Maximizing Utility, Minimizing Cost

CHARISSA ILUORE

Ultimately, the public interest should serve to encourage research, not preclude the possibility of it.

Debate 3, Charissa Iluore Featured4.9 billion dollars. That was the National Cancer Institutes’ annual budget from 2005 through 2010—and with good reason. Cancer is the second leading cause of death in the United States and the seventh leading cause worldwide. Each year around the globe, an estimated 12.7 million people learn they have cancer and 7.6 million die from the disease. Moreover, it is projected that about half of all American men and one-third of all American women will develop cancer in their lifetimes.

With those statistics in mind, it is no wonder that so many resources—so many state-of-the-art microscopes and scanners, so many researchers and physicians, so many dollars—are devoted to finding a cure. After all, eradicating such a prevalent disorder could save millions of lives. Treating rarer conditions, while still vitally important, would not have nearly the same impact. As such, the debate over whether researchers’ endeavors should be influenced by the public interest boils down, in part, to one of the basic tenets of utilitarianism: the greatest good for the greatest number. By focusing their limited funds, expertise, and energy on studying diseases that most affect the general welfare, researchers attempt to increase happiness and reduce suffering in the most utilitarian way possible.

Some varieties of research are more economically practical, and thus more utility-friendly, than others. This is a principle that Harvard professor Dr. Milton C. Weinstein, one of the preeminent experts in the field of medical cost-effectiveness, seeks to explore in his own research. In an interview with the Harvard School of Public Health, Weinstein argues that while some breakthroughs in medical research improve longevity at a relatively low cost, the marginal benefits of other advances are negligible due to sky-high price tags. And the innovations which prove the most cost-effective are treatments of common illnesses such as heart disease, HIV/AIDS, hypertension, and breast cancer. Such advances greatly augment life span and, more importantly, the quality of that life span, at a reasonable price. In other words, those treatments provide the most bang for the buck. Researching widespread diseases thus not only maximizes utility, but also proves to be a very efficient allocation of resources.

Apart from the benefits of promoting cost-effective healthcare, it makes sense that researchers’ work be guided by the public interest—simply because the public is interested in that work. Researching ailments that are highly visible and deeply resonant with the general population is a primary way of engaging the public with research. That is why people turn out in droves to walk for Alzheimer’s and to lavishly fund cancer institutes, while devoting comparatively little to illnesses like Von Hippel-Lindau disease (VHL), an extremely rare genetic condition also characterized by tumor growth. As a result, these less common, equally devastating disorders get short shrift. Despite the importance of developing a cure for cancer, it is also crucial that researchers are given the latitude to explore subjects that might not fall under the public’s purview. Ultimately, the public interest should serve to encourage research, not preclude the possibility of it. After all, “the increase of happiness and the reduction of suffering” will only truly be realized when all diseases, both common and rare, are eliminated.

Charissa Iluore is a Brevia staff writer. She can be reached at ciluore@college.harvard.edu.