In part one of this series, we noted that Alzheimer’s Disease (AD) is reaching epidemic proportions, and yet the political class seems to have little to say about it. In part two, we noted the past success of two Republican presidents, Theodore Roosevelt and Dwight Eisenhower, in solving public-health crises. In this third and final piece, we’ll consider how today’s Republicans are beginning to respond to the critical health issues of our time–cures.
But first, a bulletin from Africa: A new outbreak of the Ebola virus has killed 78 people in Guinea, and has crossed the border to the neighboring countries of Liberia and Sierra Leone. As the World Health Organization notes, there’s no vaccine and no cure. And while Africa might seem far away, it’s just an airplane ride’s distance. We might recall that AIDS originated in Africa, soon spreading around the world, killing some 36 million people, including more than 641,000 Americans.
Of course, the death rate from AIDS in the US has plummeted in recent years, as treatments have improved. So we can pause to note that it’s the science of AIDS treatment that has made the big difference–that is, drugs such as AZT and the HAART cocktail. And those breakthroughs have led to huge economic benefits for America, in terms of lower health expenditures and greater work-productivity; these benefits are estimated to total in the hundreds of billions of dollars. Indeed, earlier this year, Dr. Robert Gallo, the co-discoverer of the AIDS virus, predicted that we would soon see a “functional cure” for the disease.
And here we see an important point that seems to elude many Washington DC policy mavens: Yes, health insurance is important, but health itself is more important. Experts, mostly on the left, tell us that 45,000 Americans die from lack of health insurance every year. And that might be the case, but more than two-and-a-half million Americans die every year. In other words, more than 50 times as many Americans die of, well, death, than die from lack of health insurance. And come to think of it, even those 45,000 who lacked insurance died of something more deadly than their lack of insurance.
The point here is not to be flip about fatality, but, instead, to remind us all of the big killers: AD, heart disease, stroke, cancer, and diabetes. We might note that of the 2.51 million deaths in the US in 2011, some 682,000 befell Americans under the age of 65. When so many people of working age sicken and die, we can see a huge economic loss to the productive economy.
And of course, it’s not just the cost of death; it’s the cost illness. As noted in part one, the cost of AD treatment–including 24/7 dementia care–will be ruinous. Yet sadly, little progress–make that no progress–has been made in the treatment of AD.
Part of the problem is that AD is often confused with simple old age. But a moment’s reflection tells us that some elderly people we know are still sharp in their 80s and 90s, and others are not. In 2005, former South Carolina Republican governor Carroll Campbell, for example, died of AD at age 65. And in 2011, Pat Summitt, the winningest women’s college basketball coach ever, announced that she had been diagnosed with AD and would be stepping down from the University of Tennessee. She was 59.
Indeed, many cases have shown early onset AD afflicting people in their 50s, and even 40s. Ominously, there’s increasing evidence that AD could have a viral component; in other words, AD really could be an epidemic, in the most literal sense.
So we can see that we have a health crisis on our hands, even more than we have a health insurance crisis. Yes, it might seem that politicians are still focused on health insurance–Obamacare, pro and con–and yet, fortunately, that exclusive focus on insurance, only, is currently changing.
We might first note that one Republican, Newt Gingrich, has been championing this idea for decades. Gingrich has always been a believer in science and scientific transformation; his 1984 book, Window of Opportunity: A Blueprint for the Future, still holds up as a vindication of Big Science as a pathway to a better life. More specifically, he applied this tech approach to to health and cures in a 2006 book, Saving Lives & Saving Money.
We might note, today, a growing number of Republicans who are stepping up to the challenge of improving health itself.
House Majority Leader Eric Cantor, a Republican of Virginia, has spearheaded the Gabriella Miller Kids First Research Act, allocating money away from political spending and putting it towards research on pediatric cancer. In December 2013, Cantor’s legislation passed the House by an overwhelming margin, and in March 2014, it passed the Senate by unanimous consent; President Obama is expected to sign the bill soon.
US Rep. Fred Upton (R) of Michigan, Chairman of the House Energy & Commerce Committee, recently announced an ambitious set of hearings on the subject of medicine and medical cures:
Over the next several months [we] will begin a series of listening sessions and roundtables to gather advice and advance ideas about how to streamline the approval process, spur more scientific collaboration and ensure the United States remains the world leader in this field.
