Musings on transfusion medicine: August 2017

Revised. 3 Sept. 2017 (* in 'Panda'; Further Reading)

August's blog was stimulated by three news items in TraQ's August newsletter (Further Reading):

* The Australian donor who saved over 2 million children. The donor developed anti-D from transfusions as a 14-year-old and since age 18 has voluntarily donated red cells and plasma, the later used to prepare Rh immune globulin;

* China: Liver problems boost demand for US blood plasma (China consumes half world's supply of human serum albumin);

* Canada needs blood plasma. We should pay donors to get it. Op-ed by the author of 'Markets Without Limits', the primary thesis of which is, "anything you may permissibly do for free, you may permissibly do for money.". Even selling body organs like kidneys okay and doesn't exploit the poor, if only people above a certain level of income are allowed to sell their kidneys. Indeed, it's desirable because the market in organs helps save lives. At least that's the theory.

The blog's title derives from the 1985 Lionel Ritchie - Michael Jackson song that 'United Support of Artists for Africa' (aka 'USA for Africa') recorded and became one of the biggest selling singles of all time. I wrote two earlier blogs in 2010 and 2013 using this song (Further Reading), but now I'm whistling a different tune.

EXECUTIVE VERSION: This blog will highlight my conversion to what my dear departed Dad would call crass commercialism and commodification of everything. But I've had my come-to-Jesus-moment, folks.

I've heard thought leaders like Peter Jaworski on the value of unlimited markets and the public's misconception that buying commodities such as body organs and tissues is immoral.

Peter's research at Georgetown University focuses on the moral limits of markets, including markets in blood and kidneys and the morality of markets. He's also a Senior Fellow at the Canadian Constitution Foundation, which opposes what it sees as the watering down of constitutional principles by governments and left-wing interest groups. And now he writes opinion pieces for Canada's right-wing National Post (one of many Postmedia papers).

Henceforth, I've adopted the premise that there are no goods or services whose sale should be forbidden, except for those that it is morally wrong to sell and buy, regardless of whether filthy lucre changes hands or not. Oops! Make that shiny, clean lucre.

And your guess is as good as mine as to what 'morally wrong' may be. Because when nothing short of murder is okay to pay for - under the right circumstances - decided by gawd knows who - almost anything goes, providing it creates free enterprise markets and does some good.

So, yes, the blog is provocative and satirical, and if I offend anyone, am politically incorrect by your standards, please forgive.

My 10 Second Pitch
I'm proposing two start-ups, Slum Dog Millionaires, Inc. and Panda Unlimited, both of which trade in human tissue for the good of mankind. Our costs are low, potential profits are high. And, best of all, there's an existing global demand for our products.

Why continue reading? Maybe just food-for-thought on paying the poor and needy for plasma, which USA - land of 'make a buck' free enterprise - excels at? And to think about where the policy of
'anything you may permissibly do for free, you may permissibly do for money' will take the world?

FUTURE MARKETS
Let me propose transfusion products that will do much good, create jobs and boost economies and stock markets. Forget Trump's selfish, tunnel-vision 'America first'. Many nations can play that game and trump the land of free enterprise. With my schemes, Canada - we embrace and welcome the world - will soon rule the global blood industry.

Let me expound on the business opportunities of the future in the wild-wild world of anything can be bought and sold. I plan to create two startup companies trading in body tissues.

Both start-ups are based on leveraging the populations of the world's most populous nations in 2017, which together constitute over 36% of the world's 7.5 million people:

China (1.389 billion ~18.47%)
India (1.344 billion ~17.86%)

May even take my ideas to Canada's Dragon's Den if I can't get sufficient funding. But I'm bigly sure I can.

START-UP #1: SLUM DOG MILLIONAIRES, INC.
Slogan: 'Slum Dog Millionaires', supplying the world's plasma and making India's street urchins wealthy.

