Banner
    Dr. Evil As Spokesman For Neuroscience: You'll Pay $1 Trillion In Health Care Costs Unless...
    By Hank Campbell | January 31st 2013 11:26 AM | 18 comments | Print | E-mail | Track Comments
    About Hank

    I'm the founder of Science 2.0® and co-author of "Science Left Behind".

    A wise man once said Darwin had the greatest idea anyone...

    View Hank's Profile

    In the United States, billions of dollars have been spent on marketing to convince people to go into science careers, despite the difficulty many PhDs will have finding jobs in academia. That, coupled with the fact that efforts are on to make funding more 'equal' and establish quotas for young researchers, minorities and female grant applicants means a finite funding pool could be even more limited. The best and brightest, regardless of demographics, could end up leaving to other countries where science is more of a meritocracy.

    Despite that, the BrightFocus Foundation says more federal funding is the answer, rather than common sense funding for the best research.  They cite as evidence their survey of over 170 biomedical scientists who got funding from them, which implied that more funding would cure diseases like Alzheimer's, macular degeneration, and glaucoma. Welcome to The War On Cancer circa 1971.


    It's no surprise, really. Insiders advocate their own research or they wouldn't be in the field, so 94% agreeing that a lack of federal funding for brain and eye disease research is impeding scientific discoveries is no shock. I also have never met anyone in the corporate world who felt like they were overpaid or that their jobs were not vital to the company - even union janitors at General Motors make $50 an hour with salary and benefits and they want that to go up.

    But why this modern fetish with federal funding?  In the recent generation of academic researchers, scientists - historically overwhelmingly distrustful of government - now regard government as the ultimate credibility. Over 50% of science is now under government control, despite the fact that private sector basic research has led to most of the biomedical breakthroughs of the last century. Biomedical research is the only area the government has not taken over yet - academia moves too slow, companies say - but increased regulations have created a climate where few companies can survive to a stage III clinical trial because venture capitalists see government interference as a blockade that is only going to get worse. They also regard the lawsuits by lawyers for every new product once it is on the market as a financial pincer. Culturally, academics have declared open war on the entire field, alleging that many papers published by corporate research groups are unethical, without presenting an alternate solution for drug discovery.

    91% agreed that a lack of research funding is driving scientists from the field - which is also a little myopic in its conclusion.  Are that many neuroscientists waiting tables in restaurants?  The problem is we have too many researchers and advocates want to add more and then fund them with taxpayer money. That isn't really achievable. What is achievable is that the best researchers can be federally funded. Science is a meritocracy, the best researchers win.  The others simply get jobs in that icky corporate world. Post-doc incomes are low because there are already too many PhDs trying to stay in college.

    96 percent said limited funding was the top barrier to entry for new scientists in the fields of brain and eye disease research.  Again, nothing will solve this problem. Every special interest claims it does not have enough funding so 96% of brain researchers are in favor of, what, unlimited funding?  Well, aren't we all?  The fact is that there is no barrier to entry for people who really want to do it - we have a modern problem where both government and universities instead insist they are 'competing with the private sector for the best people'.  Academia used to be an occupation for people who loved research and did not care about money. With the advent of unlimited student loans and Pres. George Bush and Republicans doubling funding for the NIH and substantially raising science funding across the board, salaries ballooned.  But unlimited student loans are going to end and federal funding is not going to double again either. We can't do anything about the generation in academia that has 6-figure salaries and expect raises while they sit in foreign jails(1) but young researchers of the future are going to be doing research for love of research, just like their ancestors did.

    Guy Eakin, Ph.D., vice president of Scientific Affairs for BrightFocus Foundation, said in his statement,"The total U.S. health care cost for Alzheimer's alone is $200 billion annually and is expected to soar to $1.1 trillion per year by 2050 if we don't have the scientific discoveries made possible by research funding. Yet budget cuts for research continue, and we're losing the talents of a generation of scientists."



    Does that number sound real?  Expected by who? How? It seems a lot like that number record companies use to complain about music piracy, or that 'jobs saved or gained' employment figured pulled out of thin air by the government in 2009.  When you read something like "expected to soar to $1.1 trillion per year by 2050 if we don't have the scientific discoveries made possible by research funding", it is wise to reach for your wallet.

    NOTE:

    (1) And that six-figure salary he gets is 18th out of 28 - just in his one department.  Just at his one school. Academia is very much no longer toiling away by poor scholars.


