It is a shame to live with such cynicism.  And I agree that
there are many dedicated people working in medical research.
But unfortunately, I fear that cynicism is justified.

A lot of money that we spend on health care goes into research.
But a lot of it also goes into sinkholes that benefit no one.

I'm thinking in particular of the behavior of the big
pharmaceutical companies.  They spend billions on marketing and
advertising drugs.  They bribe doctors with junkets and gifts.
They convince people in terrible need that some nearly worthless
drug is a lifesaver (ask any Alzheimer's caregiver, for example,
if his parent was really helped by Aricept.)  They show happy,
healthy, smiling arthritis, Alzheimer's, and cancer patients in
TV ads that cost a fortune and leave the patients with absurdly
raised expectations of relief that doesn't materialize.

On the other side of the coin, cheap solutions to health
problems are often ignored because no one can make money on
them.  There are drugs that are no longer patentable that may be
valuable in the treatment of various diseases.  But no drug
company will fund clinical trials because they can't make super
profits selling the drugs, and very few other sources of funds
for clinical trials are available.

People who become successful scientists almost always do it
because they have a love of science.  Very often they have a lot
of concern about the application of that science too.

But business is, has been, and always will be, about making
money.  I'm not condemning that.  I'm not saying there are no
benefits to society from that.  But that's what it is.  If a
drug company can make more money by plowing two dollars into
advertising and one dollar into research, than by putting three
dollars into research, then that's what they will do.  They're
in a dog eat dog competition with other drug companies and, even
if they want to be altruistic, they'll be eaten alive if the
try.

In my view we've got to take advantage of what competition and
free enterprise can give us, but regulate it in a way that keeps
it from going off into socially unproductive or deleterious
directions.  I think we should, for example, ban drug
advertising.  No drug company will suffer because their
competitors are banned from doing it too.

That's a start on what we need to do.

   Alan

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