A: The $30 billion or so we spend a year on research feeds a $500 billion dollar industry that's turning rapidly into a trillion dollar industry. The products of basic biomedical research make the American people huge amounts of money, but the stage funded by the federal government is difficult for any individual company to do. Trying to make the companies pay for it will be very complicated and will have problematic consequences for free competition further up the researSo, you can think of it as infrastructure spending to support capitalism and commerce.
B: Improving healthcare isn't just about improving how long you live, but how well you live. What's an extra 10 years of life worth? What's living healthier over 20, 30, 40, 50 years worth? How do we judge that as a society? How do you judge that for your familThis is a value question that people have to make for themselves, but if you look at the financial choices made by families with critically ill patients, look at their demands, and look at the general level of support for eg, cancer research in society, you have the answer. An overwhelming proportion of society support spending common resources to improve medical treatment.
C: Going a bit further on the value of time, families of critically ill patients today are typically willing to spend a substantial portion if not all of their savings on medical treatment. They do this, today, for cancer treatments that extend life for 6 months. Given this is the case, does it not make sense to spend a small percentage of resources on improving the outcome purchased from that outlay?
D: Disease doesn't stand still. The needs of society doesn't stand still. We constantly need to find new ways to fight infectious diseases that are actively evolving adaptations to our treatments. As our population age, we also need to find ways to make them more productive longer. This requires constant investment. In a $17 trillion dollar economy, how many fold over would our $30 billion investment in biomedical research pay for itself if it could keep our population healthy and working for 10 years longer?
E: What's the point of anything? What's the point of life? If you are not spending money on improving the quality of life, what's a more worthwhile product? More stuff? Numbers on a spreadsheet?
Now, of course there's a limit to all these arguments. We cannot spend ourselves broke and destroy the economic future of our society. However, the $30 billion we spend on the NIH is no where close to making us broke, cutting it will not make a substantive dent against the real fiscal monsters threatening our future, instead it will limit a significant sector of economic growth and actually make us poorer. It will slow down medical solutions that the vast majority of the country want present as a safety net for when they or their loved ones fall ill. All the arrows point in one direction:
In a resource constrained environment, we should be spending significantly more on research, not less.
Other advanced nations are "advanced" partly because they can share in what we create. A number of the most dynamic ones actually spend much more, per capita, on research than we do, and they reap corresponding economic benefits: https://en.wikipedia.org/wiki/List_o...pment_spendingApparently not: other advanced nations spend less on R&D (and also less on all sorts of medical interventions and screening like MRIs or mammograms and a whole host of other things) and get comparable or superior results. With technology we currently have: anti-smoking efforts, anti-bacterial drug compliance, mold clean-up efforts, handing out inhalers for free...
They also get better health outcomes because they have different population mix, different mixture of socioeconomic conditions, and different social programs. For some countries, much of the spending that we account for in our health system they account separately for in their vast social welfare programs. Other countries have drastically clamped down on pay and other costs in their healthcare systems.
The Great Stagnation is in someways real and in other ways an illusion of accounting.I'm a tech skeptic and think we're stuck in the Great Stagnation: I'm inherently allergic to massive spending in Science (TM) because we think it's going to power through all of our problems. This isn't the Industrial Revolution anymore.
The first Industrial Revolution took place over the course of about 60 years. Over that period how much did people's lives really change? If you took someone from 1800, and made them go back to 1790, what would they notice?
Now try telling a millenial that they have to go back and live in 2007, or heck 2011. They would go into withdrawal. That tells us something right there.
Similarly, compare the car I can buy today for $25K to the one I could buy in 2007. Compare the TV I'm looking at today with the one back then. Compare my laptop, my phone. The things I use are distinctively better, but they are not really worth more.
What I'm getting at is that our society is changing in huge ways, but ones that economics isn't very good at measuring. That itself creates lots of problems in our society, which makes it feel like we are stagnating.
What's the alternative to powering through with science and technology. Suggesting that we should look for other solutions suggests that there are other solutions. If we look at history though, the alternatives do not seem very pleasant at all. Many are outright terrible to contemplate, and all too real.
Is the history of science and technology smooth? There are lull periods even in eras we recognize as revolutionary. There was a pause of about 50 years between the first and 2nd industrial revolutions. The Renaissance and the Enlightenment took place over the course of centuries. Even in the 20th century the decades of the 70s must have felt particularly stagnant to those who were experiencing its charms. Our society is actually changing faster. The reason why we don't think that's the case is that the past is vastly compressed in our perception relative to the present.
Are there revolutions on the horizon? The answer is absolutely.
The information revolution is on the cusp of breaking out into the physical world with the unleashing of AI and robotics. Ask yourself this: how much effort did it take and how many helpers did you need the last time you did some substantial repairs or remodeling on your house? Now, think about what you, by yourself, could have done, had you been able to control a robot like an extension of your hand, have it be able to move around your house, recognize the things that you are working with, be able to make it do what you want want it to do by simple commands, and be able to have heavy objects, carve, shape, paint things with far more precision and skill than you could?
Now imagine if you could put the same type of robots out in the middle of the desert, in the arctic, under the ocean, into outer space. What would it mean for construction? For exploration? For natural resource use and geopolitics? What would it mean for Canada, Alaska, Russia, Indonesia, Saudi Arabia if you can do massive construction projects in the Arctic, in the middle of the Arabian desert, on the floor of the Pacific with 90% of your human workers sitting in comfy offices in Anchorage, Montreal, Moscow, Riyah, or Jakarta? What would it mean for the average American homeowner if any contractor with a $100K robot can build your house in a week and paint the Sistine Chapels on your ceiling?
With the advances in computer vision, augmented reality, robotics, and power systems, those systems are coming surely as the tides.
What about biomedicine? Today we are developing such good technologies for characterizing biology that we can pull protein, DNA, and RNA out of individual cells and analyze them en mass, we are seeing molecular interactions between individual proteins in those cells, we are seeing the atomic details of how those proteins work with electron microscopes that can look at uncrystallizable proteins. We have CRISPR-Cas which allows people now to easily modify cells with pretty much any group of genes they want. We have computer programs now that can not only predict the shape of proteins with good accuracy (something we thought impossible just a few years ago), but design ones of your own from scratch. This year Kite Pharma just reported genetically engineered cells that likely cured lymphoma for many of the patients they tested them on:
What's next? How far away are we from cures for other cancers? On helping quadraplegics walk again? On helping people recover from vision loss? On preventing limb loss in diabetes? How much money will that be worth? And is that any less meaningful, than being able to ride the train out of your village?
Technological development has not stagnated. Instead it's continuing at an exponentially growing pace. The reason why it doesn't feel as revolutionary is that every advance is opening up even more space and directions for further growth. So whereas the minds of entire societies were fixed on particular directions of advance in the industrial age, today there are so many disparate directions that no one can fully perceive or understand the true magnitude of the progress, or how it will all fit together for the next leap.
We are sort of like cavemen coming into the modern age, looking at all the cars around us and say: Ha, look at that, 10,000 years and they are still using the wheel. Yes, the wheel is the same shape. We haven't changed it from its basic concept. The cavemen thought we'd change the wheel because the wheel was all he knew. What technology development did instead was incorporate the wheel as a basic component of things that cavemen could never have imagined.
That's a process that's constantly happening in science and technology. The things we know about, that we think have been revolutionary don't change. They just get incorporated into things that we can't yet imagine.