The current administration has proposed significantly cutting NIH funding to Universities for "indirect costs"... proposing that they will now be a total of 15% of grant awards (some places currently have >50% in their budget). Behind the scenes, I am hearing these changes would result in the complete cessation of clinical research at some institutions... as many Universities fund their CTO offices with these funds. What have you guys been hearing?
NIH funding cuts
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First, this has already been blocked by a court (for now at least).
I am a physician scientist and while this was done poorly, I don't hate the core idea of capping F&A rates. Its always seemed weird to me that institutions can set their own rate at whatever they want. My last RO1 submission had a top 3 center as a subsite and their F&A is 76%. We are a state institution and ours is 45%. Do the math. That means 8 RO1s at the top program would be 9 at our site. Foundation awards and industry set their own rates (usually 20-30%). A plus to capping F&A would be if you set it at a reasonable number and did nothing else to the NIH budget, the pay line would actually go up a few points.
But 15% is too low. Most state systems would have to either greatly downsize their research programs or make up for the funding deficits with draconian tuition increases further limiting college education to the social elite. Which...is probably the idea 🙁
Agree. Similar situation here. What I have discovered though is that, when you put a patient on a cooperative group trial, the reimbursement the university gets from the NIH is not enough to cover the research costs for tracking that patient. A lot of these "indirect costs" go to funding CTO offices... and without them, the cooperative group model of research may not be feasible.
A better system would be for NIH funding for CTO costs to be independent of individual grant awards... but, as it stands right now, a lot centers may not participate in cooperative group clinical trials (or single institution trials, for that matter).
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I dont understand how a "top tier" university will close their CTO office while sitting on an endowment of billions of dollars? This is a genuine question.
In the same light, how can they be on the verge of closing but also opening a brand new 20 story building filled with labs? This is happening at some universities. CEO of MGH makes like >5 million a year.
Lots of examples to point to where tons of money goes to questionable places in "research medicine".
Obviously nothing is that simple, but the optics of the situation are not very favorable to me.
Is 15% really too low?
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CEO makes 6 million and has a deficit of 250 million - Harvard is not touching that endowment though
This is probably why our private practice does industry sponsored trials instead of cooperative groups. Our indirect cost is 0% because we don’t get NIH monies.
I definitely feel for my friends in basic science.
I echo @NotMattSpraker. It is hard to feel sorry for some of these academic powerhouses where they are constantly putting in giant hospital buildings and research institutions, the c suite makes millions, the endowment is tens of billions, and they are outspending community practices 50:1 on NFL prime time ads and highway billboards.
If Harvard and Stanford are getting 70% and 55% indirect costs, there’s plenty of fat that these institutions have gotten used to. It’s like the top marginal tax rate, how high is high enough, if you aren’t the one footing the bill i.e. the taxpayer but you are the beneficiary/grifter, the answer is to maintain indirect cost at current levels indefinitely or push it higher incrementally over time. No one volunteers for cuts.
If Harvard and Stanford are getting 70% and 55% indirect costs, there’s plenty of fat that these institutions have gotten used to. It’s like the top marginal tax rate, how high is high enough, if you aren’t the one footing the bill i.e. the taxpayer but you are the beneficiary/grifter, the answer is to maintain indirect cost at current levels indefinitely or push it higher incrementally over time. No one volunteers for cuts.
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People just don't understand the importance of first class flights and bonuses and why phd candidates need to spend 100 hours working some weeks without adequate resources or promise of a job afterwards so that others can enjoy that. Selfish trainee scientists...
tbh I get it that basic science is a selfless thankless endeavor and it rarely leads to riches or the like. however especially in the age of AI I would question allocating more resources to research in the traditional PI/lab model. The benchmarking for the LLM’s are the hard frontier questions from leading chemistry, physics, math professors and LLM’s are doing well. I can easily see most of traditional academic research even in STEM going the way of humanities in next couple decades.
tl;dr just because a job doesn’t have much in the way of job security, doesn’t automatically suggest that it has high intrinsic value. Just ask artists and musicians. There’s always going to be a place for top 1% artists and I could see science go in a similar direction.
