August 22, 2005
Biomedical Research Seen As Capital Expenditure

Real estate investment banker Robert Klein, who initiated and providing funding for California's $3 billion Stem Cell Research and Cures Initiative which won 59% of the vote in a statewide referendum, argues that medical research costs should be seen more like an investment and less like an expense.

To Klein, medical research should be viewed as a part of the public infrastructure, like a dam or a bridge. "You've got to stop 'expensing' research," he says. "You've got to put it in the state constitution and authorize state bonds for it as a capital asset." The approach protects controversial areas of study and allows the state to account for costs over decades instead of every year. With this philosophy, Klein proposed a way for citizens to demand long-term funding. For nine months he worked with scientists, patient advocates and a team of prominent lawyers, and they eventually crafted Proposition 71 for the 2004 ballot.

Think of it this way: If potholes in the roads were causing damages to vehicles that far exceeded the cost of fixing the potholes then the political cry would go out to fix the potholes. Well, the cost of diseases and aging - both for expensive treatments and for the costs of disability - run into the trillions of dollars per year. So why do the US National Institutes of Health get less than $30 billion dollars per year while US federal, state, and local governments spend somewhere in the neighborhood of $700 to $800 billion per year for medical care and nursing care? Why does the private sector spend even more while the government also spends money to provide income to old folks who are too aged to work?

While we can not allocate money to repair and rejuvenate bodies as quickly as potholes can get repaired we can allocate money to achieve repairability of human bodies within the lifetimes of most of us. The idea of developing the means to grow replacement organs or send in cells or gene therapy to do repairs of tissue is no longer the distant imagining of science fiction. Such therapies are already available for a few diseases and more are under development. For example, two teams in Pittsburgh Pennsylvania and Innsbruck Austria have working cell therapies for repairing sphincter muscles to cure urinary incontinence.

The faster we develop therapies built upon the rapid advances in biotechnology the sooner we will start reaping the return on our collective investments in therapies that repair and rejuvenate aged, malfunctioning, and diseased body parts.

In 2003 health care spending made up 15.3% of the US economy and is projected to rise to 18.4% by 2013 with further increases beyond 2013. Currently US federal biomedical research spending (almost $29 billion out of an almost $11 trillion economy) amounts to less than a third of a percent of GDP. Why spend over 30 dollars delivering care with today's lousy treatments for every dollar spent on research to develop newer, better, and more cost effective treatments? Imagine we spent $30 dollars on car repairs for potholes for every dollar we spent fixing potholes. Our current policies are about that dumb. Effective treatments will be cheaper treatments. Also, effective treatments will boost productivity and economic output by boosting the level of function of the labor force and by allowing people to work more years. Biomedical research will pay back many times over.

My modest proposal: Fix medical research spending levels as a fixed percentage of major medical entitlements spending programs. For example, make Medicare and Medicaid each spend 10% or even 15% of their budgets on biomedical research. When their entitlements spending for provision of care goes up then their funding of research should go up in tandem by proportionate amounts. A 10% allocation of medical entitlements program spending to research would more than double current biomedical research funding. If the same pattern was repeated by other Western governments the increase in biomedical funding would greatly accelerate the rate of progress in developing therapies.

Share |      Randall Parker, 2005 August 22 01:37 PM  Aging Debate


Comments
Toby said at August 22, 2005 2:07 PM:

I assume that you intend that private medical insurers be subject to the same stipulation, and that you won't mind them passing on the increase. The chart showing the OECD nation spending on healthcare as a percentage of GDP is an interesting one. The US has always been an outlier, and the gap between it and the other countries seems to be increasing. Is there a good reason why, in a country where private contribution to healthcare is so high, this should be the case?

You've got my vote, though I'd put rejuvenation well behind spending on obesity and mental illness research.

Randall Parker said at August 22, 2005 2:18 PM:

Toby,

There are many causes of the differences on percentage of GDP that goes to medical spending. Among the causes:

1) Price controls on drugs and medical services. Note that when doctors have to work for the state this effectively is a price control on their wages.

2) Willingness of various medical systems to spend on very ill patients. Some countries are more willing to shift away from attempting to treat once a patient is terminal.

