NIH funding cuts

[yesmaster]

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To be fair PD-1 was discovered in Japan

Anyways there need to be cuts. I don’t particularly like NIH cuts but I also can’t deny there’s bloat and redundancy. The more free rein DOGE has to make deep cuts to every sector of government and reign in spending, the sooner we can move past austerity measures

 

[communitydoc13]

The more free rein DOGE has to make deep cuts to every sector of government and reign in spending, the sooner we can move past austerity measures

yikes...

When Clinton got rid of 300+K federal workers it was done with bipartisan collaboration in the legislature and a group of professional civil servants acting as a working group to figure out who was "low value". Also...300K federal jobs equals roughly 30B per year, remember the Fed is largely an insurance conglomerate with a standing army. This discretionary spending is not going to get the job done. Lets see how docs respond to a 30% cut in Medicare payments.

So far with this admin....executive fiat with non-elected shock troops targeting predictable targets based on ideology and cultural messaging.

Also, dropping basically all investigations into Musk owned entities, dropping consumer financial protections, dropping rules against foreign bribery....what could go wrong.

Do we have any indication that these folks value expertise in fields outside of their own or value population based health outcomes? I'm sure Peter Thiel is interested in living forever himself.

I encourage anyone to read Peter Thiel 's piece in the FT, Marc Andreessen's interview with Ross Douthat from NYT and anything Elon writes to figure out the emotional makeup and intellectual worldview of Trumpist tech bros...we are hosed.

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?

I agree about the structure of clinical trials in the US. This is hard. I think for many clinical faculty, their own investigator initiated trial is sort of the apotheosis of their career. But, the small investigator initiated trial is often a regressive tool in medicine (poor reproducibility, poor accrual, bad statistics).

I do think that there might be some sweet spot with diverse, smaller academic groups regarding translational and basic research. It's OK if most groups seem unproductive if the collective outcome is improved due to a diversity of approaches (sort of an expectation value way of thinking).

I think collaborative group trials are the way to go. Fed could improve what they have going on presently (although I hate to call what's going on bad). This is probably a big government solution....no?

 

[Neuronix]

I assume this is my chairman in his dreams.

 

[OTN]

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

"Our institutions are so incredibly calcified, we cannot use our own money so we need more of yours." The University of Texas, a public institution, has an endowment of $44.9 billion. Either spend that money or give it back.

We need universities to do research, and yes the federal government needs to support that research. However, they need to do it in the most efficient way possible, and I see zero (0) evidence from academia they take that seriously. NYU's Super Bowl commercial is a perfect example. I don't like the magnitude or rapidity of the cuts, though, as I fear they will be too disruptive too quickly. Hopefully this is the start of a negotiation which ultimately helps our tax dollars be spent more efficiently.

 

[drowsy12]

NYU's Super Bowl commercial is a perfect example.

no it's not. NYU is rich as are many health care systems. welcome to post-2010 world.

research is a hobby. not the money maker or the primary operations.

advertising budgets are totally different from money spent on research.

Again, to expect a health system to pay money out of their pocket out of the goodness of their heart to do research is fantasy.

 

[NotMattSpraker]

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.

Why do you think that universities generally support research that is "non-profit seeking"? I did not find that to be the case at all in my experience at them. Many are obsessed with tech transfer and spin offs. My view is that these are businesses that get special status because of their "noble goals" even though they often act just like every other business.

This is like arguing if Elsevier doesn't get to keep their billions in profit, we wont have peer reviewed publications.

Im trying to keep this pretty narrow. I don't disagree that money could be better saved elsewhere, but think that is outside the scope of our discussion. I also don't think two weird guys are going to "save America" by dramatically cutting programs by proclamation on social media. But research is absolutely hard and inefficient now under the current system, and its not unreasonable to ask for change.

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...

LOL, the pain. I love when the administrator tells me we don't have the budget for a dietician while Im looking out the window at their brand new surgical tower construction, all glass of course 🙂

 

[drowsy12]

Why do you think that universities generally support research that is "non-profit seeking"?

I mean....in what world is the majority of R01 basic science research or support for clinical research profit seeking for the university? I'm a bit confused by the question.

 

[yesmaster]

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.