There’s much bigger cost savings to be had in military procurement or other areas of government of course but that doesn’t mean there’s no waste in federally funded research
tl;dr just because a job doesn’t have much in the way of job security, doesn’t automatically suggest that it has high intrinsic value. Just ask artists and musicians. There’s always going to be a place for top 1% artists and I could see science go in a similar direction.
There’s much bigger cost savings to be had in military procurement or other areas of government of course but that doesn’t mean there’s no waste in federally funded research
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That is interesting. I am no expert, have basic CS knowledge so I thought most of it was inputs from humans or sources that humans write with a lot of "if..." coding
What are LLM's abilities to produce strong innovative basic/translational sciences, and do they need a human to do it or will there be robots doing it?
Who curates the ultimate curators?
From my experience I often end up arguing with them about math and they start making up random math haha
What are LLM's abilities to produce strong innovative basic/translational sciences, and do they need a human to do it or will there be robots doing it?
Who curates the ultimate curators?
From my experience I often end up arguing with them about math and they start making up random math haha
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No doubt academia not optimally efficient (thank god).
Efficiency quickly becomes antithetical to human values.
Also true that big academics now run as corporate entities and as such have very little loyalty to employees and disproportionately reimburse the administrative top.
I agree that these cuts shouldn’t be “shutting down” big academic places….but the pain will be spread downwards…and it will be real.
Columbia A&S cutting an upcoming cohort of PhDs by 65%. Hopkins cutting PhDs in response to unionizing.
Still, wtf people gonna do! Way better to be a mid scientist making tangential (but probably substantial) contributions than be almost anything else (including being a recent Cs graduate basically optimizing surveillance capitalism).
Also…academia clearly being targeted.
Numeracy yo!!! ~200B federal expenditure in 2024 on all research…175B just requested for “the border”
Efficiency quickly becomes antithetical to human values.
Also true that big academics now run as corporate entities and as such have very little loyalty to employees and disproportionately reimburse the administrative top.
I agree that these cuts shouldn’t be “shutting down” big academic places….but the pain will be spread downwards…and it will be real.
Columbia A&S cutting an upcoming cohort of PhDs by 65%. Hopkins cutting PhDs in response to unionizing.
Still, wtf people gonna do! Way better to be a mid scientist making tangential (but probably substantial) contributions than be almost anything else (including being a recent Cs graduate basically optimizing surveillance capitalism).
Also…academia clearly being targeted.
Numeracy yo!!! ~200B federal expenditure in 2024 on all research…175B just requested for “the border”
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This happened at the wrong time. I think too many people are self aware and smart and want things to be humanity ideal, moreso than ever.
Strip that away with machine learning things will get weird.
It would have been better in the idiocracy timeframe when everyone was super into pro wrestling.
Their president (nvm maybe we are there.....):
(Maybe NSFW or SDN, delete if needed)
Strip that away with machine learning things will get weird.
It would have been better in the idiocracy timeframe when everyone was super into pro wrestling.
Their president (nvm maybe we are there.....):
(Maybe NSFW or SDN, delete if needed)
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I feel that. Im not as pessimistic about academia as many on this board 🤣
But also, I've had a small external grant with an indirect and it just went in to a black box. Transparency is a reasonable request. No one has actually explained why 15% is not enough. Also, enough for what? Many seem to agree there is a lot of wasteful science.
If the result of this shake is boards spreading pain downwards, maybe we should be mad at those boards, not at the EO.
By the way, wtf people should do is make sure they have strong clinical skills! Thats what I tell the kids. Physician pay cut is tiny compared to the indirects 🙂
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Really just meant that most people seem to agree there is objective value of clinical service to the world, so less of a target during these existential debates. The objective value of many rad onc research efforts is much harder to define.
Speaking of that clinical skills, I additionally had a "deans tax" on the clinical side in my academic job. A tax on my clinical services levied by my employer! LOL. Not a small tax either. Before you ask, no, I did not get any kind of report to tell me how my taxes were being spent 🤣
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This happened at the wrong time. I think too many people are self aware and smart and want things to be humanity ideal, moreso than ever.
