It's actually personal

I don't write very much about my own research here (maybe I should), but for anyone who hasn't figured it out yet I do health services research. (Check out "some guy's faculty page" on the sidebar if you want more info.) I like to tell myself that the work I do has value, that it can make the world better, and that it's worth spending a few bucks on.

If that is true, the federal government is doing you a favor by taking a little tiny bit of your tax dollar and using it to support the work of me and my colleagues. That follows because there just isn't any other evident source of funding for it. There's no obvious relationship to profit for any investors. We're producing knowledge which is pretty much entirely a public good. I have produced some products which could in principle be patented, such as software and analytic methods, but the only demand for them would be from other researchers who are also dependent on federal funding.

Oh yeah, there is an itsy bitsy teeny weeny amount of foundation funding for medical research. Once in a while the Robert Wood Johnson Foundation or the Commonwealth Fund comes up with money for the kinds of things I do, but it's a trivial fraction of the federal funding. Drug companies also drop a little bit of loose change on health services research if they think it might end up boosting sales -- for example they have an interest in promoting adherence to prescriptions, i.e. that people actually fill their prescriptions and keep doing so. But I'm more interested in seeing to it that people are treated appropriately, which could just as easily mean taking fewer pills as taking more.

Basically, without the National Institutes of Health, the enterprise of which I am a part -- the biomedical, public health and health services research at the nation's schools of medicine and public health -- is doomed. It will collapse. Current doctoral students and post-docs will never get jobs. Most current faculty will lose the jobs they have, along with their research assistants. Laboratories will go dark and gather dust. Advances in health related knowledge, understanding of ourselves, and the prevention, cure and palliation of disease will largely end.

At this moment, I am anticipating a grant award, for a project I have been developing for many years. If all goes well, I should get the notice sometime next month. This will be a decisive moment in my scholarly career, the chance for me to set out on the road to solving the important problems in the provision of health care that motivated me to enter this profession; the chance to accomplish something substantial for the benefit of people who live with chronic diseases.

Unless . . .