The Starbucks Effect, Aging Boomers, and Solving the Health Care Crisis

Conspicuously absent from the debate over the health care crisis is even a hint that modern science might actually come to the rescue. Perhaps everyone has already assumed that the problem is really just aging itself – and what can be done about that? While many of us baby boomers can remember the days of gathering in hamburger joints to brag about fixing up muscle cars, today we find ourselves sitting around in coffee shops lamenting that there’s nothing to be done about age-related macular degeneration and the like. At the national level, we’ve also observed a giant shoulder shrug: in his 2013 State of the Union Address, President Obama claimed that “the biggest driver of our long-term debt is the rising cost of healthcare for an aging population.” The fact that emerging medical innovations may offer some fixes for this crisis is all but missing from the current discourse.

Recently in the press was a scarcely noticed report about a team of researchers at the Oregon National Primate Research Center that, after over six years of work and over fifteen years of preparation in the field in general, has successfully generated stem cells by cloning. The promise of this technology unfortunately sounds alarms for some that mad scientists are about to regenerate a Hitler or a Stalin. In contrast, actual stem cell researchers see within the cloning process something almost magical in terms of its potential benefits for humankind. The novel methods we are witnessing emerge in our own time may provide pathways to a kind of cellular “time machine” that can generate young cells of any kind to replace diseased, aging cells. A sloughed skin cell, for example, could be provided at no harm by an older patient, and then the subsequent cloning process could be used to create young cells genetically identical to that patient’s own cells, thereby circumventing the risk of transplant rejection associated with the current standard of care. This novel means of treating and perhaps curing numerous age-related degenerative diseases has come to be known as “therapeutic cloning,” in order to distinguish it from “reproductive cloning,” which refers to the more controversial use of cloning techniques to create a baby.

The recent report outlines how the authors managed to produce long sought-after rejuvenated stem cells by adding none other than caffeine to the cloning mix, among other tweaks made to the already established protocol. This “Starbucks effect” led to microscopic clusters of “pluripotent” stem cells capable of differentiating into an unlimited number of cell types. As a result, it is possible to create young cells of all tissue types without forming an actual cloned baby. This is the basis for referring to the tissue-specific approach as “therapeutic cloning,” in order to distinguish the goal of the procedure from that of “reproductive cloning,” which would be to create a complete human.

This line of research began about 15 years ago with the first isolation of human embryonic stem cells, which for the first time in the history of medicine opened the door onto a means of manufacturing, on an industrial scale, all of the cellular components of the human body. Scientists saw within this discovery a potential pathway to numerous therapies and cures, for example, the regeneration of new heart muscle to strengthen a failing heart and the generation of new, healthily functioning brain cells needed to treat Parkinson’s disease. This emerging field of research and innovation has come to be known as regenerative medicine. With embryonic stem cell, nuclear transfer (cloning), and induced pluripotent stem cell technology all working, medical researchers now have multiple paths to designing these new therapies.

Among the many potential applications of regenerative medicine, likely the most important will be for treating age-related degenerative diseases. Cells throughout the body have tiny clocking mechanisms built into their DNA. As a result of this ticking-clock mechanism, cells gradually lose their ability to repair damage with the passage of time. One could argue that as our age expectancy has increased, so has the duration of our suffering: many people now experience years or even decades of chronic and debilitating disease. Consider also the financial stress when a family member is diagnosed with Alzheimer’s, or has a stroke, or becomes blind due to macular degeneration, or has heart failure. We urgently need novel strategies such as those announced today in order to increase the quality of care for those who are suffering. Parallel to this need is the necessity of reducing the high costs of treating these increasingly prevalent diseases.

Unknown to the public at large, scientists finally have some impressive new tools to address both the financial and physical issues associated with age-related degenerative disease. If we were to mobilize our scientific community by funding a national discovery program to find cost-effective cures, we could combine and apply the efforts of our best minds and hands working within the emerging field of regenerative medicine. With such a synergistic program in place, we could potentially save our nation trillions of dollars over the coming decades and alleviate human suffering on an unprecedented scale. These goals are not only awe-inspiring, they are also potentially within reach. We should be encouraged to use these new discoveries in an intelligent and compassionate manner to cure degenerative diseases that have, throughout history, been considered as unavoidable, as our collective fate. Some day in the not-too-distant future, our thinking about aging itself may change radically and positively. Meanwhile, the burden of health care costs that our generation leaves to following generations will be mitigated substantially by the amelioration, even curing, of those diseases before they become so financially and physically costly. We owe our fellow man exploration in regenerative medicine. Moreover, such a program of discovery will be necessary if the United States desires to retain its leadership role in the world community.