“Unsustainable” Medical Research Racket

This past March, the prestigious Proceedings of the National Academy of Sciences ran a heated editorial warning about the looming collapse of the entire medical research system.

And I say…bring it on. We might be mostly better off without it, such as it is.

Truth be told, what does the average American citizen really have to lose from the collapse of this research racket? It has produced nothing new for breast cancer prevention over the last 30 years (as we explained yesterday). And nothing new for the treatment of lung cancer, still the No. 1 cancer killer in America.

Really–when you think about it–do really we have any truly useful new therapeutic discoveries or cures at all in the past 30 years?

We might actually save some tax dollars and reduce our national deficit if the whole system collapses. Or maybe we’ll return some money to those taxpayers who would like to keep more of their own income to look after their own health, naturally.

Now, I’m really dreaming, I suppose.

Men like Dr. Harold Varmus will keep working to never let that happen.

He contributed to the Proceedings of the National Academy of Sciences (PNAS) editorial warning about the dire state of medical research in this country. Varmus was a former Director the National Institutes of Health (NIH). Then, he went on to serve as Director of the Memorial Sloan Kettering Cancer Institute. And now, he’s back as Director of the National Cancer Institute (NCI).

I read a searing and insightful comment about Varmus on one of the better-known science websites that said:

“You cannot have it both ways…Harold Varmus traded in his scientific credentials to be Hillary Clinton’s lackey and so the federal government opened the funding floodgates for more biomedical research…even though academia has still not proven its ability to invent, let alone develop, new therapies. We are stuck with a system where the only thing that matters is grant funding–and so research directions are held hostage by the prejudices of the heads of the NIH.”

You can bet that thousands of government science bureaucrats at the NIH and the NCI put “cure cancer” somewhere in their top-10 of their “to-do list.”

But you can also bet, for nine out of 10 of them, on nine out of 10 days, curing cancer comes nowhere near the top of that list.

Instead, they focus on accelerating their next guaranteed pay raise. They focus on making sure to use their wealth of guaranteed vacation and sick days. They research ways to get their next taxpayer-funded trip to an exotic location for a “professional meeting.” And they damn well make sure they figure out how to retire sooner from their “service” with full pay and benefits, often to get a cushy job in big pharma and become a “double-dipper.”

Besides, if they ever did cure cancer, then all these tax-funded benefits would (or should) come to a crashing halt to help with the national deficit.

I can say all these things because I worked at the NIH and the NCI. I saw the all the sloth and greed up close and personal. After I left the government, I spent some time working with and in academia, where I hoped they aimed for higher standards.

And yes, as a cancer researcher at an ivory tower medical center, your mindset is intellectually and ethically higher.

But new concerns supplant the sense of mission.

Including worries about how you’ll get your next research grant funded. Worries about how to get your share of underpaid, exploited graduate students and research fellows to perform the daily tedium of the research lab. (At bare-minimum wage, or even as volunteer labor for nothing). You also have to haggle for your share of lab space. And figure out how to reduce the amount of time you have to “waste” teaching medical students.

My father worked in the aviation and aerospace industry, which is familiar with confined spaces. He couldn’t believe it when I used to tell him that I found Nobel laureates at the Hospital of the University of Pennsylvania working in offices the size of a broom closet–all for the chance to be there and stay there. I eventually got a chance to occupy an office like that myself at Thomas Jefferson University Hospital where I (and our patients and visitors) had to navigate a dark hall crowded with hospital gurneys to get there.

Without a doubt, the entire, dysfunctional medical research racket has misplaced priorities. And following the real science ranks near the bottom of the to-do list.

The authors of the new PNAS editorial warn that the entire U.S. biomedical research system “is on an unsustainable path.” They say we have fundamental problems with how we organize, staff and fund academic research. For example, there are too many trainees and highly trained research assistants. (Who can pass up all that nearly free labor clocked in at 100-hours per week?) Yet, there aren’t enough full-time academic research positions. And there isn’t nearly enough funding for all the positions across the board.

Of course, more money isn’t always the answer.

My friends Senators Mark Hatfield (R-OR), the late Arlen Specter (R/D-PA), and Tom Harkin (D-IA) worked for years to double the NIH’s budget over 10 years on a truly bipartisan basis (Arlen even served in both parties!). They optimistically believed it would lead to better health for the American people. These men were truly dedicated public servants who worked with the reality of Washington politics.

But I cautioned them at Congressional hearings in the late 1990s that giving the NIH even more money for the same old research ideas and approaches was not a wise investment. (Remember that old saying about one definition of insanity? It’s doing the same thing over and over again, and expecting different results.)

Today, the NIH and NCI have more power and funding than ever. I compare them to the “Mandarins of Medicine” who advised the Empress Dowager on how to run the declining Manchu Empire. Of course, the Empress followed their advice, which led to the eventual demise of the empire.

Today’s Mandarins of Medicine are the heads of the NIH and NCI, and their grant co-dependents in academia. As to the Empress Dowager, I leave it your imagination.

Sources:

  1. “Rescuing US biomedical research from its systemic flaws,” Proceedings of the National Academy of Sciences April 22, 2014; 111(16): 5,773–5,777
  1. “U.S. Biomedical Research ‘Unsustainable,’ Prominent Researchers Warn,” Science (www.sciencemag.org) 4/14/2014

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