Blood Plasma Sales By College Students Are Being Used to Cover Education Costs
For 20 years, I’ve relied on a drug made from other people’s blood parts to keep myself upright. I’ve had dozens, maybe hundreds of infusions by now, and each time I wonder whose blood plasma was extracted to make the drug on which I depend.
Several years ago, I set out to find some of them and ask why. There are millions of Americans who have sold their plasma for money when jobs and savings aren’t enough.
Their stories are the focus of my new book Blood Money: The Story of Life, Death, and Profit Inside America's Blood Industry. As I recount in the excerpt below, college students are a favorite target of plasma companies, who know that young students need extra cash.'
|Donate Plasma For Money
I spent time in one unique college town in the Mountain West asking why so many students there sell plasma. © Teen Vogue The geotargeting of plasma extraction leaves a lot of people out and maintains it as something people do while in school.
A look at the economics of getting a college degree can help explain why. In the thirty years leading up to the present, the average cost of college tuition in America has tripled, landing at the high end at more than $35,000 a year for private colleges.
And that’s not count- ing accompanying living expenses, which can add another $20,000 a year for each student, according to the Education Data Initiative.
The tuition and living costs vary widely, of course, but the expectation of students to go to college has risen and so has the debt that so many take on to make that happen.
In the empty space where government funding should be, plasma extraction has materialized as a Band- Aid for many students. Along with the untenable rise in the cost of higher education, student debt has soared. In my wider survey of plasma donors around the country, I heard from people who have used blood plasma money to help pay down their student debt.
In essence, these loans have saddled entire generations of students with payments the size of what their parents and grandparents might have spent buying a house and a nice car. By some estimates, student loans typically take twenty years to pay off.
The U.S. government has has taken some initial steps toward student debt relief and limiting untenable loan payments.
Even that ignited a fight over extending grace to the “wrong” people who have too much money—those who come from wealthy families or earn above a certain income level after college. We are a rich yet incredibly stingy country especially when it comes to extending a hand to those in need. State and private universities continue to raise their tuition, the cost of living is on the rise across the land, and so plasma often flows from students’ bodies to fill the financial gaps.
Looking back through recent history, the American culture of young people selling pieces of themselves, literally, is not new or wholly confined to blood.
Even when I was in college in the 1990s, I knew students who sold parts of themselves to pay for what they needed. One of my roommates was paid to be a sperm donor; a friend enrolled in every campus clinical trial possible, making $40 or $50 for each.
Paid plasma wasn’t an option in my city back then, but I heard about women selling their eggs, a prospect I found both intriguing and horrifying.
Diane Tober, a medical anthropologist at the University of California, San Francisco, has investigated the reasons women sell their eggs. Tober conducted interviews and surveys involving more than 600 egg donors, and she found that, in the United States, college debt is a leading reason women undertake this process.
Contrary to the soothing stock imagery and easy moneymaking opportunities ad- vertised, egg donation is a complex and invasive procedure involving intensive hormone therapy. It does pay women generously if they participate in multiple cycles.
But especially if repeated, the practice can have serious, long-term health consequences. A piece Tober wrote for Salon aligned with what I heard from plasma sellers: The United States emerges in my study as the only country where women in their 20s feel compelled to make medical decisions with life-long implications to reduce or eliminate the affliction of student debt.
Without this burden people may still decide to do- nate eggs for financial relief—even in countries like Spain where donor compensation is much lower than in the US—but they are not driven by the same finan- cial desperation arising from the cost of education.
We demand that young people go to college to get the jobs that will lead them into comfortable lives, but the years of higher educa- tion themselves are increasingly difficult for most people to navigate financially.
Tuition, rent, gas, and food—the basic essentials of life while in school, not even counting money for fun—have reached record highs and there’s been little effort made in most communi- ties to alleviate these burdens.
This paradox forces students to make difficult and too-soon decisions about their wealth, finances, health, and bodies.
Much of the mainstream discussion about higher education in America centers on a few wealthy private colleges where many of the students come from affluent families. I have long believed this fascination with the Ivy League and expensive private colleges stems from the fact that the people who run for national office and who write for the national media have attended those schools in outsized numbers compared with the rest of the population.
Many of their children strive for the same schools and careers. They see what they are used to seeing and talk about who and what they know best.
Many of them have never met someone who sells plasma to eke out a living. They might not know how students at public universities use the plasma money to make the rent.
