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Medical Breakthroughs And Smart Policy

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Got a bad heart? Just have a scientist build you a new one. According to a story in the WSJ, scientists are making major breakthroughs in artificially growing replacement organs out of human cells. In 2011, for example, a London based researcher made a replacement windpipe for a cancer patient, and was able to save the patient’s life by installing it. There’s still a lot of obstacles to overcome in scaling up this kind of procedure and expanding it to different organs, but based on earlier experiments with rats, scientists now think they might be close to making a replacement human heart:

Dr. Aviles said he hopes to have a working, lab-made version ready in five or six years, but the regulatory and safety hurdles for putting such an organ in a patient will be high. The most realistic scenario, he said, is that “in about 10 years” his lab will be transplanting heart parts.

The piece goes through the current state of this science in depth. Read the whole thing to get a sense of how radically human life is going to change in the next decades.

And while we’re waiting for that transformation to come, we can take advantage of the smaller but equally important innovations that continue to revolutionize daily life. An NYU student, for example, may just have invented a gel that can immediately stop almost any wound from bleeding (watch the somewhat graphic video above). A tech site called Humans Invent has the story:

“It works in three ways,” says Landolina. “The first way is it works as a tissue adhesive,” he explains. “It actually holds its own pressure onto the wound so you don’t have to do it. Secondly, when it touches the blood, it does something called activating Factor 12.”

This activates fibrin, which is the polymer you need to make a blood clot, explains Landolina. “Finally, it activates platelet cells.” The gel causes these to bind to the fibrin, causing a tight seal. Landolina says the speed at which this process happens is what triggers the healing process.

The world is in the early stages of a golden age of biotech innovation, one that has the potential to revolutionize everything from health care and manufacturing to energy production. And the biotech revolution will build on and add to the infotech revolution that has been shaking the world for the last 50 years. The 21st century will be more different from the 20th than the 20th was from the 19th. And the 22nd century will be something else again, if we don’t kill ourselves en route.

VM never gets tired of pointing this out for one very simple reason: wonks who don’t keep the innovative dynamism of our age at the forefront of their minds as they think up new policies are likely to do more harm than good. Trying to build elaborate models for the future of healthcare based on today’s delivery systems and economic models is as futile as trying to build a national transportation model in 1830 based on the success of the Erie Canal.

The tsunami of technological change headed our way means that we need to do less to build durable, rigid systems. We need to increase our social flexibility and our ability to change as new opportunities open up. That generally means more reliance on market forces and price signals, flexible regulatory regimes and open ended planning models. We need to avoid locking existing institutions and interests into rigid systems we must work harder to prevent vested interests from doubling down on the status quo.

We must also think through some of the consequences of change. One example: the last fifty years of medical progress mean that more people are staying healthy and active into their seventies and even eighties, and life expectancy has risen. This is a great blessing, but rigid and stupid social policy created a crisis out of it. The retirement age didn’t move up as life expectancy did, with the result that from the federal government down the country is facing a crisis as we struggle to support growing numbers of the “idle old.” That will only get worse if new medical advances succeed in pushing life expectancy farther up.

As the biotech revolution moves on, we are also going to have to change the way the health care system distributes health care. As computer aided diagnosis improves, nurses, technicians and even parents and patients (gasp!) are going to be able to make better informed decisions without doctors. Much of the creaky, elaborate and expensive health care delivery system we have today could be as useless in a generation as the Postal Service is today in the age of email.

The combination of rapid change with rigid policies and institutions is a recipe for disaster; we must embed flexibility into our institutions. Keeping an eye on the radical changes coming down the pipe is one way to remind ourselves that the goal of social policy today must be to plan for and accommodate change. The age of static institutions and stable bureaucratic organizations has gone for good, and we have to figure out what comes next.

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