Stories by Stephen Green

Human-Animal Hybrid Ban Goes Too Far

May 10th, 2010 at 3:43 pm 20 Comments

“An anything, a nothing, a fancy, a chimera in my brain, troubles me in prayer”
— John Donne

On April 29, the Arizona legislature approved a new law banning the creation of “chimeras”–human-animal hybrids. The new law prohibits any resident of Arizona from “creating or attempting to create an in vitro human embryo by any means other than fertilization of a human egg by a human sperm.” Some Democrats are chuckling at what they believe is a legislature that has gone out of its skull, but the issue that is being raised is real.

In recent years, scientists have started to create actual chimeras — hybrid life forms that contain genetic material from both humans and animals. That opens up the disturbing possibility of true human-animal genetic hybrids.

There have already been some early successes. In 1984, scientists at the Institute of Animal Physiology in Cambridge, England created a “geep”–a goat-sheep hybrid.  In 2003, in China, human cells were fused into rabbit embryos, creating human-rabbit hybrids.  (These developed for a few days before being destroyed.) In 2005, at Stanford University, scientists infused human embryonic stem cells into the brains of mouse fetuses, creating mice with human cells in their brains. (Scientists hope to tailor their research to treat diseases such as Alzheimer’s.) And in 2007, scientists at the University of Nevada created a sheep, 15% of whose cells were human.

But the infusing of human brain cells into an animal host poses obvious ethical problems.  What if a mouse could be grown whose brain is mostly made of human cells?  Is this a human brain? What if cells from an animal’s brain were implanted into the brain of a developing human embryo? And a baby was born whose brain was partly animal?

Could a human-animal chimera be patented, as have other genetically tailored life forms? Would such a patent be in violation of the 13th Amendment against human slavery? As some religious leaders have pointed out, the problem isn’t just in creating it, but also in discarding it after the scientific experiment is concluded.  Is it sufficiently human that discarding it becomes the taking of human life?

The National Academy of Sciences, has released a draft set of guidelines on chimera research. The NAS guidelines cover the fusing of embryonic stem cells from one species into the blastocyst (an embryo between three and five days old) of another species. The guidelines stipulate that no animal cells should be implanted into a human blastocyst.  They also state that each experiment to implant human cells into an animal blastocyst must get approval from an oversight committee and that no such chimera be allowed to breed.  These guidelines are not (yet) mandatory.

These guidelines, however, go further than what is allowed in some other countries, where human-animal chimeras have been banned. Currently, The American Prospect has endorsed the guidelines.

The prospect of chimeras has alarmed the religious right, which has sought to ban such research outright.  In March 2005, Senator Brownback (R-KS) introduced a bill to prohibit human chimeras.  That goes way too far.

As with stem-cell research, a national policy on chimeras that balances the goals of scientific research against ethical concerns is needed.

Learning from Romneycare’s Failures

April 27th, 2010 at 12:43 pm 18 Comments

The success and failures of Romneycare in Massachusetts provide a glimpse into what the future holds for Obamacare. Romneycare has expanded coverage to nearly all the citizens of Massachusetts, but has also brought rising costs and reduced access to the best healthcare in the state.

Romneycare’s mandate for employers to provide coverage and for residents to purchase health insurance or pay a penalty has been successfully enforced, 94% of Massachusetts residents now have health insurance. Only a tiny minority have not been incorporated into the system. This bodes well for the Obamacare mandate.

Unfortunately, this has not reduced costs as promised.  In Massachusetts, healthcare costs are now rising at a rate of about 7.5% annually — faster than they did before Romneycare, and despite the worst recession since the 1970s. Residents who purchased insurance are now using medical services more frequently since they only need to contribute the co-payment. Blue Cross and other insurers have imposed whopping increases in premiums as a result.

These high costs have hurt the Massachusetts economy. A study has found that they have resulted in 16% fewer start-up companies than in neighboring New Hampshire. Unfortunately, for the Bay State, moving across the border to New Hampshire to set up shop there is easy, given the short commuting times.

Governor Patrick’s solution to the increase has been price controls. Blue Cross and the other insurers are fighting him in court, and while the litigation moves forward, they have stopped insuring new policyholders, because they don’t know what premiums to offer them when they apply for insurance.

The experience with auto insurance and price controls is not encouraging.  Because Massachusetts won’t let auto insurers charge premiums sufficient to pay for the high cost of accidents, State Farm simply refuses to insure new drivers in the state.

Frustratingly, Governor Patrick has decided to embrace shortages as a feature, not a bug. Governor Patrick has now offered Massachusetts state employees the option of so-called “restricted provider networks” — health insurance policies that actually bar policyholders from receiving care at such “expensive” teaching hospitals as Massachusetts General Hospital. Those who agree to accept “restricted provider networks” get a 20% discount on their premiums. This attempt to cope with rising healthcare costs is best described as bribing residents into accepting second-rate care.

This creates additional bad incentives. These limited provider network policies will appeal to healthy consumers, who will assume that they don’t need the best hospitals.  That will siphon off these healthy policyholders, leaving the traditional open network plans with a disproportionate number of sick people filing claims for care from the more expensive hospitals, driving up premiums even further.

Where did Romneycare go wrong? It first failed to deal with the fact that anyone who suddenly finds himself entitled to more healthcare will make the most of it provided that they never have to face the cost of it. Romney also chose to ignore the single largest distortion in healthcare, the tax exemption for group health insurance that gives preference to employee based insurance. Removing this distortion would remove a significant amount of waste in the system.

However, Romney ultimately did expanded healthcare coverage in Massachusetts and there have been some benefits from Romneycare. I was able to keep my health insurance when I developed unexpected kidney failure. Under the previous system I would have lost my coverage. Romney was right to be concerned about insuring more people, even though we now have to figure out how to deal with increasing costs.