Medical research is essential to improving the economy and bettering lives

WASHINGTON— Healthcare in the United States is expensive, but its continued funding is necessary as it also is a major contributor to the economy and can better lives, according to an essay in the June issue of the Journal of the American Society Nephrology.

Healthcare costs will rise as the U.S. population increases. In order to curb these costs, government officials are taking money away from Medicare and Medicaid programs, and budget planners are reducing the funds used to support medical science. Experts have questioned this strategy, arguing that healthcare employs a large segment of the national workforce (and is, therefore, a fundamental feature of the economy) and medical research is a critical enterprise that over the long run will provide more affordable healthcare.

Dr. Eric Neilson, JASN’s editor-in-chief of the and chair of the Department of Medicine at the Vanderbilt University School of Medicine in Nashville, addressed these concerns in his essay pointing to examples of how investments in healthcare and medical research can pay off.

In addition, Neilson argues that this is not time to shrink the budget at the National Institutes of Health, which funds medical research that leads to potentially curative therapy.

He noted that the human papillomavirus vaccine, the antibiotic elimination of H. pylori–induced peptic ulcer disease, and the all-trans-retinoic acid cure of promyelocytic leukemia are all cost-effective advances that have improved lives and lowered costs. These advances took years to achieve, and long-term robust funding of research was necessary for their potential to be realized.

However, Neilson wrote that many aspects of healthcare are not cost-effective—for example, the sluggish economic productivity of the doctor-patient relationship is a chronic problem—the so called Baumol’s curse.

A number of other factors interfere with medicine’s productivity, including resistance to standardization, wasteful administration related to insurance reimbursement, unnecessary expenses created in the setting of medical uncertainty or futility, failure to embrace the hospice movement for end-of-life care, for-profit commercialism, and failure to provide good quality at a lower cost.

Also, because of a perceived shortage of physicians and nurses, the growing cost of labor will continue to plague healthcare, he argued. It is not the number of physicians, however, but their professional spending habits that will increasingly take center stage in whatever happens next. Physicians can work to lower these costs in the short-run but need to identify other solutions.

Over time, more and better research can help to counteract these expenses while benefiting the human condition, Neilson argued. “The one immediate thing we can do now is maintaining our link to science. It is the discovery ground for future advances in high technology,” Neilson wrote. “As a hedge against growing healthcare costs, the funding of science is priceless.”

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