    Comments

    John Hasenkam
    To be my usual iconoclastic self I suggest that the problem is not enough research but too much poor and replicated research. I now this is anathema to most scientists but perhaps it is time to think about how identifying those fields of endeavour where we can choose to focus our research interests in a more intense manner. (The bods could still chase their hobby horses, allow a small percentage for research of a "personal interest".) To in effect create a research program where our efforts are directed down specific pathways of investigation instead of going hither and thither all over the field. 
    There is now a wealth of evidence that pathological progression of dementias typically precedes symptom presentation by decades. A person can lose up to 80% of the neurons in the substantia nigra before they present with symptoms of Parkinson's Disease. One reason Big Pharma is walking away from dementia research could be that by the time of symptom presentation too many vicious cycles of degeneration have been set in play and trying to reverse those involves physiological processes that if targeted will create so many other problems as to make the intervention useless. It is easy to forget that physiological processes are not walled off from each other, that the perturbation of one process often involves problems with other processes. That, at least at present, creates very serious and often insurmountable problems. 

    By way of comparison consider the words of David Baltimore, a leading biologist involved in cancer research:
    "In my view," he said, "cancer is a problem that will be part of human life for a long time, if not forever ... and I expect that therapy will be slow to come. Even when new therapeutics schemes come, the plasticity of tumor cells will make it very difficult to effect total cures. For those who hope for rapid progress, this is clearly a pessimistic view." But, disturbed by his own pessimism, he concluded, "But results will come, and we, as a nation, must maintain our commitment to finding everything we can about the disease and to try in every way possible to prevent or cure it. There is, of course, the real possibility that my whole analysis is wrong and that there lie out there magic bullets that will make a huge impact on cancer mortality rates in a relatively short time. To have judged so completely wrong would give me great pleasure."
    Ahead of the Curve: David Baltimore's Life in Science, Shane Grotty

    That is not to say we should give up entirely but seeking dementia cures at this point in time is somewhat premature. In dementia research a more realistic goal is to identify the prodromal markers and seek therapies at that point in time, even in the 40-50 age ranges. We cannot cure AIDS but have achieved tremendous progress in limiting progression of the disease. Transhumanists believe all sorts of cures are possible but that's just wishful thinking. We're all gonna die, get over it. 

    Corporate driven research certainly has its problems, especially in relation to psychiatric conditions. Far too much bullshit there and not enough prosecutions for the dodgy research and pushing of drugs for off label purposes. However recent prosecutions with huge fines(GSK) should prove a big wake up call to the rest.  

    Australia does extremely well in biomedical research but with very limited funding. If you limit funding perhaps only the really determined, those driven by passion to solve the problem will enter the field and put their heart and soul into their work, rather than those driven by salaries and career maintenance. It is a common feature of creative endeavours, be it artistic or scientific, that the success comes with tremendous dedication and resolve, not necessarily a huge budget and a very high iq. Here's one eg. The Aussie doctor who is credited with the cochlear ear implant said he was driven to do this because his father was a chemist but very deaf and would embarrass his customers because they would have to yell at him about their medical conditions.The doctor was inspired by that experience and developed a truly wonderful biomedical breakthrough. We ignore the power of passion and fail to appreciate that is often just as important as budgets and salaries; if often not more important. 

    BTW Hank, in Australia our publicly funded research institutions have done tremendous work. High salaries and big budgets do not equal high motivation, no matter what CEOs might think. It can make a person too comfortable. Now please excuse me, I must prepare my argument for a pay rise. :)



    We appreciate your taking the time to cover this topic. The issue of federal vs. private or state funding boils down to an issue of who is willing to pay for basic science research. In the life sciences, the NIH is the largest supporter of medical research worldwide. Cuts to its budget are irreplaceable since even single percentage points remove hundreds of millions of dollars from the research community. NIH is also irreplaceable in its support for earliest stage research. Fundamental inquiries, with high risk and 15 year turn around on profit, are simply not the interest of for-profit research. Yet, that research is essential for corporate successes and, consequently, our economy. We are certainly not alone in that assertion (1).

    You questioned the origin of the $1.1 trillion per year number, which we had not sourced. It is a widely used estimation developed by the Lewin Group and the Alzheimer’s Association, and is referenced in the National Alzheimer’s Project Act. The data is drawn from the Medicare Current Beneficiary Survey. The methodology is described in the referenced pdf (2). There are certainly more recent, peer-reviewed, discussions of the topic, e.g, (3). While it is quite simple to argue the specifics of any long-range projection, the trends are hard to ignore.