Basically you’re defending the university presidents making millions who are sitting on billions or tens of billions in endowment money. They are holding a metaphorical gun to their underpaid postdocs and adjunct faculty and research technicians, “we’ll blow them up unless you taxpayers keep funding our billion dollar research empire!”

Worst thing that happens is those postdocs, etc. realize that academia is a path to nowhere rat race with tenure-track faculty positions impossible to get, and they might look for easier and happier careers elsewhere. Not a bad outcome actually

My prediction is that the people who lose when indirects are cut, are actually the directors and institute heads and whatnot who find their cheap labor leaving for better pastures

 

[drowsy12]

yes the total privatization of research in this country is a FANTASTIC idea.

it's not like the country's focus and money spent on biomedical research over the last 150 years hasn't been fruitful.

this is absolute lunacy. people have really lost the plot.

 

[NotMattSpraker]

I mean....in what world is the majority of R01 basic science research or support for clinical research profit seeking for the university? I'm a bit confused by the question.

Not the majority of course. I dont think the majority of research in the private sector is directly profitable.

Universities are all different, but a lot of the big names favor research that can patented or spun off into marketable inventions/companies. My point is that these are not institutions selflessly donating their time and effort to hold up American science.

 

[drowsy12]

My point is that these are not institutions selflessly donating their time and effort to hold up American science.

that's EXACTLY the point lol.

this research only happens with government funding because we as a society have deemed it to be important.

to pretend otherwise is ignorance. to pretend that they CAN or WILL just push on and do the basic science, translational science, and yes CLINICAL research without support is more than laughable.

sad to see so many people become anti-science.

we are living in history in the making.

many are on the wrong side.

 

[yesmaster]

no it's not. NYU is rich as are many health care systems. welcome to post-2010 world.

research is a hobby. not the money maker or the primary operations.

advertising budgets are totally different from money spent on research.

Again, to expect a health system to pay money out of their pocket out of the goodness of their heart to do research is fantasy.

If an academic medical center’s clinical arm is separate from its research arm, why do the AMC’s and PPSE cancer centers get to charge more for their clinical services, with the rationale that they do some research as a hobby?

 

[drowsy12]

If an academic medical center’s clinical arm is separate from its research arm, why do the AMC’s and PPSE cancer centers get to charge more for their clinical services, with the rationale that they do some research as a hobby?

PPS exemption is a whole different topic. I think Chirag and Sean's papers both make great points. But no one contends that extra revenue is meant to be used to fund R01 research or pay CRA salary for a BID vs daily radiation trial.

also tons of research happens out side these institutions.

Facts matter.

 

[temujim]

yes the total privatization of research in this country is a FANTASTIC idea.

it's not like the country's focus and money spent on biomedical research over the last 150 years hasn't been fruitful.

this is absolute lunacy. people have really lost the plot.

150 years? Current NIH grant system was set up in the 1940s-1950s.

 

[temujim]

Basically you’re defending the university presidents making millions who are sitting on billions or tens of billions in endowment money. They are holding a metaphorical gun to their underpaid postdocs and adjunct faculty and research technicians, “we’ll blow them up unless you taxpayers keep funding our billion dollar research empire!”

Worst thing that happens is those postdocs, etc. realize that academia is a path to nowhere rat race with tenure-track faculty positions impossible to get, and they might look for easier and happier careers elsewhere. Not a bad outcome actually

My prediction is that the people who lose when indirects are cut, are actually the directors and institute heads and whatnot who find their cheap labor leaving for better pastures

The pruning at each level is brutal. Literally none of my class of over 100 grad students is still in science. I think a half dozen made it to asst prof but a decade later they were out.

 

[yesmaster]

I think Chirag and Sean's papers both make great points.

You’re half correct.

 

[drowsy12]

150 years? Current NIH grant system was set up in the 1940s-1950s.

fair. I guess I was thinking back to govt grants pre NIH. but point stands.

 

[evilbooyaa]

At the end of the day, the facts are that the President's supporters are more anti-establishment science than his detractors. Thus, if he wants to reduce spending and find a palatable way to not piss off his base, he's going to pull money from research funding, which is nearly congruous with academia. I would say majority of academia already dislikes him, so what's the harm in pissing them off more?

