“Voluntary, Unpaid, and Handsomely Rewarded: Donor Benefits in the World's Whole-Blood Systems,” by Krawiec and Roth

 Around the world, "non-compensation" of blood donors allows for a variety of incentives.

Kimberly D. Krawiec and Alvin E. Roth, “Voluntary, Unpaid, and Handsomely Rewarded: Donor Benefits in the World's Whole-Blood Systems,” SSRN, Virginia Law and Economics Research Paper No. 2026-12,  1 July 2026, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=7030818  

 Abstract
The ideal of the unpaid blood donor is nearly universal; the practice is more complicated. Whole-blood systems around the world preserve a formal commitment to voluntary, nonremunerated donation-and then provide donors with gift cards, sweepstakes entries, cash "expense allowances," paid leave, tax relief, priority service, medals, and, in some places, extra points on a child's school exam. This Essay maps the gap between label and practice. Drawing on examples from thirteen countries spanning five continents, it organizes donor benefits by institutional mechanism: gift cards and sweepstakes; direct monetary transfers; paid work leave; other material and recognition-based benefits; and replacement donation and the informal cash markets it can generate. We demonstrate that "voluntary, nonremunerated donation" frequently coexists with substantial material benefits. Whole-blood donors nearly always receive something of value in exchange for their generosity; what varies is how those benefits are structured, funded, routed, and legally classified. 

 

Jurisdiction	Representative donor benefits	Legal classification / routing
United States	Nontransferable gift cards; sweepstakes (e.g., Super Bowl LX trip; $5,000–$7,000 raffles); promotional items (shirts, mugs, bags, movie tickets).	“Volunteer donor” label retained where benefits are not readily convertible to cash; sweepstakes framed as “no donation necessary.”
South Korea	Promotional K-pop photo cards; vendor and restaurant vouchers (5,000–8,000 won); merchandise; transferable blood-donation card.	Prohibited “consideration” distinguished from “commemorative gifts” and donor encouragement.
Kazakhstan	~$18.75 (2 MCI) for reimbursable donation; ~$2.34 meal equivalent for gratuitous donation.	Categorized as payment; reimbursable donation invited for shortages and rare types.
Bulgaria	Payment in narrow statutory cases (shortage, vaccine/serum/immunoglobulin production, research/diagnostics).	Voluntary/unremunerated rule with “against payment” exceptions.
Germany	Direct monetary transfers at some collection centers; refreshments and health checks only at DRK.	“Aufwandsentschädigung” (expense allowance), set per collection service.
China	Family exam-point awards (Pujiang: 1–3 points); platelet shopping cards $31–$386; paid leave, tax benefits; prepaid phone/transport cards, movie tickets.	“Gratuitous” system plus “appropriate subsidies”; tolerated monetary-equivalent and family-directed rewards.
South Africa	Data/streaming vouchers, raffles, merchandise; private wellness rewards (Discovery Vitality, Momentum, Bonitas).	Donor benefits supplied through blood-service promotions and private wellness programs.
Brazil	One paid day off per 12 months (private employees); donation-day leave (public servants); 120-day priority service at banks, hospitals, etc.	Donation converted into paid-leave entitlement and legally recognized priority status.
Spain	Donor medals, honors, and milestone recognition.	Recognition-based; no direct monetary transfer.
India	Replacement donation; illicit “professional donor” cash market.	Patient-side payment associated with replacement donation.
Nigeria	Tokens, certificates, badges, transport refunds; in practice 68% family replacement and 12.2% commercial donors.	Patient-side payment associated with replacement donation; commercial donors openly reported in donor categories.
Sierra Leone	Predominantly family replacement donors (~90%); paid donors recorded as replacement donors.	Patient-side payment associated with replacement donation; paid donors recorded as family replacement donors.
Argentina	Post-donation meal; medical certificate; 24-hour work-absence justification; 2026 shift away from replacement model.	Statutory donor benefits plus replacement-donation phase-out.

 

"If there is a lesson in this tour of the world’s whole-blood systems, it is that “voluntary, nonremunerated donation” is a phrase asked to carry a great deal of freight. It accommodates a $7,000 gift card, so long as the gift card is offered through a sweepstakes that does not require a blood donation to enter. It accommodates €60 in cash, so long as the cash is legally categorized as an expense allowance. It accommodates extra points on a child’s high-school entrance exam, paid leave, free public transit, priority service at the bank, and a tote bag—often all while the governing statute insists that blood may not be given for reward. "

The Transactions We’re Not Allowed To Have, in conversation with Brian Keating on the Into The Impossible Podcast

  The Transactions We’re Not Allowed To Have, in conversation with Brian Keating on the Into The Impossible Podcast

 

 A Nobel laureate in economics argues the bans we pass to protect our morals are quietly killing people and the data backs him up. Why the line between a market we allow and one we forbid is mostly an accident of disgust. Subscribe if you want science with evidence, not speculation.

