Althouse: 3 Americans win the Nobel Prize in Medicine, and I don't suppose that creates an occasion to talk about how our health care system might not be so terrible.

October 5, 2009

3 Americans win the Nobel Prize in Medicine, and I don't suppose that creates an occasion to talk about how our health care system might not be so terrible.

Does it?

69 comments:

Henry said...: All I can say is thank God no one from Chicago went to Stockholm to lobby for the thing.; 10/5/09, 10:03 AM
MadisonMan said...: I'm always happy when people in America win the Nobel Prize. And you have to love a winner who quotes Monty Python.; 10/5/09, 10:05 AM
Roost on the Moon said...: USA! USA! USA!

In your face, millions without healthcare.; 10/5/09, 10:06 AM
Jason (the commenter) said...: It's funny how you can win an award for things you've done years ago, you just have o stay alive.; 10/5/09, 10:07 AM
Bissage said...: This comment has been removed by the author.; 10/5/09, 10:08 AM
Joe Veenstra said...: "I don't suppose" you know that research funding has little to do with the provision of health care, right?; 10/5/09, 10:09 AM
Bissage said...: MadisonMan beat me to it.

Ha!; 10/5/09, 10:09 AM
Jason (the commenter) said...: Americans also won Ig Noble prizes for medicine and public health this year!; 10/5/09, 10:09 AM
victoria said...: What does one have to do with the other? NOTHING; 10/5/09, 10:10 AM
traditionalguy said...: Science is knowledge. These three are advancing our knowledge and deserve that prize for their dedication to the pursuit of truth that alone advances our knowledge. Hurray!; 10/5/09, 10:11 AM
Henry said...: you just have to stay alive.

So true. Poor Rosalind Franklin.; 10/5/09, 10:12 AM
David said...: Our health care system has been the innovator for the world. The rest of the world takes our discoveries and innovations to improve the life of its own citizens. That innovation and creativity is made and paid for in the USA.

I know from personal experience. I am alive because of a drug called Gleevec, owned and marketed by European company Novartis, but discovered and created in principal part by American doctors and scientists in Philadelphia, Chicago and the Pacific Northwest.

Gleevec costs almost $4000 a month here. It's virtually free in India (which rejected the patents) and much cheaper in Europe (which did not incur the development expense.) About 20% of the profits of Novartis come from Gleevec.; 10/5/09, 10:12 AM
Jason (the commenter) said...: Joe Veenstra: "I don't suppose" you know that research funding has little to do with the provision of health care, right?

Where do you think health care came from? All of it was invented.; 10/5/09, 10:13 AM
David said...: Victoria, you ignorant something or other.

The kind of innovation that wins Nobel Prizes has everything to do with quality health care. Why the hell do you think we have no Polio in the world, for example?

Talk about a credibility smasher. Yikes, Victoria, do yourself a favor and delete the comment.; 10/5/09, 10:15 AM
dbp said...: Jack Szostak is among the winners for the Nobel in medicine: I thought he already had one. He is that prominent. I hadn't heard of the other two before now, but it was not an area I followed.; 10/5/09, 10:16 AM
David said...: Note that two of the three winners are women. That's amazing. Nobel Prize winners in science and they can't do math!; 10/5/09, 10:20 AM
chuck b. said...: When your cells divide your DNA replication machinery doesn't quite finish the job at the ends of your chromosomes. So technically your genome gets successively smaller with every cell division.

It was quite the irony when they discovered Dolly the cloned sheep was born with old DNA. There was some debate whether it contributed to her early death at age 6 (regular sheep lifespan is 12 years).; 10/5/09, 10:25 AM
garage mahal said...: The kind of innovation that wins Nobel Prizes has everything to do with quality health care. Why the hell do you think we have no Polio in the world, for example?.