3) Efforts put into premature births vary between countries. Premies are very expensive (and grow up disabled in a variety of ways - I did a post on this a few weeks back). It is my understanding that the US is at the extreme on this one. I think this is a bad practice on our part. But most Americans disagree.

4) Tax treatment of medical care costs differs. So the net demand for medical vary varies as a result. Shift more private spending to pre-tax dollars and more will get spent. Require money put into pre-tax accounts be spent by end of year and people will find ways to spend it at the end of the year rather than save to spend in future years.

5) Pre-tax treatment for direct purchase versus purchase via 3rd party insurers (really 4th party since the employer purchasing of medical insurance makes them the 3rd party) creates a different demand curve. BTW, for this reason I favor a shift toward private medical savings accounts where one can buy high deductible medical insurance (say $10,000 deductible per year) and pay most medical costs from cash in the account. This would reduce demand and make providers compete more on costs.

I could probably list a half dozen more reasons and I'm probably leaving out some big ones. But these are ones that come to me off the top of my head.

Jim said at August 22, 2005 2:43 PM:

i think your pothole analogy might be a bit better if we talked about spending that money on developing a better asphalt that doesn't make potholes in the first place, rather than perpetually patching potholes in poor paving material.

i think the big question when allocating these resources for r&d is, how to do so effectively? research is perhaps one of the most variable expenses (or capital expenses, depending on your accounting semantics) imaginable when comparing the $input vs. the output value. what i mean is the vast majority of research money is ultimately not spent wisely. the majority of the breakthroughs and real advances come from a relatively small % of the research $. science has a knack for generating and sustaining huge, inefficient beauracracies.

it is this (admittedly biased) researcher's opinion that the u.s. is so far ahead of european or canadian researchers in useful inventions due to the fact that the super-stars go start companies, prostelytize their vision (in exchange for start-up money or federal r&d dollars), and go make their dreams reality.

the sublte difference - entrepreneurs are rewarded for results; beauracrats are rewarded for following a process.

but yeah, spend more on research!

Randall Parker said at August 22, 2005 3:58 PM:

Jim,

Yes, the analogy is not a perfect fit. But the point is to spend money to save much larger sums of money.

As for the unpredictability of research: Some of it is due to the fact that many things have to be tried to find one that works. Look at drug development. Drug companies have to screen tens or hundreds of thousands of compounds (or even more) to find one that has some desired activity without too many side effects. It is extremely expensive to try so many compounds. One could say "just spend money testing the compound that will turn out to work". But we don't know which one will work.

Bureaucracies and privatization: But quite a lot of academic researchers spend years, even decades, trying lots of stuff before stumbling on something to commercialize in a private firm. Without that academic research bureaucracy they never would have come across the commercializable discoveries.

Brock said at August 22, 2005 6:04 PM:

I was having a conversation with some other law-and-economics types about how we might get US spending on R&D up to Japanese levels. One of the arguments for government policies favoring R&D is the postitive social welfare externalities it inevitably produces.

I suggested that major US corporations are fully aware of the benefits of R&D, but anything which doesn't help meeet Wall St's numbers _this_quarter/half_ is always tempting to cut. My solution was that the gov't should offer a 110% tax rebate on R&D spending, or something to that effect, to make it immediately profitable to conduct research. Since big corporations are fully aware of the competetive benefits of R&D they wouldn't waste the opportunity. I also suggested that the Federal Antitrust law make a special exception for industries that are fractured into lots of small companies, allowing the little guys to pool their resources into a corporations whose only activity is R&D and tech sharing. IBM and Ford wouldn't participate in that kind of program, but the construction industry (dominated by smaller, local firms) would be able to benefit.

me said at August 23, 2005 10:41 AM:

I agree, and it shouldn't be limited so medical research either. Especially with the prices of gas we are seeing right now, and with the threat of them getting higher, the government should be funding a manhattan project/apollo program sized program for energy research. I think part of the problem is that the US is short of scienctists right now so pooring more money into science would probably just buy better microscopes. Better equiptment can speed up research, but it is less cost effective than more researchers after a point. Of corse the reason not many people are going into science in the first place is that thats not where the money is.