India has many street children. In 1994, UNICEF estimated that there were 11 million street children in India. Many are abducted and sold into slavery and the sex trade (Further Reading).

Slum Dog will recruit these kids into the equivalent of football (soccer in NA) academies. Fatten them up, get them healthy, send them to schools, indoctrinate them to believe they can save so many patients. Patients who need plasma derivatives like intravenous immune globulin (IVIG), whose potential uses grow exponentially (even if many are based on artificially created uses), and human serum albumin, whose use continues to grow in China (Further Reading).

Though Slum Dog's profits will be in the $millions, perhaps $billions on the world's plasma derivative market, we'll give the urchins a few rupees, far more than they've ever seen before. We're generous that way, it's in our DNA. Why? Because

Maximize profits, decrease costs, is what free enterprise is all about, folks.

Our strategy is to increase market share. Moreover, we're going to channel what Saudi Arabia has done with over production and flooding the market with oil, driving the cost down. If successful, we will cause the price of paid plasma and its derivatives to drop precipitously. The other big players in the plasma fractionation market will let staff go, struggle to survive. Profits will no longer justify investments:

CSL Ltd. (Australia) / Grifols S.A (Spain) / Baxalta Incorporated (U.S.) / Octapharma AG (Switzerland) / Kedrion S.p.A (Italy)

SECOND BUSINESS LINE
Wait, there's more.... It's not just the kids' plasma. Slum Dog has another business line. We can leverage the street urchins' red blood cells to generate profits for investors. Because in free enterprise, profits are all that count.

The urchins' young blood is a potential source of the elixir of youth. We're negotiating with USA's Ambrosia (Further Reading) as we speak. And we have the advantage of India already being a medical tourist destination (Further Reading), hence can decrease our advertising costs. Buyers come to us. Sweet, eh?

BOTTOM LINE
OMG, the good 'Slum Dog Millionaires' does. Following basic business practice, we'll minimize expenses to street urchins, maximize our own profits, likely in the $billions, just as the world's paid plasma industry does.

That we get rich on the backs of the poor, children to boot, (risking their health) is only fair because we risk much by funding donation centers and equipment. Street urchins only donate their body tissues (red cells and plasma), which is no big deal, right? And it's all moral because some good comes of it.

STARTUP #2. PANDA UNLIMITED
Just to show you I'm not a total markets-not morals-rule creep, Slum Dog has another business line, in its subsidiary, Panda Unlimited.
Slogan:'Panda Unlimited', supplying the world with life-saving Group O Rh-negative red blood cells

'Panda blood' refers to the Rh-negative blood type in China, which, as the phrase suggests, is 'as rare as pandas.' (Further Reading).

Only three out of 1,000 people in China are Rh-negative. But the frequency of Group O in China is 47.7%. If multiplied by the total 1.389 billion population, the number is almost 2 million people, of which ~72% are between 15 and 64. So, potentially nearly 1.4 million blood donors. And increasingly Chinese are learning English, which helps, as you will see below.

Panda Unlimited's vision is to supply the entire world with Group O Rh-negative RBC.

Our ongoing capital and operational costs will include buying consumables like needles, tubing, blood bags, refrigeration storage, collection sites and their overhead, transportation, blood testing instruments and reagents. But because of massive volume, we expect to drive suppliers' prices down.

About transportation, we have an awesome supply chain management system, whose key component is drones (Further Reading).

We've partnered with Amazon, one of the richest companies in the world, whose Prime Air will use drones to deliver goods, albeit it's not ready for prime time yet. (Further Reading)

As for collection centre costs, we've talked to Beijing about using Tiananmen Square once per week as weather allows, with royalty payment of 1% of our annual profits. As the world's largest square Tiananmen can hold up to a million people. With collection set-up and donation chairs, it still offers capacity of at least 100,000. In colder weather we plan to use heated giant tents.

