About eight years ago, I came very close to licensing some technology from the Naval Research Lab to start a company to do something extraordinary. The technology was a retinal prosthetic -- an implant that would substitute for the degraded rods and cones of an unseeing human eye. I remember my conversation with the scientist very well. He was excited about the invention's ability to allow blind people to see again. I agreed, but also suggested something else: If the technology worked as advertised, I could imagine people with healthy eyes using it also, as a way to enhance their vision or to have a "heads-up display" for their lives. It was a slightly awkward moment, as I recall. We had a shared moment of discomfort as we thought about the broader social implications of his invention.
Ultimately, the technology was licensed to another company, and I turned my attention to other deals. However, a few things from that interaction stayed with me: (i) federal labs could be a place to find interesting technologies to start businesses, (ii) federal R&D funding was a driver of advanced technologies and (iii) truly innovative technologies may have unintended social effects.
I have kept track of the development of retinal prosthetic technology since that time, and it has continued to develop and is now being commercialized in Europe. It has now been approved by the FDA for use in the U.S. The possibility that people who were previously blind will be able to make out shapes, faces, street markings and discriminate between light and dark is a terrific achievement. An article in The Washington Post captures the human side of this development very well. It also drove home to me how technology's progression will change and challenge society.
The first element of the article that struck me was the cost of the implant technology -- $100,000 per patient. This is no small amount (twice the median income of a U.S. family). Certainly, for someone who is blind, the ability to make out the face of one's child would be priceless. But, $100,000 is a lot of money. It's suggested in the Post article that the retinal implant could become reimbursable through Medicare. This would certainly bring it into reach for many more patients. It also raises some implications that are worth discussing.
The retinal prosthetic technology is one example of a growing and exciting trend in man/machine interface, which includes artificial limbs, memory enhancement and vision augmentation. As the scientists describe in the Post article, further enhancements of the prosthetic technology -- color vision, higher definition -- are likely. The message is simple, technology moves forward, and as it improves people will want it. And, medical technology is moving forward. Not just in the areas of man/machine interface, but in the areas of personalized genetic medicine, life extension therapies, brain disease and artificial organs to name of few.
My point is that at some point in the future medical technologies will be available that will either singly, or in the aggregate, dramatically change life expectancy and the productive life span of those that can afford it. As is always the case for new medical technologies, they will initially be very expensive. I wonder whether we have fully thought through the implications of these technologies. Who will pay for them -- and how -- may make the current debate about health care spending seem like a friendly dinner table chat. Imagine a life extension technology that costs $100,000 per year, but for each year of use extended a person's productive life span another year. How much would you pay to have 20 healthy years between 70 and 90? How many of the current baby boomers wouldn't want that? Who will pay for it?
The implications of enhancements in man/machine interface also raise implications for their use on otherwise healthy people. If technology is available to enhance vision, would hedge fund traders want to be able to see data in a screen inside their eye? Consider the following: As enhanced reality becomes possible (see Google Glass for the harbinger of this trend) would some people opt for a two hour operation to implant a second screen in an eye rather than wear glasses? Or, if artificial limbs become more useful than natural limbs, would some seek to utilize them? What about an artificial heart muscle that has enhanced blood pumping ability? Are we ready for enhanced humans? What will be the definition of a human?
My point in this post is that technology doesn't exist in a vacuum, and that it ripples through our society. Technology enhances our lives, but also challenges our beliefs, our values and how we see ourselves. I believe in technology, and the striving for the better which captures much of what is wonderful about the human mind and spirit. It has also been the basis of increases in the standard of living in the United States and elsewhere for more than 150 years. But, I also am concerned that as technology progresses we are a nation that is not able to absorb and address its implications. Technology will more and more challenge our accepted beliefs and social norms, and require our politicians to make hard, and informed choices.
In the technology world we often speak in hushed tones of ideas that will change the world. But, we don't often discuss how technology's progress challenges and shapes society. Nor, do we really discuss the possibility that society might reject or restrict technology's progress. Yes, we do have food fights about health care spending, or the origins of life, but these are in some ways simplistic side shows for the bigger questions to come. Are we ready for this? Are you?