Posner: Use Research Dollars to Make Life Better, But Not Longer

May 23, 2011
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[W]e can’t have a clear idea of the welfare gains from extending the life of elderly people. But we can say with reasonable confidence that the welfare of the elderly, and of altruistic members of their families, could be enhanced, without a significant increase in the longevity of the elderly, by redirecting medical research toward diseases or conditions that impair quality of life without necessarily shortening it, or at least without shortening it commensurately.

[W]e can’t have a clear idea of the welfare gains from extending the life of elderly people. But we can say with reasonable confidence that the welfare of the elderly, and of altruistic members of their families, could be enhanced, without a significant increase in the longevity of the elderly, by redirecting medical research toward diseases or conditions that impair quality of life without necessarily shortening it, or at least without shortening it commensurately. Dementia (which comes in many forms, but Alzheimer’s appears to be by far the most common) is the foremost example. It does shorten life somewhat, but on the other hand, as it is largely a function of age, its prevalence is increased by increases in longevity; and dementia is not only psychologically very hard both on the demented and on their families, but also very costly in the amount of care that demented persons require. Blindness, deafness, loss of mobility, and Parkinson’s Disease and related degenerative nerve diseases (life shortening, but often the effect on lifespan is less than the effect on quality of life) are other examples of diseases where investing in medical research might yield substantial increases in elderly utility without significantly increasing longevity. Stroke is an example of a medical condition that both reduces longevity and has often dramatic negative effects on quality of life.

Yet the National Institutes of Health expect this year to spend only $18 million on dementia research, $154 million on Parkinson’s research, and $337 million on stroke research, compared to more than $8 billion on cancer, heart disease, and diabetes research, even though the diabetes “epidemic,” while real, is due largely to obesity and bad diet. (Eye disease, however, seems generously funded at $817 million.) ….But the enormous expenditures on cancer research have not been very productive, and very promising research programs in dementia (notably research on an Alzheimer’s vaccine) are greatly underfunded both publicly and privately. In my view this is a regrettable imbalance.

More from Richard Posner at The Becker-Posner Blog. See Gary Becker’s comments here.