Strip that away with machine learning things will get weird.
It would have been better in the idiocracy timeframe when everyone was super into pro wrestling.
Their president (nvm maybe we are there.....):
(Maybe NSFW or SDN, delete if needed)
We are there imo.
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don’t places like Harvard and Stanford factor in “rent” as part of indirect costs? Market rate “rent” in Palo Alto and Boston must be stratospheric.
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For public institutions using accepted standard direct cost rates, 15% isn’t even close if they do legit science. The costs of doing animal research alone are enormous. Standard per diem rates to house small vertebrates in animal cores only recoup a fraction of the operating costs. Personnel alone includes husbandry staff, vets, admins (ordering etc) and required regulatory staff. We haven’t touched the energy, equipment, facilities, or supply costs.
Now, none of this is to say something in the range of 20% couldn’t work. It would require overhauling the budgetary process to capture much more of these things as direct costs because they are critical to doing research. The science community wouldn’t love this because higher direct costs would mean the scope of grants would have to be more limited and focused. There would be growing pains but no doubt, it would almost certainly reduce waste. As I very clearly indicated above, I don’t think this is inherently bad and if done right, it could end up even helping pay lines. But it’s a process that requires some time and planning which is not what was attempted here.
The issue of wealthy top tier places with huge endowments, astronomical tuition rates, and armies of rich donors crying poverty and cutting staff without touching their trusts or cutting executive pay after decades of charging higher rates than most simply because they can…I’m right there with you. Many of these same places also do everything they can to push the Medicaid (or worse) patients onto us to eat those costs too. But who will across the board cuts hurt the most. Hint, it’s never the richest guy in the room.
Again, the general concept proposed is not a horrible idea. But the attempted execution showed absolutely no foresight or comprehension of how the system actually works and exactly what waste is being targeted.
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Academic labs are run like fiefdoms. Everyone PI has their own area of focus. There is nothing streamlined for cohesive efforts (like SpaceX for example)- it's not designed to have the best people come together to make amazing short-term progress. Because everything is so spread out, there is tremendous waste, if waste is defined as excess money spent that is not progressing things at what could be done in a more efficient model. Every university has dozens of core facilities, and almost all of them suck. Wouldn't it be more efficient to focus on a few, excellent core labs throughout the country? Every university has hundreds of faculty that produce nothing of long-lasting value (mostly incremental advances that never progress to new standards of care).
I hope some of the federal changes stimulate a revamp of how research is conducted. The current model gets credit for occasional discoveries that have outsize impact like immunotherapy (from << 1% of labs). It should be obvious that better systems could be designed - and I hope these initial changes move things in the right direction. Universities should select specific focus areas and build teams (PIs now working collaboratively) around those areas - and compete for big grants as universities, bench to clinic translational work (like pharma). NIH/HHS can more easily keep track of progress. Less work is meaninglessly replicated. Less trash science. More high-level focus on high priority work, with competition between universities (not PIs) to compete for who gets to do it.
This model does not currently exist (except in weaker forms in pharma & spore grants). The expenditure to progress ratio for this type of work would be exceptionally higher than things are now. Get rid of the fiefdoms.
Note: I run a translational research lab (discovered new drug target) ... and I'd much rather work in a system where an entire well-oiled ecosytem was in place to translate discoveries (domain experts and funding in place at all levels to run each next-step). Individual labs or departments are not setup well at all to do this in the current system, which adds tremendous cost, especially wasted time fighting for funding at each step.
I hope some of the federal changes stimulate a revamp of how research is conducted. The current model gets credit for occasional discoveries that have outsize impact like immunotherapy (from << 1% of labs). It should be obvious that better systems could be designed - and I hope these initial changes move things in the right direction. Universities should select specific focus areas and build teams (PIs now working collaboratively) around those areas - and compete for big grants as universities, bench to clinic translational work (like pharma). NIH/HHS can more easily keep track of progress. Less work is meaninglessly replicated. Less trash science. More high-level focus on high priority work, with competition between universities (not PIs) to compete for who gets to do it.
