When I began my training in pediatrics in the 1970s, most children diagnosed with cancer did not survive. Today, the vast majority of children diagnosed with cancer are cured.
I pulled out and juxtaposed for effect the above two sentences, which appear at different points within the introduction to the latest issue of Stanford Medicine Magazine. The author was our Dean of Medicine, Dr. Phil Pizzo.
This wasnâ€™t the point of Philâ€™s article, but ask yourself: How did our country manage to move from the situation described in his first sentence to that described in the second? Who should we thank for taking us from a point where an oncologist could say to terrified parents â€œItâ€™s cancer, but we can probably cure your childâ€ versus â€œItâ€™s cancer, your child is probably going to dieâ€?
The U.S. federal government, thatâ€™s who.
You mean the free market didnâ€™t transform pediatric oncology? No, it didnâ€™t. There are many brilliant medical scientists in the private sector and I have always given them credit for their life-saving work. But plowing billions of research and development dollars into improving the care of uninsured patients is not good business.
â€œWhat are you talking about?â€, a government critic might respond, â€œmost children are covered by health insuranceâ€. This is true: With government provided Medicaid, government provided SCHIP and a government provided tax break on employeeâ€™s family health insurance coverage, most children indeed have insurance. Without the large pool of potential purchasers created by those federal insurance programs and policies, private sector companies would never invest in finding cures for rare childhood diseases.
But even the governmentâ€™s expansion of health insurance for children didnâ€™t lead the private sector to fully fund research on cures for childrenâ€™s cancer. But that was okay, because the National Cancer Institute was there to pour billions of dollars into cancer research until cures were found.
Donâ€™t all those brilliant scientists and clinicians deserve credit? Of course they do, as do the federal loans and state government support that gave many of them the education to maximize their brilliance and built the labs and hospitals in which they did their work.
The audience members at the recent Republican candidateâ€™s debate who applauded at the thought of uninsured people dying may well cheer on the idea of getting the meddling government out of the way so that children with cancer could be free to die early, excruciating deaths. But when the value of medical science is raised with government-bashing candidates for office, their usual response is something along the lines of â€œof course I wouldnâ€™t cut cancer research.â€ One wonders therefore why they donâ€™t make sure to always say so rather than demonizing â€œguvmintâ€ whole cloth. And why donâ€™t journalists, every single time, candidates trash the federal government as universally interfering and incompetent, ask them why they want to live in a society where more parents attend their son or daughterâ€™s funeral instead of their high school graduation?