If one doesn't have access to or cannot afford these innovations, it doesn't do them a bit of good does it?; 10/5/09, 10:25 AM
Salamandyr said...: It's a fair point that this prize is for research done in the 80's. If circumstances have changed between now and then regarding the quality of research into medicine, there may be a fair point there that we are in a healthcare "crisis".

However, I don't think that is the case, and any advocate of healthcare "reform" must explain how he is going to deal the circumstances described by David in his post.; 10/5/09, 10:25 AM
miller said...: Good for them.

Is there something about the American for-profit system that leads to Nobel prizes?; 10/5/09, 10:26 AM
chuck b. said...: (Telomeres, the basis of this research, are the regions at the ends of your chromosomes.); 10/5/09, 10:27 AM
Ignorance is Bliss said...: Does it?

Not really. Nobody ever said we don't do good research. Maybe we could discuss this as part of the free-rider problem to explain part of why we spend more on healthcare for basically equal results. But it does not address the unequal access.

And note that I say this while opposing the current reform proposals.; 10/5/09, 10:28 AM
Peter Hoh said...: And if it's not so terrible as some people claim, then we can rest assured that it's good enough, smart enough, and doggone it, people like it.

There are prize winning steers, too, but that doesn't mean that our hamburger is safe.; 10/5/09, 10:30 AM
Wince said...: Nerd Alert!; 10/5/09, 10:34 AM
chuck b. said...: Early preclinical development of Gleevec was carried by Swiss chemists working at Ciba, later Novartis. (Interestingly, they were looking for a treatment for chronic myelogenous leukemia, a disease associated with abnormally short chromosomes.)

When a company like Novartis takes the drug into the clinic, development becomes global (well, Europe and the US) and those development costs are spread out.; 10/5/09, 10:40 AM
ObamaNation said...: Stupid wingnuts -- what does technological progress in medicine have to do with the quality of medical care?

As soon as President Obama removes the corrupting influence of the profit motive from medicine, we'll see diseases wiped out and life expectancies double and triple.

And Garage is right: What about those millions of Americans who can't afford your precious polio vaccine? Huh, reichwingers?; 10/5/09, 10:47 AM
Salamandyr said...: Obamanation, that's a dangerous callousness to other species you're showing there. Do you think humanity really has the moral authority to just cavalierly wipe out entire species like polio and smallpox? Those are living breathing creations of Gaia as well!; 10/5/09, 10:52 AM
victoria said...: Sorry, David, no deletion here. I'm siding with Joe Veenstra. One has nothing to do with the other. Most of the work that these people do is funded by the federal government and universities. IF this translates in to new drugs, cures for diseases, so much the better.; 10/5/09, 10:57 AM
Lockestep said...: Two misleading comments:

Roost said In your face, millions without healthcare.

It is a little late in the game to throw out this sort of line and expect it to fly. No one is denied healthcare in the US. The level of services might vary, but the uninsured are treated.

Ignorance said explain part of why we spend more on healthcare for basically equal results.

Not so. Compare five-year survival rates for the major cancers. The US dramatically outperforms the EU and Canada. Age of survival and surviving illness are two different animals. Because of our superior healthcare system, we survive deadly illnesses longer than our counterparts in other developed nations. Because of our lifestyle issues (which involve making dangerous and/or unhealthy choices), we die sooner than we should. US obesity prevalence, for example, sits at about 25% in the US, vs. 15% in Canada, and around 10% in France and Germany.; 10/5/09, 10:59 AM
former law student said...: No, but the Nobel Prizes do create an occasion to talk about the effectiveness of federally funding of research. The bulk of the funds for the telomere research came from the NIH.

Note also how the public option competes, but does not replace the private options in medical research:

Blackburn is a professor of biology and physiology at the University of California, San Francisco. Greider is a professor in the department of molecular biology and genetics at Johns Hopkins University School of Medicine in Baltimore. London-born Szostak, 56, has been at Harvard Medical School since 1979 and is currently professor of genetics. He is also affiliated with the Howard Hughes Medical Institute.

