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Greener Pastures Overseas

Millions of Americans with serious diseases and disabilities await federal funding to research stem cells.

By PAM BERNS

The New England Journal of Medicine published two poignant articles in a recent issue. In one, Stem-Cell Politics, Susan Okie, M.D., wrote about the efforts of some lawmakers to initiate stem cell research in their states despite the president's veto of the Castle-DeGette stem cell bill, passed by Congress earlier this year. The bill would have allowed the National Institutes of Health to fund research by increasing the number of stem cell lines developed from excess embryos donated by couples who used in vitro fertilization. These embryos are routinely discarded.

Okie points to former Republican Senator John Danforth, an Episcopal priest, who says that the Gospels support stem cell research. She also cites experts who claim that Bush's limitations have hampered progress and that may have discouraged many U.S. researchers from entering the stem cell field here. A 2004 survey of scientific literature illustrates that articles on stem cells by authors from other countries outnumbers those by U.S. authors.

Okie cites a July survey by the Pew Research Center for the People and the Press that found 56 percent of the respondents said "it was more important to conduct stem-cell research that might lead to cures than to avoid destroying human embryos, and only 32 percent said that preserving the potential life of embryos should be the priority."

No doubt, many of the 32 percent who support Bush's veto argue that adult stem cells will be adequate to support new cures for diseases and disabilities. However, some recent findings debate that premise.

A recent article in The New York Times by Nicholas Wade reports that "biologists have uncovered a deep link between life span and cancer in the form of a gene that switches off stem cells as a person ages." This study by three scientists, originally published in Nature, found that the discovery that cells are "switched off with age does not seem too encouraging for researchers who hope to use a patient's own adult stem cells to treat disease. That result may undercut opponents of research of human embryonic stem cells who argue that adult stem cells are enough to build new tissue."

Meanwhile, millions of Americans with serious diseases and disabilities await federal funding to research stem cells, anxiously hoping the years that Bush interfered with science will not have prevented cures to their illnesses as time runs out.

Scientists are wary of entering a field that is extremely vulnerable to political manipulation. If researchers want to continue doing stem cell research, they can work with long-term funding and facilities abroad that are not available in the U.S.

Obie quotes Nobel laureate Thomas Cech, president of the Howard Hughes Medical Institute, "It's considered to be an extremely risky career move to move into an area that could become criminalized."

The New England Journal of Medicine's other article of interest, America's New Refugees--Seeking Affordable Surgery Offshore, describes how seriously ill Americans are receiving treatment in low-income countries such as India, Thailand, Mexico, Lebanon and Pakistan. Stem cell researchers are not the only Americans going overseas.

Arnold Milstein, M.D., M.P.H., and Mark Smith, M.D., M.B.A., write that "middle-income Americans are evading impoverishment by expensive, medically necessary operations" by going overseas. They cite an uninsured, self-employed middle-aged carpenter who was quoted $200,000 by a near-by hospital for an acute mitral-valve prolapse operation. After his son--a medical student--went shopping for a cardiovascular surgeon, he found an American-educated surgeon who operated on his father for $6,700, including the hospital and physician fees at a new, privately funded hospital in New Delhi, India.

Milstein and Smith write that the trend to search for treatments abroad is "driven by the escalation of out-of-pocket spending for health care and insurance premiums beyond the grasp of low- and middle-income Americans."

"There is a direct relationship between the cost of insurance premiums as a percentage of income and the proportion of employees who decline coverage; in some low-wage industries, more than 75 percent of workers who are eligible for benefits turn down employer-provided health insurance, Milstein and Smith write. This response is understandable; in 2006, the average health care expenditures for a family of four for the first time exceeded the entire annual earnings of a minimum-wage worker." The authors attribute the study to the California HealthCare Foundation. They also write that one American business is offering employees up to $10,000 per operation requiring complex procedures to have them done at a credentialed hospital in India. Is this the future of employer-based coverage?

Milstein and Smith write that Bangkok's Bumrungrad International Hospital reported that 55,000 Americans were treated there in the past year; 83 percent of those patients underwent noncosmetic procedures. It's a shame that in a country as prosperous as this one, health insurance and life-saving treatment is beyond the grasp of so many Americans.

The old news is that since Bush took office the number of Americans without health insurance has grown to 47,000,000. Today's news is that as health insurance companies deny coverage for insured members, we are all at risk. And those of us who feel satisfied and smug about our own health insurance have to take pause at the injustice in a system that makes it impossible for 1 in 6 to simply buy insurance in this country. This system is broken, and it's cruel and inhuman to reduce working families to living one illness away from bankruptcy. We are all there, but for the grace of God.

Published: December 01, 2006
Issue: Holiday 2006

Comments

Right on!
We need to bring essential stem cell research back to the U.S. Hopefully we'll see it begin to happen this year with the shift in power in Congress.
Jeremy Wilson, Jan-04-2007