A few months ago, I accepted some free pizza in exchange for a quick cheek swab to register my genetic code in the bone marrow donor database. Just this past week, I received an e-mail notifying me that I was a match. Like any other engaged citizen, I want to pursue this opportunity to help someone in need.
However, this taboo realm of health care is fraught with skewed incentives. Most health care amounts to a patient paying a skilled professional to use sophisticated equipment to address an ailment. Presumably, this patient (more likely, his or her insurance) will pay the medical professionals who provide the treatment, as well as the technical professionals who developed and sold the medical equipment to the clinic or hospital. But for some reason, the donor of the lifesaving bone marrow seems to have missed out on this market system.
Rather than having the ability to seek stem cells on an open market, the patient is condemned to wait until he or she is matched with a willing “donor” (about a 1 in 500 chance).
We seem to have fallen in the same trap here as we did with carbon and the environment. Many environmentalists harbor an innate belief that nature and its resources are simply too precious to carry a price. But as we have found with climate change, this is not a useful attitude.
Prices are very real mechanisms that mediate an exchange of goods or services and control the incentives that determine much of human economic activity. We can manipulate these prices and incentives with taxes and subsidies, but the price is necessary all the same. Human tissues have a price, and the government should allow the market to determine it.
Well-intended laws preventing this only serve to isolate patient from donor. I have no doubt that patients who want to preserve their lives would be happy to compensate donors for their time and efforts. Yet it seems our institutional health care web of clinics, insurance companies and government entitlement programs leaves no compensation for folks who are willing to go out of their way, spend time and money driving to appointments, endure extremely uncomfortable procedures, and put their body and immune system at risk.
Undoubtedly, a company that could develop a sophisticated biologics product to provide the same clinical outcome as a bone-marrow transplant would be compensated on the order of millions, perhaps billions of dollars. So why isn’t there even a spare penny for real, organic, 100 percent human stem cells?
For example, I use my bicycle as a form of transportation daily, and if I am recovering from an invasive bone marrow extraction procedure in my pelvis, I risk lost mobility and lost wages. This is a real cost for which I would like to be compensated.
I want to move forward with this process, but aside from the pizza, the incentives just aren’t there.
Michael Rush lives in St. Paul.