So, two private organizations and one public. The win also shows the value of immigration: Two of the three researchers are immigrants (Blackburn being from Australia).; 10/5/09, 11:00 AM
MadisonMan said...: I have to ask: Are these women winners really happy? I can't think that winning a Nobel Prize is following the road that God has designed them for.

Wouldn't they have been happier with 11 kids suckling at their teats over the course of 15 years? The Bible says they would.; 10/5/09, 11:00 AM
Adrian said...: garage mahal said...
If one doesn't have access to or cannot afford these innovations, it doesn't do them a bit of good does it?

Well, garage, remember how twenty or so years ago only the richest wall street types could afford cell phones? really bulky, unreliable, ugly cell phones that cost tens of thousands of dollars? and how, now, cell phones are infinitely better and faster and sleeker and so darn cheap that most plans give them away for free and even the homeless have them? funny how that works!; 10/5/09, 11:00 AM
ObamaNation said...: Salamandyr -- you're right, of course. I misspoke.

I'm sure that President Obama wouldn't preside over the genocide of another species; I'm sure that he'll allow small communities of the smallpox virus, AIDS virus, etc. to thrive in such Gaia-foresaken out-of-the-way backwaters as Idaho, Alabama, and possibly Oklahoma.; 10/5/09, 11:03 AM
Anonymous said...: There is no healthcare or insurance crisis.

The crisis is invented. Obama and the Democrats want their hands on the money. That's all. Money and power.

Our healthcare system isn't perfect. Nothing is. We were doing fine before Obama the Savior came along.

The Democrats have embraced a dual strategy of (1) devastating the economy with absurd environmental and anti-development legislation, and (2) conjuring up dumb solutions to solve the problem that they created. Thus, we've legislated our own oil industry out of business, driven our factories out of the country, etc.

This strategy cannot continue for much longer. The destruction is massive.

If only the Republicans had a better idea.; 10/5/09, 11:05 AM
Shanna said...: If one doesn't have access to or cannot afford these innovations, it doesn't do them a bit of good does it?

New stuff always starts off expensive. It gets cheaper as time goes on (go generic drugs!). Your basic early adopter graph is replayed time and again.; 10/5/09, 11:09 AM
ObamaNation said...: FLS and Victoria are perfectly correct: We have no need of crude capitalism to motivate innovators. These researchers, and their universities, had no interest whatsoever in future profits to be made from their research.

I'm sure that they'll immediately donate any licensing fees that they might receive to a good charity.

Take that, all you Rethuglican luddites, who think that all institutions of higher learning should be bulldozed and replaced with venues for tractor pulls!! Oh, all the times I've read calls for the demolition of research facilities in these comments.

And I say that we have no need of private for-profit research in any field. All engineering should be done by government-approved public-university professors. Hell, we'd have flying cars by now, if this had been done 20 years ago.; 10/5/09, 11:11 AM
Jim Hu said...: It might provide an occasion, due to Liz Blackburn being the outspoken supporter of stem cell research who was not reappointed to W's bioethics commission.; 10/5/09, 11:12 AM
chuck b. said...: I would think if one was going to be very concerned about the future of basic research and drug development, one would be more concerned with Bush's prescription drug benefit than Obama's insurance policies.; 10/5/09, 11:12 AM
former law student said...: These researchers, and their universities, had no interest whatsoever in future profits to be made from their research.

The payback time on basic research is approximately eternity. Only government or disinterested charity can operate on such a schedule.; 10/5/09, 11:18 AM
Craig said...: This comment has been removed by the author.; 10/5/09, 11:32 AM
ObamaNation said...: FLS, I agree completely. That's why those greedy bastards at Wyeth, and Abbott Labs, and Eli Lilly, and Pfizer, and GlaxoSmithKline, and on and on, make almost no money.

The dumb bastards would be penniless, if not for bailouts and handouts from the government; and bereft of ideas, if not for government-funded research.