Foolish Mortal said at August 23, 2005 12:51 PM:

Futurepundit -- where the future still holds bright, shining, crackpot socialism for all! And look over here: moving sidewalks, personal helicopter cars, and the largest fins and the grooviest 8-track tapes imaginable! All this was made possible by laser-guided precision government spending, keenly able to distinguish between good investments and wasteful spending. The politicizing of science and the universities never was a problem, because we all evolved morally, and the U.N. was there to provide ethical guidance. And the drugs got so good and our minds expanded so much, we believe anything -- anything at all!

Randall Parker said at August 23, 2005 1:00 PM:

Foolish Mortal,

Sarcasm is not rational argument.

History is not on your side in science.

US military government spending in the 1950s and 1960s for very high priced semiconductors funded the development of the semiconductor industry before semiconductors could be justified for much civilian use. Those early semiconductors went into government rockets and government airplanes.

US government funding of a group at Harvard recently produced a method for sequencing DNA that is an order of magnitude cheaper than the existing state of the art. The basis for the existing DNA sequencing technology was worked out at CalTech with US government grants. Though the original Sanger method that they built upon was funded by UK government grants.

Even though a very low percentage of government funded grants produce anything useful those that pay off pay off so big that they pay back all the grant costs many times over.

Rob McMillin said at August 23, 2005 2:21 PM:

Still waiting for that big payoff to justify the Apollo program. That is, we don't get to hear about the failures because those fall by the wayside and don't make the press.

Rob McMillin said at August 23, 2005 2:23 PM:

By the way, me, still wanting to know how a "Manhattan Project"-style program is likely to have a happy ending. The Manhattan Project had as its aim a small number of atomic weapons, cost be damned. Isn't cost the deciding factor as to whether new energy technologies are going to be successful? And therefore, how will unconstrained spending (or nearly so) on research be likely to deliver same?

Foolish Mortal said at August 23, 2005 2:30 PM:

Randall,

And NASA brought us Tang! I recommend an article by Iain Murray at TCS, "Nationalizing Science" (http://www.techcentralstation.com/081105F.html).

Regarding sarcasm, I find it's a very useful rhetorical instrument. You try to drown the argument in isolated, tedious, unending details that drive off anyone that doesn't have an entire day to chase down and refute them, and then declare victory to the empty benches. I use humor to point out what is blindingly obvious: socialism hasn't just failed in the details -- it has failed spectacularly, messily, catastrophically.

History is not only on my side in science, your side is on the side of the armless and legless knight in Monty Python, declaring defiantly "It's only a flesh wound!" Good luck with that.

Randall Parker said at August 23, 2005 2:32 PM:

Rob,

The Apollo program's purpose was not to make space travel cheap. Its purpose was to demonstrate at the height of the Cold War that we could do some huge bold human exploration before the Soviets could. It was all about prestige and competition in the realm of status. That is how JFK saw it. The Apollo program achieved its goal.

As for the Manhattan Project: Again, it had a specific purpose. Again, it achieved its goal.

As you well know, I'm arguing for much more basic research in photochemistry and electrochemistry. The goals are to find cheaper and lighter and more space efficient materials for photovoltaics and batteries respectively.

Also, I'm arguing for R&D focused on making pebble bed reactors, thorium reactors, other 4th gen approaches and breeders technologically feasible and cheap.

I see nuclear and solar as the energy production technologies we ought to accelerate. I also see batteries and perhaps eventually hydrogen as means to store energy derived from nuclear and solar.

Randall Parker said at August 23, 2005 2:43 PM:

Foolish Mortal,

If you are not interested in arguing with evidence then you have come to the wrong place.

I see the libertarian arguments against government funding of scientific research as motivated by a desire to promote the belief that government can do nothing particularly well. The problem with this viewpoint is that in the case of science most scientific knowledge has no immediate commercial value. The market does not provide much incentive to fund science. Now, if the market did provide a lot more incentives for science I'd expect the market to deliver more science per dollar. But here in the real world the bulk of science will not get funded if the government does not fund it.

The transaction costs involved in an intellectual property rights system that would provide sufficient incentives to fund science would cost orders of magnitude more to adjudicate the intellectual property rights than governments now spend on research. Intellectual property rights systems do not work as well or as easily as physical property rights systems, all your indignant sarcasm not withstanding.

