Permit me to share one aspect of the innovation issue: does innovation always mean creating the better and the bigger (or the smaller) and the newer? That seems to be Mandel's view. Mandel surveyed what he described as a "decade of disappointments", based on the lack of success in commercializing an "astounding number of technological breakthroughs across a range of fields" in 1998. And what are these fields? Mandel lists them as follows: cancer treatment, cloning, fuel-cell-powered cars, gene therapy, improvement drug development, miniaturized silicon-based machines, satellite-based intranet, speech technology, and tissue engineering. "Citius, altius, fortius" would seem to be the innovation motto here.
Mandel suggests various reasons for the lack of commercial success for each of these technologies, but the overarching point of his article is that more and better technology is the ultimate foundation for successful innovation. This view of innovation would seem incontrovertible, even if the precise reasons for the lack of commercial success of these innovations can be debated. Not so fast, however. It may be the case that in our preoccupation to make things better, bigger (or nano-smaller), and newer, i.e., innovating, at least in the bricks and mortar sense, we are actually doing a disservice to the role of innovation in propelling society, at least in some contexts. Let's take, for example, medicine and the provision of medical services
More generally, I am drawn to the observations of the notable physician-writer Atul Gawande. Gawande describes a visit to India, the birthplace of his parents, as he views close-up the strengths and weaknesses of the Indian medical practice. Based on this experience and other observations, Gawande listed three "virtues" which he claims account for success in providing medical services: diligence, doing right, and ingenuity. Innovation is notably absent.
I recall listening to a podcast interview of Gawande in which he particularly expressed admiration for the ability of the Indian doctor to adopt himself to the demands of fewer resources and less specialization by maximizing his ability to meet the demands of the particular situation. Indeed, as I remember, Gawande suggested that too much innovation might sometimes even get in the way of providing quality medical services. based on these three delivery-based virtues.
So what does this mean for IP? At the least, it suggests that IP may have a more ambiguous relationship to innovation than we would like to admit. Certainly better medical devices and equipment have made it possible to provide better medical treatment, and patents provide a role in that process. But patents, and IP more generally, may have little or nothing to offer at the point at which medical innovation is more about execution than invention, whereby IP is uncoupled from innovation at potentially mission-critical points.