My guest won the 2012 Nobel Prize for designing the systems that match kidney donors to patients who would otherwise die waiting.

We cover why it’s easy to buy heroin but hard to hire a hitman, what surrogacy bans actually do to the babies they’re meant to protect, why paying kidney donors could end a shortage that kills thousands a year, and the trade-off statement he wants every lawmaker to say out loud.

He has been called an organ trafficker. He explains why that’s the point.

What you’ll hear:

Why banning something that people want often makes it more dangerous

The kidney market America won’t build and what that silence costs

What the hitman vs. heroin ban asymmetry tells us about effective prohibition

The McCormick statement: the trade-off acknowledgment most policy debates refuse to make

How prediction markets are eroding the boundary between public and private information

Whether Milton Friedman was right to be embarrassed by the economics Nobel

There’s no such thing as a solution. There are only trade-offs.

CHAPTERS

00:00  Who gets called an organ trafficker?

02:26  What makes a transaction repugnant?

03:14  Why bans without support create black markets

03:36  Heroin is easy. Hitmen are not. Why?

04:44  Prohibition, NASCAR, and moonshine

07:26  Surrogacy: legal here, criminal in Europe

12:30  When money turns something legal into a crime

14:28  Can religion corrupt a market?

15:56  Who actually pays for college?

21:38  The Enhanced Games: drugs as a marketing platform

25:30  Adderall, Erd0151s, and the science of getting sharper

30:58  Why AI makes market congestion worse before better

35:00  100,000 kidney failures a year. 30,000 transplants.

36:44  Portland decriminalized heroin. It failed.

39:22  The trade-off statement politicians refuse to make

41:14  Can you legalize sex work and shrink trafficking?

47:42  Kahneman chose to die. Who should decide?

48:30  Should we put GLP-1 drugs in the water?

56:12  America is the Saudi Arabia of blood plasma

01:00:54  Prediction markets and inside information

01:01:34  Sports gambling is more addictive than it looks

01:11:40  Peter Nobel called economics a marketing stunt

01:13:32  Is economics a real science?

Get the transcript, fascinating bonus content, and my Monday M.A.G.I.C. Message: https://briankeating.com/yt

Have a .edu email and live in the USA? You automatically win a meteorite: https://BrianKeating.com/edu

Subscribe: https://www.youtube.com/DrBrianKeating?sub_confirmation=1

 

Featured Guest:

Alvin Roth website: https://web.stanford.edu/~alroth/

Moral Economics (book): https://www.amazon.com/Moral-Economics-Prostitution-Controversial-Transactions/dp/1541702018
 

A roadmap for international kidney exchange in India

  India, which performs the third most kidney transplants in the world (after only the U.S. and China) is a natural location for international kidney exchange on a global scale.  Here's a brief outline of the legal, administrative and procedural obstacles that need to be overcome on the way.

Kashiv, Pranjal MD, DM1; Balwani, Manish Ramesh MD2; Kute, Vivek B.3. International Kidney Paired Donation: Implications for India and Other Low- and Middle-income Countries. Transplantation ():10.1097/TP.0000000000005807, June 26, 2026. | DOI: 10.1097/TP.0000000000005807  

Another NBA Player Charged With Rigging Games for Gamblers

 Bets on a particular player's performance open the door to sinister influences in sports.

The WSJ has the story:

Another NBA Player Charged With Rigging Games for Gamblers
According to a federal indictment, Malik Beasley was in debt to a former teammate when he agreed to help gamblers by manipulating his own performance. By Jared Diamond  and Robert O’Connell 

"The government’s indictment identifies four games during the 2023-24 season where it said Beasley agreed to participate in the scam. Beasley had allegedly accumulated millions of dollars in gambling losses and, at times, owed money to Davis, a retired forward who played with Beasley on the Minnesota Timberwolves during the 2020-21 campaign. In return for fixing his games, Beasley would have his bill to Davis reduced or eliminated, according to the indictment. 

"The charges against the 29-year-old Beasley are yet another example of a prominent NBA player swept up in illegal gambling activities—and the implications for the league are chilling. On Jan. 26, 2024, the day Jontay Porter removed himself from a Toronto Raptors game with a fake injury so his conspirators would win bets, there was another game on the take 500 miles away. (Porter has since pleaded guilty to federal charges and is awaiting sentencing.) 

...

"Once Beasley was on board, the next question was which games to target. The government says the gamblers specifically looked for non-marquee games—far from the NBA’s nationally televised showcases on ESPN and TNT—where Beasley could manipulate his performance.

“It’s better not to be on tv for us,” one defendant wrote in a group chat.