Staffing costs, normally substantive, will be minimal. Forget cost efficiencies gained by RNs supervising inexpensive donor care associates for blood collection. We're joined with Japan and Hong Kong's humanoid robotics makers (Further Reading) to pilot a robotics system for blood collection. These robots never tire, will work 24 hr shifts, don't demand raises and forget the burden of perks like health insurance, sick leave, and pension plans.

Face it, the more people you can eliminate in your operation, the more profits you make.

How will we entice the one million+ Group O Rh-negative Chinese to donate voluntarily? We've taken a page from US blood centres and offered various goodies. * Moreover, even China has tried incentives (Further Reading):

* Children of Chinese blood donors offered grades boost as incentive

Our biggie? We'll sweeten the pot by promising Chinese male Group O Rh-negative donors that they will be entered in a lottery to win an Rh-negative wife from Canada or the USA.

Because China's one-child policy left its men with a severe shortage of women to marry, they should leap at the chance. * For example, There's now a black market selling women’s eggs to infertile couples who can now try for up to two children after the scrapping of the one-child policy.

* Schoolgirl’s brush with death from selling her eggs casts spotlight on China’s black market

Added plus is that after 12 RBC donations (2 years) per male donor, they, their Rh-negative wives and offspring, can enter a lottery to migrate to Canada with transportation and legal costs paid courtesy of Panda Unlimited. We'll fund one lottery/month, meaning we potentially lose 12 donors per year. Unless no one's lottery ticket is drawn.

The only proviso is, if they meet Canadian blood donor criteria, they must agree to donate to one of Canada's government-funded blood suppliers for one year (six times). That way, Panda Unlimited gains credit as a supporter of CBS and H-Q and is not seen a competitor.

How will Panda motivate Group O Rh-negative women in Canada and USA to marry men in China?

1. We'll appeal to unmarried folks by advertising on all the Internet dating services, especially to women worried about their biological clocks ticking down and with iffy marital prospects, who desperately want children;

2. We'll pay their costs to travel to China to meet prospective mates F2F if required, or they can talk via the Internet. It's up to them which men they choose;

3. For every Rh-negative child produced they'll get a bonus payment via a prepaid credit card (as is done with paid plasma in USA and now Canada);

4. We'll support their efforts to bring spouse and children to Canada, which welcomes immigrants.

SECOND BUSINESS LINE
Wait, there's more....Our other business line is harvesting the recovered plasma from whole blood donations and supplying it to our parent company, Slum Dog Millionaires. No additional costs except transportation and storage, with mega-profits. Pretty sweet, eh?

BOTTOM LINE - OMG, the good Panda Unlimited does:

China's men have wives and offspring to care for them in old age;
Moreover they can move to the West, experience democracy for first time in their lives;
Unmarred Western women can dream of children to fulfill their maternal instincts;
Panda stimulates economy and lessens the impact of baby boomers retiring;
Supplies the world with Group O Rh negative RBC.

Yes, we're making mega-bucks off our blood donors who desperately want to mate and have families. But it's win-win-win-win. Panda wins - blood donors win - childless women win - world wins. Winning/doing good justifies everything. Even selling body corpses for profit, which may be Slum Dog Millionaires third business line

FOR FUN
'We are the World' is perfect for this blog. We and our bodies are commodities to be traded for profits that benefit free enterprise companies, their owners, and investors. Markets that value profits over exploiting humans rule. Of course, I'm kidding. Please Resist!

We are the world
We are the children
We are the ones who make a brighter day
So let's start giving...

How many iconic US artists can you recognize? And, admit it. This production and these singers are awesome, a word I seldom use.

We are the world (1985, written by Lionel Ritchie and Michael Jackson for 'USA for Africa' benefit)

As always, comments are most welcome.

FURTHER READING
Earlier blogs

We are the world - Musings on how we can lessen the global trade in body parts (15 Feb 2010)
We are the world - More musings on commercialization of the blood supply (13 April, 2013)

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