Nitpick: If you would like to rename your interstate, you’ll have to pick an even number - but since the even numbers are all taken in the Bay Area… Wait, all of the odds are taken, too; I-380 is the spur from I-280 to San Francisco International Airport.
But if you support my New Mississippi River Bridge, I might convince AASHTO to give you a whole new interstate to make loops and spurs from. Whaddya say?
Sam Stone, I agree some measure should be taken of a person’s ability to afford their own care, but the underlying issue you bring to my mind is this:
Is it fair that the elderly, who spent the bulk of their lives paying taxes, some of which went to fund some of the greatest medical research ever done in the world, should, once they reach an age where they are more likely to need the products of that research, be told, “Sorry, pal, you’re on your own! Lotsa luck…”
Well, this is the formula from the left (not sure if you’re a lefty, but it’s used by them a lot) that I just won’t accept. Don’t use tax money to fund medical research in the first place. Then the whole issue of giving seniors some benefit for funding it does not even exist.
But I agree wholehaeratedly with Raveman. When companies find they’re opperating in the red, the CEO calls everyone in and says “Alright. We’ve got a 10% across the the board reduction. Have your spending plans on my desk in a week and I’ll go over them. I want you all to cut 12% and then I’ll use my exeutive decision to tweak that so it’s an overall 10% cut.”.
Gov’t has no long term plan to reduce spending. In fact, there seems to be an implicit assumption that it will just grow and grow and grow.
And I won’t even get into the crazy accounting rules the gov’t uses. People throw around deficit numbers like their some scientific fact. Gov’t accounting is so out of whack with standard business accounting practices that I just can’t come to any real conclusions. I use the numbers to judge whether things are going up or down, but whether we actually operate in a surplus or deficit seems to be impossible to actually know.
I know I’ve said this before, and I’m sure most of the posters here will disagree, but frankly deficits don’t bother me all that much. As a practical matter, politicians have proven that they will always spend more money than the take in. So you’ll never balance the budget by raising taxes. The deficit is the price we have to pay to keep spending from growing more. It’s exaclty like the posted speed limit on the highways. If you want to keep people from driving faster than 75, you post the speed limit at 65.
Oops! I meant 305, not 380.
Yep. Looks like you just need to convince some people to put up some signs… Give your state legislators a call, too.
Not sure? (Sob) He hasn’t noticed! To set the record straight: Yes, I’m a lefty, but I’m a lefty who has learned the very important lessons that good solutions don’t come solely from the heart, but from the brain with the heart as an advisor, and that shame and guilt don’t count for anything.
There’s a lot of excellent medical research being done in this country, with a hell of a lot of funding from the government. Who will pay for it?
Here you start to remind me of Ross Perot’s television addresses, comparing the US to a business.
IMO, the government is not a business. the current business philosophy in this country is that a business exists to maximize return to its shareholders TODAY. Of course, a smart CEO will have a long term plan, but that is not the focus.
The government is not a business. The CEO does not have final say over the budget, for one thing. And the government needs to focus not only on today, but on the future. It’s right there in the Pre-amble:
“…secure the blessings of Liberty to ourselves ** and our posterity **…”
It’s not simply an investment vehicle, it’s a body that we create and maintain in the belief that our rights are better secured than if we did not have a government.
I think a great way to “promote the general Welfare” is to make it less likely that Grandma is dying of some preventable or curable disease just because she can’t afford adequate medicine.
And that impression is why neither the Dems nor the Pubs in recent years has done anything to shrink government, just steer the increasing cash flow to their pet projects. I think Cuomo put it best in 1984:
“We believe in only the government we need, but we belive in ALL the government we need.”
It matters less to me that the government grows or shrinks than whether it is acting in what I think are the country’s best interests.
Say it, sister! Testify!
Look at the summary tables on the budget link, and you’ll see that while there is a budget deficit, there is an “off-budget” surplus. What does this mean, other than that the government is taking in extra money it has no plans to spend on anything it’s willing to talk about? At least they post this fact publicly.
A certain amount of deficit doesn’t bother me either. Deficit means debt, debt means treasury bonds, and treasury bonds are an important, stable part of a lot of people’s investment portfolios. I do think that the government needs to have a plan to reduce it’s debt, however.
The medicare discussion has bogged down due to our collective lack of expertise. For the time being, I suggest we (and by we, I mean those who are participating in this thread without becoming obsessed with the naming of interstates, many thanks to all of you) leave the mandatory spending items as is, without change in legislation unless further budget examination makes it clear there is a need.
