Precision Medicine vs. Public Health $$$ – NIH Funding Priorities Not A New Debate.

Posted on | August 29, 2016 | Comments Off on Precision Medicine vs. Public Health $$$ – NIH Funding Priorities Not A New Debate.

Paul Starr, Princeton

Paul Starr’s observations (The Social Transformation of American Medicine, p.370) in 1982:

“In 1964 a Presidential Commission on Heart Disease, Cancer, and Stroke (the DeBakey Commission) which had been appointed at the behest of the Lasker lobby, recommended a massive commitment of federal funds to establish ‘a national network of regional centers, local diagnostic and treatment stations, and medical complexes designed to unite the worlds of scientific research, medical education and medical care.’ The report paid no attention to any environmental, nutritional, or other public health and preventive concerns. Like the report of the Hospital Commission of the 1940s, the DeBakey Commission report was a classic of the kind of myopia that the medical establishment of the mid 20th century confused with visionary ideas. No one, as Elizabeth Drew later pointed out, ever asked whether other diseases such as those affecting children or diseases that could actually be cured might be more worthy of federal effort. The commissions conclusions in favor of a medical assault on heart disease, cancer and stroke were foreordained by the commissions name and its composition (the Lasker lobby as one of its representatives said had a quorum.) The aim was to make medical services more available, but there was little thought as to whether such an investment might actually make a difference in health.”

Eli Ginzberg, Columbia U. Health Economist

And from Eli Ginzberg in 1992:

“I learned several important lessons from my term on the Advisory Committee to the National Institutes of Mental Health(1959-1963): that most bureaucrats measure their success by the amount of money they are able to extract from Congress…; that there was a cozy relationship between the senior officials of NIMH and the academic medical leadership, much like the relationship of senior procurement officers in the Pentagon and the aerospace companies; (and) that fashion and enthusiasm dominate the world of medical ideas and policy as they do other fields.” (from The Eye of Illusion, p.82.)