"There was also infighting among the group, with some bettors chasing big paydays while others settled for more modest wins. At one point, one defendant accused another of betting so much that he single-handedly altered the lines, which risked drawing suspicions from authorities. "

Sports Betting, Prediction Markets, and ‘Repugnant Transactions’--a conversation at Covers.com

 I was recently interviewed at the gambling hyper-site Covers.com about the growth of sports gambling both on dedicated sites and on prediction markets.

A Nobel Laureate Talks Sports Betting, Prediction Markets, and ‘Repugnant Transactions’ by Geoff Zochodne -  "Nobel Prize-winning economist Alvin E. Roth has published a new book that can help put the raging debates about sports betting into a very relatable context." 

"It’s not often, or ever, you see a Nobel Laureate writing about his ties to match-fixing. 

That is until you see Nobel Prize-winning economist Alvin E. Roth writing in his new book that he feels “a certain connection” to point-shaving. It's just for reasons that have less to do with economics or match-manipulation and more because of a shared name.

Another Alvin Roth, nicknamed "Fats," was banned from the NBA because of a college basketball point-shaving scandal that came to light in the early 1950s.

“He (Fats) was also sentenced to jail, but a judge permitted him to join the army instead,” Roth writes in his recently released book “Moral Economics: From Prostitution to Organ Sales, What Controversial Transactions Reveal About How Markets Work.”   

...

Roth spoke to Covers over the phone recently about his book and his framework for approaching “repugnant transactions,” which, yes, can include sports betting. 

“Remember that when I say something is repugnant, I don't mean that I don't like it or that you shouldn't like it,” Roth said. “I mean that some people don't like it, and I think that gambling falls squarely into that category. Lots of people like to gamble, and lots of people, other people, think they shouldn't be allowed to, so it's a repugnant transaction, and there have been laws of all sorts allowing or banning it. And we've gone back and forth with the United States on lotteries, and more recently on sports betting.”  

...

“I fear that online gambling will have much to teach us about addiction,” Roth writes.  

...

Again, gambling is not the focus of Roth’s work. Nor are prediction markets, which critics often describe as a new form of gambling. Yet Roth says one of the things he writes about is that it is hard to ban something in a given jurisdiction when it’s legally available and within reach in another jurisdiction.

“And, of course, the internet makes everybody a neighbor to everybody else,” Roth says. 

In other words, the fact that prediction markets have popped up offering de facto sports wagering in states that have yet to legalize sports betting is not some new phenomenon. It’s all in keeping with society’s ongoing tug-of-war with morally contested markets. You can ban, you can regulate, but somebody will probably be unhappy in the end with what you’ve done and may still seek out what you’ve forbidden or restricted.  

A dozen books enjoyed by venture capitalists (from a16z)

 Reading lists are interesting both for the books they describe, and for what they say about the list makers. Here are a dozen interesting-looking books from people at the venture capital firm Andreeason Horowitz (aka A16Z).

A reading list for the deeply curious
Part one of our summer reading list: 12 books on technology, markets, AI, code, and the systems behind change.   a16z crypto 

Four of the twelve recommended books come under the heading  How markets are designed.

These are those: 

Moral Economics: From Prostitution to Organ Sales, What Controversial Transactions Reveal About How Markets Work by Alvin E. Roth

“My doctoral advisor, Al Roth, has been thinking for decades about ‘repugnance’ – why some people prefer that some markets should not exist. In Moral Economics, he tackles the motivation for these prohibitions and the trade-offs they force, head-on. And he explores, in particular, how such non-market norms emerge and sometimes later collapse — limitations on alcohol and drugs, and, in a completely different category, same-sex marriage have all been relaxed in recent years — and what this means for making markets in the future.” – Scott Duke Kominers, research

Why Nations Fail by Daron Acemoglu and James A. Robinson

“Acemoglu and Robinson’s central thesis, that inclusive institutions drive prosperity while extractive ones cause stagnation, maps surprisingly well onto crypto. Decentralized protocols are essentially an attempt to hard-code inclusive institutions: open access, no gatekeepers, rules enforced by code rather than by whoever’s in power. The book is a great lens for understanding why certain blockchain ecosystems thrive while others are captured by insiders. A must-read for anyone thinking seriously about governance, whether at the nation-state or protocol level.” – Kira Song, finance

An Engine, Not a Camera: How Financial Models Shape Markets by Donald MacKenzie

“Sociologist Donald MacKenzie’s An Engine, Not a Camera is nominally a book about financial economics, but its real subject is more provocative: What happens when theories stop describing the world and start changing it? MacKenzie traces how academic models of markets escaped the university and became embedded in the markets themselves. First published in 2006, it remains relevant today in a number of contexts — not least because of the recent interest from TradFi in crypto. But I wanted to read it again because of the book I’m working on with colleague Robert Hackett, about how computer science theories acted on the world.” – Tim Sullivan, editorial

