There’s a UK organization called To Hatch that provides fertility treatment advice to people considering the use of IVF. From the look of the website, a lot of this seems like useful information a discerning consumer would want to have. To Hatch is a charity and maintaining the website and collecting the information they make available costs money. You can make an on-line donation if you choose.
But To Hatch recently developed a different fundraising scheme (and I use the word in the British sense to mean “plan”) that has been in the news a bit. Some call it a baby lottery. Here’s the deal: You buy a ticket for 20 pounds, which I think is the range of $30-40. Each month there’s a drawing. The winner gets 25,000 pounds worth of fertility services. (That’s about $40-50,000 if I’m right about the exchange rates.) You can use them yourself or you can give them to someone. And here’s what’s included for the lucky winner:
The competition promises that winners will be given accommodation in a luxury hotel before being chauffeur driven to a clinic for treatment.
If standard IVF fails, they will be offered donor eggs, reproductive surgery or even a surrogate birth.
They will also get a mobile phone so they can maintain contact with medics at all times.
(I love the inclusion of a mobile phone. I thought I was the last person in the universe who doesn’t have one, but maybe this would be a dedicated line for those who are already connected.) The UK gambling commission just approved ticket sales and the tickets are set to go on sale July 30.
Much of the quick reaction has been critical as the headline in the Telegraph (“Babies to be Won Monthly”) suggests. But there is more thoughtful and supportive consideration, too. The HFEA (the relevant British regulatory agency) has expressed concern but it does not seem to be in a position to stop the process.
So what to think? Is it really any different from a lottery where you bought at $25 ticket for a chance at a $20,000 prize? I’ve purchased tickets like that from many charities, though none with a prize that is quite so rich. (And just for the record, I’ve never won the prize.) Surely if someone won a cash prize they’d be entitled to take it and spend it for fertility services. Apart from the general objections to gambling, what’s the trouble here?
It’s important to note that winning doesn’t guarantee that you actually get to use IVF. Fertility doctors will still be acting as gatekeepers. It seems to me that what you are getting is free access to something you would otherwise have to pay for. Of course, some people couldn’t possibly pay for it. IVF is expensive, even in the UK. While the national health service has covered fertility treatments in the past it will be reducing coverage as it reduces spending. Thus, it is undoubtedly true that there are people for whom the lucky ticket is the only way they’ll have access to the services.
There is something troubling here, but I think it’s probably something that troubles me about many lotteries: They play on people’s foolishly optimistic assessments of their chances of winning and are more likely to appeal to those who can probably least afford the tickets. But I cannot see what is particularly troubling about the nature of the prize offered.
ART is expensive. Access to it is denied to those who cannot afford it. There’s no real justification for that except for the ordinary dynamics of the market economy. This lottery offers a tiny number of people a way around harsh economic realities. I this regard, I think it is just like any other lottery.