The downstream effects and worries people have about lack of scientific progress as a result of this - I do not believe he has fully thought that out, or he has had though ti tout, and feels that institutions can be more efficient than they currently are. The reality is, the answer is most likely somewhere in the MIDDLE of where either the president or academia think it should be.

 

[communitydoc13]

The line between public and private has always been murky. NIH gives plenty of money to the private sector for development.

Bell labs benefited from tax revenue and gvt guarantee of a telephone monopoly. The research record for Bell labs is basically unparalleled. Of course, large US companies through the early 1980s functioned completely differently, with long term horizons and some substantial accountability to their employees.

Most universities are not terribly good at patenting. I am fine with this. The ****tiest scientist I ever worked with filed patents all the time for treatment "approaches". They seemed vague to me and the substantial progress being made was small. The patent filing certainly was not facilitating progress.

I would personally increase research funding if I were president. I would emphasize accountability by both academia and the private sector. I would hire more civil servants to do this. The cost of the civil servants would of course be low compared to the grants provided (as is typical). It would be a fabulous long term investment in our country. The research would pay for itself over time...I would not be granular or single minded regarding assessment of value...I'm happy that we found a fast neutrino.

Maybe I would limit compensation for CEOs and Academic Deans (for recipient organizations) relative to their lowest paid employee. I know...the tyranny.

This is not what's happening. What's happening is sudden cuts in funding by fiat to academic and public institutions who have to plan and budget years in advance, while simultaneously dismantling governments role in regulating the private sector.

Not a way to continue America's greatness...Mencius Moldbug probably happy.

More immigrants and more research funding!!!!!! Why is no one advocating for this?

 

[temujim]

At the end of the day, the facts are that the President's supporters are more anti-establishment science than his detractors. Thus, if he wants to reduce spending and find a palatable way to not piss off his base, he's going to pull money from research funding, which is nearly congruous with academia. I would say majority of academia already dislikes him, so what's the harm in pissing them off more?

The downstream effects and worries people have about lack of scientific progress as a result of this - I do not believe he has fully thought that out, or he has had though ti tout, and feels that institutions can be more efficient than they currently are. The reality is, the answer is most likely somewhere in the MIDDLE of where either the president or academia think it should be.

Big name journals like Nature and Science published editorial opinions trashing Trump. Should they be surprised at the blowback? Whatever the merits, likely going to be a big push at NIH/NSF/DoD/etc to delete what this administration considers "politicized science". Between the reduction in indirects and cancellation of a lot of grants/contracts, perhaps the pay lines will be more favorable for what remains (as it seems unlikely the total NIH/NSF/DoD/etc appropriation will decrease). Maybe even for radiation oncology where the funding is less than a rounding error.

 

[NotMattSpraker]

that's EXACTLY the point lol.

this research only happens with government funding because we as a society have deemed it to be important.

to pretend otherwise is ignorance. to pretend that they CAN or WILL just push on and do the basic science, translational science, and yes CLINICAL research without support is more than laughable.

sad to see so many people become anti-science.

we are living in history in the making.

many are on the wrong side.

What is the wrong side here?

Are you arguing that the system should not be touched? Indirects are fine where they are, variable across institutions? No changes should be implemented?

 

[communitydoc13]

What is the wrong side here?

Are you arguing that the system should not be touched? Indirects are fine where they are, variable across institutions? No changes should be implemented?

I can't speak for Drowsy.

Of course the system should always be under critique. Changes when done properly are always good. I strongly agree that as a nation, our accrual and efficiency regarding clinical trial implementation is poor compared to peer nations.

I myself am surprised that there is responsiveness to the way this is being done. That the cultural context is not being emphasized. That the grotesque inefficiency of breaking eggs and then rebuilding is not being emphasized. That there is a belief that Donald/Elon are acting in good faith? That our own academic experiences, while imperfect, weren't in general viewed as a tremendous gift. That this admins actions don't seem like a process optimized for drama and cultural impact rather than judicious and lasting reform.

I would personally take a sclerotic but stable government, committed to the liberal consensus, and committed to playing a large role in our technological trajectory (which is in fact very scary) rather than a dismantling of government and an emphasis on fast movement and corporate hegemony in the hands of men who have demonstrated remarkably low EQ and an aversion to governance of any sort.