This model does not currently exist (except in weaker forms in pharma & spore grants). The expenditure to progress ratio for this type of work would be exceptionally higher than things are now. Get rid of the fiefdoms.
Note: I run a translational research lab (discovered new drug target) ... and I'd much rather work in a system where an entire well-oiled ecosytem was in place to translate discoveries (domain experts and funding in place at all levels to run each next-step). Individual labs or departments are not setup well at all to do this in the current system, which adds tremendous cost, especially wasted time fighting for funding at each step.
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A few random points:
1) one cannot simply tap into an endowment like a savings account
2) Without indirect funding, it is not feasible for many universities to conduct clinical, translational, basic science research. Reworking the budget is, of course, possible, but will set back research years
3) many young scientists who spent their early careers developing projects will see them evaporate overnight. These talented young men and women may simply leave science
4) Many Universities use these indirect moneys to fund clinical trial offices, and will need to lay off their staff, turning the stomachs of politicians Here’s how much the NIH cut would cost UAB: ‘Jeopardizes life-saving research’
5) The man behind the funding cuts stands to personally profit billions from the very tax cuts that slashing the NIH budget is meant to offset.
6) NIH investment returns $2.46 on every dollar invested. Can one say the same about the tax cuts?… or military spending.
I am sure everyone could think of some better, more efficient, way to spend this money … but I bet most of you would agree that it would be better to pay for clinical trials than to pay Tesla’s taxes.
Of all the places in the federal budget where there is “waste”, is this really the first place we should be trimming the fat?
1) one cannot simply tap into an endowment like a savings account
2) Without indirect funding, it is not feasible for many universities to conduct clinical, translational, basic science research. Reworking the budget is, of course, possible, but will set back research years
3) many young scientists who spent their early careers developing projects will see them evaporate overnight. These talented young men and women may simply leave science
4) Many Universities use these indirect moneys to fund clinical trial offices, and will need to lay off their staff, turning the stomachs of politicians Here’s how much the NIH cut would cost UAB: ‘Jeopardizes life-saving research’
5) The man behind the funding cuts stands to personally profit billions from the very tax cuts that slashing the NIH budget is meant to offset.
6) NIH investment returns $2.46 on every dollar invested. Can one say the same about the tax cuts?… or military spending.
I am sure everyone could think of some better, more efficient, way to spend this money … but I bet most of you would agree that it would be better to pay for clinical trials than to pay Tesla’s taxes.
Of all the places in the federal budget where there is “waste”, is this really the first place we should be trimming the fat?
If you found out tomorrow that your Lab had to be shut down because the university could no longer provide the necessary infrastructure (and is selling the research building to a developer), would you happily hang up your lab coat, knowing that yours was a “reasonable sacrifice” so that future scientists could conduct research more efficiently?
Scientific research is actually one of the few things that the US does really well. Sure, it can be more efficient but the solution isn’t burning down the system.
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What if...the cruelty is the point?
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I think it's an imperative to call out evil when you see it.
Has there ever been contrition from these players? I don't think so.
There was once a powerful nationalist movement that embraced technology while dismissing science (which rarely gives you the answers that you want). We shouldn't replicate that.
I could apply a "high efficiency" model to my very own clinic...drop physicians by 40%, physicists by 33%, RTTs by half. Cut operating costs and face to face patient time. I could probably negotiate a 60% compensation raise.
It would be wrong.
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Are we overproducing PhDs? Ive read a data-driven argument that this is bad for society. I agree this was not done well and there are better places to cut waste, but those do not negate that there is waste in science. I also agree there is COI here that few are discussing.
The CTO problem is a nice example where I get confused. People have been talking about streamlining trials for decades and it seems to be all talk. Now would be a good time. When I was in academics, I watched the CTO staff turn over at a very rapid rate because they would all be poached by pharma. I felt it harmed our productivity, but people didn't seem that bothered by it. At least not enough to raise CTO staff pay to retain them...
Trials stopped during COVID.
