The baby industrial complex
Last week, I had three phone calls with my insurance company to find out whether my plan covers in vitro fertilization (IVF). First they said yes, then they said, “What’s IVF?” and third, they said no. Long story short, my husband and I are probably looking at least $15,000 for one round. That’s including drugs, anesthesia and, when I’m feeling put upon, car service to the fertility clinic with by far the best success rates in New York City why shop anywhere else? and dolabuy , naturally, the least convenient coordinates (so far east it’s practically in the river).
Fifteen thousand dollars. Sure would be nice to spend it on food, shelter and a Louis Vuitton diaper bag for an actual child, not the 30 percent likelihood of one. Should I “relocate” to, God help me, my parents’ house in Massachusetts, where Gov. Mitt Romney’s evolving anti choice views notwithstanding IVF is universally covered? Should we travel as “fertility tourists” to Israel, which covers all treatments and offers low out of foreign pocket rates? Down the road, will we wish we’d saved the cash for adoption fees?Whatever we decide, one thing is already clear: For us along with at least 10 percent of American couples fertility is not a miracle, it’s a market. “Advances in reproductive medicine have indeed created a market for babies, a market in which parents choose traits, clinics woo clients, and specialized providers earn millions of dollars a year,” writes Harvard economist Debora L. Spar in her provocative new book, “Baby Business: How Money, Science, and Politics Drive the Commerce of Conception.” “Eggs are being sold; sperm is being sold; wombs and genes and orphans are being sold; and many individuals are profiting handsomely in the process.”
And she’s not saying that’s wrong. The problem, Spar argues, is that because “it is difficult to conceive of a child as commerce” no one is willing to call the baby business what it is: an industry. And as long as it’s not truly considered an industry, it will continue to fly under the regulatory radar, she says. industries that “operate with virtually no rules” not much more beyond a requirement that clinics report their success rates to the CDC (which has no means of actually enforcing that requirement). Spar’s contention: “Governments need to play a more active role in regulating the baby trade.”
Yeah, but. this government? “The debate will not be cordial,” Spar concedes in her book. In his recent State of the Union address, President Bush did take up certain bioethical matters, saying: “Tonight I ask you to pass legislation to prohibit the most egregious abuses of medical research, human Designer Louis Vuitton Replica Handbags cloning in all its forms, creating or implanting embryos for experiments, creating human animal hybrids, and buying, selling or patenting human embryos.” “Human animal hybrids”? Yes. But the types of regulations Spar proposes would affect real people, not goat people, now without the not so hidden agenda of defining embryos as people.”We need to acknowledge the market that reproductive technologies have created and then figure out how to channel this market toward our own best interests,” she writes. “It’s no use being coy about the baby market or cloaking it in fairy tale prose. We are making babies now replica louis vuitton , for better or worse, in a very high tech way. We can moralize about these developments. or we can plunge into the market that desire has created, imagining how we can shape our children and secure our children without destroying ourselves.”Salon recently spoke by phone with Spar, the Spangler Family Professor of Business Administration at Harvard Business School, about the economics of the baby trade and how reasonable regulation could democratize, rather than politicize, the fertility industry.
I wrote my last book on the politics of the Internet, and inevitably people would ask me: What is the next cycle of technology that will have the same effect? A technology so radical that it creates a market that didn’t exist before, and people jump into it and do all kinds of wacky things because there are no rules though people will eventually want them? It hit me that the answer was reproductive medicine. Don’t we have a history of reacting to certain innovations say, birth control, IVF like they’re signs of the apocalypse, but then adjusting to and absorbing them into our culture?
As people know, there was major opposition to contraception for hundreds of years. If you go back to the witch trials of the 15th century, most of the witches were midwives. The argument, and it was partially true, was that midwives knew how to birth babies, but they also knew rudimentary forms of contraception and that was considered witchcraft. There was major moral opposition to the use of contraception, particularly the use of condoms. But it turned out that contraception was a really good business. So as the manufacturers continued to make the stuff, they started doing so well that they became a lobbying force in their own right. Then Margaret Sanger came along. She got the replica louis vuitton American Medical Association to come out in support of contraception. They supported contraception only when it was prescribed by a doctor. Now think about that: Maybe they had a change of heart, but they also created a whole new area of business Fake Louis Vuitton Replica Bags for themselves. That’s the market trumping morality for you.