I mean if you like what these guys are doing...you like what they are doing.

Maybe this will reduce tuition, improve graduate student, post-doc and junior faculty pay, and put more power in the hands of academics within their institutions as opposed to in the hands of upper admin and donors. Maybe it will drive more really smart kids to not focus on the bottom line.

It's also not where the big money is on a national level.

 

[Lamount]

"Our institutions are so incredibly calcified, we cannot use our own money so we need more of yours." The University of Texas, a public institution, has an endowment of $44.9 billion. Either spend that money or give it back.

We need universities to do research, and yes the federal government needs to support that research. However, they need to do it in the most efficient way possible, and I see zero (0) evidence from academia they take that seriously. NYU's Super Bowl commercial is a perfect example. I don't like the magnitude or rapidity of the cuts, though, as I fear they will be too disruptive too quickly. Hopefully this is the start of a negotiation which ultimately helps our tax dollars be spent more efficiently.

When you look at the US budget, the NIH budget is a bargain. Money invested in the NIH has 240% ROR... why cut anything?

The NIH is, quite frankly, one of the most efficient ways that we can spend tax payer money. If you would argue that ALL government spending is wasteful, I wouldn't agree but can certainly understand your reasoning, but would ask... of all the things in the budget you could cut, shouldn't the NIH be the very last?

It's like an overweight patient comes in to have treatment for LA HNSCC... and rather than just focusing on treatment, you admonish them to restrict their carbs. Sure, eating to many donuts is a problem... but for that guy, it is the least of his worries. Perhaps you worry about his other problems and save that one for last.

 

[Lamount]

Basically you’re defending the university presidents making millions who are sitting on billions or tens of billions in endowment money. They are holding a metaphorical gun to their underpaid postdocs and adjunct faculty and research technicians, “we’ll blow them up unless you taxpayers keep funding our billion dollar research empire!”

Worst thing that happens is those postdocs, etc. realize that academia is a path to nowhere rat race with tenure-track faculty positions impossible to get, and they might look for easier and happier careers elsewhere. Not a bad outcome actually

My prediction is that the people who lose when indirects are cut, are actually the directors and institute heads and whatnot who find their cheap labor leaving for better pastures

If you think the big cats would be the ones hurt by the cuts... you haven't been paying attention. When has that EVER happened? Jobs are always cut before bonuses. Maybe you would see such a thing at State Universities, but NYU... never in a million years. It's also worth mentioning that the CTO budget at many Universities is actually directly tied to NIH indirect funding -i.e. fewer grants this year = CTO has less money.

My prediction is that this doesn't actually happen... but in the interim, some of those post docs are going to have the rug pulled from beneath them and never recover.

If you really want to go after Universities in a meaningful way, peg tuition increases to inflation. That's what is paying for all those admins.

 

[drowsy12]

I can't speak for Drowsy.

Of course the system should always be under critique. Changes when done properly are always good. I strongly agree that as a nation, our accrual and efficiency regarding clinical trial implementation is poor compared to peer nations.

I myself am surprised that there is responsiveness to the way this is being done. That the cultural context is not being emphasized. That the grotesque inefficiency of breaking eggs and then rebuilding is not being emphasized. That there is a belief that Donald/Elon are acting in good faith? That our own academic experiences, while imperfect, weren't in general viewed as a tremendous gift. That this admins actions don't seem like a process optimized for drama and cultural impact rather than judicious and lasting reform.

I would personally take a sclerotic but stable government, committed to the liberal consensus, and committed to playing a large role in our technological trajectory (which is in fact very scary) rather than a dismantling of government and an emphasis on fast movement and corporate hegemony in the hands of men who have demonstrated remarkably low EQ and an aversion to governance of any sort.

I mean if you like what these guys are doing...you like what they are doing.

Maybe this will reduce tuition, improve graduate student, post-doc and junior faculty pay, and put more power in the hands of academics within their institutions as opposed to in the hands of upper admin and donors. Maybe it will drive more really smart kids to not focus on the bottom line.

It's also not where the big money is on a national level.

ditto.