I have managed to enroll patients in academics, outside academics, through COVID, low staffing; the world did not end.
From your article: “So, what is the result of the NIH cuts? Research is stopped, lives are lost, American jobs are destroyed, communities are threatened, and our country loses the edge we need to win the future.”
If lives will be lost, step up and help? Is that not part of your mission? UAB has a 1 billion dollar endowment by the way. I do not think it is valid to say that it cannot go to these kinds of expenses. I realize its not that simple, but its also not impossible.
If the institutions would rather close a CTO than spend their own money, why should the tax payers pay for their CTO? I am open minded there could be a reason, but hyperbolic statements about lost lives and "losing the future" do not do it for me.
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60-80% of biomedical research is not reproducible. how much of it is fake/wrong, leading whole fields down wrong paths like with Alzhiemers? The system needs to change. There is a lot of throwing the baby out with the bathwater when it comes to this kind of blowback. Similar situation happened with prior auth: hospitals bankrupting society invites insurers/prior auth to come in and indiscriminately ration care.
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I actually doubt it. I am not a fan of the individual churning out these executive orders and while I do think he has shown many times over that he quite capable of being indifferent to other people's hardships of it suites his objectives, he is above all things transactional and there is little if anything from his public life to suggest cruelty or suffering is the goal to him.
I think the part that needs to be said out loud here is none of us have any idea what the their objective actually is. Are they using the threat of major cuts to desensitize us to smaller ones? Are they flooding the system to distract from a bigger goal? Do they believe fringe legal theories and actually think they can bypass congressional spending? Who knows. No point being too reactionary with everything that comes out.
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I do wonder what portion of our taxes are going to CTOs? Back of the envelope is miniscule.
I don't know what goals are for endowments...nor do I even have a sense of reasonableness. Should endowments be aspirational (to ensure future growth and capital intensive projects) or should they be limited to ensure rainy day funds and to limit acute austerity measures?
If all academic institutions had to make a big portion of their endowments liquid for operation costs in the setting of an acute change in anticipated federal funding....does this have negative market impacts (negatively impacting pension funds etc).
Has any of this been thought through by this administration prior to changes in funding by fiat? Doesn't seem so.
I would have no problem in a real audit and analysis of discretionary federal funding, including research funding (as stated before, total research funding sits at ~200B or ~ 3% of federal annual budget). But I think it is likely that a sudden change in funding (when not necessary) likely leads to the opposite of efficient responses. (e.g. layoffs followed by re-hires, temporary cessation of trial accrual, pauses in actively accruing trials). It also will negatively impact human responses, including the talent pool for academic medicine and training programs in the short term and the talent for industry science in the long term.
How is this a good thing?
? Haitians eating pets? "These people hate our country". Have you seen excerpts from a rally? Maybe not cruelty as a goal but cruelty as a tool? Absolutely.
His campaign alone was cruel. His rhetoric is cruel. His executive order regarding transgender people is cruel. He foments a certain brand of collective meanness. He openly embraces retribution. His prior tax plan was targeted disproportionately at blue states. His support within academia is abysmal and I'm sure he is aware.
I doubt this particular cut was motivated by cruelty, however.
There is little to suggest (as of yet) that he has an appetite for directed violence (outside of lawfare) on Americans (although violence on his behalf he seems OK with).
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Lets stop this direction of the conversation now. FWIW, we are saying the same thing. I just used softer language (indifference to...) to try to keep the mods from deleting my post.
The relevant point to this board is we don't know what the goal of these proposals are or how hard they intend to fight for them. These are certainly anxiety provoking times, but we are still at least a few steps removed from huge interruptions to scientific research, much less mass layoffs. Those of us in science and academia need to pay attention and have contingency plans. But we also need to remember "some people" care as much about the perception of winning as they do actually making major change.
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No, I don’t think the dramatic short-term change is the right way to do it. I think there needs to be a longer term transition plan with meaningful input from all stakeholders.
