Posts tagged ‘NIH’

When Funding Battles Trump Mission

Some Federal agencies are able to maintain their mission over many decades without much change from administrations that come and go.  The National Park Service is a good example.

Other agencies, in the desire to get funding, constantly recast their mission based on whatever flavor of the month is hot.  Here was one example I cited before, from the NIH, which, amazingly, managed to recraft its mission in the context of climate change to make itself more immediately relevent to the Obama folks:

Remember, the point of this all is not science, but funding.  This is basically a glossy budget presentation, probably cranked out by some grad students over some beers, tasked to come up with scary but marginally plausible links between health issues and climate change.   Obama has said that climate is really, really important to him.  He has frozen a lot of agency budgets, and told them new money is only for programs that supports his major initiatives, like climate change.  So, every agency says that their every problem is due to climate change, just as every agency under Bush said that they were critical to fighting terrorism.  This document is the NIH salvo to get climate change money, not actual science.

I have worked with the US Forest Service for years as a private operator of many of their recreation sites (for whatever faults they might have, they have been an early innovator on privatization -- without it, they could never have kept all their recreation sites open given their budget constraints).  The USFS has always had a mission challenge.  They are specifically tasked with balancing five missions -- Environmental preservation, timber, minerals extraction, recreation, and ... I can't remember the other one.  Grazing maybe.

In practice, this has meant of late that whatever interest groups among these five who are willing to spend the most time in court are able to shape the USFS mission in their direction, and in practice this has meant environmental groups.  As a result, Timber, the main source of USFS funding (from private timber fees) has pretty much been killed in the USFS, creating a funding crisis.  With their very logical timber mission gone, the only thing the USFS is unique at is recreation, as it is (surprising to many people) the largest recreation organization in the world.  However, this seems to be next on the environmentalists' target list.

So I suppose it is no surprise that the US Forest Service has decided to abandon any sense of long-term mission and simply glom onto whatever is the pet issue of the current administration.  For this year, they have latched onto climate:

The Forest Service has issued a national road map for responding to climate change, along with a performance scorecard to measure how well each individual forest implements the strategy.The new blueprint outlines a series of short-term initiatives and longer-term projects for field units to address climate impacts on the country's forests and grasslands.

"A changing global climate brings increased uncertainties to the conservation of our natural resources," Agriculture Secretary Tom Vilsack said in a statement. "The new roadmap and scorecard system will help the Forest Service play a leadership role in responding to a changing climate and ensure that our national forests and grasslands continue to provide a wide range of benefits to all Americans."

The last sentence could be rewritten as "we will continue to do everything we have done in the past but relabel as much as we can as having to do with climate change."

I can only speak to the recreation component, but this is the largest recreation organization in the world.  In some sense this new mission is roughly equivalent to the National Park Service hypothetically announcing in the Bush administration that it was going to focus on the war on terror.  In many areas of the USFS they, at their own admission, have years or decades of deferred maintenance.  From watching them at close range, they very clearly don't have the resources to handle the missions they have already taken on, and so it is going to dedicate its resources to this:

Immediate assessment actions include providing basic and applied science to help managers respond to climate change, conducting workshops, utilizing national monitoring networks, furnishing more predictive information, developing vulnerability assessments, tailoring monitoring and aligning service policy and direction.

Longer-term assessment will focus on expanding the agency's capacity for assessing the social impacts of climate change, implementing a genetic resources conservation strategy and fortifying internal climate change partnerships.

To the extent that some of this means "monitor forest health," I thought the organization was already doing that.  As to the value of the rest of this stuff?  Forgetting for a minute if the work should even be undertaken, under what possible allocation of expertise in the Federal bureaucracy does "assessing the social impacts of climate change" fall under the purview of the Forest Service?

Something for Atlas Shrugged Readers

Do you remember the State Science Institute report on Rearden Metal?  If you were like me, you thought that this ridiculous report was an exaggeration, a literary device to make a point.  But as in so much of Atlas Shrugged, I am finding that it was no exaggeration at all.

Check out this real life example of "science."  From the real state science folks at the Interagency Working Group on Climate Change and Health.

There are potential impacts on cancer both directly from climate change and indirectly from climate change mitigation strategies. Climate change will result in higher ambient temperatures that may
increase the transfer of volatile and semi-volatile compounds from water and wastewater into the atmosphere, and alter the distribution of contaminants to places more distant from the sources, changing subsequent human exposures. Climate change is also expected to increase heavy precipitation and flooding events, which may increase the chance of toxic contamination leaks from storage facilities or runoff into water from land containing toxic pollutants. Very little is
known about how such transfers will affect people's exposure to these chemicals"”some of which are known carcinogens"”and its ultimate impact on incidence of cancer.  More research is needed to determine the likelihood of this type of contamination, the geographical areas and populations most likely to be impacted, and the health outcomes that could result.

Although the exact mechanisms of cancer in humans and animals are not completely understood for all cancers, factors in cancerdevelopment include pathogens, environmental contaminants, age, and genetics. Given the challenges of understanding the causes of cancer, the links between climate change and cancer are a mixture of fact and supposition, and research is needed to fill in the gaps in what we know.

One possible direct impact of climate change on cancer may be through increases in exposure to toxic chemicals that are known or suspected to cause cancer following heavy rainfall and by
increased volatilization of chemicals under conditions of increased temperature. In the case of heavy rainfall or flooding, there may be an increase in leaching of toxic chemicals and heavy metals
from storage sites and increased contamination of water with runoff containing persistent chemicals that are already in the environment. Marine animals, including mammals, also may suffer
direct effects of cancer linked to sustained or chronic exposure to chemical contaminants in the marine environment, and thereby serve as indicators of similar risks to humans.64 Climate impact
studies on such model cancer populations may provide added dimensions to our understanding of the human impacts.

