
get the same kind of right losing blood right you're
seeing plasma, there's a bit of a recovery time, but
you'd be able to donate plasma like every six days
or so if we had compensated donation here. That's one
of the other reasons that compensation can really make sense
with blood donations. You might go a few times a year,
(05:32):
right and getting like even a one off donation is
pretty good. With a paid compensation regime, you'd have someone
who's gone through the initial paperwork and then they show
up far more regularly, maybe once a fortnite. It's really
you get efficiencies in processing because it's the same person
coming back repeatedly. There's no harm in doing so, it's safe.
(05:53):
It happens all the time in the US. There aren't
adverse consequences. But you can get those efficiencies in donation
because you get the same person coming back repeatedly because
you're not asking them to give up huge amounts of
time for free.
Speaker 2 (06:07):
One of the big respects doctor, you know, from the
ethics standpoint, is that it could be turning parts of
the human body into a commodity. So if we were
to compensate for plasma donations, what would need to change
is that legislation that would need to be altered.
Speaker 4 (06:22):
It'd be in the Human Tissues Act, where there are
general prohibitions on compensation for these products in the human body.
So we've gotten a kind of exemptions for that for
compensation for time out of the workforce sometimes. So Minister
Bishop progressed legislation that passed unanimously through Parliament that allowed
compensation for life kidney donors. That's been helpful. We could
(06:46):
allow compensation here as well. I would prefer to allow
private centers to set up and pay compensation not you
see some of the efficiencies that result in the American
and the Canadian setups where they can drive down costs
while maintaining safety. It seems to really work well. If
we weren't prepared to go that far, you could just
(07:07):
have a stand compensation regime for the time that donors
are spending and pee enough to make them want to
come back repeatedly.
Speaker 2 (07:17):
Eric, It is a fascinating discussion. Thank you very much
for your time. Really appreciated it, and we will speak
to the Georgetown ethics professor maybe in the next couple
of weeks on his research as well. But it's an
interesting idea.
Speaker 1 (07:29):
For more from News Talks B listen live on air
or online and keep our shows with you wherever you
go with our podcasts on iHeartRadio.
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