As to what he hoped to learn, Upton continued, “We already have some pretty good hints.” He cited five areas: first, encouraging personalized medicine; second, harnessing the power of individual and social networks; third, using new tools to lower the costs of clinical trials; fourth, encouraging the FDA to modify its risk culture; and fifth, promoting innovative partnerships, such as the one recently forged by the National Institutes of Health and a group of drug companies, aimed at encouraging greater collaboration among scientists, doctors, patients, and big data analysts.
Other prominent Republicans have raised their voices. Last year, US Rep. Michele Bachmann of Minnesota contrasted the gap between our medical potential, on the one hand, and our performance, on the other. As she put it,
It’s the 21st century; we have smartphones that can double as medical buddies and supercomputers that can data-crunch their way to new cures. With that sort of technological momentum on our side, there is no reason that we can’t power our way to a cure for diseases, including Alzheimer’s.
On March 22 of this year, former Arkansas governor Mike Huckabee closed his Fox News program with this missive:
I wonder if we could muster the energy to take on an issue that affects almost every American family. Alzheimer’s Disease will strike 1 in 6 women in her 60’s, twice the rate as she is likely to have breast cancer in her 60’s. For a man, it’s a 1 in 11 chance of developing Alzheimer’s in his 60’s. Women are also 2 ½ times more likely to be 24 hour a day caregivers for someone with Alzheimer’s. 16 million Americans are expected to have Alzheimer’s by the year 2050, and the cost will explode to $1.2 trillion a year for care–5 times the entire current Medicare budget. Isn’t it time that instead of attacking Republicans and making empty threats to stand up to Putin, the President ought to be waging war on Alzheimer’s?
All good points. Then Huckabee continued,
I would urge the Republicans in Congress to take the initiative in this endeavor, and call for and fund a space race type commitment that would find the cause and create a cure for this horrible disease that has touched most of our families and taken loved ones from us slowly, dreadfully, and ruthlessly. We once decided that polio needed to be eradicated because it was robbing our children of their strength and energy. We funded the research and it resulted in a cure. The coming apocalypse of Alzheimer’s disease is not only a human tragedy, but a budget killer. We’ve already saddled the next generation with a huge debt from spending foolishly. Will we saddle them with an even bigger burden of paying the exploding costs of long term care? The cure might be expensive, but surely the cost of doing nothing is even greater. Some solutions aren’t cheap, but are certainly less expensive than $1.2 trillion.
And on April 1, Cal Thomas, the most widely syndicated columnist in America, released a new book, What Works: Common Sense Solutions for a Stronger America, in which he observes:
Obamacare is already adding to the cost of medicine, including raising taxes to help pay for it. Suppose that instead of Obamacare, the administration had launched Obamacure. That might have garnered bipartisan support and enormous amounts of goodwill from people of all political perspectives.
So help, in the form of better thinking on healthcare, and health, is on the way. The question, still, is how long it will take to change the system, so that it focuses on science of health, as well as the finance of insurance.
In the meantime, the system itself seems to be getting worse, not better.
It would be nice, for example, if the government wouldn’t fight so hard to keep lifesaving drugs away from needful patients. Earlier this year, the parents of nine-year-old Josh Hardy of Fredericksburg, VA, rallied popular support to secure needed treatment for their son. The #SaveJosh campaign was successful, in large part because Fox News’ Peter Johnson Jr. took up the cause on the air, but there are many more such instances–and sadly, most of them have not had a happy ending.
The larger issue, of course, is the federal government’s disinterest in developing new medicines. Indeed, the Food and Drug Administration seems more interested in hounding an imaginative diagnostic startup such as 23 and Me, than it is in accelerating the delivery of new cures.
In other words, Republicans–and Democrats sharing the same goals–have a lot of work to do, clearing away the accumulated barriers to healthcare innovation.
What’s needed is a comprehensive strategy, a cure strategy, focusing on all the factors that inhibit medical innovation, including the FDA, the trial lawyers, and the general inertia of government.
More broadly, we need vision–the vision to see a world without so many crippling and deadly diseases. The vision to do to AD, for example, what we did to polio–that is, make it disappear.
Using ingenuity to cure disease is a most American idea. And also a most Republican idea; after all, a cure is less expensive than care. It’s cheaper to beat than to treat.