Remember, the point of this all is not science, but funding.  This is basically a glossy budget presentation, probably cranked out by some grad students over some beers, tasked to come up with scary but marginally plausible links between health issues and climate change.   Obama has said that climate is really, really important to him.  He has frozen a lot of agency budgets, and told them new money is only for programs that supports his major initiatives, like climate change.  So, every agency says that their every problem is due to climate change, just as every agency under Bush said that they were critical to fighting terrorism.  This document is the NIH salvo to get climate change money, not actual science.

The Only Health Care Cost Control Idea the Democrats Have Ever Had

I think this article makes it clear that, no matter what the rhetoric, the only health care cost control idea Obama and the Democrats ever had was saying "no" to care.  Whatever one calls this (managed care, rationing, death panels) it is really not that much different from what insurance companies have been doing for years.  And it is areal irony that Democrats passed this legislation feeding off anger of voters with insurance companies saying "no", when their plan really depends on the government saying "no" even more often  (or else there won't be any cost savings).

The author argues that information is important for patients to make better decisions:

When patients are given information about potential benefits and risks, they seem to choose less invasive care, on average, than doctors do, according to early studies. Some people, of course, decide that aggressive care is right for them "” like the cancer patient (and palliative care doctor) profiled in this newspaper a few days ago. They are willing to accept the risks and side effects that come with treatment. Many people, however, go the other way once they understand the trade-offs.

They decide the risk of incontinence and impotence isn't worth the marginal chance of preventing prostate cancer. Or they choose cardiac drugs and lifestyle changes over stenting. Or they opt to skip the prenatal test to determine if their baby has Down syndrome. Or, in the toughest situation of all, they decide to leave an intensive care unit and enter a hospice.

I agree, but I would go further -- information and incentives are important.  And the absolute most important bit of information when it comes to cost control is price, and patients under Obamacare have absolutely no incentive to give a sh*t about price even if they were informed of it.  Exactly the opposite of the incentives I have had since I took on a high-deductible health care policy several years ago.

Update: Brad Warbiany discusses the proposed IPAB and its powers to shape health care spending in the context of Congress as an addict trying to control its impulses.  However, I think Brad underestimates the power of the board to be captured.  What will result is rulings for more coverage of procedures with powerful lobbies, offset by less coverage of procedures with weaker lobbies, irrespective of the science.   Just look at the diseases the NIH and NSF gives grant money for -- the grants have nothing to do with the science of where research could be most productive and everything to do with diseases that have large and powerful constituencies.

Update #2: Isn't it interesting to see the NY Times, after arguing for months that Obamacare was not about rationing, is now admitting that rationing is the key to success.  It reminds me of this that I wrote a while back:

I have decided there is something that is very predictable about the media:  they usually are very sympathetic to legislation expanding government powers or spending when the legislation is being discussed in Congress.  Then, after the legislation is passed, and there is nothing that can be done to get rid of it, the media gets really insightful all of a sudden, running thoughtful pieces about the hidden problems and unintended consequences of the legislation.

Subsidies Beget Subsidies

For years in Arizona we have been told by the state government that we need to subsidize science.  I have never really figured out why my life would be better if scientists lived in Arizona instead of California, but apparently when governors get together and compare their states' penis lengths, this is one of the key topics that come up.  Why we need to subsidize, for example, bio-science in Arizona to keep up with California but folks in Kansas don't need to subsidize, say, awesome golf resorts to keep up with Arizona has always escaped me.  I have always felt that if we just keep taxes low and wait long enough, California is going to blow up and we will collect a lot of the best and brightest with no extra effort.

Well, I am starting to understand why we needed to subsidize bio-science with our Arizona taxes.  We apparently need to do so to ... attract large grants for Federal tax money.  So by subsidizing this sector locally, we built it up enough to attract Federal subsidies.  Great.  Actually we probably did not build up the sector per se, we just built a quality private bureaucracy that had the skills and incentives to write lots of successful grant applications.  Apparently there is still work left to do, though, as other states have invested in even larger grant-magnets:

States with strong science bases such as California, Massachusetts and New York, each landed more than 1,000 grants.

Twenty states secured fewer grants than Arizona's haul of 101 awards.

Arizona scientists will study things such as predicting asthma in babies, prostate cancer and the behavioral responses of kissing bugs, which are blood-sucking insects linked to a blood-borne disease that afflicts 11 million to 13 million people in Mexico and Latin America.

Arizona scientists say the batch of stimulus dollars through the NIH is a welcome change from years of stagnant federal funding for scientific research.

"There was no increase in federal funding for cancer research for five years - that was devastating," said Dr. David Alberts, director of the Arizona Cancer Center in Tucson. "Now, I'm encouraged."

Wow - thus we see why government spending grows so much faster than inflation.  Flat spending = devastating.

If I were in academia, the study I would like to do is to try to assess the total value destroyed by state and local governments merely in trying to move businesses and facilities from one part of the country to another.

Very Interesting Observation

From Tyler Cowen:

The NIH works as well as it does because the money is mostly protected
from Congress. It is not a success which can easily be replicated. The
more money is at stake, the more Congress wants to influence
allocation. We should guard this feature of the system jealously and
try to learn from it. If we can.

I had not ever thought about it this way, but this is probably a correct observation about government:  The more money in a program, the more likely it is that Congress will want to direct that money to take political credit for it and reward their cronies, and therefore the more likely the program is to fail.