Human Health on the Open Market

With just about everything handed over to the marketplace these days, the surrender of yet another aspect of human life to the tentacles of the market has lost much of its shock value.Still, I was surprised recently to hear of a proposal by a Harvard law professor to develop a market for racial discrimination. (Employers wanting to discriminate on racial grounds would be free to do so, but would have to pay a fee.) Perhaps some sharp entrepreneur will soon think up a way to apply modern market principles to the desire to maim and torture.Another area where the market has made amazing inroads lately has been human genes. Once the private preserve of the human body, genes have now been recognized for the hot marketable commodity that they are.In fact, the lively political debate sparked by U.S. President George Bush seems like a sideshow to the more profound issues raised by stem cell research. Mr. Bush would have us believe that the compelling moral issue here has to do with the fate of tiny microscopic bundles of cells extracted from human embryos (which are slated to be destroyed anyway). Apparently some people think it's better to just chuck those cell bundles into the garbage along with the rest of the embryo rather than use them to develop dramatic new treatments for dreaded diseases suffered by millions of humans who actually exist.But there's a more important aspect of this whole issue that's attracted little attention: Why are we handing something so potentially important to human welfare over to the marketplace?I'm referring to the fact that a private company, Geron Corporation of Menlo Park, California, has been granted exclusive commercial rights over key aspects of stem cell research.A little background: Back in 1998, a biologist at the University of Wisconsin, Dr. James Thomson, was the first to isolate stem cells in human embryos. Dr. Thomson handed over the patent on his dramatic discovery to the university's research foundation, which negotiated a commercial deal with Geron Corporation.This raises the prospect that a private company will have a monopoly over future medical treatments. Some scientists have already expressed concerns there may be restrictions placed on their stem cell research, or that other companies developing stem cell lines might be charged with patent infringements. The result could be delays in making medical treatments available, or higher prices, or both.Actually, Geron doesn't have a monopoly on stem cell treatments for the whole body. The foundation only granted Geron exclusive commercial rights over future stem cell treatments for six body parts: bone, blood, muscle, nerve, liver and pancreas. Whew! It appears there's lots of room for competition in other key body parts - the brain is still up for grabs, for instance, and nobody has yet cornered the market for the stomach, gall bladder, small intestine, leg, etc.But why should Geron have any sort of monopoly? For that matter, why should something as important to the fight against life-threatening diseases be held exclusively in private hands? This sort of private ownership is justified on the grounds that companies invest billions of dollars to develop medical products, so they are entitled to intellectual property laws that give them exclusive rights to sell these products.But these huffy claims often exaggerate the role of the private company. Certainly, the research that led to Dr. Thomson's medical breakthrough was not just funded by a private company.His breakthrough was only possible because he was able to draw on earlier discoveries made by hundreds of other scientists over the years - including those working on stem cells in the last two decades. This accumulated scientific knowledge, developed by countless people over many centuries, would seem to belong in the public domain.Furthermore, much of this essential background research was funded by government - that is, by the public. This is strikingly true in the stem cell case.Geron contributed only US$1-million to Dr. Thomson's research - and only after Dr. Thomson had carried out years of related research funded by the U.S. government - in addition, of course, to receiving his state-funded salary and using state-funded research facilities. In fact, Dr. Thomson's crucial breakthrough came while conducting the federally funded research. He figured out how to extract stem cells from monkeys. He then pointed out in an academic paper that this same technique could be applied to humans. Geron, spotting the commercial possibilities, was quick to offer him money to do so. Important medical breakthroughs often happen this way.Governments spend massive public funds to finance the long, costly basic research, which is then scooped up by private companies that go on to reap the financial rewards.But if government provides the crucial funding, it should at the very least demand a role in ensuring the resulting medications are made affordable to the public, which has largely paid for their development. Ironically, almost the opposite occurs. Rather than making sure the medications are affordable to the public, governments enforce patent laws that allow corporations to keep prices for the medications high by preventing others from producing them at lower prices.While the market may be the perfect vehicle for distributing hair gel, laundry detergent and golf carts, there are some things it seems less adept at handling - like racial discrimination, bones, blood, muscles, nerves, livers and pancreases.

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