Book excerpt: Richard Titmuss (1907-1973) was a pioneer in the field of social administration (now social policy). In this reissued classic, listed by the New York Times as one of the 10 most important books of the year when it was first published in 1970, he compares blood donation in the US and UK, contrasting the British system of reliance on voluntary donors to the American one in which the blood supply is in the hands of for-profit enterprises, concluding that a system based on altruism is both safer and more economically efficient. Titmuss’s argument about how altruism binds societies together has proved a powerful tool in the analysis of welfare provision. His analysis is even more topical now in an age of ever changing health care policy and at a time when health and welfare systems are under sustained attack from many quarters.