Obama's Cancer Proposal: What Is Desirable Is Not Always Feasible

Professor Thomas Sargent, Nobel Laureate in Economics and Professor at New York University, presented several points in his Graduation Address at the University of California, Berkeley (his undergraduate alma mater) in 2007.

Sargent’s speech was short, consisting of twelve simple precepts about the discipline of Economics, which he called “organized common sense.” President Obama and the current cast of presidential candidates hoping to succeed him should read and reflect on this speech. A link can be found at the website: .

Sargent’s first point is simple: Many things are desirable but are not feasible.

Simple and clear, is it not? My old thesis director at Johns Hopkins, the late Jurg Niehans used to say, time and time again, that just because a theory makes sense, is easy to understand, and clear, that it is not trivial and irrelevant. It is often the easiest to understand and clearest theories that are first forgotten, overlooked, or misunderstood by policy makers. Obama’s State of the Union is a case in point. As Sargent would note, we face, collectively, feasibility constraints.

As we know, in his 2016 State of the Union, President Obama’s called for more funding for cancer research, comparing this project to Kennedy’s challenge to achieve an American on the moon by the end of the 60’s. The JFK-inspired Apollo Program, of course, was political: to show that Soviet Union, which had beaten us in getting a satellite to orbit the earth, that we are better. However, it is hard to see how the Apollo program was, economically, a wise use of our resources as a nation.

Yes, it is desirable to have a cure for cancer (or several of the many very different types of cancers) in our lifetime, or even next week or tomorrow. However, just because it is desirable does not make it feasible. Scientific progress comes when progress comes, full stop. Ideas come from continuous experimentation as well as insight, as a result of much patience and perseverance in research. Furthermore, it is not as if there is little or no funding for cancer research. There are also numerous non-financial incentives for researchers to work hard, with all due diligence, including prestige among colleagues, promotions, and publicity.

Throwing more and more federal money at cancer research, on top of current funding, does not in any way guarantee that good ideas and insight and cures will materialize sooner rather than later. Less competitive and more lax funding standards, coming from more abundant funding, may, in fact, retard the advent of substantive progress in science. Many sloppy research proposals are more likely to get funded, and of course, with more funds available, managers at research institutions and universities are all too prone to find reasons to increase administrative overhead. Thus much of the additional funding may not go to basic research but into the budgets of administrators for non-research related activities.

Yes, we sympathize with Vice President Biden over the loss of his son to cancer, and President Obama’s desire to respond in a concrete way, as well as Vice President Biden’s desire to leave a legacy in memory of his son. We would like to see less incidence of this scourge. But until a cure arrives, likely piecemeal, for various forms of cancer, we have to make do with preventative, albeit less dramatic, measures, such as continued vigorous anti-smoking campaigns, advocating better diet, exercise, steps for managing and reducing stress, and less consumption of alcohol. Our sympathy with Vice President Biden is not a reason to make far reaching policy decisions.

As Catholics and believing Christians, of course, we can pray. We pray to the Holy Spirit for forgiveness, for inspiration in our daily life, in thanksgiving, and in adoration. We can also pray for the same Holy Spirit to guide researchers engaged in cancer research as well as in all other research leading to greater healing in our human condition. The point of this cautionary note on President Obama’s final State of the Union is that more federal funding is not a panacea for the ills facing the human condition. We should not underestimate the power of prayer and perseverance in research.

Paul D. McNelis, S.J., America’s contributing editor for economics, holds the Robert Bendheim Chair in Economic and Financial Policy at the Graduate School of Business Administration at Fordham University, New York.

Update: Father Paul McNelis responds to the comments below:

1.  Heart disease kills more each year than cancer and is significantly much more prevalent among low-income minority groups, specifically African Americans, starting from a young age. Why should not heart disease get the same priority as cancer from Vice President Biden?  Well we know why.  But is this a reason for major public spending on one disease and not another

2.  On the Apollo program, one comment seemed to say I was calling for environmental spending.  I stated the the Apollo program was not a wise economic use of our national resources. Meaning wealth spent on programs.  Clearly the brunt of government spending on Apollo went to the aero-space industry, the high end of the income distribution, which created jobs for high-skilled workers who paid taxes.  But as someone in university during the turbulent 60's, I cannot help but think that if only a fraction of the Apollo funding went to inner city schools, with better paid teaching in the inner cities, as well as more widespread head start programs, we would would not be in the mess we are in today in our major cities.  My feeling is that the tragedy of Lyndon Johnson is that Great Society programs did not go far enough, in targeting inner city education, especially at the primary level.  As well as providing better basic health care to people in the inner cities.  Like the Viet Nam war, the Apollo program was not a good use of our national resources.  Looking back, both are examples of American hubris. 

