The Health Care Issue Nobody Talks About

RESEARCH

To be honest, it is more than a health care issue. R&D is an economic issue that is relevant across the economic spectrum. Anyone who is familiar with DARPA knows how R&D in one area can have significant outcomes in a totally different area. The space program is another example.

There are two ways to use tax dollars: expenditure and investment. The "Bridge to Nowhere" was expenditure. The Iraq war is expenditure. Medical research, DARPA and NASA are investments. Their work is characterized by long-term gains. If more "Joe six-packs" understood this basic concept they might be able to resist swooning every time a pseudoconservative rockhead promises less taxes and less spending as the cornerstone of a pseudoeconomic plan.

Yeah, I'm not holding my breath, either.

For a good essay on the importance of funding basic research, I point you to Nobel laureate Roger Kornberg's* piece in the latest issue of Stanford Medicine Magazine:

The major medical advances — X-rays, antibiotics, magnetic resonance imaging, genetic engineering, to name a few — have one thing in common: They resulted from discoveries made in the pursuit of knowledge for its own sake, not prevention or cure of disease. The lesson of this experience is counterintuitive. To solve a difficult problem in medicine, do not study it directly, but rather pursue a curiosity about nature and the rest will follow. Seek knowledge and understanding in all fields, from physics to biology. Do basic research.

But almost as soon as this lesson of the past is learned, it’s forgotten.

The problem is not only scientific but also political. The support of basic research has traditionally come from government rather than the private sector, and for good reason. The time line is very long — basic problems take decades to solve. Only the public, with a lifelong interest, will support such an undertaking. Industry, with a short-term interest and eye on the bottom line, can hardly be expected to do so... Government clearly has a special responsibility and a unique role to play.

Some 50 years ago, in perhaps the most farsighted action of any legislative body in history, the United States Congress established the National Institutes of Health to fund basic biomedical research. The genius of the NIH lay in its funding mechanism. In contrast with the time-honored system in Europe, where support flows from governments to universities to departments to professors and finally to researchers, the NIH provides support directly to researchers. Proposals are submitted by individuals, young and old alike, and are judged by panels of peers. The NIH is a form of scientific free enterprise, a marketplace of ideas, with selection on the basis of merit.

The return on this investment by the government has been huge... The annual budget for cancer research today is only $5 billion, less than 10 percent of our annual expenditure on soft drinks, less than a week of the war in Iraq.

So far, neither of the leading presidential contenders has taken a position or even responded to invitations from scientific organizations to be informed about the problem. The public has to understand, and to convey to Congress and the candidates, the importance of science and the NIH. Life-saving discoveries hang in the balance, and we must, especially in economic hard times, protect the basis for future prosperity.


(* Roger Kornberg's father, Arthur Kornberg, was also a Nobel laureate)