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One last thing I can’t let go of is that we need to be cautious of how we define waste and inefficiency in the context of macroeconomics. It is fundamentally impossible to drastically improve efficiency in a given industry without eliminating jobs. There has to be a realistic assessment of how that is offset. Otherwise, you are just trading one problem for another and reallocating costs rather than reducing net expenditures. This is one of the biggest reasons that my faith in the current economic approach is…limited.
True, but if you shift employment from one industry/setting which is inefficient (government jobs) to another which is more efficient (private sector) then efficiency overall is improved and the impact on net expenditures would be positive. In addition, reducing government employment/expenditures should reduce the T bill rate, which would increase capital available to the private sector, which should in turn spur private sector employment, which should help those who lost government jobs.
I actually don’t agree. I’m not a Tesla shareholder beyond index funds. But if we zoom out from rad onc and look at healthcare in general, we have bad outcomes as a nation. I don’t blame the public or politicians for feeling like NIH money not being well spent.
Alternatively, if it wasn’t for a certain billionaire, we would be handicapped in modern warfare (no spaceX), AI (no openAI), cars and EV’s (no Tesla). All you’d have is legacy car companies and their jobs program, and progressive politicians and their jobs program. Socialism, baby.
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Right out of the "fork in the road" memo that all federal employees received as part of their (not legally substantiated) invitation to resign. They used the term "productivity" in lieu of efficiency.
How Twitter Threw Employees Under The Bus (And Elon Musk Ran Them Over)
A new study sheds light on the impact of the Twitter acquisition on its employees. Management and the board abandoned Twitter's mission statement and core values and failed to protect the interests of Twitter employees. Elon Musk didn't do much to rectify the situation. Or did he?
www.forbes.com
The federal government up till this point has had a remarkably good brand as an employer. Places like NIH, NSA, FBI do very well with recruiting.
There is no doubt that Musk's lack of risk aversion has pushed some industries forward for the good (there is always some good that comes from any movement). However, I would never want to be his employee. Like all individuals, he is remarkably wrong about many things (see Sam Harris' recollection of their conversations regarding Covid).
Collective expertise is always good to have.
Different things. NIH remains an incredible engine for medical research and improving standards of care.
Our outcome deficit (relative to other wealthy nations) is overwhelmingly driven by disparities within our population (is this Admin going to focus on this?). I'd like them to. Sounds a little bit like DEI?
Our lack of value is overwhelmingly driven by our exorbitant pricing.
I'm happy to support the implementation of a good single payor system by this administration.
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I don’t believe health outcome differences are driven by disparities. Poor minorities working at Chipotle still earn more than the average salary in many euro nations. much more gov money spent on education as well. Inner city Baltimore has more money spent per student than almost anywhere in the world, yet less than 1% are grade level profficent.Right out of the "fork in the road" memo that all federal employees received as part of their (not legally substantiated) invitation to resign. They used the term "productivity" in lieu of efficiency.
How Twitter Threw Employees Under The Bus (And Elon Musk Ran Them Over)
A new study sheds light on the impact of the Twitter acquisition on its employees. Management and the board abandoned Twitter's mission statement and core values and failed to protect the interests of Twitter employees. Elon Musk didn't do much to rectify the situation. Or did he?
The federal government up till this point has had a remarkably good brand as an employer. Places like NIH, NSA, FBI do very well with recruiting.
There is no doubt that Musk's lack of risk aversion has pushed some industries forward for the good (there is always some good that comes from any movement). However, I would never want to be his employee. Like all individuals, he is remarkably wrong about many things (see Sam Harris' recollection of their conversations regarding Covid).
Collective expertise is always good to have.
Different things. NIH remains an incredible engine for medical research and improving standards of care.
Our outcome deficit (relative to other wealthy nations) is overwhelmingly driven by disparities within our population (is this Admin going to focus on this?). I'd like them to. Sounds a little bit like DEI?
Our lack of value is overwhelmingly driven by our exorbitant pricing.
I'm happy to support the implementation of a good single payor system by this administration.
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It is incedible how much poorer places like Canada and the uk have become over the past 15 years compared with us. Both countries used to be on par. Now our poor = their middle class. Disparities can be explained by inherent group differences in cutures and traits.