3.  Some question my reference to prayer.  I would ask the readers to look at the work of Daniel Sulmasy, M.D, now at the University of Chicago, formerly at Georgetown, where we overlapped.  The role of religion, prayer, and pastoral care in medicine  are receiving serious attention both in research centers around the country, at places like Chicago. and being published in major medical journals.  My point is that effective medical care and progress in treatment of the serious disease  are now looking in to the spiritual dimension of human person.  This is not just coming from me as a Jesuit priest but from leading researchers at the University of Chicago.

4.  Tom Sargent's second point is that communities and individuals face trade-offs in their use of resources.  The same if true for governments.  Spending more money on cancer research will draw more research activity into this area, away from other research areas, like heart disease and other diseases which affect the more more predominantly.  There are costs and benefits to any new spending venture.  

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Stanley Kopacz
1 year 8 months ago
I don't see how exploring this knowledge space more intensely and expanding the population of experts can't help but yield applicable therapies. In addition, there will be spinoffs into other areas as occurred with the Apollo space program which Professor McNelis disparages. It is true, however, that the money saved by not pursuing cancer research can go into more useful things like Mideast wars and maybe further billions for billionaires.
geoffrey greetham
1 year 8 months ago
I am puzzled by Reverend McNeil's comment: "However, it is hard to see how the Apollo program was, economically, a wise use of our resources as a nation." This comment mirrors the tone of his comments. It seems the father McNelis would have us pray and work hard to solve all our problems. These comments from a well trained Jesuit father simply shows the great weakness of economic thought. The idea that "Many things are desirable but are not feasible." means to turn away from the idea is simply short term economic thinking -the significant problem of our current American era. For example, the moon landing program provided a significant economic effect. "Chase Econometric Associates attempted to answer in 1976. They came up with a ratio of 14:1… that is that for every dollar spent on the Apollo mission, the US public received a benefit of $14. By 1976, research from the moon mission had already benefitted the aereospace industry, computer industry, car industry and international communications industry, just to name a few." Moreover it was and still is today "it is very difficult for us to imagine the benefits that so-called ‘blue skies’ research can bring to people in the future." Moreover, economic analysis of the benefits of scientific research is difficult, if not impossible. This short term thinking is evidenced by the author's comment "we didn’t put money into R&D in other key areas like energy and natural resources". Energy and natural resources were not on any ones radar in the early sixties. Yes, it would have been great to develop capabilities freeing from fossil fuels, but mans, and especially Americans, arrogance led us at the time to believe that they caused no deleterious effects and that they would be here for us virtually for ever. The author is right to say that some of the money will be misspent, that there is no one cure for cancer but given the total refusal of America to accept climate change, to expect government services for no or very little tax burden and the well proven record of American business to think only of profit and short term gain, there is no reason to believe the expenditure of these funds can do any worse than most of the difficult to validate or prove economic theories the vast majority of economist would have believe as the path to financial enlightenment and well being. To succeed one must dream big and take risks. More often than not failure will result. But it was the Enlightenment that took us out of the age of myth and demons and into an era of scientific research and daring. Yes, must of the dollars spent will provide only a small boost the local economies in the shorter.; but suppose one < just one< cure is found the value to the lives saved far out weighs the need for a belief in a capitalism that make super rich sultans of a few and leaves the rest to suffer their crumbs - all in the name of yet another "wise" economists advice. I for one cant recommend to many solutions - but if Father McNelis were to pay more attention to his current Pontiff's words of charity and mercy maybe he could see through the weakness of his analysis and remember not everything is about today's value. Gold is good for somethings but it is not a God and the future will not ( nor has it ever been) written by those who could only find current utility in ones effort.
Ed Dailey
1 year 8 months ago
Given that Fr. McNelis is an economist, we might expect that he would offer some facts to support his suggestion that the President's call for more funding of cancer research is just "[t]hrowing more and more federal money at cancer research". Cancer survival rates have increased dramatically. Is this simply serendipitous?
Chuck Kotlarz
1 year 8 months ago
