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Debating Cancer

Several of the Democratic presidential candidates gathered yesterday in Iowa for a debate and forum on cancer sponsored by the Lance Armstrong Foundation. Armstrong, a cancer survivor and advocate for research, began the event by telling the crowd that “the next occupant of the Oval Office must discuss this critical issue with voters.”

But as the forum went on, it became increasingly difficult to see what exactly there is to discuss. Of course everyone agrees that cancer treatment and research are critically important. Cancer in its various forms kills more Americans than any other disease (having surpassed heart disease for that top spot in 2005). And cancer research receives about $5.5 billion a year in funding from the National Institutes of Health, far more than is allocated to any other disease and about 25 percent more than was spent on cancer research in 2001.

So what is there for candidates to say? “Even more money” is the easy refrain: both John Edwards and Hillary Clinton promised to double the budget of the NIH (which currently stands at $28 billion). But throwing money at medical research can have unintended consequences. When the NIH budget doubled between 1998 and 2003, the many cautionary lessons that emerged pointed to the hidden dangers of rapid growth in research funding. Beyond funding, candidates described more and more extreme ways to limit smoking (while acknowledging he wasn’t sure if it would be constitutional, Edwards endorsed a national ban on smoking in public places).

The bulk of the debate, however, was taken up with arguments about a federally financed single-payer health care system. Not arguments pro and contra, mind you, but arguments about just how far to go and how to get there—with John Edwards again taking the cake by promising he wouldn’t even let the insurance and drug companies be involved in the development of his system. A serious moderator (i.e., not Chris Matthews) might have brought up the comparatively dismal figures for cancer treatment in several developed nations that have universal health care systems. But Matthews just let the aimless arguments continue.

Meanwhile, in the real world of cancer research, serious progress is being made, in no small part because of the work of those evil pharmaceutical companies. Cancer death rates have declined by about 1.5 percent per year for the last fifteen years, and cancer is slowly becoming more like a chronic disease than a swift killer. Much work remains, but, as yesterday’s forum made clear, it’s not the work of politicians.


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