The Baby Business - Part. 2
Posted on December 12th, 2007 – 4:48 PMBy May Chen
As promised, Josephine’s take on today’s talk…
It’s always good to put things in perspective, and Debora Spar did that for the infertility business Thursday when she gave a talk at the University of Minnesota.
She’s the Harvard economist who wrote the book published last year called “The Baby Business,” who estimates that the infertility marketplace is worth about $3 billion.
Sounds like a lot, right? Well, her latest research is on the bottled water business and that’s worth about $58 billion.
Well, it might be small in the grand commercial scheme of things, but we are talking about babies here, and being parents.
She said that some things in this country could be better for infertile couples or single people who want be parents. For starters, health plans could view infertility as a medical problem, which it often is, and include it in their health coverage. They could set some parameters. For example, they don’t have to pay for a single, 53-year-old former cocaine addict to have twins. (She swears that’s a true case. Her health plan, which is required to cover infertility by Massachussetts law, paid for that woman to conceive twins via IVF.) But what about a 27-year-old who can’t have children because her tubes are blocked?
She also said it might be a good idea to put payment caps on the price of egg donation, which has on rare occassions has reached $50,000 for so-called ivy league eggs. And Spar said she was struck by the fact that there are Ivy League eggs, but no Ivy League sperm that fetches a higher price than, say, Ernie’s who tends bar. Sperm is universally priced the same no matter who provides it. So why is that?
She didn’t have an answer, but maybe you have some thoughts?
4 Responses to "The Baby Business - Part. 2"
I went to Spar’s lecture and it was very good. I would encourage anyone who is interested in this topic to listen online to her MPR interview (which I didn’t hear but my husband said was good listening). I think the U will also post Spar’s lecture online too.
What has stuck with me about Spar’s comments is something she said at the outset: That despite the fact that baby business is, in so many senses, truly a business — billions of dollars, demand and supply, and many other market-driven/driving components — people are loathe to talk about it in business terms. I keep thinking about this. Yes, when we are paying for reproductive services or adoption services we are paying for the services, but are we not also buying a baby?
In my own case (mother of one biological(unassisted) child and one adopted child), I have often wondered what we could have “bought” if we had not adopted. A new kitchen? A timeshare? Or, more soberingly, if we had pooled our adoption money with 10 other families couldn’t we have funded a school or a clinic for 10 years in our daughter’s country of birth?
Likewise, when we look at the cost of multiple failed repro attempts, or the cost of a successful repro attempt that results in multiple premature births, what else could that money be buying?
I’m not suggesting we stop making babies this way. From my own experience I know that it just feels wrong to put a price tag on a child — no matter how conceived or brought into a family. But why are we so willing as a society to spend so much money on making babies when we are so unwilling to spend money on the babies already made? What could $3billion a year do to feed hungry schoolkids and get preschoolers ready for K?
Tobi, she made me think as well about why we are loathe to describe infertility treatments and adoption as a business. But I think Susan Wolfe (the moderator and a law professor at the University) was correct in saying we buy conception services. We — or our health plans — buy health care services when we’re pregnant. That makes it a much more indirect commercial relationship between patient doctor. And that’s the key difference. As long as infertility is not covered, the commercial relationships between doctors, clinics and donors, are undisguised. Sometimes that’s good. Sometimes it’s not.
As for why we don’t spend money on the babies we already have — we do. I’m sure you do, even though you haven’t started a school in a poor country. But there’s a difference between providing social support like that and being a parent. The world needs both. JM
The difference in cost between using an egg donor versus a sperm donor is in the effort and invasiveness of the procedures. Egg donation has many physical risks as well as a large time and effort commitment on the part of the donor. Sperm donation…not so much, unless it really takes them a while. 
Just like a surrogate is not paid for a healthy baby, but the time commitment and discomforts/risks/etc. of the pregnancy, egg donors are not paid for their eggs. They are paid whether eggs are retrieved or not in many cases, though sometimes there may be a stipulation on number of mature follicles or otherwise.
As far as the 53 year old former cocaine addict versus the 27 year old with blocked tubes, I think this is an area people are afraid to touch because a line would be drawn somewhere…a line which separates those who are fit to parent and those who are not fit to.
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