But in the rest of the country, in pockets like Rexburg and across cities and states less wealthy, students are selling their body parts to pay for their education.
At BYU-Idaho in Rexburg, tuition is much lower than the national average—less than $5,000 per year. The university is deliberately affordable.
Many of its students come from rural parts of the Mountain West, where family incomes are lower than in other regions of the country, and whatever extra money students can earn for meeting their living expenses is welcomed.
Among the students I interviewed outside the plasma center in Rexburg, most said they use the money for rent, gas, or groceries.
Tuition itself isn’t the issue; their blood money goes toward the price of living. The median household income in Rexburg is less than half the national average—about $31,000 a year here, compared with $67,000 nationally.
This persistent wedge of income disparity helps to explain why a city so small has two thriving paid plasma extraction centers.
On the front window of the Grifols Biomat right near the BYU-Idaho campus, a large sign spells out for students how much they can make by selling their plasma every month: DONOR PAYMENTS 1st donation $25 2nd donation $30 3rd donation $35 4th donation $40 5th donation $75 6th donation $75 7th donation $75 8th donation $100 9th donation $100 10th donation $100 Total in 9 donations: $555 Total in 10 donations: $655 Below this schedule in the window is the schedule for new donors, for the first month they sign up, who make $100 each time.
It’s a lure to pull them into the system and get them hooked on blood money. I can’t help but think back to the dystopian plasma economy slogans of China, urging farmers who were poor to offer up their veins to be tapped in exchange for promises of potential wealth: “Stick out an arm, show a vein, open your hand, and make a fist, 50 kuai.
” Or, “If you want a comfortable standard of living, go sell your plasma,” and “To give plasma is an honor.” It seemed ludicrous in China; it feels the same here.
At the plasma center just off campus in Rexburg, I met a few students who showed up twice a week to make the maximum amount of money. Across from a fancy chain cookie store, I stood on the sidewalk and caught plasma sellers as they left the building. Many of them did not want to use their real names in print, but they seemed happy enough to talk about it.
I asked a person I’ll call Paul, a junior at the college, if he was embarrassed to tell people he sold his plasma. He looked at me like I wasn’t that smart. No, he’d never thought to be ashamed of it. That’s because nobody cared if you sold plasma in Rexburg. “It’s just what we do,” he said.
The downside was that if he got bounced from donating for some reason—or if he missed a week for any reason—he had to start all over again. He referred his friends to the center as new donors so as to get bonus money whenever he could. I asked if he ever got sick from the process, and he said no, but his girlfriend had to quit after only two donations because it made her too tired to function the rest of the day. I’ve noticed this divide repeatedly.
Some plasma donors don’t notice anything but the hassle of time and needles, while others can’t get past the crushing fatigue. I’ve spoken with several scientists about the health impacts, and the main concern is the frequency of plasma donation in the United States. To refill that giant pool, companies do what they can to draw donors in twice a week, every week, for as long as possible.
We are the only country in the world that allows people to donate their plasma so often. And even though formal studies have not linked serious health problems with long- term donors yet, the rush and demand for plasma as much as twice a week does raise questions. The fatigue, the nausea, the chills—they are all aftereffects. The plasma industry insists it is not exploiting people, that payment schemes are, technically, only tokens of appreciation for donors who give their time.
But the business has built a deliberately complex pyramid of payments and incentives designed to draw people and keep them in the system. The reality of the plasma economy tells an entirely different story from the one the industry wants to present.
In college towns like Rexburg, a steady stream of willing raw material is derived from a large part of the population who are willing and need money. Nobody gets rich selling their blood plasma.
They get by, barely, or get a little closer to being able to afford some of the things that bring them some joy. Though the industry maintains that its pay- ment schedule is to compensate donors for their time, that dona- tion time doesn’t increase with each donation.
Rather, the payment schedules are clearly designed to pull people in as often as possible to make the maximum amount of money. More specifically, in Rex- burg, a person who never misses twice-weekly donations can make more than $7,000 a year—a healthy income for a college student in a town with a high rate of poverty.
If you’ve already made seven donations in a month, why not up your income just by adding one more trip to the plasma center? This is how the companies keep people returning, even when the crushing schedule feels like too much for their bodies to handle. In essence, the payment structure punishes those who don’t come as often.