 

[Lamount]

"Our institutions are so incredibly calcified, we cannot use our own money so we need more of yours." The University of Texas, a public institution, has an endowment of $44.9 billion. Either spend that money or give it back.

We need universities to do research, and yes the federal government needs to support that research. However, they need to do it in the most efficient way possible, and I see zero (0) evidence from academia they take that seriously. NYU's Super Bowl commercial is a perfect example. I don't like the magnitude or rapidity of the cuts, though, as I fear they will be too disruptive too quickly. Hopefully this is the start of a negotiation which ultimately helps our tax dollars be spent more efficiently.

Perhaps a better example would be...

Lets say a city has a food stamp program that comprised <0.5% of its budget. In general, it has significantly decreased the rates of food insecurity. However, an audit found that nearly 30% of the people who use the program really don't qualify and are abusing it... but it isn't really feasible to improve screening procedures to know who the abusers are. Someone may just argue "let's cut the food stamp program by 30%... THAT should eliminate the fraud". However, in reality, you are far more likely to harm the right people than the bad ones...

I'd personally rather see 7 hungry people have food on their table, even if I know that 3 more are abusing the system. So I'd argue you focus on the remaining 99.5% of the budget where the odds of encountering abuse and inefficiency are far higher...

 

[evilbooyaa]

What is the wrong side here?

Are you arguing that the system should not be touched? Indirects are fine where they are, variable across institutions? No changes should be implemented?

I actually find myself agreeing with NMS here.

I agree it's heavy handed and on the extreme, but are we supposed to be happy with the status quo that for every dollar that NCI gives out, an additional 50-60% goes to admin as well? And applaud that? And that having any sort of discussion about what an academic institution should be allowed to charge the NCI is.... bad?

To all the folks that are outraged at how this will affect the careers of those in academics, should consider that if indirect costs were appropriately self-regulated by academic institutions and were in the 20-30% range nationally for all institutions, this aggressive of a measure would not have been the 'win' in terms of saving money that it is.

More researchers doing more projects with less administrative bloat. As long as the total amount of NCI expenditure is the same, there will be an increase in number of funded grants.

 

[yesmaster]

It’s better now with google scholar and medRxiv but it is still ridiculous that taxpayer dollars go to NIH research and then we need to pay to get access to most papers. Like it’s literally supposed to be a public good.

 

[communitydoc13]

It’s better now with google scholar and medRxiv but it is still ridiculous that taxpayer dollars go to NIH research and then we need to pay to get access to most papers. Like it’s literally supposed to be a public good.

I do believe that a move to open access wherever possible will benefit the public.

Still need peer review. The model may need to change. I don't know if philanthropy will float prestige journals (which are important) and I would be skeptical of corporate sponsorship if remotely related to the field of publication.

Maybe a high value public expenditure?

 

[Lamount]

I actually find myself agreeing with NMS here.

I agree it's heavy handed and on the extreme, but are we supposed to be happy with the status quo that for every dollar that NCI gives out, an additional 50-60% goes to admin as well? And applaud that? And that having any sort of discussion about what an academic institution should be allowed to charge the NCI is.... bad?

To all the folks that are outraged at how this will affect the careers of those in academics, should consider that if indirect costs were appropriately self-regulated by academic institutions and were in the 20-30% range nationally for all institutions, this aggressive of a measure would not have been the 'win' in terms of saving money that it is.

More researchers doing more projects with less administrative bloat. As long as the total amount of NCI expenditure is the same, there will be an increase in number of funded grants.

It’s actually not that expensive. You’re talking about the infrastructure to put 10s of thousands of people on clinical trials costing the same as
-2 B2 bombers or
-11 F22s

We aren’t a poor country and spend much more money on much dumber things. We could double the NIH budget and and still be spending less than an eighth on health research as we do on the military.

 

[Lamount]

It’s better now with google scholar and medRxiv but it is still ridiculous that taxpayer dollars go to NIH research and then we need to pay to get access to most papers. Like it’s literally supposed to be a public good.

This… I agree with 100%

 

[medgator]

It’s actually not that expensive. You’re talking about the infrastructure to put 10s of thousands of people on clinical trials costing the same as
-2 B2 bombers or
-11 F22s

We aren’t a poor country and spend much more money on much dumber things. We could double the NIH budget and and still be spending less than an eighth on health research as we do on the military.