Thank Gaia for the government. Is there anything that it can't do?; 10/5/09, 11:34 AM
Craig said...: This comment has been removed by the author.; 10/5/09, 11:37 AM
ObamaNation said...: Craig, you're absolutely right. Americans are dumb as posts.

Just look at the Althouse commenters' favorite drug, Viagra. It was first made in ENGLAND, by people working for that very British company, Pfizer.

And they probably cribbed their work from government employees, too.; 10/5/09, 11:38 AM
Craig said...: For what it is worth, I did a _rough_ calculation of the ratio between percentages of nobels won since 1970 and each country's current share of the population pie:

county % of nobels / % of pop
United States 149.68%
Germany 64.74%
France 40.82%
United Kingdom 188.36%
Sweden 477.93%
Australia 120.74%
Switzerland 343.25%
Japan 6.94%
Italy 14.73%
Denmark 160.43%
Argentina 21.87%
Austria 105.96%

If I knew how to post the excel file backing up this data, I would. But I don't.

Anyone suggesting these three winners confirm American leadership in innovation has more work to do. Our main comparison for health care purposes is the UK, home of the (infamous?) NHS. The UK is beating us in Nobel efficiency.

(My apologies re the deleted posts; I need a more efficient copy editor.); 10/5/09, 11:43 AM
Jim Hu said...: Craig -I believe you can use Google Docs to make a spreadsheet public.; 10/5/09, 11:58 AM
former law student said...: Invited to show how anyone has been able to cash in on telomeres, a quarter-century later, "obamanation" can think only of how to artificially inflate his penis.; 10/5/09, 12:01 PM
garage mahal said...: ObamaNation...
Craig, you're absolutely right. Americans are dumb as posts.

Just look at the Althouse commenters' favorite drug, Viagra. It was first made in ENGLAND, by people working for that very British company, Pfizer.

And they probably cribbed their work from government employees, too..

Wow. A strawman slipping down a slippery slope made of red herring. If I didn't know better I would guess this was our very own Hoosier Daddy in disguise :); 10/5/09, 12:42 PM
Bruce Hayden said...: Invited to show how anyone has been able to cash in on telomeres, a quarter-century later, "obamanation" can think only of how to artificially inflate his penis.

That is almost an admission that government subsidized research does not pay off economically.

Part of the problem with government subsidized research is that it is invariably into areas that are politically popular, instead of places that will pay off through bringing the most people the biggest health benefit.

Thus, you have far more money being spent on AIDs research than for many much more common killers. And more spent on female cancers than male by far, because (IMHO) women whine more.

I am not saying that government supported research cannot be a good thing (after all, this Internet thingy we are using right now came out of DARPA research). But, rather, it just doesn't bring much in the way of useful health care products to us within any reasonable amount of time. The research done here was very important, and so, I think, deserving of a Nobel prize. It just isn't going to save lives in the short run of a decade or so.; 10/5/09, 12:43 PM
Cedarford said...: David - "The kind of innovation that wins Nobel Prizes has everything to do with quality health care. Why the hell do you think we have no Polio in the world, for example?."

Apples and oranges. 2 of the 3 researchers were educated in foreign countries, Australia and Britain, They all have no involvement in US healthcare, or it's quality. They are doing basic genetic research in a convenient univeristy rearch place (USA) that brings foreigners and some USA natives together.
And apparantly, capitalism and the "profit motive" is absent as a motivation to excel. Though they will of course gladly take the prestige and Swedish money behind the Prize the get.
Some of the Nobels in medicine may one day lead to better, higher-quality healthcare. Some may not. Just as certain Prizes in Physics may one day lead to "better quality space travel". Then again, perhaps not...