Your sense of certainty about your beliefs has a neurologically similar basis to the certainly that the faithful of other religious hold about their beliefs.

David Foster said at August 23, 2005 3:00 PM:

Why look only at the $30B spent by NIH? There are also large amounts of R&D dollars being spent by pharmaceutical companies and medical device manufacturers. These should be included in any overall look at national medical R&D spending.

Randall Parker said at August 23, 2005 3:32 PM:

David Foster,

Throw in pharmaceutical and biotechs and - at least as of about a year ago - that adds in another $33 billion. Though some portion of that is funded by sales of drugs and devices abroad. Also, the pharmaceutical industry includes cost of money as an R&D expense. So if they spend 12 years to bring a drug to market (which is not unusual) the money they spend in year 1 gets interest added to it every year. The cost of money alone amounts to half of their costs. So divide their annual number by two to even start to get down to what they really spend in labs. Plus they probably manage to throw in other stuff into that category that doesn't really fund lab work.

Also, keep in mind that the pharmaceutical industry watches what academia produces from research to look for new targets for drug development. The pharmas are doing more of the D in R&D and less of the R. Academics find some protein and figure out a role for it (e.g. COX2) and then the pharmas see that the academics are saying this has potential as a drug target and the pharmas all go screening compounds against it. Then 10 years later out come a bunch of drugs that target that protein. That's what happened with COX2 and Vioxx, Celebrex, and the other COX2 inhibitor whose name I can't think of at the moment.

So the bulk of science gets done with government money in academia.

Foolish Mortal said at August 23, 2005 4:43 PM:

Randall,

The evidence I am refering to when I say that socialism has failed and failed spectacularly is a thing briefly summarized as "the 20th century," but maybe we're not allowed to refer to the past on futurepundit.com. The evidence is overwhelming and heavily documented. If you pretend not to be aware of it, then this is definitely not the place to argue with evidence.

More specifically, your argument about government funding of basic research doesn't relate to your evidence. You're making the elementary mistake of confusing science and product development. You realy believe Medicare should be providing basic medical research? And you can't think that development of semiconductors, rockets, airplanes, and batteries isn't research so basic that no free market research can undertake it, can you?

I can't tell whether you have no sense of humor at all, or whether you're dryly mocking yourself. There is nothing indignant about Monty Python or my post. When you lose an argument, you can only say that your opponent has a sense of certainty so great that it is "neurologically similar to religion"? That's your comeback? You seem awfully certain about your own beliefs, but I was just assuming you were wrong, reasonable, and willing to listen to opposing viewpoints, not a neurologically extreme jihadist, but maybe having a sense of humor allows me to give the other guy a break.

Ryan Waxx said at August 23, 2005 6:50 PM:

As much as I *want* your argument to be true, Futurepundit, I have to point out a rather large flaw.

Making people live longer will *not* decrease the costs of end-of-life care, anyplace short of achieving full immortality. Why? Because weather the end comes at 100 or 200, we will still spend a rather large chunk at that end (at the point of declining returns, our compassion for the aging will allow no less), but this time with even an more drastic chuck of spending at the end.

Histocially, cancer wasn't always the large killer that it used to be. Smallpox, consumption, pneumonia, typhoid fever and malaria... not to mention childbirth... claimed far more. Most of those diseases we conquored to the point where they killed relatively few. But now that we live longer, we run into the body's inherent design flaws at the end (arterial plaque, brain degeneration, rogue growths like cancer). As we address each one of these flaws, the ones not yet addressed become more deadly (relatively) in turn.

As the amount we can do to stave off death increases, the amount we *WILL* do to stave off death will also increase. Even if society cannot afford it. Especially short-term, as all technologies go through a 'only the rich can afford it' stage.

This is not an argument that we should not invest in such tehnologies, simply that you change your reasoning method. I suggest you focus not on less overall cost, but rather on more productivity per human life saved this way. The costs will expand, but so will total wages earned over that expanded lifetime, hopefully enough to cancel out the cost.

We can morally do no less. Medicine has always been the science of mercy, an attempt to alleviate suffering or at least create a long time of well-being to balance out the suffering at the end. To the extent that governments are supposed to further the interests of its citizens, this is a worthy cause.