I left Rexburg after two days of chats with students on the street corner and drove back through the mountains to Montana, all the while thinking about the trap that is higher education. The students I met were focused on getting a degree, graduating, and moving into middle-class jobs.
But to get there, they had to sell pieces of their bodies. From BLOOD MONEY by Kathleen McLaughlin. Copyright © 2022 by Kathleen McLaughlin.
Reprinted by permission of One Signal Publishers/Atria Books, a Division of Simon & Schuster, Inc.
'Blood Money': Inside the global business of selling plasma
Sign up for the On Point newsletter here. Millions of Americans sell their blood plasma every year.
It’s part of a global, multibillion dollar business. “If you go to the Red Cross … you are limited to donating 13 times a year — once every 28 days,” Kathleen McLaughlin, author of the new book Blood Money, says. “If you go to a for-profit plasma center to sell plasma, you can do it twice a week, up to 104 times a year.” But what is plasma used for, and why is it a big, largely hidden business? Today, On Point: Inside the for-profit business of selling blood plasma around the world. Guests Kathleen McLaughlin , journalist.
Author of the new book Blood Money: The Story of Life, Death and Profit Inside America’s Blood Industry. (@kemc) Dr. Morey Blinder , hematologist.
Professor of medicine at the School of Medicine at Washington University in St. Louis. Also Featured Patrick Herdener , longtime blood plasma donor who donates more than 100 times per year. Darryl Wellington , journalist who has reported on the plasma economy.
Poet laureate of Santa Fe, New Mexico. (@darrylwellingto) Cory Lyons , Columbia, South Carolina resident who sold plasma in college. Jenni Hecht , Sturgis, Michigan resident and plasma seller. Kathi Young , Cameron, North Carolina resident and plasma seller. Mary Seebach , Middletown, Ohio resident and plasma seller. Interview Highlights What is plasma and why is it important? Dr. Morey Blinder: “ Plasma is the liquid part of blood, which is about 55% of the total blood volume. The rest of the blood is composed of the cells, such as red cells and white cells and platelets.
And there are ways to donate the blood as whole blood, usually through volunteer donor programs. And then there are ways to donate. Just the plasma that we’ve been speaking about. The plasma is usually collected in for-profit centers, and the whole blood that’s collected is generally volunteer, the donors are not reimbursed for this financially. And so there is a difference there.
And in fact, the FDA requires that products be labeled as volunteer or paid donor.” On what makes it such a medically valuable resource Dr. Morey Blinder: “ There are thousands of proteins that are in plasma. Some of them are at very high concentration. All of the plasma donor collections that are made are fractionated. They are not directly given back into individuals from a paid plasma donor. So the fractions that are most commonly used are albumin, which is needed in blood.
It helps those on volume expand or if you will. It’s used in a lot of clinical situations. A second product is the Immunoglobulin that Kathleen has taken.
It can be typically as an IVIG or intravenous Immunoglobulin. And then the third group of products are the blood clotting factors that were used predominantly for hemophilia and related bleeding disorders, but other blood clotting problems as well.
So that is where most of the plasma is processed and turned into.” On researching the global plasma industry Kathleen McLaughlin: “About 20 years ago, I was diagnosed with an autoimmune disease. Quite rare.
And the treatment for it is a medication that is made from human blood plasma. It’s called intravenous human immunoglobulin. So it’s the immune particles that are extracted from plasma. And I have on average, a half a dozen to ten infusions per year to keep this illness at bay. They’re very long, boring, tedious infusions of kind of a lot of medication.
They take about 6 hours each time. “And I have a lot of time to think sitting in a chair, just sort of watching this fluid drip into my own veins. And for 20 years off and on, I’ve thought about where this medication comes from and who is donating and selling plasma to provide it.
And I just got to the point where I needed to try and figure that out.” On Kathleen’s beginning experience with blood plasma Kathleen McLaughlin: “I lived in China full time for 15 years.
I was a reporter there, and I moved there knowing that I needed this plasma drug. I also moved there knowing that China had had a big plasma debacle. So back in the 1990s, China had tried to create what they called the plasma economy, where they were paying poor farmers for their blood plasma.
And then the plan was to turn it into profit making drugs like the one that I take. “Right around that time, HIV entered the blood system. We hadn’t yet figured out how to kill viruses in blood, and it spiraled into an AIDS catastrophe in rural China that killed a whole lot of people. So I knew about this, and I also knew that China had banned foreign blood products because AIDS was viewed as a foreign disease and a foreign virus.