As for the polio vaccine, the effective one was developed turned out to be the Sabin one. Albert Sabin was educated in public university, and also developed vaccines against dengue fever and Japanese encephalitis while serving in the Marine Corps in WWII. Like the polio vaccine, he shunned any pursuing any patent or profit from his vaccines - considering it immoral to block drugs or vaccines that should be free to the masses. Most of his polio vaccine work was paid for by Ohio taxpayers at U of Cincinnati.
He prevailed on the Eisenhower Administration to make it free to US schoolkids..and on to distributing it free to the world through Foundations..

His rival, the more famous Jonas Salk, whose vaccine has made a comeback in use...also shunned a patent and licensing his discovery to Big Pharma to profit on. "The US needs to work Government public healthcare services in other less fortunate nations, who need to distribute this to the People..and if we don't help them, the Soviets will."

A reminder again that Eisenhower and Nixon (1st President to have proposed universal health care for America) were very different in their thinking on better health for American citizens than the Goldwater-Reagan school of thought that believed the profit motive and "free market" is what made American healthcare "the envy of the world".; 10/5/09, 12:56 PM
David said...: garage mahal said...
"If one doesn't have access to or cannot afford these innovations, it doesn't do them a bit of good does it?"

My example was polio, Garage. The vaccine, which has been much improved over the last 50 years, has been made available worldwide through a variety of programs. Rotary International has spearheaded the effort recently.

From a recent news article, here are the results of that effort:

"Launched in 1988, the GPEI -- spearheaded by Rotary, the World Health Organization, U.S. Centers for Disease Control and Prevention and UNICEF -- has reduced the number of polio cases by 99 percent over the past two decades, from more than 350,000 cases in 1988 to an estimated 1,600 in 2008."

Rotary and the Gates Foundation have just pledged another $630 million to take the final difficult steps to complete eradication. Achieving this goal involves overcoming weaknesses in the vaccine delivery systems in a few third world and conflict afflicted areas.

Gleevec, the drug that keeps me alive, is made available at no or reduced cost by Novartis to thousands of people who can not afford to pay. In this country no one need go without the drug, regardless of their health plan, due to the efforts of the company and various private entities.

Your cynicism is sad--so much good is happening and has happened in public health and medicine throughout the world, and the United States and American companies are at the center of most of these efforts.; 10/5/09, 12:58 PM
David said...: And why, Cedarford, do you suppose that they come to the USA to do their research? It's because we have the funding, the infrastructure, the able colleagues who can stimulate further advances and the innovative spirit to draw them here.; 10/5/09, 1:00 PM
Cedarford said...: "shoutingthomas said...
There is no healthcare or insurance crisis.

The crisis is invented."

Talk to an employer or holder of private health insurance that saw it's cost double in the Dubya years. They will laugh at you.

Or those that looked at Medicare's 37 trillion unfunded lonf-term liability. Costs now far outstrip FICA...and Bush's big payoff to Big Pharma...free or nearly free drugs bought at full premium price from drugmakers by the US Government ....pushed that burden on future generations from 24 to 37 trillion. (Seems poor dumb Dubya was convinced by supply side ideologues that no taxes need pay for this huge new benefit or for two wars - just cut taxes and let that 'ol Reaganomics supply side magically fund all obligations...); 10/5/09, 1:07 PM
Cedarford said...: David said...
And why, Cedarford, do you suppose that they come to the USA to do their research? It's because we have the funding, the infrastructure, the able colleagues who can stimulate further advances and the innovative spirit to draw them here.

They come to America because we built a pretty good university research system, backed by taxpayer and Foundation funding.

Which has little or nothing to do with or private healthcare system.

In fact, most private enterprise US drug companies are now "offshoring" their developmental drug research..tapping in to good basic research in USA, Australia, France, etc..to cheaper places - notably India, China, E Europe.