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it’s pretty simple. Either you believe in government sponsored research or not.
The idea that one would expect academic institutions or any other corporation to pay to do research is fantasy world. Why would any corporation do that? Do you not understand basic economics?
Stop the nonsense.
The idea that one would expect academic institutions or any other corporation to pay to do research is fantasy world. Why would any corporation do that? Do you not understand basic economics?
Stop the nonsense.
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Sorry guys. This is insane. (as is public messaging presently)
Just do a stupid AI (I know... AI is woke) or google search even. I'm not going to post links. There are a ton of studies. Bloomberg has a nice comparison of US vs UK health outcomes. (I will drop one data point...black women live to almost 83 on average in Rhode Island (blue) and 67.5 in WV (red)). Are WV black women inherently inclined to live 16! years less on average?
Life expectancy disparities by income in the US are greater than in peer countries, even when normalized by race (if you were getting at that). Rich Americans and rich Brits do roughly as well as each other.
You should probably have intuited our disparities by income just by your clinical experience. The cross-country comparisons do require public health professionals....and international collaboration.
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Haha, I cant tell if you're being sarcastic!
Because an incredibly low percentage of scientific and medical research that the NIH funds can lead to profit and most is not even designed for profit, even on the clinical research side. How does say University of Arkansas benefit profit-wise from investing money in enrolling patients to a BID reirradiation trial for head and neck cancer?
Like I said you either believe in the importance of the US government funding research or not.
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Regardless of how they view the benefit, UAB is choosing to be in this game. They are an NCI CCC. They are required to put people on trial to keep that designation, so they enroll. I saw some complaining that cancer centers "lose money" enrolling to national trials, and that is sometimes true on paper. But they have high perceived value of being an NCI CCC, and you could probably argue they profit from that status. Way larger discussion.
Even HCA, the shareholder company, has a branded trials program.
To your other post, plenty of private healthcare companies spend a fortune on research and turn a nice profit.
Your points simplify the issue way too much and don't seem congruent with reality in the US. Your last sentence is also a false binary.
I believe in the importance of government funded research (and public-private partnerships) but also don't think our system should be a big check into a black box.
sure I don't think anyone wants that. what is clear is that institutions can perform the majority of non-profit seeking research only with the significant underwriting of the federal government, and it seems ridiculous to pretend this isn't the case. many of the points people are making to defend the move (either out of support for an ideology or a misguided anti-elite sentiment) seem to ignore this basic reality.
Which means they are getting millions of dollars in grant funding to do this work! That is the point.
Without the money to pay for the infrastructure and manpower, it doesn’t exist.
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I think the funding should exist but be more efficiently utilized. How many trials get opened with close to no patients enrolled at most centers?
Why make research harder? So that we can learn from our pain? That’s some hardcore accelerationism haha
Out of all the trillions this administration plans to shell out discretionary spending in their the proposed budget, what fraction of those dollars would be spent on a better cause?
“If the institutions would rather close a CTO than spend their own money, why should the tax payers pay for their CTO?” Common, really? Firstly, universities are about as nimble as a Saint Bernard. It will take them two years to form a search committee to find the committee to find the funds. Secondly, because NIH funded research has produced -and continues to produce- some of the most important health discoveries in the world.
Look, I am not here on a soapbox defending university leadership… but they are going to be fine either way. The ones who will suffer are the 30 year old junior faculty, post-docs etc… who have spent the past 4 years of their lives on a project, and are about to get the rug pulled. They deserve better and we deserve their future discoveries
Ha! Immunotherapy vs the cybertruck. One cures cancer, the other looks like it was designed by my 8 year old.
“we owe billionaires our gratitude” -interesting take.
Have seen a number of clinical trial office financials and most of them run a profit. Have to have the volume and the right pharma mix. But that's why a lot of these places restrict the number of co-op group trials. They do enough to keep the cancer center support grant, but not so much they significantly affect that profit.
Anyway, wait until you find out how much of the profit a hospital/system scrapes off from the rad onc department. Like you know it's happening, but when you see the hard numbers...
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