My father died of polycythemia. Red blood cell cancer. The only treatment modern medicine could offer was regular reductions in blood volume as a way of countering his abnormal erythrocyte production. That is to say bloodletting. Bloodletting. Twenty-first century science was as helpless before his disease as the doctors who made house calls to George Washington and John Adams.
There was a long decline. Early retirement. Surgery to remove an enlarged spleen only made things worse. In the endgame -- a term the medical profession has borrowed from chess -- he was bedridden. Too frail, too clouded, too much pain. It came on quickly, unexpectedly. We were caught unprepared.
In his final days my dad was in agony. He begged us for one of his guns. Over and over. Some nights I think back and wonder which would have been the best choice. Probably the Colt. He owned a gorgeous .357 Colt Python. Classic gun blue. Six inch barrel. Ventilated rib. We used to go shooting together when I was a kid. He would load it with .38 special so the recoil wasn't so severe. That would have been important in his weakened condition. They're worth a fortune these days. Mom gave it away after he died.
My father served his country. In the Air Force during wartime, then as a civilian working on hydroelectric dams. In the end, his country didn't much seem to care. They certainly couldn't provide a cure for his illness.
I serve my country, too: I do medical research. My country doesn't much seem to care about me either.
You can tell a lot about a country by looking at its money. Not the money itself, although that is also revealing (England put Charles Darwin on theirs; try to imagine that happening over here in the colonies). More to the point: How it spends its money. Americans primarily spend their disposable income on trinkets, sports, and whatever pubescent siren we're sexualizing this month. This, of course, after the government has taken their cut. Yes, yes, taxes are a moral outrage and highway robbery and an affront to God -- sit down Ms. Rand. But they provide additional insight. For the public's priorities are reflected in government spending, and I'm certain of this because it's what I was taught in 9th grade Civics class.
The two biggest dollar items in the federal budget provide for seniors, with our combined annual Social Security and Medicaid/Medicare expenditure currently about $1.7 trillion. Apparently the goal is to keep you suffering for as long as possible. Because one thing the federal government does not spend much on is medical research. The primary government agency that funds medical research is the National Institutes of Health. The NIH budget is about $30 billion. That sounds like a lot of money. But total dollar amount is not the yardstick we should use. Rather, we should examine the percentage of submitted grant applications the NIH can fund. We call this the payline.
The payline is currently down around the single digits. Roughly one in ten grant proposals submitted can be funded. Or, to put it another way, nine out of ten don't get funded. Not because they're bad ideas; because there's no money. In one of those proposals there may have been an idea that would have helped you one day. A cure for polycythemia, for example. But we'll never know. Sucks to be you.
For many academics, NIH funding is their only source of income. A 10% payline would be like if you got paid once per year, but instead of getting a paycheck you roll a 10-sided die. If one magic number comes up, you get paid. Otherwise, you get nothing. Luckier faculty draw a regular paycheck from a university. Their grants only go to buying equipment and supplies and supporting students. But if faculty don't bring in grant money, a university will do everything it can to fire them. Even if they have tenure. Sucks to be them, too.
It is here Rush Limbaugh, Grover Norquist, John Boehner and other self-proclaimed experts who have made a career out of telling people what they want to hear will begin to crow about the free market. After all, if a scientist has an idea that is worth anything, won't some company pay him or her handsomely for the sweat of their brow?
Don't bet on it.
In the 1980s, UCLA scientist Dennis Slamon discovered a compound that seemed promising for treatment of Her-2 positive breast cancer. He approached the Bay-area biotech firm Genentech to market it. They turned him down. Why? Because the company had decided to focus on drugs that were less risky and more profitable. That focus no longer included cancer drugs.
This is but one anecdote (recounted in Siddhartha Mukheejee's Pulitzer Prize winning The Emperor of all Maladies), but it illustrates the larger truth. Biotech companies aren't in the business of curing disease, they're in the business of making money. Genentech eventually relented and produced Slamon's drug (after they were picketed by breast cancer advocates, we might note). But there is only so many times a for-profit company can take such a gamble.