Ryan Waxx said at August 23, 2005 7:34 PM:

A side issue: Regarding the libertarian argument against government funding against medical longetivity research:

There are ligitimate criticisms to be made against government funding of research. One of the primary reasons that socialism and communism fail is because they have no way to determine the proper price for goods (physical or intangible). In the old Soviet Union, there was an old and bitter joke that communism would take over the world... except for Denmark, which would be forever kept as a test market for pricing.

Having capitalism choose what subject to spend dollars on is indeed often more efficient. Government funding substitutes a politican's judgement for an entrepeneur's, which is usually a bad thing. But there are exceptions to this rule. The human geonome project was funded primarily by governments, an entrepeneur would have few incentives to create a general database like this one unless he planned to make up the costs by charging for access. And yet, this body of knowledge is going to support genetic researchers for generations to come.

"All government funding of research is a bad thing" is off the mark. If company X develops a method for reproducing organs, does that research become evil if the research was partly (or even fully) funded by the government? I think not.

Government programs, including research, are often filled with avoidable waste and are at times completely unusable and/or nonsensical. But even so, a world without govenment funding for research would not be a better world. Realizing this difficult truth is the difference between being a libertarian ideologue, and being a libertarian-leaning grownup.

Randall Parker said at August 23, 2005 9:37 PM:

Ryan,

Have you ever read the late Lewis Thomas MD's Lives Of A Cell: Notes Of A Biology Watcher? Thomas pointed out that ineffective treatments are much more costly than effective treatments. As one example he compared TB sanitariums with anti-TB drugs and vaccines. Once anti-TB drugs were developed people who had spent years being supported by taxpayers in sanitariums just got up and walked out well. They became taxpayers rather than benefits receivers and their cure was cheap.

An excellent cure for cancer will, similarly, cost less than the surgery, radiation, chemotherapy, repeated lab tests, and repeated MRIs and CAT scans. Ditto for high quality cures for many other diseases.

I've already seen a comparison of the cost of cell therapy for incontinence versus the standard chronic long term treatments for incontinence and not surprisingly the cell therapy is much cheaper.

Look at rheumatoid arthritis. What would the correct therapy for it look like? It would instantly stop the auto-immune attack. Ditto for MS, Sjorgen's disease, and many other auto-immune disorders. The ability to instantly stop MS would save tens of billions of dollars per year. People who are cared for instead would work.

Some Stanford epidemiologists compared people who live differing number of years and found that over the age range they examined the people who lived differing numbers of years spent the same numbers of years invalid and seriously ill. This argues against the idea that people who live longer will cost more.

The whole intent of rejuvenation therapies is to extent functional lifespans, not invalid lifespans. An extension of functional lifespans will increase the ratio of workers to retirees and remove a huge fiscal burden of unfunded government liabilities for the care of old people.

Also, rejuvenation therapies will cause us to avoid illnesses.

Randall Parker said at August 23, 2005 9:46 PM:

Foolish Mortal,

You offered an argument? I must have missed it. You made a broad generalization. You appear to be asserting that since markets work better for most things that they work better for all things. You haven't proven this assertion. It appears to be an article of faith with you. I've offered an explanation for why I think this is wrong and your response is sarcasm and Monty Python. I like Monty Python but you aren't making a real argument.

You haven't offered some new opposing point of view. You seem to be offering simplistic libertarian free market utopianism. But it is hard to tell since you really are saying so little.

Ryan Waxx said at August 24, 2005 12:19 AM:

> Once anti-TB drugs were developed people who had spent years being supported by taxpayers in sanitariums just got up and walked out well.

One major disqualifying problem with your analogy. We are talking about general life-extending therepies here.

You don't walk out of 'life' well. You walk out dead. And there will be a bill at the end. If not for one thing, than for another we haven't solved yet. What matters is not the final, total cost, which WILL BE HIGHER AT THE END for a longer life (on average), but rather how much living (and from a financial viewpoint, working/paying taxes) you do beforehand.

> The whole intent of rejuvenation therapies is to extent functional lifespans, not invalid lifespans.