Same story with US drug manufacturing. The large preponderance of over the counter, prescription drugs you take have left US manufacturing behind. They are now made in Mexico, subsidized Canadian factories, Columbia, Brazil, Egypt, India, Puerto Rico, tax-free Swiss factories, Japan, Taiwan. China's move to grab jobs from Puerto Rico and US firms in Mexico was temporarily set back by Chinese QC problems with tainted milk, grain, pet food.; 10/5/09, 1:26 PM
Jeff said...: America has the best healthcare in the world . . . if you can afford it. I don't recall anyone claiming that our healthcare system is terrible because of the doctors, so I'm not sure what your point is.; 10/5/09, 2:52 PM
John said...: American health care is great, if you can pay for it. What's so poisonous about a public insurance option? If you tell me that that equals socialized medicine, you're an idiot.; 10/5/09, 2:53 PM
blake said...: If one doesn't have access to or cannot afford these innovations, it doesn't do them a bit of good does it?

Actually, garage, in the case of polio it does, doesn't it?; 10/5/09, 2:54 PM
blake said...: Craig,

Did you include Nobel prizes for peace?

'cause I'd hate to think missed Al Gore in your calculations.; 10/5/09, 2:54 PM
blake said...: Talk to an employer or holder of private health insurance that saw it's cost double in the Dubya years. They will laugh at you.

Only if they fail to see the inventiveness of the government in creating it: The tax deduction for employer-obtained insurance; the market domination by Medicare and Medicaid; the corrupt tort system; the various states' insurance mandates, etc.; 10/5/09, 2:56 PM
blake said...: Unless of course it's one of those sardonic laughs.; 10/5/09, 2:58 PM
Cheryl said...: Don't forget we also have the world's suckiest school system, and we don't turn out any decent mathematicians or scientists anymore.; 10/5/09, 4:58 PM
J. said...: Hey numbskull, that's 2 Americans and an Australian.

You know Australia?... It's that place where they have universal health care, a thriving private insurance industry and world class hospitals that even poor people get to benefit from.; 10/5/09, 8:20 PM
Elliott A said...: @j. You cannot compare us to a country like Australia that hardly has any people, or Norway which has only 4 million homogeneous educated ones, etc.; 10/5/09, 9:04 PM
William said...: Typical overdressed bimbo microbiologists.; 10/5/09, 11:17 PM
J. said...: @Elliot - Actually you can compare and even contrast.

Australian health expenditure in 2007 was 9.1% of GDP which is considerably less than the United States at 16%. (Aust. Institue of Health and Welfare http://www.aihw.gov.au/expenditure/health.cfm)

Australia's population equals about 7% of the U.S. (CIA World Factbook)

Australia's 2007 GDP was 5.5% of the U.S. (CIA World Factbook); 10/6/09, 2:25 AM
gawker said...: Just a note : When you are making a point, make sure you're pointing it exactly at David's brain otherwise he's going to miss it.; 10/6/09, 11:50 AM
gawker said...: Dear Ann Althouse,
The only possible conclusion one can draw from this blog post is that you are entirely clueless about the health care debate.; 10/6/09, 12:35 PM
The Space Above the Couch said...: Congratulations America. And what are the chances the winners are in favor of health care reform?

Most smart people and the majority of doctors seem to be.; 10/6/09, 12:41 PM
jim said...: ???

Equivalancy fail - sorry, but the life-expectancy, infant-mortality & preventable-chronic-illness stats aren't exactly backing you up here. On average, you're still paying Porsche prices for K-Car results, no matter how many medical researchers win Nobels.

The system is awesome if you're rich enough to pay for elite-tier care - otherwise you're screwed. In the real world, that means most Americans are screwed, period.

There's an easy way to tell if the US is doing it right or not. How many nations are seriously looking into adopting an American-style system?

Now you've got the gallows humor of MC Michael Steele saying the AMA has no authority to speak on health-care ... this is the caliber of intellectual debate the right is bringing to the table.

Turns out maybe "go with your gut" isn't such a cunning plan after all.; 10/8/09, 1:29 PM
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www.onlineuniversalwork; 2/3/10, 11:28 PM