A Man for All Markets: From Las Vegas to Wall Street, How I Beat the Dealer and the Market by Edward O. Thorp

“Growing up, I was obsessed with the movie 21 and the idea that you could actually use math to beat the house. This book is the autobiography of the man who essentially started it all. Edward Thorp went on to apply those same principles to Wall Street, becoming the father of quantitative investing. It’s an incredible story about using pure logic to disrupt rigged legacy systems, which perfectly captures the same builder mindset we see in crypto today.” – Ben Wu, talent

The moral economics of prediction markets, in the NYT

 As part of it's Dealbook feature, the NYT yesterday included this conversation about The moral economics of prediction markets

"The economist Al Roth, a professor at Stanford University, shared a 2012 Nobel Prize for his work in market design and matching theory. He spoke with Sarah Kessler about his latest book, “Moral Economics,” which offers a framework for understanding controversial markets, and how it applies to prediction markets. The conversation has been edited and condensed.

Your book explores what you call repugnant markets — meaning some people don’t think they should exist — like prostitution, surrogacy and drugs. How do prediction markets fit in?

When I think about repugnance and prediction markets, I think back to when Darpa proposed a policy prediction market that became characterized as a terrorist prediction market, and people really objected to that.

That objection was sort of misplaced. It would be great if terrorists who were planning attacks wanted to tip their hand by betting on them in advance. But also, if you were a terrorist who knew about the 9/11 attacks in 2001, and you wanted to make money, you wouldn’t bet on a prediction market. You would short United Airlines and American Airlines.

What do you make of all the reports of insider trading on prediction markets?

The reason we forbid insider trading in securities markets is to give people confidence in them. Securities markets have an important financial function that is threatened by insider trading, and I’m not sure that prediction markets necessarily do.

What worries me about the current state of prediction markets and Washington insiders is more the blurring of private and public functions. I don’t think that being an associate of the president should allow you to bet on a Truth Social post by President Trump. That is very bad public policy, but not necessarily an indictment of prediction markets per se.

Do you have an opinion on whether prediction markets should be regulated by the C.F.T.C. or state gambling authorities?

Futures markets, like securities markets in general, play other roles in society. If you’re a farmer who’s growing wheat, a futures market allows you to sell your wheat before you’ve planted it, which allows you to buy the fertilizer and make plans. That’s one role for federal regulators.

The contract has a delivery date. It says on a certain day a freight car is going to deliver potatoes to me. If, for example, someone tried to corner the potato market by reserving all the freight cars so that you wouldn’t be able to deliver on the contract, the regulator could intervene.
With prediction markets, there’s nothing that has to be delivered. It’s just that someone has to adjudicate whether the bet was a yes or a no. That requires maybe some kind of regulation, but that seems more like a customer relations thing.

Is there anything that you would change about the design of prediction markets?

I have some ideas about what we can do about gambling and addiction. An appropriate regulator or consumer protection agency could start to require that apps allow you to put a limit on your betting.

Before the game starts, you can say to the app: When I’ve lost a hundred dollars, shut down. Don’t let me make any more bets.

And that might help some people just the way bartenders are supposed to stop serving you if you’ve had too much to drink. "

The Netherlands Records Its First Assisted Death of a Child Between 1 and 12

 A child receiving medical aid in dying clearly arouses more repugnance than when an adult accesses MAID.  But surely that isn't because we think that a child dying in agony can tolerate it better than an adult.  Difficult cases should make everyone think more clearly about their positions.

The NYT has the story:

The Netherlands Records Its First Assisted Death of a Child Between 1 and 12
Physician-assisted death for terminally ill children in that age group has been allowed in the country since 2024. By Claire Moses

" A doctor in the Netherlands assisted in the death of a terminally ill child aged between 1 and 12 for the first time, a Dutch minister told lawmakers.

"Sophie Hermans, the minister of health, welfare and sport, disclosed the death in a letter this week to the Dutch House of Representatives. Assistance in death for children in this age range has been legal under certain rules since 2024.

"She wrote that it had been reported late last year to an expert committee that reviews such cases, and was its first notification for a child between 1 and 12.

"Ms. Hermans’s letter referred to “a termination of life” without giving specifics.

...

"In 2020, the Dutch government announced plans to allow doctors to end the lives of terminally ill children who are under 13 years old. Hugo de Jonge, the health minister at the time, predicted that the rule — which went into effect in 2024 — would facilitate the deaths of about five children a year.
"
Before the rule change, the country already allowed doctors to assist the deaths of people who are over 12 or less than a year old as long as their parents had consented. 

...

"In Colombia, assisted death is allowed for children between the ages of 6 and 12, so long as the child understands the concept of death. Belgium also allows children to die with the help of a doctor."