Facebook and media hysteria regarding the repeal of Obamacare suggests that it will be patients who will be harmed (with death, for example). Medicine will continue to advance and physicians will continue to get paid well.
Facebook and media hysteria regarding the Trump Administration’s proposed funding cuts to various federal agencies suggests that science and scientists will be harmed.
Does this show what a crummy career science is compared to medicine? (see “Women in Science” for a comparison) Nobody says that doctors will be harmed if the federal cash river is interrupted or redirected. But if scientists can’t get their tax dollars they are apparently headed for the unemployment line. According to the hysterical, science is incredibly valuable yet there is apparently no foreign government or corporation that would want to hire a typical U.S. scientist.
Why should young people be encouraged to enter a field that is this vulnerable to the U.S. government not being able to find another $20 trillion to borrow?
doctor’s paying clients are individuals; doctors are OK as long as individuals have cash (or insurance)
scientists’ paying client is humanity. the best proxy for paying humanity is the paying government; scientists are OK as long as the government has cash.
chose who you want to serve and bear the consequences.
mishka: Exactly. Scientific research is indeed incredibly valuable, but paying for scientific research is a collective action problem, because the benefits are widely distributed. That’s why it’s largely funded by governments rather than businesses. And that does indeed make science vulnerable to political shifts. When politics is highly polarized, as it is in the US right now, choosing science as a career means taking on some big risks.
No one is attempting to interrupt the flow of money to doctors. Not in a serious way anyway. Single payer might do it, but how likely is that? MDs are reliable, significant campaign donors in every district. Scientists are not.
Supposedly the proposed NIH cuts are aimed at indirect costs. STAT news has a good summary:
https://www.statnews.com/2017/03/31/nih-indirect-costs-universities/
“A Nature investigation in 2014 found that universities negotiated reimbursement rates in the range of 20 percent of the total grant amount on the low end and 85 percent on the high end. Most rates fell between 50 and 60 percent.”
There are private universities that claim IDC rates of over 100% ! Presumably they don’t get reimbursed by NIH at those rates, but they try.
“The Gates Foundation, for instance, caps its reimbursement for indirect costs at 10 percent. Yet researchers still apply for those grants.”
Saw someone on Twitter mention that no one seems concerned about the IDC rates that defense contractors claim.
Maybe cap NIH IDC rates at 20% or so? And/Or require the state or (if a private university) the endowment to provide matching funds?
It’s now the dream of every unicorn startup to be centers of research that was formerly government funded rather than just product factories. Google, Facebook, & Uber are doing almost entirely what universities used to do & focusing very little on actually driving taxis.
Thanks @philg on keeping us informed that science is a terrible carrier opportunity. That’s what I recall from my misty past but it is good to know that something is constant in this world. However it is very hard to persuade new aspiring generation of scientists to act on someone’s past experience or present advise of people who are not Novel prize winners. This fact points to limitation of IQ testing as a general intelligence indicator tool Nevertheless, I want to note that NIH funding as percentage of federal budget has been steadily falling since after peaking in the middle of Bush II government and was reduced by sweet agreement between democrats, Obama administration and Boehner through automatic budget cuts for most of Obama presidency. NIH director was already upset through 2014 and duly emphasized political aspects of funding, apparently to no avail. https://www.usatoday.com/story/news/nation/2014/04/23/nih-budget-cuts/8056113/
Apparently by the end of Obama presidency NIH was providing about 30% of all US biomedical research funding. 20% of 30% is 6% of total. Apparently everyone is worried of reduced funding. To a layman it seems that 94% of funding is not affected. However every biomed researcher I heard about is running scared. Do I hear only of biomed research that has no value or does NIH funding leads to other funding sources?
Yes, science is a bad career unless one is independently walthy. I read your essay about women in science late in undergrad ~ 10 years ago and it has strongly influence she how I think about my career.,
Unrelated to the central topic of this post, how do you think science should be funded? Do you think government should privide funding?
With all that gets financed by federal government I think science should be last spending (except defense) considered for cuts. Sure way after highway bills are cut. We are paying state fuel taxes, local taxes and different types of transport authorities fees daily just support our highways and other means of transportation. When properly managed science investment has large new value creation potential unlike some highway/railway to nowhere.
A doctor is a scientist. If you like your plan you should be able to keep your plan. If you don’t like your plan you shouldn’t need to keep your plan.
If the plan you like is not available or affordable, it’s a self-solving problem – you just get sick and die. “No plan” is a very big part of the plan.
The studies keep coming in showing places with rudimentary single payer health plans have better outcomes than the USA approach. Why not provide such a plan and let wealthier people buy supplementary plans (it’s not insurance)?
Per this blog entry, science is a terrible carrier choice and thus there always will be studies providing outcome demanded by customer, especially when customer is a congressional Democrat or all too often now Republican who funds useless idle ‘research’ that gives science bad name. Major well known government provided health care systems are bad, certainly worth that we had here in the USA 7 years back. But I agree that many people would choose to die in the distant future to give 20% to 50% of their after-tax income to health insurance.
Those places don’t have better outcomes when adjusted for ethnicity and lifestyle. It’s the same or a little worse, but of course quite a bit cheaper.
the other Donald: Why not do what Europeans do? We do that when it comes to building public transit systems, for example, and it costs us at least 5X as much. In both the U.S. and, for example, Germany, that’s done via a “single-payer” system in which the government is the buyer. By the same logic, if Koreans and Taiwanese can build awesome electronics at competitive prices we should simply do what Koreans/Taiwanese do and then we wouldn’t have to import flat-screen TVs, integrated circuits, etc.
[See http://www.newyorker.com/magazine/2017/01/23/where-the-second-avenue-subway-went-wrong for some numbers]
Philg:
We can make integrated circuits https://en.wikipedia.org/wiki/List_of_semiconductor_fabrication_plants
and, most likely, cheaper transportation infrastructure. When we don’t, it’s probably a function of incentives. Who might want to make public transit systems more expensive? I’ll bet it wouldn’t be difficult to come up with a pretty long list.
Regarding health care: you can tell your Facebook friends they don’t need to worry. Despite controlling both the executive and legislative branches of the US government, the Republicans can’t agree with each other on what to do about health care. (Former Gawker editor Alex Pareene has a long rant talking about how the disconnect between right-wing media and reality has backfired on the Republican Party.)
Someone said it before, but it still amazes me that anyone who has been to department of motor vehicles driver license processing facility still considers single payer a viable option.
Dean: be amazed. I have been to my DMV 4 times in the last year. A new license, a replacement license for my son as well as his driving test. Each visit was quick and efficiently handled. I signed up via the web and they texted me when my appt time was nearing. If only Wells Fargo, AIG, and Blue Cross Blue Shield had such efficient business processes in place……
cliff,
was it on a date and time of you choosing fitting in your schedule? Or you had to come early on the dmv anointed day to be one of the faster served? Hope you did not feel guilty for being a cog in efficient DMV wheel.