Should taxpayers be forced to fund medical research?  Should taxpayers be forced to fund any research at all?  The academic researcher would say (and has said), “if government doesn’t fund this who will?”  As more and more people are “looking behind the curtain” and finding that national bankruptcy is actually possible and budget cuts are unavoidable, brace yourself for the whining and gnashing of teeth from those who have been gorging themselves at the medical research trough.  See my 1995 letter here.  This comes up from time to time because honest physicians periodically scratch their heads after reading an article in a medical journal and wonder,”So? So What? What relevance does that piece of research (funded by a government grant) have to my practice….or to anything for that matter?”  It seems that lately, the shame associated with frivolous research done as a manifestation of expert grant-writing with little or no purpose at all, is gone.  Academic research departments have expensive labs and staffs and increasingly their eyes are on the next government grant, not on any particularly useful discovery.  Currently, some research department revenues support the academic clinical practice (taking care of patients) while in the past it was the other way around.  Common sense, huh?  If the government pays more for research than for taking care of patients, well, you get more research, right?  I guess my point here is that without the market driving research we are more likely to get research for the sake of research rather than research geared toward results.  I include private charitable foundations in the term “market” because the funds are not confiscated from taxpayers and thus are not politicized.

The politicization of research, an unavoidable result of government funding, has consequences.  Lobby’s and lobbyists spring up with pressure groups.  Politicians are painted as demons unless they “care” enough about this or that disease to “fund” research.  Diseases without lobbies go to the bottom of the list.  The search for a cure for this or that disease is a long process, but almost guaranteed to last forever if discovery of a cure ends your federal funding!  Ayn Rand’s “State Science Institute” actually lives!

Here is one way  it might go:  a drug company makes large donations to the political campaign of one of the derelicts in Washington.  He leans on members of a committee in charge of funding some government grant-giver to award a lab (at an academic institution also benefitting from the largesse of this same drug company).  That academic lab does a study (and is paid nicely for this) that determines that this or that new drug (made by the above drug company) is indeed safe and effective.  What?  You think that this doesn’t happen?

How much more research money would the global warming guys get if they determined that the data showed that the earth’s temperature hadn’t significantly changed?  Maybe that’s why researchers at the East Anglia Climate Research Unit withheld data that led to this very conclusion.  See here.

Taking the market out of the research process has consequences just like taking the market out of anything.  There are mal-investments and distortions.  Research is done in one area that could (or should) have been done in another.  Failure to make discoveries is often rewarded with even larger grants.  I am anxious for this distortion to end and await the end-of-the-world arguments and whining from those cut off from this funding when it does end.

G. Keith Smith, M.D.