February 07, 2006
Bush Administration Proposes Medical Research Budget Freeze
Medical research will pay off with cures to diseases and eventually full body rejuvenation within the lifetimes of some of us alive right now and yet George W. Bush wants to freeze the NIH budget.
In stark contrast to his initiative for physical sciences [ScienceNOW, 1 February and 3 February], President Bush today proposed a budget freeze for the National Institutes of Health (NIH) in 2007, holding its funding steady at $28.6 billion. The proposal, part of the President's overall budget request to Congress, is drawing concern and even outrage from biomedical research advocacy groups, who worry that NIH is losing ground after its budget was doubled from 1999 to 2003. Now the budget proposal, which curbs domestic discretionary spending while boosting funding for national defense, must wind its way through Congress before being approved in some form later this year.
This is being penny wise and pound foolish. A freeze is really a cut by whatever the rate of inflation turns out to be. So medical research is getting cut 2% or 3%. Yet medical research is, in my opinion, the best value per dollar of government spending.
Well, let me see -- double up the budget, NOT A SINGLE NEW CURE OR TREATMENT TO HIT THE MARKET, let alone anything we could call groundbreaking research, and the Shrub freezes the budget (or a real-term cut if you prefer). Forgive if I don't cry.
Let's kill the NIH, get rid of the FDA (or at least do what CATO suggests http://www.cato.org/pubs/handbook/hb105-32.html), repeal the whole absurd regulatory matrix and let's get around to kicking the ass of disease.
Throwing my money (by forced expropriation called taxes) into the black hole of the NIH is not going to double our lifespan anytime soon.
We need a couple thousand garage-bio-tech entrepreneurs, and we need them now. No government program is going to give us this. The only thing that will is a massive deregulation and a return to health freedom, somehting we sorely lack in the United States. It is absurd that I can get more done faster in Singapore and China than I can here.
Amen on that Brainpik, now if we could only get rid of ALL of the regulatory agencies that our wonderful government has cooked up over the years, we could get down to really doing some work.
That would be a budget INCREASE freeze. Panic mongering moonbat.
In response to Brainpik, the biggest reason we've seen no cures is profit. A drug company that cures an illness destroys it's market. That's just not good business.
Just look what NIH has done with their 100 billion they received for AIDS research over the years. We know now many things that don't cure AIDS and none that do.
On the other hand, there are a great number of spinoffs from defense R&D. I am excited about the spinoffs from the billions of dollars the military is spending on combat robots. It will help us remain competitive with the Japanese in this area as they are far ahead of us.
Hmm... this is a very difficult topic indeed.
I think first and foremost, however, Bush is setting the precedent that Medical Research is a low priority of this administration.
In many ways this also sets public opinion in these areas, and servers to hinder overall progress in the field.
On the other hand, Presidents like Bush have shown that there is really no reason to trust these bloated self (and special interest) serving bureacracies - as they are massively inefficient and constantly at the whim of the political partisan agendas.
Finally although private research may lead innovation, tying medical research so intimately to profit margins clearly servers as a massive conflict of interest in many areas.
Perhaps in the future we could look to creating efficient, non-profit organizations, which would be the best of both worlds.
I myself am currently trying to pioneer such an agency in the field of technology, and perhaps others will form spontaneously as we continue to raise the standard of living around the world.
"Throwing my money (by forced expropriation called taxes) into the black hole..." WILL continue none the less.
Cutting programs does not reduce the size of government because it is just spent elsewhere. Your money will be spent, along with any thing else that can be pillaged, on Bush's favored scams the military-security state complex and big energy giveaways. The days big government transfer benefits to citizens --other than corporate citizens --is quickly passing.
Brainpik: I think you're falling into a logical fallacy. You probably can't name who came up with most of the big discoveries. You also can't come up with any that the NIH did. Despite the former, you conclude the NIH must not have done anything useful.
Here's a list of things they've done:
In there is the rubella vaccine, for instance. How much is that worth?
No cure for AIDS, but from my link:
Protease Inhibitors Prolong Lives of AIDS Patients–a new class of anti-HIV drugs called protease inhibitors shown to help significantly prolong the lives of AIDS patients. NIH-supported basic research paved the way for the development of this new class of drugs, from discovering the HIV protease enzyme to determining its three-dimensional structure in order to design drugs to block its action, to conducting drug-screening efforts and clinical trials. (Extramural)
I kind of wonder if the Bush Admin isn't trying to spank med researchers for pushing stem cells.
Just because the government doesn't do something, doesn't mean it won't happen!
Just do a quick google search on increases in VC investment in medical startups.
I tend to agree that government research is a good way to spend money, but I want to fight the idea that it is the only way that research will get done.