Putting a man on the moon all but assures a cure for cancer is feasible. The discovery potential of the world’s eight billion people is mind boggling. Does cancer research offer a good return? Firearms are the number two killer of US males ages 15-44 while cancer does not even make the top ten for this group. A major legacy of the space program, satellites, handle trillions of voice, data, and video transmission tasks across all countries and continents. Satellite navigation systems guide people, vehicles, ships and aircraft. Satellites help support earth, marine, and atmospheric research and help obtain meteorological data, land survey data, etc. The space program at its peak in 1966 was less than 5% of the federal budget. Contrast that with today’s financial industry at nearly 10% of GDP. Who would have thought it would take 10% of GDP to run an ATM?
Chuck Kotlarz
1 year 8 months ago
My first comment reflects the original piece. However, Father Paul’s response (shown after the original piece) to the posted comments adds another dimension. Gauging the success of Lyndon Johnson’s Great Society programs depends a lot on where one looks. For example, a look at today’s White House might lead one to conclude the Great Society a huge success. One can also see that states most strongly aligned with the principles of the Great Society have an African American college graduation rate 40% higher than states least aligned. More recently, ACA has positioned blacks eighteen and younger no more likely to be uninsured than whites. Texas has the country’s highest high school black graduation rate and some best practices perhaps could transfer to inner city schools. San Antonio’s largest inner city school district dropout rate fell to less than 10% in 2013. The dropout rate exceeded 25% in 2007.
J Cosgrove
1 year 8 months ago
A Moonshot or Moonshine?
An article that appeared in the last week on this. http://www.usatoday.com/story/opinion/2016/01/14/obama-state-union-address-biden-cure-cancer-column/78753580/ Here is a quote from a previous State of the Union address
"I will also ask for an appropriation of an extra $100 million to launch an intensive campaign to find a cure for cancer, and I will ask later for whatever additional funds can effectively be used. The time has come in America when the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease. Let us make a total national commitment to achieve this goal." Richard Nixon, 1971
Obama and Nixon have many things in common. An incredibly divided nation as a result of their actions and a war on cancer. But is it really Groundhog Day for Obama?
Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives. It will launch a new effort to conquer a disease that has touched the life of nearly every American, including me, by seeking a cure for cancer in our time. Obama - February 2009 in speech to a joint session of Congress Last year, we made the largest investment in basic research funding in history -– (applause) -- an investment that could lead to the world's cheapest solar cells or treatment that kills cancer cells but leaves healthy ones untouched. Obama - State of the Union Address 2010 So tonight, I’m launching a new Precision Medicine Initiative to bring us closer to curing diseases like cancer and diabetes, and to give all of us access to the personalized information we need to keep ourselves and our families healthier. Obama - State of the Union Address 2015
As a cancer survivor, I appreciate all that has been done in cancer research and the dedicated people I found in oncology. But there is already lots being done in cancer research and much more is needed. But if I were to put the money some place, it would mainly be in Alzheimer's research. That seems to be the disease that scares everyone as my wife had a horrible experience watching her mother for 7 years essentially wasting away without knowing anyone around her. It is something that many of our friends have also experienced with their parents. For an article just out from Stanford. Read how researchers are using the immune system to fight cancer and what the regulatory hurdles are for new approaches. This is cutting edge research already going on https://alumni.stanford.edu/get/page/magazine/article/?article_id=83001
Chuck Kotlarz
1 year 6 months ago
Since 1976, the NASA publication “Spinoff” (http://spinoff.nasa.gov/) has profiled nearly 2,000 space technologies that have made their way -- in one way or another -- into the private sector. Perhaps one lesser known byproduct of space technology: "While developing life support for Mars missions, NASA-funded researchers discovered a natural source for an omega-3 fatty acid previously found primarily in breast milk that plays a key role in infant development. The ingredient has since been added to more than 90 percent of infant formula on the market and is helping babies worldwide develop healthy brains, eyes and hearts." Another lesser known byproduct of space technology: "Looking to ensure the absolute safety of prepackaged foods for spaceflight, NASA partnered with the Pillsbury to create a new, systematic approach to quality control. Now known as Hazard Analysis and Critical Control Points (HACCP), the method has become an industry standard that benefits consumers worldwide by keeping food free from a wide range of potential chemical, physical and biological hazards."

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