• Welcome to OGBoards 10.0, keep in mind that we will be making LOTS of changes to smooth out the experience here and make it as close as possible functionally to the old software, but feel free to drop suggestions or requests in the Tech Support subforum!

Why the cancer "moonshot" is a bad idea

TownieDeac said:
In the case of HHS Prevention programs, lobbying from Big Sugar basically single-handedly defunded CDC Diabetes Prevention funding (around $73MM in 2016 will be $0 in 2020). Big Tobacco lobbied against the CDC Office of Smoking and Health, which will see its $126MM 2016 budget reduced by 25-30% per year for the foreseeable future.

More or less a public health disaster, though these programs will apply to get their funding privately like they do every time a bill like this goes through.
Click to expand...

That's so awful. Like disgustingly awful.
 
Deacfreak07 said:
That's so awful. Like disgustingly awful.
Click to expand...

Oh yea super messed up, plus Big Sugar can say they strongly supported this bill, and a "Cures" bill looks great on their lobbying resume.

If you want to know why prevention hasn't been accepted wholesale by health systems yet, follow the money. There's just none to be made in prevention.
 
First the bill doesn't lock in the funding of the agencies, so you get a couple 100 million a yeah to the NIH where you can easily then keep funding at the exact same level through the general federal budget, most likely to happen in a republican controlled government.

For that you get reduced pharma regulation mostly in the form of quicker drug approval through the idea that you approve drugs with biomarkers instead of clinical outcomes, a horrible precedent. Especially disheartening is long term studies are necessary to prevent the very "yay looks at this bill we are going to help the opioid epidemic" from occurring in the first place. More stringent studies might have helped prevent clearly highly addictive drugs from ever even entering the market.

Further the prevention and public health fund should become a continuously increasing mandatory spending not cut. It helps maintain national vaccination stockpiles, pandemic preparedness etc... one could call it the oh shit Ebola is going airborne Pourdeac act of 2015 or Zika, yeah it's already here where's the fucking money.

So in summary, I'm tired of the dance and show with scientific funding and more critically public health. This shit has consequences for every single person and it's one of the most highly lobbied sectors probably outside of energy. Positive is this stuff always finds bipartisan support with negative being everyone cheers and claps while nothing really changes.
 
Interestingly enough, Newt Gingrich is one of the sanest voices in the room when it comes to science funding, and always has been. There's really no reason science funding shouldn't be above congressional funding oversight with super-long term commitments.
 
Think about how fucked up it is that the CDC, the worlds top public health agency and preventer, preparer, and executer of all public health emergencies needs to have a foundation that lobbies congress as well as for outside funding to continue to operate in the capacity that experts deem appropriate. Thank god for things like Bill and Melinda Gates Foundation and The Bloomberg Foundation
 
That article puts preventive in the area of you are already doing something to your health, so you need to screen for X because now you are at risk. Move up the tree and be preventive in stopping the action from even starting so X no longer is higher risk. So don't screen the smoker for lung cancer, stop then from smoking, don't prevent heart attack by screening but prevent the obesity and so on. Cost effective and huge benefits.
 
ThinkingWithMyDeac said:
That article puts preventive in the area of you are already doing something to your health, so you need to screen for X because now you are at risk. Move up the tree and be preventive in stopping the action from even starting so X no longer is higher risk. So don't screen the smoker for lung cancer, stop then from smoking, don't prevent heart attack by screening but prevent the obesity and so on. Cost effective and huge benefits.
Click to expand...
That has never been found to be cost effective. You start running into issues where you've just replaced one problem with another. Stop smoking......great for lung cancer rates......but nicotine pretty much blocks neurodegeneration (via glial cells) so dementia/AD rates would increase which is FAR more costly to the system than the lung cancer. Then there's the moral issue. Who is to say what is the best "prevention" for who? Are you really going to run around and fat shame people to stop obesity? It's a hell of a lot more complex than just saying "we need prevention!".

BTW, the FDA already uses biomarkers so this really wouldn't change anything there, just encourage more use of those endpoints. A lot of good drugs aren't getting approved these days because of the stringent FDA regs and their analysis. When one cardiovascular blip can kill an entire drug class which happened to us....we have problems. Clinical trial designs suck these days. Doses are picked to avoid any tiny toxic effect that threaten approvals....to the point where they're below therapeutic levels. That means the drugs never actually get tested and we're fulling ourselves into thinking that's a great thing because it's "safe". Clinical trial compliance is a huge issue too....that can't be corrected after the trial and used to win approval. The entire trial has to be redone with that in the study design prior to running it driving up costs even more and most of the time the small company can't afford it so the drug is shelved. It's crazy.
 
Are you suggesting that smoking is good for healthcare? The T Zone !
 
TownieDeac said:
Interestingly enough, Newt Gingrich is one of the sanest voices in the room when it comes to science funding, and always has been. There's really no reason science funding shouldn't be above congressional funding oversight with super-long term commitments.
Click to expand...

As nice as that would be, constitutionally, what does that even look like?
 
TownieDeac said:
Oh yea super messed up, plus Big Sugar can say they strongly supported this bill, and a "Cures" bill looks great on their lobbying resume.

If you want to know why prevention hasn't been accepted wholesale by health systems yet, follow the money. There's just none to be made in prevention.
Click to expand...

Just take a look at the reaction when local and state governments try to ban supersize sodas.
 
Who gives a fuck if public health is "cost effective?"
 
pourdeac said:
That has never been found to be cost effective. You start running into issues where you've just replaced one problem with another. Stop smoking......great for lung cancer rates......but nicotine pretty much blocks neurodegeneration (via glial cells) so dementia/AD rates would increase which is FAR more costly to the system than the lung cancer.
Click to expand...

This is incorrect. Tobacco use increases the risk of dementia and other neurodegenerative diseases, such as ALS. There is some evidence that tobacco use may decrease the risk of Parkinson's disease, but it's not dose-dependent and some think it might be more likely that those with premorbid Parkinson's are less likely to smoke, confounding study results.
 
DeacinBama said:
As nice as that would be, constitutionally, what does that even look like?
Click to expand...

I'll leave that to the fat cats in Washington to sort out. I'm towniedeac and I'm ready to party.
 
Rafi said:
This is incorrect. Tobacco use increases the risk of dementia and other neurodegenerative diseases, such as ALS. There is some evidence that tobacco use may decrease the risk of Parkinson's disease, but it's not dose-dependent and some think it might be more likely that those with premorbid Parkinson's are less likely to smoke, confounding study results.
Click to expand...

Yeah those neuro diseases are more or less plaque in the brain fwiw
 
TownieDeac said:
I'll leave that to the fat cats in Washington to sort out. I'm towniedeac and I'm ready to party.
Click to expand...

I dig it. If I'm ever in Philly and no longer in need of a DEA license, I'll look you up.
 
You must log in or register to reply here.
Back
Top