Blood money

A safe and ready blood supply is essential in modern medicine, but it costs money. The American Red Cross doesn’t pay donors, but it incurs heavy expenses as virtually the sole supplier of blood to the hospitals of New England. Costs include recruiting donors, screening them, drawing the blood, checking for purity, processing and fractionating the supply, and delivering it to hospitals.

Hospitals pay the Red Cross for whole blood and for such fractions as red cells and platelets. But for many years these payments have not covered Red Cross costs. In the past 10 years, its charges have lagged behind price indexes. Carol Dembeck, a spokesperson for the New England Red Cross, says it has gone into debt by nearly $400 million. She says its costs have gone up 27 percent in the past five years, while its prices have risen only 9 percent.

What to do? The answer came in March in the form of a Red Cross letter to New England hospitals that the charges would rise as of July 1, in some cases sharply.

For many hospitals the sudden price increase came as a shock. Blood bank administrators and pathologists at northern New England hospitals have been conferring by telephone and at a meeting June 1 at Concord, Mass.

One participant at the Concord meeting was Dr. Irwin Gross, medical director of the blood bank at Eastern Maine Medical Center. He puts the unexpected increase at 12 percent and calls it a serious situation. The Bangor hospital is trying to negotiate a lower price with the Red Cross. As a long-range alternative it is considering gathering and processing blood either by itself or in cooperation with other hospitals.

At the Dartmouth-Hitchcock Medical Center in Lebanon, N.H., the blood bank is facing a price hike of 45 percent above what it was paying a year ago. The administrative director, Jeffrey Silverstein, calls the cost of blood “a significant part of our budget.” He attributes the increase partly to a Red Cross decision to supply only red cells that have been processed to remove the white cells. Mr. Silverstein says the center has been using red cell units that include white cells and is being “forced” to accept the more expensive “leucocyte-depleted” type. The Dartmouth-Hitchcock blood bank is looking seriously at hospital-based community collection of blood.

Both men praise the Red Cross for its safe and reliable blood supply, but as Mr. Silverstein says, it has gotten a little bit too pricey for most people. Both hospitals expect to continue cooperating with the Red Cross in blood drives. Both emphasize the increasing need for donors as new procedures require more transfusions. Only 5 percent of eligible donors now give blood.

Mr. Silverstein likens the situation to a couple visiting their favorite restaurant, where they love the food and have come to know the proprietor. But on this visit, they open the menu to find that the prices have nearly doubled. “They still like the restaurant and the owner, but they’ve got to look at an alternative.”