A company that is bankrupt can't help anyone. Furthermore, Slamon was not specifically looking to cure for Her-2 positive breast cancer. He was investigating retroviruses when he stumbled across the drug that would become Herceptin. Such open-ended investigation is unthinkable in a system that demands quarterly results and quarterly profits.
Thus the lesson: Research does not lend itself to free-market solutions. Yes, biotech companies have R&D departments. But they rely on an existing knowledge base. That knowledge base is provided by decades of university research.
If you want the cures to keep coming, or arrive in the first place, you must fund basic research. You must fund the universities. You must fund the NIH. Not later. Now. Not sometime. All the time. The deep things in science are not found because they are useful, they are found because it was possible to find them. Robert Oppenheimer, speaking about his craft. The scientist who literally made America a superpower.
And so my challenge: Congress could double the NIH annual budget with a quarter of a percent tax increase on households with annual incomes greater than $1 million. That's about $2,500 each. Less than one day's wage. Simple bad luck demands they, too, will suffer their share of disease. How many of them would trade one day's wage for a cure? I suspect all of them would. Some of us did not have that option.
Many of us still don't.
The Free Market Will Not Save You
There is a genetic component to cancer. Some, like retinoblastoma, burn through a family generation after generation. A benign polycythemia has been identified which is hereditary, but current opinion seems to be that its hateful cousin is not. Still, considering we're using Revolutionary War era treatments for the disease, I'm not optimistic about the prognosis if/when my turn comes. I already bought a gun. Be prepared, the Scouts say.
But who knows. Maybe America will come to her senses before that gospel day arrives. Maybe enough of us will see our fathers dying and ask why. Or our mothers, brothers, sisters, children. The call goes out that we've had enough. The NIH coffers will overflow, university research revitalized. Somewhere, a faculty or postdoc or graduate student is working late, the campus deserted. This night is different than the thousand that came before. The oscilloscope blips. There is your reprieve. Money well spent, we will say in hindsight, even if today taxpayers have to be dragged by the scruff of the neck to the altar of reason.
One day, when we finally tire of the right wing mantra.
Another liberal who thinks he knows better than hard working Americans how you should spend your own hard earned money.
You're goddamn right I do.
There was a long decline. Early retirement. Surgery to remove an enlarged spleen only made things worse. In the endgame -- a term the medical profession has borrowed from chess -- he was bedridden. Too frail, too clouded, too much pain. It came on quickly, unexpectedly. We were caught unprepared.
In his final days my dad was in agony. He begged us for one of his guns. Over and over. Some nights I think back and wonder which would have been the best choice. Probably the Colt. He owned a gorgeous .357 Colt Python. Classic gun blue. Six inch barrel. Ventilated rib. We used to go shooting together when I was a kid. He would load it with .38 special so the recoil wasn't so severe. That would have been important in his weakened condition. They're worth a fortune these days. Mom gave it away after he died.
My father served his country. In the Air Force during wartime, then as a civilian working on hydroelectric dams. In the end, his country didn't much seem to care. They certainly couldn't provide a cure for his illness.
I serve my country, too: I do medical research. My country doesn't much seem to care about me either.
You can tell a lot about a country by looking at its money. Not the money itself, although that is also revealing (England put Charles Darwin on theirs; try to imagine that happening over here in the colonies). More to the point: How it spends its money. Americans primarily spend their disposable income on trinkets, sports, and whatever pubescent siren we're sexualizing this month. This, of course, after the government has taken their cut. Yes, yes, taxes are a moral outrage and highway robbery and an affront to God -- sit down Ms. Rand. But they provide additional insight. For the public's priorities are reflected in government spending, and I'm certain of this because it's what I was taught in 9th grade Civics class.
The two biggest dollar items in the federal budget provide for seniors, with our combined annual Social Security and Medicaid/Medicare expenditure currently about $1.7 trillion. Apparently the goal is to keep you suffering for as long as possible. Because one thing the federal government does not spend much on is medical research. The primary government agency that funds medical research is the National Institutes of Health. The NIH budget is about $30 billion. That sounds like a lot of money. But total dollar amount is not the yardstick we should use. Rather, we should examine the percentage of submitted grant applications the NIH can fund. We call this the payline.