A lot of the cost cutters of certain political stripes will focus on things like cutting NIH, npr and planned Parenthood budgets while ignoring elephants in the room like CMS/SS/DOD

 

[drowsy12]

I actually find myself agreeing with NMS here.

I agree it's heavy handed and on the extreme, but are we supposed to be happy with the status quo that for every dollar that NCI gives out, an additional 50-60% goes to admin as well? And applaud that? And that having any sort of discussion about what an academic institution should be allowed to charge the NCI is.... bad?

To all the folks that are outraged at how this will affect the careers of those in academics, should consider that if indirect costs were appropriately self-regulated by academic institutions and were in the 20-30% range nationally for all institutions, this aggressive of a measure would not have been the 'win' in terms of saving money that it is.

More researchers doing more projects with less administrative bloat. As long as the total amount of NCI expenditure is the same, there will be an increase in number of funded grants.

I understand the sentiment. Of course I agree that we want to 'cut waste' (though of course 'waste' of some type is inherent to nearly every large organization whether a corporation or a government)

The issues are:

- does not seem to be coming from a good faith attempt at improving research (come on) but rather part of a general attack on instiutions
- The indirect costs are being used to fund the research enterprise, full stop. neither you nor I can quantify what the right 'cut' is but again, doesn't seem to be designed to do a best attempt cut to preserve the research mission but rather a blind man in the dark.
- I see no reason to believe that significantly cutting research infrastructure will lead to 'more projects'. No, in fact it will lead to less research overall.

The idea of 'cutting fat admin' always sounds great but there's no way you think that will actually be the result of this.

to be clear, my concern is not the 'careers' of academics, but rather the continued innovation and scientific progress of the country and thus the world, period.

 

[radiation]

I think that's the main issue here, I think its undisputable that NIH funding needed reform but the assumption that cutting indirects is going to result in the money saved going to some useful alternative is not guaranteed or likely to happen.

"Money Saved By Canceling Programs Does Not Immediately Flow To The Best Possible Alternative"

Money Saved By Canceling Programs Does Not Immediately Flow To The Best Possible Alternative

...

www.astralcodexten.com

 

[ramsesthenice]

I think that's the main issue here, I think its undisputable that NIH funding needed reform but the assumption that cutting indirects is going to result in the money saved going to some useful alternative is not guaranteed or likely to happen.

"Money Saved By Canceling Programs Does Not Immediately Flow To The Best Possible Alternative"

Money Saved By Canceling Programs Does Not Immediately Flow To The Best Possible Alternative

...

www.astralcodexten.com

I can’t take either side seriously until they get real about the budget. Republicans want to cut spending to balance tax cuts (look at the roadmap released by Johnson) and Democrats want to raise taxes to support more spending. Both attempts have predictably grown the debt. When someone acknowledges we need to raise (or at least maintain) revenue AND cut spending, I’ll be all ears. Until then, I have zero faith any of them are serious about addressing the long term implications of our debt.

This is more the same. Blame someone else, do enough to make your base happy and address your pet projects, but not enough to actually change the situation. The best possible outcome is it ends up being a catalyst for meaningful cooperation. Color me pessimistic.

 

[drowsy12]

I can’t take either side seriously until they get real about the budget. Republicans want to cut spending to balance tax cuts (look at the roadmap released by Johnson) and Democrats want to raise taxes to support more spending. Both attempts have predictably grown the debt. When someone acknowledges we need to raise (or at least maintain) revenue AND cut spending, I’ll be all ears. Until then, I have zero faith any of them are serious about addressing the long term implications of our debt.

This is more the same. Blame someone else, do enough to make your base happy and address your pet projects, but not enough to actually change the situation. The best possible outcome is it ends up being a catalyst for meaningful cooperation. Color me pessimistic.

this may be veering off topic but does a deficit REALLY matter? or is it a political tool used as a scare tactic?

 

[OTN]

this may be veering off topic but does a deficit REALLY matter? or is it a political tool used as a scare tactic?

