Regenerative Medicine and Universal Healthcare

In a recent diatribe, I took on the liberal idea that healthcare should be universal with a twist. I tried to tie the right to a responsibility like the welfare to work programs. Someone suggested it was a slippery slope that could lead to discrimination in the workplace. Instead of discriminating by fixed characteristics such as race, this type of discrimination would be based upon lifestyle choices. I thought it was a bit of an apples and oranges comparison. I mean, an employer should be able to discriminate against a convicted thief, since that person could conceivably create great costs for the company if he returned to his nefarious ways. So why should a smoker get health insurance as a right, or if he did, why shouldn't he have to pay an extra fee to offset his vice? But then it occurred to me whether I might feel differently in a near future when regenerative medicine using stem cells, therapeutic cloning of organs, RNA interference drugs, etc. could conceivably make it possible to restore health to anyone regardless of how they lived their lives.

Now keep in mind a few things. In such a scenario, everyone still grows old and even if they take care of themselves, they will die. So potentially everyone who desires to stay healthy for as long as possible will be candidates for this type of medicine. And that could be potentially every living person on the planet. So we will all need it regardless of how we live our lives and it could possibly restore our health even when we were pretty far gone by today's standards. On the other hand, those who abuse themselves will need it earlier in their lives and more often to reap the benefits. In addition, some preliminary research suggests that a healthy lifestyle, good nutrition, etc., dramatically increase the effectiveness of these therapies. In order for stem cells to thrive, they require the person who has received them to nourish them well. But, to play my own devil's advocate, let's say such therapies could extend the average lifespan to 150 or even more. And that after a certain age, we would all need these therapies quite frequently in order to maintain the benefits. Then, the difference between needing a boost starting when you were 60 versus when you were 75 would seem somewhat inconsequential. Another unknown factor is how much such methods would cost per annum compared to current costs of procedures like open heart surgery or the latest chemo drugs. Procedures like transplanting cloned organs will not be cheap and if you need a new heart every ten years instead of every 50 because you smoke, I might feel the same way as in my previous post.

However the issue of fundamental fairness is much more dramatic under this scenario. In the current world, most of us will die somewhere between about 50 and 90. A few folks die younger and a few later. And in all cases, it will be from our bodies just wearing out. Genetics will be the major determinant of the upper possible age of death for most, with lifestyle being the main modifying factor. But in a future world, where people could actually live at least a complete second lifetime or, under some scenarios, even live for centuries, then we have a major ethical dilemma. If only those who can afford the therapies or get their acts together sufficiently before age 50 to qualify for receiving them under a lifestyle litmus test get to reap this reward, we will have essentially begun a major experiment in eugenics. We will end up in a world where the rich and otherwise privileged will live for centuries, accumulating great wealth and power. The poor and downtrodden (who often have the worst health habits) will die as they always have. However, they will continue to reproduce, providing the virtually immortal elite with an endless source of labor and no chance of ever breaking their hold on power. That perhaps far-fetched science fiction scenario creates an interesting case in favor of universal healthcare for all in the near future in order to prevent a world that will make the current disparity between the haves and have-nots seem like a nostalgic dream. Hmmm.