Perhaps Bush IS thinking long term, fiscal policy wise: the less groundbreaking research, the shorter life spans of seriors eating up entitlements :-P
While I am an ardent supporter of basic and applied research, I must agree that a freeze is not worthy of tears. Having worked in a research lab for years at a major research university I must say that a vast number of projects are n+1 (maybe n+0.0000001) projects that consume money and offer nothing that is material to humanity or science. The problem I saw was two-fold: Many researchers propose research that is too incremental in nature that and are already known to be rat holes; and two, experimental design and statistical methods are not worthy of a good undergraduate stat student. Both of these contribute to vast amounts of waste in the system.
I know that the freeze does nothing to address either concern. I also know that it is the marginal dollar that goes to new approaches and researchers. Thus, like some of you I fear that the freeze is a potential loss.
I would actively support a substantial increase in spending if we redirected our objectives from looking at diseases in a largely operational manner to longetivity. We need to shift the paradigm if we want to move beyond incremental progress.
Note that pharmacy industry R&D budgets went up just as much as government budgets during the big increase of NIH funding. I think I did a post where I mentioned the numbers about a year ago. Well, the pharmaceutical companies are producing fewer new drugs than they used to. Regulations are not the main reason for that. The big pharma tried to switch prematurely toward rational design of drugs and away from searching compounds found in nature.
But drugs produced by NIH are not the measure of NIH's success. NIH funds researchers who discover knowledge that then gets privately developed into products. For example, the development of COX2 inhibitors was made possible by basic research into COX variants and where they were found in the body and how the different COX variants worked. Does NIH get credit for the resulting drugs? Not by Brainpik's erroneous measure of NIH productivity. But by my measure NIH gets the credit.
Similarly, who funded angiogenesis and cancer research for decades before it finally paid off in commercial drugs that cure some forms of cancer? NIH. Dr. Judah Folkman at Harvard pioneered this area and worked for decades with NIH funds. Private corps were not about to step up to the plate and fund research for decades before the pay-off happens.
I find the libertarian attitude toward government funded medical research to be ideological fundamentalism based on ignorance about how science gets done. Ending the ignorance takes a lot of learning. You have to follow research for many years and read how various pioneers made discoveries that finally got translated into treatments after they spent their entire careers pursuing problems. But why spend all that time and effort learning when you can just assert from your ideological beliefs that you know the truth?
Hear, hear. Scientific knowledge works like GPL'ed software, not real estate.
The big problem with freezing NIH growth is that only the incremental and most PC research will be funded. NIH funds primarily based on ratings from external review groups of 'experts' who are overwhelmingly old guard (you have to have received a NIH grant and preferably several to be considered for service on these reviews). Any new ideas will challenge one or more of the old guard and therefore receive a less desirable score than one that 'checks all the right boxes' defined by the orthodox views. When times are flush this doesn't make too much difference, since lots of research is funded. But when funding is tight, the new, potentially risky ideas will be canned even if they are great science. There is a reason why it took 10 years for the idea that GI ulcers are due to an infectious agent rather than just acid to reach acceptance and drop medical spending on ulcers by billions of dollars per year.
"I find the libertarian attitude toward government funded medical research to be ideological fundamentalism based on ignorance about how science gets done."
That is blowing up the complainst a bit. You have exxagerated both the cuts and the probable effects, and have failed to address the very real increase in private investment in research. How is that for not looking at the facts?
Where did I exaggerate the cuts? I said the freeze means a cut by the rate of inflation. How is that inaccurate.
As for the probable effects: Again, what did I say that was an exaggeration?
I failed to address the very real increase in private investment? I've gone to the trouble in a past post to dig up both private and government spending trends and how the ratio between them stayed unchanged during a period of large government spending increases.
As for the private investment: Most of it is shorter term. I've provided examples of how long term research yields great findings that private investment isn't going to fund.
Look at what I report on this blog with links to various research findings. Is the private sector going to take over funding the Harvard Nurses Health Study if the government stops funding it? Of course not. Lots of stuff isn't going to get done if the government doesn't fund it. There's a big difference between money for research and money for product development. Private money is focused on shorter time lines and development of ownable knowledge. Government research is focused on longer time horizons and knowledge that can not be owned. We need both.
Who cares? The research that the federal government does is only a small fraction of the spending done by private enterprises. Also, if the federal government continues on it's current spending spree the total debt that is issued by the treasury will continue to increase thus preventing U.S. research institutions from getting access to the bond markets because of the increased interest rates for debt financing.
"The research that the federal government does is only a small fraction of the spending done by private enterprises."
I'm sure I could try harder for a better number, but this link:
says that their members (including most of the biggies - Abott, Bayer, Brystol Meyers, AstraZeneca, Wyeth, Merck, etc) spent 38 billion in 2004 in R&D.
So the claim that 28 billion would be "a small fraction" seems to be without merit.