    We can acknowledge limitations of attitudinal surveys, but the real message is that a growing percentage of our population are affected by Alzheimer’s disease, macular degeneration, and glaucoma. Supporting the best science is essential. Science is, as you correctly point out, a meritocracy - and we should expect the poorest trainees and scientists to not make the cut. We agree. But expanding the effort is an equally important response to human and fiscal costs of illness.

    1. http://www.researchamerica.org/app/webroot/uploads/EconomicImpactofResea...
    2. http://www.alz.org/documents_custom/trajectory_appendix_a.pdf
    3. http://www.ncbi.nlm.nih.gov/pubmed/23305821
    For simplicity, items 1 and 2 are compendia, but reference specific sources.

    UvaE
    even union janitors at General Motors make $50 an hour with salary and benefits and they want that to go up.


    Pretty good-- that's $3 more per hour than I make, but if unemployed PhDs are working as janitors, I 'll let it slide.....:)


    Does that number sound real?  Expected by who? How?
    If you assume a 2% annual increase due to inflation , and assuming the present $200 billion figure to be accurate, it would cost $416 billion in 2050 dollars to treat an equal number of Alzheimer patients. Now of course there will be more afflicted, but how many more?



    According to this source:


    By 2050, the number of people age 65 and older
    with Alzheimer’s disease may triple, from 5.2 million
    to a projected 11 million to 16 million, barring the
    development of medical breakthroughs to prevent,
    slow or stop the disease.(47), A11

    So there you have it. The 1.1 trillion dollar figure is based on the upper range of a prediction but deceivingly presented as fact and without mentioning inflation.


    Hank
    The problem with every projection like this is that if we add up all of the projections from all of the advocacy groups for all of the different things, the cost is far more than the GNP of the world in 2200 AD and the impact is on 2X as many people as will ever even have been born.

    No one trusts projections because groups don't want to make honest ones, they want to make an impact.  It is why the public doesn't trust anyone in science these days.
    Gerhard Adam
    The comment about janitors making $50/hour is a bit misleading without separating out what is paid in benefits versus actual salary.  If that's only $3/hour more than you make, then you're coming out ahead.  The $50 number includes the healthcare, retirement, etc. benefits that GM pays so it isn't part of the salary.  In addition, it is equally important to take such average numbers and assess how much of it is in paid overtime.

    The fact is that no janitor at General Motors or anywhere else is grossing $100K per year.
    Mundus vult decipi
    Hank
    Separating out the actual cost of a worker, that a company has to pay in a contract, and saying it does not count because that is not the final paycheck, would explain why American business is in the toilet - employees think benefits are magic. The minute one of these janitors had to pay actual health insurance cost, you can bet it would be factored into what they make from then on.
    Gerhard Adam
    I didn't say it doesn't count, I said it's misleading.  I'll be willing to bet that Enrico's comment didn't count the cost of his benefits.  I'll also suggest that the overwhelming majority of people don't have any idea of what costs their companies carry for them in benefits and would never consider claiming it as part of their income.

    So, unless people are willing to talk total cost when comparing income, I stand by my comment that the $50/hr claim is misleading.
    Mundus vult decipi
    UvaE
     I'll be willing to bet that Enrico's comment didn't count the cost of his benefits. 
    You're right. My figure excludes benefits, but we have to pay our own salary insurance and for medical insurance not covered by medicare and for 50% of our pension. So between our high tax rates and those additional deductions, I never see 40% of what I quoted.

    Of course part of the 40% of other people's pay checks is what pays my salary in the first place. So i should not really complain! The rate is also high due to medicare and other social services. The former is very good, if you live in a small city. Otherwise, as I've pointed out previously, all hospitals in Montreal are overcrowded and have long waiting lists for basic tests and surgeries. 
    Relative to the U.S., the main advantage of raising a family in Quebec is the "low cost" of quality university education. In essence, the government is footing the bill, but it gives many lower income families a chance to send their kids to college. My dad was a tailor and could easily have paid for my two degrees, but it was so cheap that I paid for most of it with what I earned during summer jobs.
    It's gotten a little more expensive now, but we have Registered Education Savings Plan, where the federal government will give you a 20% bonus annually (maximum $400 per child) for any money we set aside. It can then be invested tax-free until the child attends college. 
    Gerhard Adam
    I understand, especially when there are differences in the way various programs are implemented in different countries.  My point though, is that unless everyone is talking about the "fully loaded" costs, then it is misleading to quote one against the other, unless adjustments are made to ensure that a comparable comparison is taking place.