This proves you weren't listening. Where did I say, or even imply 'invalid lifespans'? I was talking about functional lifespans. But since you brought it up, you do have to acknowlege that the same technologies *will* be used to lengthen invalid lifespans as well as functional ones. Unless you prophesy a 'let the crips die off' movement in the medical profession? I think not.

Your MS example merely proves my point better, as you conclude 'People who are cared for instead would work.' Check my 2nd paragraph for why.

You are on the right track, but the 'reduce costs' thing is anti-logical when you look at the whole picture instead of a disease-by-disease basis. Try instead a 'the longer lifespan pays for the extra costs, with dividends'.

Randall Parker said at August 24, 2005 9:13 AM:

Ryan,

You are making a false assumption. You claim that life extension therapies are going to be expensive. Well, initially yes. But their costs will follow the same sort of curve that computer chip thru-put, fiber optics bandwidth, and hard drive capacity costs have followed: They will fall by orders of magnitude and will fall rapidly.

No, I'm listening. You are repeating an argument I've heard many times before. I just disagree with it. I've made many posts citing examples of how biotechnology is following the same pattern of development as computer technology. See my category archive Biotech Advance Rates.

When the body is looked at as a whole picture and rejuvenated the costs will be lower than when it is treated on a disease-by-disease basis. The rejuvenation will be done using microfluidics and nanotechnology. Instead of surgeons going in to carefully repair each organ you'll just get injections. No surgeon. No anesthesiologist. No operating room. The injections will drop in costs by many orders of magnitude. Manufacturing costs will be similar to that for desktop computers.

Hospitals will contain far fewer people since disease will be rare. Ditto for nursing homes. Also, home care workers and physical therapists will similarly find much less demand for their services.

Foolish Mortal said at August 24, 2005 11:13 AM:

Randall,

I'm glad we've moved from claims of neurologically religious certainty to simply moving the goal posts. Now all I need to do is prove (prove!) that markets are superior to socialism in all cases, everywhere. Talk about indulging in sweeping generalizations!

Let's keep it more modest: I'd say that since socialism (government control of economic investment and consumption) is egregiously worse than free markets in 99 and 44/100% of situations (n.b. for the humor-impaired: this is hyperbole for humorous effect), then I would urge "Caution!" when propounding socialism. Maybe it's time we put a warning label on it: handle with care, contains radioactive material.

But when I came here from Instapundit (libertarian, but certainly nothing like the caricature of libertarians you indulge in here) and read your cheer-leading of all things socialist (though you don't either call it socialism nor deny that it is socialism -- just "that which is not markets" and apparently "must not be named"), I thought it humorous that a site called "futurepundit" would be predicting that socialism is the future. It sounds like the anachronistic "futurism" of the Jetsons and swoopy plastic furniture.

If you remain unconvinced unless someone "proves" the superiority of free markets (markets are always present, even though they're horribly distorted and inefficient under socialism) in every case throughout time and space, then you are unconvincable. But to judge from your generally rational tone and clear love of science, I would not think that you are unconvincable, just emotional on this topic.

But economics rules politics, demographics, science and the future (along with the present and the past), so I would recommend some economics reading for you. Stick with Nobel Prize winners, if you want to be able to drop names, if you want, but read James Buchanan (1986 Nobel) on public choice theory. But, honestly, if you find someone clinging tenaciously to the flat earth theory (or creationism, or socialism, or...), decrying the lack of evidence, and accusing the other side of religiously-inspired fanaticism, then maybe a couple of posts on a blog aren't going to magically convince them.

Randall Parker said at August 24, 2005 1:37 PM:

Foolish Mortal,

You insist on very distorting and deceitful simplifications. I do not do "cheer-leading of all things socialist". I point to very specific problems which cause specific market failures. I think markets work better in most cases.

No, I'm not emotional on this topic. I'm quite empirical in fact. You are religious on the topic of markets. It is a common ideological libertarian affliction. I grew out of it. Hopefully you will eventually as well.

You assume I haven't read big name market advocate economists. Well, sorry to disappoint but I've read Mises, Hayek, Friedman, and many of the other usual suspects.

