profits, and inequality, generated by manipulating social or politicalconditions to get a larger share of the economic pie, rather thanincreasing the size of that pie. And the most iniquitous aspect ofthis wealth appropriation arises when the wealth that goes to the topcomes at the expense of the bottom. Myriad's efforts satisfied boththese conditions: the profits the company gained from charging for itstest added nothing to the size and dynamism of the economy, andsimultaneously decreased the welfare of those who could not afford it.

While all of the insured contributed to Myriad's profits - premiumshad to go up to offset its fees, and millions of uninsuredmiddle-income Americans who had to pay Myriad's monopoly prices wereon the hook for even more if they chose to get the test - it was theuninsured at the bottom who paid the highest price. With the testunaffordable, they faced a higher risk of early death.

Advocates of tough intellectual property rights say that this issimply the price we have to pay to get the innovation that, in thelong run, will save lives. It's a trade-off: the lives of a relativelyfew poor women today, versus the lives of many more women sometime inthe future. But this claim is wrong in many ways. In this particularcase, it is especially wrong, because the two genes would likely havebeen isolated （“discovered,” in Myriad's terminology） soon anyway, aspart of the global Human Genome Project. But it is wrong on othercounts, as well. Genetic researchers have argued that the patentactually prevented the development of better tests, and so interferedwith the advancement of science. All knowledge is based on priorknowledge, and by making prior knowledge less available, innovation isimpeded. Myriad's own discovery - like any in science - usedtechnologies and ideas that were developed by others. Had that priorknowledge not been publicly available, Myriad could not have done whatit did.

And that's the third major theme. I titled my book to emphasize thatinequality is not just morally repugnant but also has material costs.

When the legal regime governing intellectual property rights isdesigned poorly, it facilitates rent-seeking - and ours is poorlydesigned, though this and other recent Supreme Court decisions haveled to one that is better than it otherwise would have been. And theresult is that there is actually less innovation and more inequality.

Indeed, one of the important insights of Robert W. Fogel, a NobelPrize-winning economic historian who died last month, was that asynergy between improved health and technology accounts for a goodpart of the explosive economic growth since the 19th century. So itstands to reason that intellectual property regimes that createmonopoly rents that impede access to health both create inequality andhamper growth more generally.

There are alternatives. Advocates of intellectual property rights haveoveremphasized their role in promoting innovation. Most of the keyinnovations - from the basic ideas underlying the computer, totransistors, to lasers, to the discovery of DNA - were not motivatedby pecuniary gain. They were motivated by the quest for knowledge. Ofcourse, resources have to be made available. But the patent system isonly one way, and often not the best way, of providing theseresources. Government-financed research, foundations, and the prizesystem （which offers a prize to whoever makes a discovery, and thenmakes the knowledge widely available, using the power of the market toreap the benefits） are alternatives, with major advantages, andwithout the inequality-increasing disadvantages of the currentintellectual property rights system.

Myriad's effort to patent human DNA was one of the worstmanifestations of the inequality in access to health, which in turn isone of the worst manifestations of the country's economic inequality.

That the court decision has upheld our cherished rights and values isa cause for a sigh of relief. But it is only one victory in the biggerstruggle for a more egalitarian society and economy.

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