I have ideating on healthcare innovation and recently wrote a long form on it. Although the seed of the idea came from a preceding work on rebooting science policy for developing countries). I had drawn insight from the contemporary American WW II efforts that had served the country in great earnest.
Policy issues are delicate to negotiate. These are abstruse ideas as they provide a general direction to guide the funding efforts. There is a complete dissociation from outcome measures to funding inputs. For example, cancer research is a moniker for biomedical pathways. I am not denouncing the curiosity-guided research, but it has assumed colossal proportions in contrast to alternative domains where it has declined.
University based approaches to research are generally patentable. There is an upsurge in pharma guided efforts to “discover pathways”. As bulk of grants are taxpayer funded, the benefits don’t flow back to public in form of cheaper medicines. This feeds on itself and is self perpetuating.
This is a highly simplistic explanation. There are complex layers of regulation, incentives and middlemen that would preclude a singular narrative. I am genuinely surprised that there has been ample “research” on the fiscal toxicity and usually conferences provide a splendid avenue for a lot of chests beating and hand wringing. However, that research would help only if they implement it.
Policy issues are problematic to implement because it requires a delicate balancing act. One section may get affected (or offended) to the degree they allow themselves. It depends on the warped incentives and how easily the influence groups can market themselves. The traditional ideas of a union (and hence a disintegration of the concerted bargaining power) have resulted in several splinter groups with “individual voices” that muddles the debate.
What is the way out? Frankly, none. It wouldn’t alter. Fuding the same set of ideas would only preserve present problems. Healthcare funding demands identification of a broader benefit (for example- preventive healthcare for population) than a narrow subset (triple negative breast cancer with some XYZ mutation). It doesn’t serve as “progress of science” but vanity metrics because it holds the society to leverage.
The option for the policy planners is straightforward- greater good versus individual gains. It cannot be held hostage to the “influencers on social media” but requires a comprehensive analysis of the thought process that benefits everyone. I would suggest a middle of the road approach.
The article is behind the paywall and I can merely include the raw format before it was edited for clarity. However, the fundamental concept and dogma continues the same.