We’ll move on to the largest discretionary line item, the National Institutes of Health (very appropriate in light of John Mace’s post). Bush want’s to give them over $27 billion (scroll to the bottom of the link), the primary stated purpose of which is to fund medical research.
I’ll put it to Mr. John Mace:
If we were to slash this, where would equivalent funding for such research come from?
Whoops!
A llink in my last post was supposed to take you Bush’s FY 2004 Health and Human Services budget proposal, but something has apparently gone terribly wrong, as the link did not work for me just now.
John Mace brought up the idea that the federal government should not fund medical research. If not the feds, who? Or does it matter if it gets funded at all?
More to the point, it already HAS been funded. The current generation known as the “baby boomers” have had their taxes funneled into drug research/medical research for decades. Even if we all agree that drug/medical research should be handled by the market, what do we do with the current imbalance? Should we simply write off all the investment and expect no return? That hardly seems fair, and it’s a kick in the nuts for any new company who wants to get into research to pull that funding channel and leave them floundering among their competitors who not only have their own profits, but the “gift” of tons of Federal money from the past years.
I think it is fair to expect lower costs for the end product if you underwrite the research for the product. Medicare should be able to purchase these drugs/products at a reduced price because they paid into it for years. Independent insurance agencies may not get this discount, but then they haven’t paid into the industry research directly like the Feds have. Saying that the government shouldn’t support research is all well and good, but that can’t be applied retroactively. What do we do NOW in the situation we ARE in?
Enjoy,
Steven
Sorry. I’ll just refer to you as Lefty-Scot in the future to make up for it.
Health care is a business. It should be funded as such. I think this is where you and will disagree fundamentally. But, I’ll just add that if gov’t moneys are needed for medical research why does any private funding exist? I don’t have the figures at hand, but I’d wager that there is more private than public funding.
Yeah, gov’t and business are not exactly the same, but there is a lot of overlap. Especially when it comes to how to handle a budget. BTW, the CEO does a lot more than just deal with “day to day issues”. I disagree that the major focus of a CEO is not long term. Many companies hav a COO to deal with the short term issues and a CEO who focusses more on the long term. At any rate, I think there is lot that gov’t could learn from business.
No comment on the “grandma” deal. That looks to more as an emotional appeal than a rational argument.
I’d pretty much agree on this. I do think the Pubs have a slight edge on the Dems here, but it’s very slight. There are a few Pubs who are dedicated to this, but no enough to really matter. I’m not aware of any Dems who fundamentally want to reduce the size of gov’t.
Wow. A point of agreement. I like it!
I think I already answered that above. Pls don’t use the “grandma” defense on me again, though. I don’t buy it, and it doesn’t make me a granny-hater.
Get some figures then. Bush wants over 27 billion. Who’s paying more? And it is not strictly a business, as a great deal of the inital research is done by academia and the scientific community.
But not, IMO, the concept that the main goal is today’s bottom line.
Not trying to make a strictly emotional argument here. I was reading into your line of arguments the idea that there’s really no reason for the government to think it ought to provide medical care for seniors. I think I have found precendent in the stated reasons for instituting our current government structure in the first place. The Constitution tells us the government exists, in part, to “promote the general Welfare”. To me, then, ensuring medical care for those who need it is within that purview.
We must also remember that we do not live in a vacuum in the world. We would all like America to be seen as a leader among nations, and we must give other nations a reason to acknowledge that supremacy beyond the sheer amount of ordinance we are able to drop at their doorstep. I believe most people in the world think the elderly should be cared for. We would do well to support the same idea here.
One reason socialism/communism was attractive to some was that the citizen was assured (at least in theory) of a certain minimum acceptable lifestyle, as opposed to American capitalist democracy’s “sink or swim” philosophy.
Especially at this time in history, when we seem to be on a path of dismantling another government every ten months, and worldwide respect for all but our military prowess has fallen, IMHO, to its lowest ebb since before WWI, America must be able to point to the quality of life its system affords its citizens if the spread of democracy is its true goal.
So, while I don’t think America should make everyone rich without any work on their part, I believe there should be a minimum livable level below which the system will not let you fall. Medical care for seniors and the poor is a part of this puzzle.
That said, I certainly would hear arguments to the effect that Medicare and Medicaid as they currently exist are not the most effective way to bring about this goal, but I would NOT abide their dismantling without a proven effective system simultaneously put in place.
