Healthcare was clearly not a priority during most of the Trump administration as they slowly eroded the Affordable Care Act and despite promises to the contrary, never provided a national alternative. “The Trump administration leaves a devastating health legacy far beyond COVID-19, according to a new study in The Lancet by 33 researchers, led by professors at Harvard Medical School and the University of California at San Francisco.
“The report finds that the Trump administration’s health policies resulted in 461,000 unnecessary U.S. deaths annually—in addition to 40% of America’s COVID-19 deaths thus far, plus 22,000 avoidable deaths annually from environmental policies.” Arianne Cohen, FastCompany.com, February 11th. We know that a lack of uniform worker healthcare, particularly given that the per capita cost of US healthcare is double the average paid by all the other developed nations, decreases efficiencies and has actually cost us jobs.
It is assumed that we outsource work in favor of cheap overseas labor, but we lost tons of auto manufacturing to Canada, where wage rates pretty much mirrored US rates, because the cost of US healthcare coverage added $1500-$2000 per average vehicle, while Canada provided that benefit to workers without a separate cost. The pandemic has reminded us how much worse American employment and productivity impact average workers when compared to the support systems, universal healthcare and safety nets routinely available in every other developed country on earth. As my February 12th blog, Calling COVID Cure Cash Co-Pays, illustrates, even those Americans with decent health insurance are not insulated from massive and often crippling co-pays and deductibles.
But there is another huge hole in American healthcare. Over the past few years, as federal scientific and medical research dollars became sacrificial lambs in the Trump administration’s efforts to slash corporate taxes and reduce government support, as well as direct federal research, for what were considered non-essential or secondary priorities, the onus of such research fell increasing on the private sector. And while some of that private support supported general and non-commercially directed university and foundation research, most research dollars, especially those conducted directly by private enterprise, had strings. One of the hidden strings is a desire from big pharma not to erase diseases from which they currently generate massive profits. Like diabetes. But there are other strings.
This string-tied privately funded research generally carries two primary directives: 1. Focus on a consumer base big enough to make the fruits of such research profitable and 2. Produce a marketable product within a three-to-five-year time span. For those suffering from ailments affecting particularly small cohorts, their only hope from this effort was an accidental spinoff benefit from bigger research.
For those medical niches that are too small to attract significant donors or funding from pharmas, there is no place to turn except governmental support. Grants from states and the federal government to foundations and universities, in addition to direct research within the National Institutes of Health, Centers for Disease Control, etc. and knowledge sharing with comparable institutions overseas, are essential. As this pandemic has proven beyond a shadow of a doubt, supporting such otherwise uneconomical research needs to be a national priority. For doubters, remember that research spins off unexpected benefits, so a solution to a small issue often becomes the answer to a bigger medical issue.
If our new President can move this this through a Congress with strong GOP resistance to this kind of government program, there is a Biden administration proposal aimed at precisely this arena. Health Advanced Research Projects Agency (HARPA). “Insulin, a hormone that turns sugar into energy, is notoriously expensive. Diabetics, which lack the hormone, can pay as much as $700 for five injection pens. But what if we could invent a more efficient supply chain that brought down the cost? Or better yet, what if we could create a market-ready technology that could reverse diabetes?
“As part of his first-100-days effort, President Biden’s administration is working to form a new agency that could change the face of healthcare: an Advanced Research Projects Agency for Health. This new agency would pay academics and private companies to develop innovative health products and services, mimicking the process of the Defense Advanced Research Projects Agency (DARPA), whose work helped create the internet. The goal would be to create a government engine that could help advance innovation into real-world products for healthcare that could solve persistent problems: high drug costs, lack of treatments for rare diseases, poor systems of care, and of course, pandemic preparedness.
“Biden has proposed spending a bold $300 billion on research and development over the next four years. It’s part of his plan to grow jobs in the U.S. Among the sectors he highlighted for investment were health, medicine, and biotechnology. It’s in this section of his vision that he proposes the development of an advanced research group for health.
“HARPA would join an existing roster of what is known as ‘research project agencies.’ There is DARPA, which operates under the Defense Department, and there is BARDA, the Biomedical Advanced Research and Development Authority (part of the Department of Health and Human Services). There is also ARPA-E, an agency created in 2007 to explore commercial innovation in the energy sector, which has led to incredible advances in new fuel types and battery technology. All these agencies contract with the private sector and academic institutions to work on cutting-edge research projects over a three- to five-year period. They all have multibillion-dollar budgets. On the campaign trail last year, Biden suggested that ARPA-H should have a $50 billion budget and live within the Department of Health and Human Services.” Ruth Reader writing for the February 12th FastCompany.com.
DARPA, the military equivalent, was created after the Soviet launch of the first space satellite, Sputnik, in 1957. Is the pandemic a sufficient motivator for HARPA? I sure think so. It is also a job creator, able to create and keep the new jobs resulting from evolving patents right here in the United States. Why should we let China, Russia and even Europe fun research for industries that will create jobs for them… noting that we would be forcing Americans to buy their medical patents and resulting medications from their foreign sources? We can and we must remain competitive!
I’m Peter Dekom, and we have to remember that we built our massive economic power by innovation and research, enhanced with better educated workers, and that is a tried and true formula for our success.
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