    BTW, I'm not arguing that the GM workers are under-paid, nor over-paid.  This is often where there is much confusion, because whatever one company does regarding benefits, does NOT translate into a typical wage.  As a result, you have some companies that skimp on benefits, while others are lavish.  Yet, the base salary for the position may be quite similar. 

    So, presumably, unless someone is holding the CEO hostage, the benefits and terms provided by any corporation to a union, were freely negotiated.  I find it ironic, that unions are so often frowned upon by the same individuals that believe in a free market, and yet when it is actually practiced, then it's a negative event.
    Mundus vult decipi
    UvaE
    So, presumably, unless someone is holding the CEO hostage, the benefits and terms provided by any corporation to a union, were freely negotiated.  I find it ironic, that unions are so often frowned upon by the same individuals that believe in a free market, and yet when it is actually practiced, then it's a negative event.
    For the sake of the average worker, there has to be a sane situation in between having no unions at all and one where they are so big that they strike a strong resemblance to the corporations they are dealing with.

    Hank
    My statement, which remains correct, was "even union janitors at General Motors make $50 an hour with salary and benefits" - and they would like it to go up.  As I said, and has been lost, no one thinks they are overpaid.

    So researchers in academia getting funding from an organization are obviously going to list the need for more funding. They do not feel over-funded and would like their compensation packages to go up. 
    UvaE
    So researchers in academia getting funding from an organization are obviously going to list the need for more funding. They do not feel over-funded and would like their compensation packages to go up. 
    It's just another example of an organization getting too big and then becoming self-serving. As you said, 
    the problem is we have too many researchers and advocates want to add more and then fund them with taxpayer money. That isn't really achievable. What is achievable is that the best researchers can be federally funded.
    Gerhard Adam
    ... there has to be a sane situation in between having no unions at all and one where they are so big that they strike a strong resemblance to the corporations they are dealing with.
    That's the insanity of it.  There can't be.  Unless you have the same level of power, financial or otherwise, you will have no influence.  How can workers possibly negotiate, without a powerful union, when many governments are afraid to negotiate with these companies?

    That's precisely why most boycotts are simply gestures that have little impact.  Unless and until a sufficient number of individuals is involved, most companies can readily weather such upsets.

    That's why unions have to become so large.  It can certainly render them counter-productive, but no more so than the same corporations that abused their workers giving rise to unions in the first place.  Hard to say which is worse, although I expect that whatever side of the negotiating table one sits on will be a factor.
    Mundus vult decipi
    MikeCrow
    Let me note that for the most part, every company I've worked for has treated me fairly. I've had better than average pay, good benefits, company participation in my 401k, stock discount purchase plans, and equity in the business itself, one of which turned out to be quite valuable.

    The point is that you get compensated for your worth to a business. It's a business it has to make a profit most years, a manager of billions in equity needs to be paid at least enough for the majority to not steal from the pot (and there are still a lot that do, hopefully getting caught and send to prison for it). And if it's your equity that started the business you should make a rate that's more than simple interest, otherwise why risk your money while having to work 24x7 to make 5%?

    The argument that most profits need to be shared by the employees, IMO doesn't hold water. They should get a fair wage for their value to the business, which includes getting more if there aren't enough people wanting (or skilled for) that particular job. But, if you're getting a lot more than your value, you have a target on your back, so if you want to make more, increase your worth.
    Never is a long time.
    Gerhard Adam
    That may occur, it may not.  I also know that the problem doesn't simply exist with corporations, but any time someone has the backing of the government to hold people as financial hostages.
    The point is that you get compensated for your worth to a business.
    That's not really true, but then I'm not arguing about compensation.  However, the true issue of compensation is a function of supply and demand, as well as what the market will bear.  I don't have a quarrel with that.  What I do have a quarrel with is when government enables businesses to circumvent the supply/demand equation simply so that they can avoid having to pay what the market demands.  It's like the nonsense about illegal immigrants doing jobs that "no American wants to do".  That's rubbish, of course, the real reason is that no American will do the job for the paltry wages and conditions that the growers want to pay.  So, the illegal immigrants argument is nothing more than an objective that allows others to come into the country so that they can be exploited to work for a wage that no one else would.

    BTW, I've always been curious as to why CEO's that manage to destroy companies still manage to get compensated for way more then they are worth.  Why is the "value" standard only ever applied to regular employees?
    The argument that most profits need to be shared by the employees, IMO doesn't hold water.
    Again, I don't know where this is coming from, but I agree that profit-sharing isn't a valid complaint.

