With $500,000, you could buy
- 1 experimental bio-engineered organ for one young father.
- 250 courses of prenatal care.
- 81,168 pints of Chubby Hubby Ben & Jerry’s Ice Cream.
Obviously the Chubby Hubby would create the most joy, but which option would create the most health for the money? If we thought rationally about spending health care dollars, we would invest in ideas that touch as many people as possible. Instead, venture capital and research dollars go into laboratories that experiment with growing human organs using the patient’s own stem cells. (See A First: Organs Tailor-Made With Body’s Own Cells, New York Times 9/15/2012)
I can hear the gasps already. How can I say that pushing the scientific frontier is not worthwhile? How can I be a wet blanket on progress, when it could save lives? If it were my husband who needed a new windpipe, I wouldn’t stop at anything – right?
Here’s the problem with that reasoning: as soon as tissue engineers can make new windpipes, livers, and lungs, there are patients who could use them. The cost of engineered tissues bumps up the cost of health insurance, putting it further out of reach for more people. This means that fewer people get medical care, even basic care.
So to save a few people with engineered tissues, we sacrifice a lot of health for many others. The same phenomenon applies to any health technology advance. I challenge anyone to cite a health technology advance that has reduced health costs.
Ironically, we would be better off – that is, have more health for more people – if we slowed down inventing new technologies, machines, and treatments. This is not likely to happen. Venture capital and research dollars are magnetized to the most attractive, profitable opportunity. Right now, those opportunities are in tissue engineering and the like. While many will whine about putting more emphasis on preventive and primary care, the money is in specialty and catastrophic care.
We need something more attractive than high profit biotech to draw our attention and our dollars. If, for example, we set a national goal to replace fossil fuel completely by 2030 and created institutes and grants for research, then biotech would fade as a priority.
In the meantime, we will get more ways to save fewer lives at great expense.