Bio-tech Good… ?

A couple of students in the capstone seminar noted that biotech has a significant upside. Playing devil’s Luddite, I replied as follows:

Really?

Not to be the naysayer, but I see as many problems being caused as solved.

Let’s start with the most positive of these. A cure for cancer would be nice. I am guessing we all know someone who has been ravaged by cancer, and it’s not a pleasant death to watch in most cases.

How much would such a treatment cost? When Jonas Salk was asked who owned the vaccine for polio, he said “the people.” How likely is it that “the people” will own a cure to cancer. Almost 0. Millions die in Africa from HIV-related illnesses. Although there is no cure, there are increasingly effective treatments, denied to all but the richest African. Now imagine this in the case of cancer.

Who will have access to anti-cancer drugs, replacement organs, clones, and artificial limbs. I suspect I will. My income, while moderate, is still better than 90% of American families, better than 99.9% of the world’s. While I won’t get the first treatments, I can probably hope to scrape up enough to treat my cancer.

Already your life expectancy is dependant on your level of income. Since 1950, the life expectancy of an average white male in America has increased by 10 years. It has remained the same for an average black male. What happens when we begin to be able to eliminate the major causes of death: heart disease, cancer, etc.. Will we see an even further gap in how long people live. Being wealthy already guarantees you greater chance to live longer–will this disparity grow to ridiculous lengths?

Or do we (finally!) nationalize medicine? Does everyone deserve to live forever? About 14% of our GDP is spent on health care (in Europe the number runs from about 7% to 11%). Take a look at the graph from the Commonwealth Fund (http://www.cmwf.org/programs/international/chartbook_charts1.asp ). It’s not hard to see where spending on health is going–doubling every decade or less. That’s good news for those in the health care business, maybe, but it means that by 2012, when many of us will probably be greater users of the health care system than today, expenses on health care will likely be nearly a third of the GDP. By the time I’m sixty, I would be surprised if less than half my income were going to health care.

You can already see this in the costs of HMOs and health insurance. It’s not a winnable battle. At what cost prolonging life?

And that’s just the anti-cancer drug! Cloning is a whole other can of worms–that’s why we aren’t doing it (yet!).

Finally, remember that all new technology is a double-edged sword. Biological weapons will become more directed, more lethal, and more widespread. Eugenics once again rear their ugly head. We will have to face some serious issues about who owns your body, and how much can be replaced before you are no longer human.

The alternative to promoting work in genetics and health generally is not attractive. Saying we don’t need new drugs is not a popular position to take. But even saying we need to look at this pragmatically seems somehow coldhearted. There is something unhealthy, though, about a society in which the benefits of new medications, technologies, and techniques go entirely to those who can pay for them.

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