    The point with unions is that every contract is agreed to by the company's management.  So, they can't complain.  If the point is that the union exerts unfair leverage in getting concessions ... well, they're all big boys, and if they can't or don't know how to negotiate, then perhaps they shouldn't be earning the salaries they're getting. 

    The fact is that many businesses made agreements [pensions, etc.] and then renege on them because of their own bad management practices.  Yet, those same companies would do everything in their power to squeeze every last penny from you, if you had an agreement with them and had to renege on payments.  That's what I mean by the double standard.  They get government protections, you get nothing.  For example, if I'm late on a payment to a company, they get to charge late charges, etc.  On the other hand if that same company is late on payments to me, they act is if I should be happy that I got paid at all.  Why?  Because they know they can outlast me in court and I have no means to compel them.  That's why dealing with some of the largest corporations invariably turns into an adventure where a 30-day-net usually ends up being 120-day-net.


    Mundus vult decipi
    MikeCrow
    For the most part I don't really have an issue with any of this. Let me address a couple things though.

    What I do have a quarrel with is when government enables businesses to circumvent the supply/demand equation simply so that they can avoid having to pay what the market demands.

    Fair enough, and
    The point with unions is that every contract is agreed to by the company's management.
    I see what the government does and what the Union does as two sides to the same coin. You're right the Co signs the Union contract, but they do so by force, much like the Gov forces certain behaviors.

    BTW, I've always been curious as to why CEO's that manage to destroy companies still manage to get compensated for way more then they are worth. 

    Most CEO's get a large portion of their compensation through stocks, and if they tank the company, their stocks are worth much less. As for their contracts, I'm not sure they more companies don't litigate to get them revoked, but they probably feel like it's cheaper no to.

    Why is the "value" standard only ever applied to regular employees?

    I don't think that's true, but there is a big difference in magnitude of compensation, I agree.

    The fact is that many businesses made agreements [pensions, etc.] and then renege on them because of their own bad management practices.  Yet, those same companies would do everything in their power to squeeze every last penny from you, if you had an agreement with them and had to renege on payments.  That's what I mean by the double standard.  They get government protections, you get nothing.  For example, if I'm late on a payment to a company, they get to charge late charges, etc.  On the other hand if that same company is late on payments to me, they act is if I should be happy that I got paid at all.  Why?  Because they know they can outlast me in court and I have no means to compel them.  That's why dealing with some of the largest corporations invariably turns into an adventure where a 30-day-net usually ends up being 120-day-net.

    Having been a contract consultant for a while, and experiencing some of the draconian financial deals, I agree.
    Never is a long time.
    Gerhard Adam
    You're right the Co signs the Union contract, but they do so by force, much like the Gov forces certain behaviors.
    Well, in any kind of a power struggle, someone is going to perceive being "forced".  Unfortunately, I still view this as a problem of the company's own making.  If there was a better sense of fairness and equity, there would be less need for these kinds of measures.  So for me, the union protecting the undeserving employee is little different than corporations paying million dollar bonuses and rewards for under-performing CEO's.  In either case, someone that doesn't deserve the reward is still getting it.
    As for their contracts, I'm not sure they more companies don't litigate to get them revoked, but they probably feel like it's cheaper no to.
    That's part of the disconnect.  Corporations don't seem to have any problem violating all kinds of contracts when it involves customers or employees.  Yet they suddenly become coy when it comes to corporate officers.

    CEO positions should have the same kind of probationary period that employees have.  Unless the CEO has a demonstrated track record of doing well for the company they're supposed to be running, there should be no contract in place.  Furthermore, any losses they incur, should come out of their compensation packages, especially bonuses.  In reviewing CEO performance, the business environment is filled with stories about CEO's that were disasters for the companies they were running, so why did they walk away with millions? 

    You may be right regarding the lawsuit issue, but again, this demonstrate that companies aren't very conscientious about their image or the message they are sending when they allow this kind of disparity in behaviors.  A classic case in point is the Akers saga at IBM.  Any employee that was as incompetent in their position would have been terminated.  Yet, he could almost single-handedly destroy one of the largest corporations on the planet and walk away unscathed. 

    Mundus vult decipi
    John Hasenkam
     In dementia research a more realistic goal is to identify the prodromal markers and seek therapies at that point in time, even in the 40-50 age ranges.
    I wrote the above a week ago. Today I read below.

    "The scientific community and the FDA believe that it is critical to identify and study patients with very early Alzheimer's disease before there is too much irreversible injury to the brain. It is in this population that most researchers believe that new drugs have the best chance of providing meaningful benefit to patients."
    A most sensible approach. :)