What I perceive in Bush’s proposals to be an HMO-style lowest-bidder competition ain’t it. Again, today’s bottom line shouldn’t be the ultimate goal for government, ESPECIALLY not in the realm of healthcare.
I agree with you, Mtgman , and a similar conundrum exists regarding Medicare and Socail Security. They are both limitless social contracts where you agree to pay the system to care for others with the understanding that you will be cared for in return. Any proposal to slash these programs must deal with the backlash from that aspect of such an act.
Perhaps when I’ve got more free time I’ll look for some figures. But don’t forget that you are the one who asserted that gov’t funding was essential for medical researches. You’ll need more facts to support that argument than just plopping down Bush’s budget numbers. That proves absolutely nothing. And you bring up “academia and the scientific community” as if that is some source of funding outside gov’t or private industry. Sorry, but you’re double dipping there. Where do you think “academia” gets money for research? And what is “the scientific community”?
Well, “promote the general welfare” can be used to justify anything that might be seen as a “worthy goal”, so I don’t find it a useful reference. Hell, it could be used to justify the gov’t supplying free lollipops to children. Besides, I don’t think I’ve ever heard of the preamble used as a justification for a particular action by the gov’t. Show me something in the body of the Constitution and then we can talk.
I’m not completely closed to the idea of providing some “minimum level of support” for the poor (although I’m still highly skeptical that the gov’t is the best means for doing it), but “seniors” is pushing it. As Sam pointed out, if anything “seniors” as a group are better off financially than the general population. I don’t see the need to add “seniors” to “the poor”, other than the fact that they are a powerful special interest group. And another reason I’m skeptical is that gov’t programs have a tendancy to take on a life of their own, and grow out of control. First it’ll be “seniors”, then it’ll be “everyone else”.
Let me add that I do respect your views, that I apreciate your starting some very interesting threads, and that you’re not afraid to self indentify as a “lefty”. But as much as this debate is enjoyable, you and I are so far apart on what our philosophy of gov’t is that I’m not sure there is much real value debating any particular policy detail. We just come to the table with a whole different set of assumptions. I’m mot saying that I don’t want to play, but let’s just keep that in mind as this continues. I’m guessing that 9 times out of 10 we’ll have to agree to disagree.
No figures here either, but I can tell you that at the (state) university I attended there was a faculty member of the Biology department who taught no classes. He had a research lab in the science building and he did medical research full-time. No students, but still he was a tenured professor at a state school. Not sure what kind of research he was doing, I think it was cancer research, but the point remains that this gentleman was a full-time state employee working on state premises with state-funded equipment and a private labratory the state paid the upkeep on. State benefits package as well. Private donations, even from corporations, to the university were virtually nill and the ones the school did get were in the form of athletic funding.
I’ve seen and met at least one full-time medical researcher and part of his pay and labratory came out of the government’s pocket. Part of it came out of mine when I paid tuition and fees to the university. An anecdotal point I’ll admit.
I’m not quite willing to make the assertion that medical research would dry up without federal monies, but I’ve read enough articles about advances in medical science to see things like “Doctors at Johns Hopkins University” repeated quite frequently. A interesting tidbit about Johns Hopkins funding sources
Even if the research would go on without Federal aid, this would be a major blow to the research community as it currently exists. I’d guess that research would still happen, but at a slower pace. Johns Hopkins research is also partly funded out of its general funds(mostly generated by student tuition/fees).
This article from Cornell University has some interesting details about their research funding. Emphasis mine.
Looks like nearly three fifths of the research budget(~270 million/ ~465 million ~= 58% just from the named federal sources) for this university comes from the government. The private sector pays for ~25 million out of a ~ 465 million budget. Where I come from that’s something like 5%. So you’ve got 37% unaccounted for. That’s where the “budgeted research – a category supported by general university resources” comes in. I’d actually guess that Cornell and Johns Hopkins, becuase of their prestigious reputations, foot less of the bill for research out of their general budget than schools like my alma mater did. After all, how hard do you think it is to convince an appropriations committee that Johns Hopkins is a good avenue to allocate research dollars to?
Enjoy,
Steven
[sub]Ok, maybe I lied about the figures thing[/sub]
Steven:
Good input. The researcher you refer to, though, most likely got outside funding for his research other than the university. It could’ve come from the gov’t or industry or a combo of both. Applyig for the research grant-- a time honored tradition of academics.
I wouldn’t be at all surprised if university research was mainly funded by the gov’t. But you are ignoring all the research that goes on in the pharmaceutical companies (for drugs) and private hospitals (for surgical procedures).
