What does gene editing mean for society? How complex is the procedure? What is the likelihood that mistakes will be made in the process? What happens to discarded embryos?
The book you are seeing on your screen may look like a normal book; it is not. It is a conversation in which you are a participant. The book does not offer pat answers to hard questions. In fact, it barely even gives definition to hard questions. Rather, this book presents that stage in which science is most challenging and, arguably, most interesting—the period of identifying just what the problems and issues are. That is why we solicit your help in writing this story—the story of extreme events in social systems.
The participants in this book-writing enterprise are independent thinkers who wish to understand the forces impinging on social systems and the systems’ often dramatic and extreme responses to those forces. Extreme events, the sudden and discontinuous response of social systems to these forces, are what we for shorthand term X-Events. X-events We imagine the reader to be a person who wants to intelligently manage his or her actions and behaviors in the midst of an X-event—in short, to manage an organization in chaos. And not only manage, but be a beneficiary of that event. Explicitly, we understand that there are no simple answers to social questions. But but there is at least a gestalt that can help an individual anticipate and manage X-events. The program outlined here is to build the gestalt by total immersion in the topic—by examining the issues from many perspectives.
Suppose you are a prospective parent. Can you and do you want to affect the properties of your baby. Would you like it to be disease free? How about athletic or intelligent? What is the science? What are the ethics?
The news is full of commentary on gene editing of humans. What is gene editing? How is it different from GMOs and other types of genetic engineering? What are the ethics? How is the course of human evolution being changed?
The infant mortality rate in the U.S. is about 1/50 of what it was in 1850. This is a tremendous drop in the number of children dying. This drop in child deaths led to the greatest social upheaval in history, the demographic transition.
We live in a world of abundance. What are the implications?
How does abundant child healthcare lead to male angst? Watch this video and find out.
The concept of supply and demand is the cornerstone of economic theory. For simple commodities, the theory predicts that the demand for a product decreases as the price of the product increases and consumers are unwilling to pay the higher price. The supply increases as the price increases and suppliers increase production to capture increased profits. The actual price of the product is a compromise between the desires of consumers and the acumen of suppliers.
The pharmaceutical market place is not entirely a free market. The extreme demand for lifesaving products can make standard economic assumptions inoperable. Therefore, regulatory mechanisms have emerged to protect patients and to provide patients access to affordable medications. There are three aspects of pharmaceutical operations in the U.S. that are regulated by the government:
It is clear that the U.S. cannot continue its current course in which healthcare costs are more than 17% of GDP and outcomes are significantly behind the rest of the world. It is also clear that Americans are an optimistic people with a firm belief in the idea of progress, which manifests itself in technological and business innovation. The two visions for healthcare that were presented at the Forbes Healthcare Summit are almost caricatures, however. There is opportunity for creative individuals and institutions. Technology has not been applied evenly in healthcare. While the U.S. can be proud of its innovations in high-technology procedures, its adoption of information technology is not even at the level of the pizza industry. Both visions emerged as a result of economic incentives, one to increase revenue, as was the case in Texas, and one to reduce costs, as was the case in upstate New York. The question now is how do we shift the incentives to create the proper mix of outcomes, cost, and risk?
Prevention, of course, is vital early in life. In my book SECRETS OF ETERNAL YOUTH, we study the newest information about brain plasticity. In 1995 it was discovered that our brains, contrary to previous beliefs, can grow new neurons all of our lives. The major factors that keep are brains young and even make them younger are diet, exercise, curiosity, learning and attitude. (Editor’s Note: SECRETS OF ETERNAL YOUTH will be available in the summer of 2016)
While patents on medical devices seem normal, patents on drugs and chemical entities may seem like a stretch. I am not sure that the law makers in Venice in 1474, who invented the legal concept of a patent, envisioned the need to patent molecules. In fact, molecules were not even envisioned at that time. We all know that a patent allows an inventor time to commercialize his or her product, but are patents really needed for the economic viability of healthcare? Shouldn’t healthcare be all about saving lives and promoting health and not about making money on people who desperately need healthcare? Do patents have a benefit to patients, not just the patent holders? I think the answer to this question is “perhaps.” Patents promote diversity of products in the healthcare market place by forcing inventors to develop drugs outside the domain of currently patented products.