No, economics does not rule science. Humanity is not homo economicus and the simplifying assumptions of economics are not consistent with the evolved nature of homo sapiens. In other words, free market economics is sometimes wrong. Some economists are beginning to catch on to this obvious fact as they study behavioral economics and neuroeconomics. For example, check out my previous post "Brain Rewards For Carrying Out Altruistic Punishment". But quite a few of the unempirical market ideologues "cling tenaciously" to their faith every bit as intensely as the Marxist faithful did in previous generations.

In science just because something works a certain way in certain conditions it is not logical to assume that the same thing will work that way in other conditions. This fact is inconvenient for the faithful such as yourself. But reality is that way.

epobirs said at August 25, 2005 2:00 AM:

I'm sorry but the analogy just doesn't work. Research cannot be rationally likened to fixing a pothole. If I allocate funds for CalTrans to repair a specific stretch of road I can do so with reasonable expectation of the desired outcome, a reaired roadway, being delivered on time and on budget.

Research isn't like that. It's entirely speculative. It may produce something useful or it may only reveal that the path to a desired goal was a dead end. If at the end of the project the guy in charge throws his hands up and says, "We got nothing," it's just a typical outcome.

Thus far the California Stem Cell initiative is just a massive gift at the behest of a welthy man (but apparently not influential enough to round up $3 Billion of capital investment from the private sector) to the research community from a state with a severe deficit problem. We simply have no business taking on this expense. (We are overwhelmed with corruption in state spending already, so who in their right mind doesn't believe a major portion of that $3 Billion won't be stolen?)It may produce wondrous advances that will benefit me greatly in my lifetime or it may produce not a single useful thing. There are no assurances and no recompense for the tax payers if the use of their money comes to nothing. In the meantime there are very real potholes in our roads and more occurring at a far greater rate than the responsible agencies can cover. The private sector is not going to fix those potholes but they will make investments in research if they don't think they can get taxpayers to pick up the tab instead. I have no problem if someone gets to be the next world's richest man because he made the right investments or spends a major portion of his life rounding up capital for his company. If the government didn't suck up so much of that potential investment capital for their harebrained bridges to nowhere and such, how much of it might be more wisely invested through the free market.

The Manhatten Project is often invoked in such discusions but I feel its use borders on Godwin's Law. The circumstances just aren't the same in the minds of the people expending the funds. Those developing the first atomic weaponry went into that project with the deep and genuine understanding that the fate of the entire planet could revolved on what they achieved out there in the desert. Not a vague threat as well live with. Age, disease, accident, etc., that every human has endured. But rather the real threat that this was for all the marbles within just a few years. We live under a death sentence but it just doesn't have the motivational power that the Axis threat presented.

The Manhatten Project is also wrongly presented as Big Science at its finest. In fact, it was Big Engineering, as was the Apollo program. There is a very important difference there. In both cases the projects began with strong existing evidence of their feasibility. The same cannot be said for tossing massive funds at basic research. It should also be noted that the NASA we were left with after Apollo end was an entity designed for a goal that was no longer. Rather than pursuing continuing improvements in access to orbit and beyond, then moving those advances into the private sector, it instead just kept stumbling from one proposed Big Engineering project to another. The ISS was created to give the Shuttle a ongoing mission and the Shuttle in turn a reason to keep funding ISS. The return on investment has been pathetic compared to what we might have today were NASA run as a DARPA for aerospace. The last thing I want to see if I hope for real results is the creation of a NASA for stem cells.

Randall Parker said at August 25, 2005 8:28 AM:

Eric,

If the Manhattan Project was just development then it could have been done by engineers. But in fact it required the best scientific minds in the United States, Canada, Britain, and most of the best scientists from Europe as well. Also, its duration could not be predicted in advance.

Aging kills more people in 50 years than all the wars in history.

As for science being speculative: We do not know how much money we'd have to spend to solve various scientific problems. But that problem is not unique to basic science. I've been on military aerospace development projects where the same was the case. They kept trying year after year. But it was correctly viewed as development. The military saw that the benefits of trying to push the cutting edge were enormosu and were willing to keep trying. Well, the same holds true for disease cures and rejuvenation therapies. $50 billion per year or $100 billion per year for 10, 20, or even 30 years is a paltry sum compared to the benefits of eventual success. We will spend $500 billion a year for defense during that time.