Even the $38 billion versus $28 billion comparison gives the pharma cos way too much credit. A large fraction of their cost is the cost of capital: i.e. interest on money borrowed to develop drugs. Plus, some of that money goes toward regulatory requirements. So the actual number of dollars spent on research and development is probably half the $38 billion figure.
However, that portion that goes to R&D mostly goes to development. They do not fund much basic research. Rather, they watch the basic research that governments fund and look for discoveries that point in directions that can be commercialized.
Again, the libertarian opposition to government funded research is based on a foundation of ignorance about who does basic research and how it goes done and why.
I don't doubt that you're right; the 38 billion figure is almost certainly an upper bound on what the listed companies spend, given that it's what they're putting on a website for PR purposes. Now the $28 nillion NIH spends probably isn't all strictly R&D (there's administration, awareness programs, etc), but the vast majority probably is. So we're in the right order of magnitude, anyway - enough to show that it's not small potatoes.
More to the point, I'd wager that when one looks at basic research, NIH pays for the majority of it.
Half the cost of drug development is the cost of money. So out of the $800 million it costs to bring a drug to market $400 million is the cost of money. Therefore I suspect $38 billion a year for drug development probably should be slashed in half to get real outlays per year actually spent on research and development. If that is the case then the NIH is easily outspending big pharma.
Also, NIH is just one government source for medical research. Other governments fund research. I suspect that $38 billion is global for big pharma. So NIH to big pharma is not the relevant comparison.
A later post by Alex Tabarrok reports the per drug development cost might be a few tens of millions more. But that doesn't change the money cost much if at all.
More generally, see Alex and Tyler Cowen's Medicine category archive for lots of interesting insights on medical economics.
Randall: "But why spend all that time and effort learning when you can just assert from your ideological beliefs that you know the truth?"
I lost it for a moment and thought you were talking about President Bush. :)
Surely you jest in putting up that list of NIH accomplishments...the first generation of that rubella vaccine was developed by maurice hilleman at Merck...NIH has a good record of advancing something after the innovation is already made, as in that case, but has a pathetic yield in human health for the money put in. Brainpik may write exciteable prose, but he/she may be right on the money here.
That laughable list when examined closely results in very few if any actual clinically useful products actually pioneered by NIH supported scientists. And even the seeming successes like rubella, when you look under the hood, you see basically grunt work after the real discovery was made elsewhere
How many vaccines, cancer cures and disease treatments should be on that list for the, what, 600 trillion dollars spent by the NIH so far in its history? They are probably beaten in terms of lives saved by George Papanicolau alone who was just about driven out of town by the same crony structure on which the NIH is based. That list is an indictment, I wouldn't put it up as evidence for more NIH funding.
You cite Judah Folkman, but the man also was just about shut down as a nut by the NIH review panels. The NIH has a pathetic record when it came to funding Folkman when it mattered, when the innovation was actually taking place and needed funding. The NIH over and over funds someone like him after he's already struggled through with the help of non-NIH funds, and the record is then obscured as to how poor the NIH funding actually is at acheiving the objectives presented to the public.
Sorry I've come late to this debate. Brainpik states Well, let me see -- double up the budget, NOT A SINGLE NEW CURE OR TREATMENT TO HIT THE MARKET, let alone anything we could call groundbreaking research, and the Shrub freezes the budget (or a real-term cut if you prefer). Forgive if I don't cry.
Apart for the blanket statement without any backup data, where does it stated that the NIH is in the business of making drugs? The usual process is for discoveries from NIH funded work to proceed to biotech (in some cases the investigators actually forming companies via the help of venture capital).
Another Brainpik gem Throwing my money (by forced expropriation called taxes) into the black hole of the NIH is not going to double our lifespan anytime soon.
I just love people who complain about having to pay taxes, but if anything breaks, or is not working the way they see fit (e.g. the NIH) all they do is complain. Give us all be a break. If you can do better, then get out here, find the money, set up your lab, get the staff, jump through all the hoops to keep things going while the discoveries are being made and then come back and tell us how good you are. I've been doing it for 20 years, I really don't need to hear anymore.
It is absurd that I can get more done faster in Singapore and China than I can here.
Well I'm waiting and I have been waiting for a long time to see this. My lab and many others like me have trained a lot of folks from these countries. Oh wait that's right many forgot to go back. What are you going to do deport them?
Us is burning way to much fuel on the medical research rising.What you need is a "head", not some ass executives.
Us research, despite huge investments, is not producing alot more in medical field compared to other countries.Why? Because of lack of common sense and trust.You will be suprised how many deseases still have no reasonable cure and how many drugs are trash,despite huge investments.
Somebody was right, pharmaceutical companies invest more in nice looking recepients, but most of the drugs on the market are dust in the wind with more side effects than cure power.
Good luck and I wish you a healty life, 'cause cancer still kill the same amount of people today like it did yesterday.I bet if you cut the research in Us to 0 funding, not much difference will be noticed.Ahaha
A proud taxpayer