So my solution was to smuggle in my own plasma drugs. So I would pack them in my suitcases. And every time I would come across the border, I had to check a little box on the customs form that said I was not carrying blood products because they were very explicit about it.
But in fact, I was. “And then this was, I would say, a very different time in China. I don’t think I could do this now.
This was throughout the 2000’s and early 2010’s. I would take my plasma drugs that were made and sold in the United States to a hospital in Beijing or Shanghai where I lived and asked them to infuse them into my veins. So if you can imagine doing that, just showing up at a hospital with drugs and saying, Can you put these in for me? But they did. And I lived like that for years.
So that was the beginning of my experience. And then when I moved back to the U.S. in 2016, I realized that the United States had actually created the plasma economy that China sort of tried to create. We did it while nobody was paying much attention.” The motivations of people in the plasma industry Kathleen McLaughlin: “It is a choice we made accidentally, if you will.
I don’t think that most people have really thought about why we decided to do things this way. There hasn’t been a big national debate over what should we pay for and what shouldn’t we pay for.
I think that most people draw the line at, you know, you shouldn’t be able to sell a kidney. So there are three things that you can get paid for in the United States, plasma, sperm and eggs. “And I don’t think we’ve had a big debate about that. I mean, most countries in the world ban the ban the payment of or ban, paid plasma donation. So we are very unusual in the context of the rest of the world.
I will say, though, I think that I think that our thinking on this is a little bit confused because people do get paid for it. A lot of people donate or sell their plasma. But I also see this as a very altruistic thing.
“And many of the people that I interviewed, you know, the person that you interviewed at the top of the show who is selling his plasma a hundred times a year, he has continued doing it because he wants to help people. And this was really yes, most people I have spoken with do it because it pays and they need the money.
At the same time, they’re very happy to be able to contribute something back to people who need it. So if you’re poor, you don’t often have the opportunity to help out in an altruistic way in terms of like giving money to a charity or, you know, donating in other ways because you don’t have a financial cushion that allows you to do that.
Selling plasma kind of offers this ideal in that way where you’re getting paid, but you’re also giving back. “And I just wonder how we came up with the societal view on this, that donating blood is heroic. You know, it’s a great thing to do. And, you know, people should be celebrated for it. People talk about it all the time. If you donate blood, you get a little sticker.
You tell your family. But if you’re donating or selling plasma, it’s stigmatized as something that people don’t generally talk about even with their own family. The fact is, as a recipient of plasma products, I know that what people are doing is very altruistic. I mean, it allows me to live a very normal life.” Companies are making money off of it, but profit in health care is not unheard of. So. Where is the harm? Kathleen McLaughlin: “We really don’t know the long-term effects.
These studies are not long term. And I think that people who are doing this deserve as much care and concern as wealthy people in our society do. And to me, what’s going on right now, because this is a hidden economy, because it is stigmatized, because a lot of people tend to look down on this practice is we are not giving adequate care and concern to people who sell plasma. I also think that really, in many ways, this industry is just a symptom of the problems in our society. And what I mean by that is there are a lot of college students, for example, who sell plasma.
“And to me, that’s just a symptom of the problem, which is university education is too expensive. And the fact that we’re expecting 19-year-olds to figure it out and go out and sell parts of their blood is quite disturbing without having a national conversation of is this who we want to be? Do we want to really be the kind of country where we expect 19- and 20-year-olds to sell pieces of themselves to fund their education? So I haven’t found, you know, strong evidence that there is something wrong with this industry or this practice. I just think most people who haven’t been broke before are unaware of it. “And we need to change the stigma around it because it’s all related to a stigma against poverty that we have in this country.
So it’s more to me, a matter of figuring out if this is who we want to be. I also think that people should get paid more. You know, I think we should understand how much profit is being made, who’s making that profit, and why aren’t the people who are selling plasma getting more of that money? You know, and I think that, as Dr. Blinder pointed out, the lack of long-term studies, we actually need to invest in long term studies on the health of plasma donors and see if 104 times a year, twice a week is actually okay for a person’s health.” Related Reading The Atlantic : “The Twisted Business of Donating Plasma” — “Since 2008,
plasma pharmaceuticals have leaped from $4 billion to a more than $11 billion annual market. Donors desperate for the cash incentive from high-frequency “plassing” may be putting their health, and the public’s, at risk.” This article was originally published on WBUR.org. Copyright 2023 NPR. To see more, visit https://www.npr.org.