Hey, who do you thinking funded the development of Viagra?
I was a TA in the science department for a while and the lab I worked in was right down the hall from the research lab this man had. I spoke with several professors about it while I was there. He did get some funds from federal sources, but he was still on the university payroll and the lab building and some of his equipment was paid for by the university. His job was guaranteed by the university(tenure) and his benefits package came out of the university’s budget as well. I heard no mention of private funding for his research, but what I did know of the university’s private funding(mostly sports sponsorship) didn’t make me think it was “most likely” that he was funded by a private source.
Tons of research happens in the private sector as well. I might even say that the private sector is now the primary medical research venue, but that shouldn’t be confused with the assertion that the private sector research is all we need. Numbers on private sector research are far harder to gather. I just wanted to show that research, governmentally funded as well as university funded, is alive and well in academia.
A single university(Cornell) which spends ~144 million dollars on medical research(31% of it’s research budget of 465 million) per year makes me think that they do indeed carry a fair bit of the burden of researching. If the federal government spends 27 billion per year on research that is more expediture than the revenue of all but the top 158 companies in the world. There are only 158 companies with more REVENUE per year(according to the global Fortune Magazine rating) than the government spends on research. I’m sure the private sector does a fair bit of research, but 27 billion for research in the current budget is still a HUGE amount of research funded by the government. And that is still just the feds. State and local governments and other public monies(like a state university employing a researcher) factor in as well. I just can’t imagine that governmental monies aren’t a VERY significant part of this picture. For reference, GlaxoSmithKline, a very large pharmacutical company(Fortune 140 on the global list) has a annual revenue of 29.5 billion. How much of that revenue goes right back into research? 10%? 15%? How many of these companies would it take to equal the amount the government(at various layers) spends?
Pfizer(Fortune 127 on the global rankings) says they have a 5.3 billion annual budget for R&D. This is ~16.4% of their 2002 revenue.
So the worlds largest private budget is around 1/5 of the Federal research budget. They are also very proud of their ties to Academia(which is very heavily governmentally-funded). Still gotta go with my gut feeling that the government is a huge player in this market and that they deserve some recompense for this investment(possibly in the form of reduced price prescriptions for Medicare patients). If the governmental monies, Academicly-employed researchers and academic facilities went away then I’d guess innovation would either stifle or prices would skyrocket.
Enjoy,
Steven
I bolded the key statement. Who determines this? We could spend 100% of our GDP on med research and still not solve all the problems. I just prefer to let the private sector to determine the “need”, rather than the public. Our addiction to public monies for medical research is rather like our addiction to gov’t subsidies to farmers. How can we assure that we have all the food we “need” if we leave it up to the private sector? I say that sarcastically, of course, because no one would serioius challenge the fact that there would be no food crisis if the gov’t pulled out of agriculture subsidies (phased out over a few years of course so the market isn’t jolted).
The other factor in public vs. private funding is that a private company is in the business of generating profit, which means its research is going to be primarily in the area of sellable drugs.
If medical research is only sponsored by corporations, and corporations primarily research drugs, where will research into non-drug treatments (e.g. lifestyle changes, environmental changes) for various conditions come from?
And John, Agriculture is high enough in the list that we’ll get to it soon enough in another thread. 
The other factor in public vs. private funding is that a private company is in the business of generating profit, which means its research is going to be primarily in the area of sellable drugs.
If medical research is only sponsored by corporations, and corporations primarily research drugs, where will research into non-drug treatments (e.g. lifestyle changes, environmental changes) for various conditions come from?
And John, Agriculture is high enough in the list that we’ll get to it soon enough in another thread.
From lonely academics who simply have a love of knowledge?
From advice magazines like Men’s Health or an equivalent Women’s Journal. From HMOs that are trying to reduce costs and offer discounts to people who subscribe to certain lifestyle choices.
Don’t make the mistake in assuming that if the gov’t is funding “x” now that “x” will simply disapear if the funding is withdrawn. Who would deliver the mail if the gov’t got out of that business? You can bet the void would be quickly filled.
And if the funding isn’t there, one might ask if there is acually a need or interest in the product in the first place.
Hey, we’re not just blowing smoke here. The Senate Finance Committe just began hearings this week on proposed amendments to Medicare to include a prescription drug benefit.
WARNING: PDF Files!
So far it seems that the Pubs are just as much behind continuing and improving Medicare as the Dems, rather than decalring it be a total loss and abandoning it.