The payline is currently down around the single digits. Roughly one in ten grant proposals submitted can be funded. Or, to put it another way, nine out of ten don't get funded. Not because they're bad ideas; because there's no money. In one of those proposals there may have been an idea that would have helped you one day. A cure for polycythemia, for example. But we'll never know. Sucks to be you.
For many academics, NIH funding is their only source of income. A 10% payline would be like if you got paid once per year, but instead of getting a paycheck you roll a 10-sided die. If one magic number comes up, you get paid. Otherwise, you get nothing. Luckier faculty draw a regular paycheck from a university. Their grants only go to buying equipment and supplies and supporting students. But if faculty don't bring in grant money, a university will do everything it can to fire them. Even if they have tenure. Sucks to be them, too.
It is here Rush Limbaugh, Grover Norquist, John Boehner and other self-proclaimed experts who have made a career out of telling people what they want to hear will begin to crow about the free market. After all, if a scientist has an idea that is worth anything, won't some company pay him or her handsomely for the sweat of their brow?
Don't bet on it.
In the 1980s, UCLA scientist Dennis Slamon discovered a compound that seemed promising for treatment of Her-2 positive breast cancer. He approached the Bay-area biotech firm Genentech to market it. They turned him down. Why? Because the company had decided to focus on drugs that were less risky and more profitable. That focus no longer included cancer drugs.
This is but one anecdote (recounted in Siddhartha Mukheejee's Pulitzer Prize winning The Emperor of all Maladies), but it illustrates the larger truth. Biotech companies aren't in the business of curing disease, they're in the business of making money. Genentech eventually relented and produced Slamon's drug (after they were picketed by breast cancer advocates, we might note). But there is only so many times a for-profit company can take such a gamble.
A company that is bankrupt can't help anyone. Furthermore, Slamon was not specifically looking to cure for Her-2 positive breast cancer. He was investigating retroviruses when he stumbled across the drug that would become Herceptin. Such open-ended investigation is unthinkable in a system that demands quarterly results and quarterly profits.
Thus the lesson: Research does not lend itself to free-market solutions. Yes, biotech companies have R&D departments. But they rely on an existing knowledge base. That knowledge base is provided by decades of university research.
If you want the cures to keep coming, or arrive in the first place, you must fund basic research. You must fund the universities. You must fund the NIH. Not later. Now. Not sometime. All the time. The deep things in science are not found because they are useful, they are found because it was possible to find them. Robert Oppenheimer, speaking about his craft. The scientist who literally made America a superpower.
And so my challenge: Congress could double the NIH annual budget with a quarter of a percent tax increase on households with annual incomes greater than $1 million. That's about $2,500 each. Less than one day's wage. Simple bad luck demands they, too, will suffer their share of disease. How many of them would trade one day's wage for a cure? I suspect all of them would. Some of us did not have that option.
Many of us still don't.
The Free Market Will Not Save You
There is a genetic component to cancer. Some, like retinoblastoma, burn through a family generation after generation. A benign polycythemia has been identified which is hereditary, but current opinion seems to be that its hateful cousin is not. Still, considering we're using Revolutionary War era treatments for the disease, I'm not optimistic about the prognosis if/when my turn comes. I already bought a gun. Be prepared, the Scouts say.
But who knows. Maybe America will come to her senses before that gospel day arrives. Maybe enough of us will see our fathers dying and ask why. Or our mothers, brothers, sisters, children. The call goes out that we've had enough. The NIH coffers will overflow, university research revitalized. Somewhere, a faculty or postdoc or graduate student is working late, the campus deserted. This night is different than the thousand that came before. The oscilloscope blips. There is your reprieve. Money well spent, we will say in hindsight, even if today taxpayers have to be dragged by the scruff of the neck to the altar of reason.
One day, when we finally tire of the right wing mantra.
Another liberal who thinks he knows better than hard working Americans how you should spend your own hard earned money.
You're goddamn right I do.
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