America no longer exceptional

A long, sad essay in JAMA by Hamilton Moses and friends, which they are actually allowing you, the rabble, to read. In the interest of fiscal responsibility and the fundamental principle, as articulated by Jesus, that nothing government does is good, with the exception of  killing people and blowing stuff up, the U.S. is no longer globally dominant in biomedical research. Yes, we still do about half of it, but NIH funding has been declining steadily in real terms, by 13% since 2004. We'll keep on slipping behind. That also means, of course, that for people like me to get our proposals funded is becoming nearly impossible -- something like 3% of applications are now successful.

Industry has increased its share of research funding, but they obviously go after what's profitable, not what's necessarily most in the public interest. And no, despite what Jesus says, that is not the same thing. Industry is not investing in basic research, but in "me too" drugs that they can patent.

What is worse, from my selfish point of view, is that our investment in health services research is paltry. That's research to get the wonderful new science to actually benefit people, cost-effectively. It's only about 0.2% or 0.3% of national health expenditures, i.e. 1/20th of national research funding. This is very low compared with other industrial sectors, where managers know that technology doesn't implement itself.

Are we going to hear about this in the 2016 campaign, or will it be all about Benghazi and deregulating the banks? I know what I expect.