‘It’s gamified’: inside America’s blood plasma donation industry
“The backs of both my hands are a spider web of tiny white and pink scars,” writes Kathleen McLaughlin, “a roadmap showing where dozens of nurses in several cities on both sides of the Pacific have punctured the thin skin with a needle, leaving inside the vein a tiny plastic tube that allows medication to flow directly into my bloodstream.
” McLaughlin has a rare chronic illness (Joseph Heller, the author of Catch-22, had a similar condition) that can cause her immune system to attack the wrong parts of her body, threatening her hands and feet and ability to walk.
She requires periodic infusions of a treatment made from the immune particles in other people’s blood plasma.
“It works like a charm,” she says by phone from Butte, Montana. But McLaughlin, 51, has come to understand that the blood that sustains her is drawn from some of the most economically vulnerable people in America.
For the past decade, the journalist has researched and reported on the global trade in plasma and all it says about class, race and inequality.
The result is Blood Money, a book that combines the personal and political to examine a for-profit medical industry literally sucking the blood of the American underclass. It also adds to a body of literature about deindustrialised towns and hollowed out communities that have haunted political discourse since Donald Trump and Bernie Sanders stormed the national stage in 2016. Photograph: Simon and Schuster But the tale begins in China, where McLaughlin went to work in 2004.
Aware of virus risks in the blood supply in China, where outbreaks of hepatitis were routine, she decided to bring her own. She smuggled American plasma in her luggage as she passed through Chinese airports and was never caught. She admits: “China is a very different place today, much more repressive. I don’t think that I’d be able to do this today and I wouldn’t do [it] today.
When I was there, things were a lot looser and the rules were a little fuzzier. China felt a bit like a free-for-all back then. I was never that afraid of smuggling blood products into China. I thought that if I ever got caught doing it, that maybe I’d get a fine or something like that.”
During her years in China, McLaughlin was keenly aware of the risk to people who, like her, needed others’ blood to survive. “
There’s never been an official accounting of what the death toll was caused by the blood plasma industry in China during those years. There was an immense amount of stigma around people from those [poorer] parts of China because, even though the government worked very hard to cover it up, stories got out and people throughout China knew about it.” On one occasion she travelled to north-east China and interviewed people who, exposed to chemicals, needed infusions of immunoglobulin.
“I asked them about the risk and their response was, ‘Yeah, we all know about that, but what can you do? We don’t have any other choice.’ At that time you had people living in the system in China who depended on the same things that I did, but they didn’t have the luxury of bringing it from another country.
There was always so much more risk to them than to me.” McLaughlin moved back to the US part-time in 2016 and for good in 2018. A 400-mile drive took her to Salt Lake City, Utah, and a meeting with a Chinese woman. Shuping Wang had worked at a plasma collection centre in Hunan province, discovered HIV in the system and turned whistleblower, fleeing to America soon after.
Shuping Wang took McLaughlin to a plasma centre in Salt Lake City. “To her there was this parallel with what she had seen back in China. They were open seven days a week and it concerned her that they were continually operating and paying people for their plasma.”
McLaughlin started researching the American blood industry, little known in part because the sellers she interviewed live far from the major cities where the media is concentrated. “I thought when I was living in China the plasma economy, which is what they called it, was this very dystopian thing that only China would try to do.
It turned out that the United States had already done it.” America is one among a handful of industrialised countries that allows people to be paid to donate blood. It is the world’s biggest exporter of human blood plasma, supplying about 70% of global use, its industry worth more than $24bn in 2021.
Each year an estimated 20 million Americans sell their plasma, although figures are imprecise. There are more than a thousand for-profit centres operating legally across the US. McLaughlin, a former Knight Science Journalism fellow at MIT, comments: “I have started to see it like dollar stores, pawnshops and payday lenders. It’s one of these industries that has grown up alongside the fault lines in our economic safety net.
It finds a hold in communities where people are struggling and, because we have more people struggling and rising inequality, it’s really taken off.” So who is the typical blood seller and why do they do it? McLaughlin had expected to find the poorest of the poor but, it transpires, most of them are screened out because a plasma donor must have a permanent address.