I've been on non-military aerospace projects where a company funded something for literally 20 years trying to break through on a new method of navigation. Again, it was product development.

We can reasonably infer that many biomedical research problems are going to be solved in the next few decades because the advances in instrumentation, computers, and techniques have sped up the rate of discovery. No, we can not predict with high accuracy when any particular milestone will be reached. But the benefits are so enormous that they are worth pursuing even thought we can not tightly schedule progress toward the various goals we seek to reach.

Mr. Econotarian said at August 26, 2005 2:05 PM:

Heh, as an Econotarian, I would love to see more socialized basic R&D spending (which is an investment), but less market-distorting items like socialized education and Medicare.

Randall Parker said at August 26, 2005 3:19 PM:

Mr. Econotarian,

I agree with you.

As a way to transition away from our current methods of funding medical care I want to shift toward medical savings accounts. In such accounts people could buy very high deductible catastrophic care medical insurance. They'd be required to put large deposits in them to pay for routine care and even moderate sized illnesses.

Currently most people get their medical insurance from employers since employers can buy medical insurance with pre-tax dollars in group plans. We need to provide equal advantage to pre-tax treatment paid for directly by patients. Cut out the employers and the insurance companies.

Education: I favor ordering the state owned and operated universities to record all lectures on high res and to release on DVDs available to the taxpayers who funded the lectures. The watching of classes should be separated from enrolllment. Test taking should be available to anyone who wants to pay to take tests. Again, admissions and enrollment would be separated. Someone should be able to watch lectures and accumulate credits toward various proficiency certificates.

Pam Young said at December 22, 2005 9:19 AM:

Just a comment from someone in AZ... even if the money WAS supplied for research, there could be other unexpected problems...

I am a private citizen who ran their own research project on the cause of MS - and I HAVE isolated not only the cause of MS, but the base source infection for ALL of the so-called autoimmune disorders. My work was not based off any prior studies, beliefs, books or Internet information.

What I did has been proved out - to a small extent. It took several years of coaxing, but in 2003 I finally talked a DENTIST into giving me a particular antibiotic with refills. After 8 solid years of progressive disability, I was able to walk again normally;the chronic optic neuritis, head tremor, left-sided weakness - all visible signs of the illness - disappeared.Although the antibiotics have helped me completely control the MS for over 2.5 years, the actual infection needs to be addressed in a more aggressive manner (than oral antibiotics) to permantly eradicate it. With a high degree of certainty, I also know how it can be done - sans antibiotics.

Here is the problem I offer you - the unexpected obstacle I ran into headfirst... there appears to be a population of doctors, researchers and others involved in these areas who DO NOT WANT "the cause" TO BE FOUND.

When all symptoms resolved after approximately 9 weeks of antibiotic use, I thought my doctors would be highly curious about what I'd done - if not outright elated.

Nothing could be further from the truth.

When I'd contacted a former doctor I'd seen (an MS researcher!) at UCLA's Reed Research Center, she was implemental in having most of my healthcare immediately terminated. My neurologist of 8 years (her best friend) would not see me and instead termed me as a patient; she also termed me from seeing anyone else connected with University Physicians - and no explanation was given.When another doctor was actually going to run tests to see if I was correct about the infection, he was notified that I'd "had many tests - all negative for MS (FALSE!) and I was "fired" for manipulating care". The dentist told me that these same doctors were insisting that I either had mental issues or was running a scam. I have insurance - but lost almost ALL care.

I have tried desperately to have someone examine my case... Rosalind Kalb with the National MS Society? - she could only say that this particular type of infection had never been considered as the source of MS and ended with the statement, "congratulations on finding something that works for you".

I am not "the only one"... thus far, 5 different autoimmune disorders have responded in like manner to the antibiotics. I have no doubts that they ALL will respond in similar fashion. The unique infection I found explains virtually ALL of the mysteries and enigmas associated with these conditions. I can even tell you why autoimmune disorders are on the rise, why familial tendencies exist and most definitely why people are prone to having MORE than just one autoimmune disorder.

It is a long story - but I hope, one day, someone who is TRULY interested in "finding the cause" may listen.

In any case, I am left to question - even if the money was there FOR research, how "HONEST" would that research be?

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