It definitely does matter. The USA is headed towards a fiscal cliff/debt spiral which can be very difficult to bail out of. Currently servicing the debt makes up 13% of federal spending. As the debt increases due to Medicare/Medicaid/Social Security obligations (all this trimming that we've been discussing means nothing fiscally compared with those programs), which will increase due to the aging population, the interest rate needed in order to sell the debt will naturally increase, as the risk that the US will default will be higher.

Higher interest rates to sell the debt ---> increased percentage of federal spending/GDP needed to service the debt --> increased chance of default --> higher interest rates needed to sell the debt. The ouroboros will eat its own tail until there is nothing left.

The US can either completely default on the debt (which it has 4x previously in its history) or can print its way out of the problem by devaluing the dollar as much as is necessary in order to service it. I don't believe it's possible for the US GDP to grow enough to pay off the debt, no matter how much immigration is increased. If the US devalues the dollar, Americans will finally understand why having the dollar as the world's reserve currency has been so, so crucial to our prosperity. I believe we were headed towards a debt default/currency exchange to the digital dollar until Trump and the GOP won. All bets are off now, but I don't think we can "efficiency" our way out of this mess. Maybe we'll just default, and the world will simply accept that it needs a Blue Water Navy for global trade, and that navy is ours. We shall see.

 

[ramsesthenice]

this may be veering off topic but does a deficit REALLY matter? or is it a political tool used as a scare tactic?

Absolutely. In the immediate, the cost of paying for that debt takes away from other spending initiatives. Since debt compounds and the principle keeps growing, the share of budget going to paying debt keeps rising as well. This part is real and happening now.

At some point, things get worse. If we ever reach a point we can’t borrow and actually defaulted, interest and inflation would seriously disrupt the economy even in the most optimistic forecasts. Before getting there, congress would and should approve austerity measures to stave it off as long as possible. They would look like this executive order but would be constitutional and legal.

If/when this happens is partially protected by realities of the global economy. All major economies are in debt to each other. If a major player like China or the US actually defaulted and quit making debt payments, the consequences would global. Despite all of the tough talk, there is an element of mutually assured destruction in trade wars. Everyone is highly motivated to keep the first domino from falling.

 

[drowsy12]

fair points. I guess my point was that what I think matters more is debt as percent of GDP more than the debt number itself.

 

[ramsesthenice]

fair points. I guess my point was that what I think matters more is debt as percent of GDP more than the debt number itself.

Yes, that is basic economics. The more money you have, the more debt you can carry. The cost of our debt at this very moment is tolerable, but it’s growing. Rapidly. There is a tipping point. We can argue over where it is, but no one can deny its existence. And the idea that maximizing efficiency alone will be enough is pure fantasy.

 

[NotMattSpraker]

this may be veering off topic but does a deficit REALLY matter? or is it a political tool used as a scare tactic?

If you have not read it, the book Debt: The first 5000 years is very interesting. I read it when it was front of mind a couple years ago when the author died. It has problems but found it to be a good read and nice alternative hypothesis on this question.

I do believe that a move to open access wherever possible will benefit the public.

Still need peer review. The model may need to change. I don't know if philanthropy will float prestige journals (which are important) and I would be skeptical of corporate sponsorship if remotely related to the field of publication.

Maybe a high value public expenditure?

I think this is a similar and related topic, maybe even easier to express my issue with this stuff. For me it always comes back to the question... does Elsevier need $3 billion in profit? An absolutely insane profit margin. I can at least sympathize that hospitals operate on very thin margins.

We are wanting to be budget conscious but keep glossing over the fact that these organizations are pulling massive amounts of money out of the system.

 

[yesmaster]

this may be veering off topic but does a deficit REALLY matter? or is it a political tool used as a scare tactic?

We have a time traveler economist from 2021

Back when MMT was the intellectual cover for the massive deficit spending for future generations to pay for

 

[DebtRising]

Wait till you see what RFK tries to do to the AMA and Medicare payments.

 

[yesmaster]

As long as they’re across the board cuts instead of corporate welfare for the mega hospital systems, we will grab market share and emerge stronger on the back end.

 

[drowsy12]

As long as they’re across the board cuts instead of corporate welfare for the mega hospital systems, we will grab market share and emerge stronger on the back end.

good luck!

 

[ramsesthenice]

As long as they’re across the board cuts instead of corporate welfare for the mega hospital systems, we will grab market share and emerge stronger on the back end.