Fast forward once again: The science behind the pill was known for some time. But none of the corporations fake designer bags wanted to touch it because the moral outrage was so high. The work that finally brought the pill out of the laboratory was entirely funded by one woman who was the heiress to the McCormick reaper fortune, whose husband was schizophrenic and she didn’t want cheap replica handbags to risk having a schizophrenic child. Once the pill was actually out, companies were very nervous about getting behind it. But when they did, the sales were so big that it just trumped the opposition because there was so much money in it and there still is.
So the first IVF is performed in 1978, and people go wild. There’s massive opposition. There’s marching in the streets. There are people declaring that the end of the world is nigh. And you know what? It turns out there’s an awful lot of people who want to use this service. Literally within a year or two all of the public opposition goes away. Because the people for whom this technology works, they want it to work so badly, they’re willing to do anything, pay anything, and they really drown out the critics even though it’s not a public, politically organized fight. And so the market, the combination of supply finally emerging to meet this long standing demand for reproductive options, just trumps the opposition. I’m predicting we’re going to see the same thing with stem cells. There is still a puritan element among many people who really want to believe that reproduction is a private, intimate process, guided by Mother Nature. It’s not the kind of issue on which people have felt comfortable organizing politically. Unlike cancer sufferers or AIDS sufferers, there’s been no momentum. And of course, the doctors and clinics have no interest in being regulated.
Meanwhile, the politicians don’t want to touch this with a 10 foot pole. There aaa replica designer handbags are starting to be murmurs of protest against IVF for that reason, because it creates excess embryos.
Yes, that’s where IVF does run straight into abortion. You are creating in almost all cases excess embryos that do not subsequently become children. But it turns out there are ways you can avoid that and the European countries do a pretty good job you can limit 1:1 replica handbags the number of embryos that you create and implant. I think some discussions along those lines would actually be useful, and we could probably find a way to make both the IVF proponents and the abortion opponents happy. This is where a business perspective is helpful Fake Louis Vuitton Replica Bags , because ultimately it’s a cost thing. If you have a couple who has saved up exactly $12,400 they can do IVF once. They’re going to be inclined to push the doctor to implant five embryos at once. And the doctor’s going to be inclined to go along. That is probably going to create excess embryos. And implanting more than two embryos may lead to a more dangerous pregnancy. Whereas if you were to say, “Let’s control replica designer handbags costs and change the incentive so that parents, doctors and society have an interest in implanting only one or two embryos,” you get a very different outcome. That’s what many of the European countries do.
And when that woman has quintuplets, there’s also a cost to society. So it’s not as if the people who manage to afford fertility treatments are doing what they do in a vacuum.
That’s one of the most important and overlooked pieces that these high quality designer replica handbags wholesale private choices impose public costs. These “miracle quintuplets” we see? We’re all paying for those miracle quintuplets. They are replica louis vuitton bags from china hundreds of thousands of dollars in delivery costs that our insurances are all picking up in one way or another. Many times these kids, sadly, have learning disabilities, delays, medical issues throughout their lives. The parents pay upfront. What kind of regulations should address the kind of genetic tinkering that can produce “designer babies”?
I think the early cases of what we now call “designer babies” are things with which most people would have absolutely no trouble whatsoever. They’re people dealing with horrific genetic diseases. And if you’re facing the prospect of having another child with Tay Sachs or cystic fibrosis, you will do anything to ensure that you get a healthy kid. I’d go so far as to say that these poor folks shouldn’t have to pay everything out of pocket. If we can help people give birth to children who do not bear these horrific genetic diseases, I think that’s a good thing for replica louis vuitton bags society to be willing to pay for.
The problem is that it’s a slippery slope. It’s pretty easy to say yes when the disease you’re talking about is a genetic disease that’s going to give the child an early, horrible, painful death. What do you do when it’s a predisposition to breast cancer? Then how do you choose? That’s a problem this technology has created.