Kathleen McLaughlin: ‘It’s these places where people are economically fragile, not necessarily desperately poor.’ Photograph: Rio Chantel “What I found instead was a lot of people who, say, 25 years ago would have been middle class, and they just don’t make enough money for that lifestyle any more. I get the sense that one of the biggest demographics is college students. We’re talking about like big public universities where there are a lot of students who don’t come from wealthy backgrounds; I’ve talked to people who use this money to buy books, to pay to go out for a night, for ‘beer money’.
“You will also find people in communities like Flint, Michigan, where I spent a lot of time, who used to be able to expect to have this very normal American middle-class lifestyle and wages and benefits no longer keep pace with that.
There are people doing it to buy groceries and to pay for housing. There are also people who are selling plasma to take a vacation. “It’s these places where people are economically fragile, not necessarily desperately poor. The kind of fragility that we didn’t have 25 or 30 years ago when there were more social-safety protections.” She devotes a chapter of the book to Flint, a majority Black city which infamously endured one of the worst human-caused environmental disasters in US history when lead leached into its water system. It has six plasma centres serving fewer than 100,000 people.
“Flint to me says something more about the state of America than anywhere else I went because there is this incredible pride in being the birthplace of the American middle class. People will tell you they had this amazing labour movement that built all these great jobs on which you could raise a family. That has just been hollowed out to the point where you don’t have a lot left.” But the most productive plasma centres are clustered along the southern border, where Mexican citizens cross over to sell plasma in the US.
“Our political leaders like Trump don’t want them in the United States but we have been allowing people to cross over to mine their bodies for blood plasma, so what does that say about us?” Rates of pay for blood vary across the country.
A person might, for example, make $40 their first donation, then $50 for their second, and receive a bonus if they make four donations in a month. “It tries to incentivise you to go as often as possible. “
I know at one point when I was in El Paso and the border had been shut down, so this pool of Mexican citizens who had been coming over to sell plasma was not allowed to come in, the payment rate was up to $1,300 if you went in twice a week, which is one of the highest I’ve seen.” McLaughlin did not find significant evidence that giving blood frequently has negative health effects in the long term. “A lot of people get extremely tired. There is a lot of fatigue. A lot of people I talked to didn’t notice anything at all and they’re totally fine with it. It seems like it’s a very personal, individual thing.”
But she does point out that when people donate blood to the nonprofit Red Cross, they are limited to once every 28 days, which works out at 13 times per year. Those who sell to a for-profit centre can do it 104 times a year. “The disparity between those two limits is shocking.” Donating blood for free is lauded, but donating it for money is stigmatised.
Photograph: Eddie Moore/Albuquerque Journal/Zuma/Rex/Shutterstock And whereas donating blood for free is lauded, donating it for money is stigmatised. “If you think about blood donation, it’s something that we consider quite heroic.
If you go to the Red Cross and donate blood, you’re saving a life, you’re not getting paid for it. “But somehow this practice of donating plasma for pay comes with a pretty heavy stigma. A lot of the people I interviewed who do sell plasma had not told their families that they do it because they were afraid of what their families would think: there would be some kind of judgment or their families would be worried about their health or concerned that they don’t have enough money. ‘The stigma is entirely linked to the fact that we stigmatise poverty in the United States. We look down on it.
We don’t respect people who aren’t wealthy in the same way that we respect wealthy people. It’s been interesting for me to see the way that people view selling plasma as being somehow problematic and that’s definitely contributed to the fact that this industry is kind of hidden.”
Still, should we make a moral judgment about the blood industry? It is not, after all, pushing an addictive substance like opioids, but rather is helping the health of people in America and around the world, McLaughlin included.
She replies: “We need to ask ourselves that. From my perspective as someone who depends on this substance, what people are doing is incredibly altruistic. “I also think a lot of people are being financially coerced to do it and, the way the system is set up, you get paid more per donation for each donation you make.
It’s gamified in such a way that people are encouraged to donate quite often and because it is a hidden industry, most Americans haven’t really considered if this is who we want to be. “If you know that there are potentially millions of Americans who have sold their plasma to pay for things like groceries and vacations, are you OK with that? For me, it’s more a matter of getting people to think about it, that our economic situation is such that this is part of our fabric now and are we comfortable with being that way or do we want to think more deeply about how we can make this more feel more of a choice for people?” She adds: “The industry itself isn’t necessarily the problem.
The problem is that we have let this industry become a part of people’s incomes. I don’t know that that’s the kind of society we want to be.”