Uhhhh. All indications so far are that “pay to play” is the name of the game. I wouldn’t hold my breath.

 

[RickyScott]

That most the work funded by the NIH is fraudulent/unreproducible and that the nih funded gain of function research in Wuhan support overhauling a broken system. It needs to be rebuilt. Racist DEI grievance work was the straw that broke the camels back.

 

[Chartreuse Wombat]

and the world will simply accept that it needs a Blue Water Navy for global trade, and that navy is ours

Umm..

The U.S. Navy is Falling Behind China, and The Pentagon Knows It

The Pentagon recently released its annual report on China’s military developments and its findings are clear: China is eager to continue earning its keep as the Pentagon’s “pacing challenge,” while our military struggles to keep up. China’s Naval Developments Among a list of rapid developments...

www.aei.org

Report to Congress on Chinese Naval Modernization - USNI News

The following is the Jan. 30, 2024, Congressional Research Service report, China Naval Modernization: Implications for U.S. Navy Capabilities — Background and Issues for Congress. From the report China’s military modernization effort, including its naval modernization effort, is the top focus of...

news.usni.org

The End of the World is Just the Beginning - Zeihan on Geopolitics

Author and geopolitical strategist Peter Zeihan maps out the next world: a world where countries or regions will have no choice but to make their own goods, grow their own food, secure their own energy, fight their own battles, and do it all with populations that are both shrinking and aging.

zeihan.com

I wouldn't count on US naval supremacy unless we build more ships

 

[medgator]

That most the work funded by the NIH is fraudulent/unreproducible and that the nih funded gain of function research in Wuhan support overhauling a broken system. It needs to be rebuilt. Racist DEI grievance work was the straw that broke the camels back.

 

[evilbooyaa]

It’s actually not that expensive. You’re talking about the infrastructure to put 10s of thousands of people on clinical trials costing the same as
-2 B2 bombers or
-11 F22s

We aren’t a poor country and spend much more money on much dumber things. We could double the NIH budget and and still be spending less than an eighth on health research as we do on the military.

Your examples are mostly immaterial. Would you expect a Republican president to cut military spending and piss off his base?

I understand the sentiment. Of course I agree that we want to 'cut waste' (though of course 'waste' of some type is inherent to nearly every large organization whether a corporation or a government)

The issues are:

- does not seem to be coming from a good faith attempt at improving research (come on) but rather part of a general attack on instiutions
- The indirect costs are being used to fund the research enterprise, full stop. neither you nor I can quantify what the right 'cut' is but again, doesn't seem to be designed to do a best attempt cut to preserve the research mission but rather a blind man in the dark.
- I see no reason to believe that significantly cutting research infrastructure will lead to 'more projects'. No, in fact it will lead to less research overall.

The idea of 'cutting fat admin' always sounds great but there's no way you think that will actually be the result of this.

to be clear, my concern is not the 'careers' of academics, but rather the continued innovation and scientific progress of the country and thus the world, period.

The clutching of pearls from those in academia in having a President target for cuts the group of the population that has been nearly 100% against him from Day 1 is what I don't think I'm understanding. To reiterate, I don't agree with the move (as done), but did we expect this president to not have academic institutions in his crosshairs?

As an unbiased observer, how many people have their hand in the cookie jar that is academia that aren't adding (sufficient) value?

If an institution sees the indirect cuts and wants to lay off its people who have direct grant funding... then I don't know what to say to that. Don't do that?

In regards to increasing payline - If, pre-rule, let's say the NIH budget is 100M and say each investigator gets 1M but their university gets 0.6M (60% indirect cost), that means 62.5 investigators can be funded.

Post-rule, say each investigator still gets 1M but their university gets 0.15M (15% indirect cost), that means 86.9 investigators can be funded.



MOD NOTE - This thread is walking a tightrope of stuff that's worthy of talking about but breaking of SDN's no political discussion rule out of SPF. I'm guilty of it as well, but let's try to ensure that the discussion is in regards to NIH funding cuts and its influence and not go too broadly into a discussion about politics. Leaving the stuff about debt and naval superiority for the time being but if we get even more tangential I may have to prune the thread and put it on a path to being locked.