The potential for improvements in medical care from gene research and new technologies such as enzyme therapy cause an economic problem. These treatments have the potential to cure very rare and specific genetic illnesses for which historically there has been no treatment and no obvious potential for a permanent cure. This makes the emerging technology potentially extremely expensive.

We have no ideological problem in wondering whether this creates an economic problem. Whilst we would not argue that healthcare decisions should be made principally on economic grounds, there is a real economic problem of affordability. These treatments would not exist at all without state involvement and resources allocated to health care must have a limit. Therefore an economic decision needs to be made about which treatments should be funded and which shouldn't. Decisions like this should be made by a central body of experts rather than left to individual health organisations, but that doesn't change the need for someone to take these hard decisions.

Public bodies regularly have to make life and death decisions. A value on human life is used in making road transport safety decisions, for instance. It would be appropriate to make explicit calculations that take into account age, benefit, likelihood of a permanent cure emerging and cost in deciding whether public provision of a particular treatment is socially beneficial.