In individualistic societies, the cultural motivation isn't going to come in the name of collective action. In the era of how much state funding of state driven science in the US is being pulled, you're 100% correct that all that will be funded will be rich people looking to cure themselves.

mRNA research, first discovered in the 1960s, couldn't get much funding for years/decades and had to scrimp through what they had. And then it got a burst in funding and was publicly available in a year.

Why can’t we just ask our governments to spend more on research? Want some rich person to donate $100 billion on cancer research?

The US government and European governments could find that amount of money every year.

> The US government [...] could find that amount of money every year.

Sorry, that money is already earmarked for killing Iranian school girls and funding a gestapo to terrorize immigrants and American citizens. Ain't got enough left over after we cover those essentials.

We are not the bosses of the people in the government, so asking does very little.

The United States and world spend huge amounts of money on this, not even to mention the enormous amounts of private research.

The takeaway here is getting money into the hands of smarter and more motivated people.

No we absolutely don't. The US hardly spends anything on research.

The entire yearly budget for the National Cancer Institute is $7 billion dollars. To put this in perspective, that's 3 days of funding the DoD. For cancer. That kills well over half a million Americans per year.

The takeaway is that we should invest in research rather than letting people die.

It's a problem of incentives.

Governments have a limited (although large) budget, and no incentive to spend it well[1]. You don't get promoted as a government administrator if you approve a Nobel-prize-winning grannt.

If you don't get rewarded for good work but may get punished for taking risks, you optimize for risk minimization, even if this means a lot of potentially-good work not getting done.

Nobody blames the FDA when millions of people die from the-medicine-hasn't-been-invented-yet-itis, everybody blames the FDA when ten or so people die from a side effect nobody saw. This impacts FDA policy.

This person has the best incentive there is in the world, the incentive to live. He didn't care whether the people getting his money correctly filled form 437-F, or whether they have the relevant paperwork that verifies their legitimacy in a way which can be described by legal rules.

[1] Incidentally, finance has (had?) the opposite problem. If your bonus is calculated as min(0, percentage * profit_generated), you will maximize risk, optimizing for bets that give you great returns most of the time, but wipe you out completely some of the time, as your losses are clamped to 0.

> If your bonus is calculated as min(0, percentage profit_generated)*

I assume you meant `max(...)`? Otherwise you will at best get zero dollars in bonus, and at worst owe your employer money. ;)

(I get min/max backward all the time too.)

You can't compare the output of small teams driven by a fanatic with a single output metric with government funded research. NIH invests about 40 billion in research a year in the US as it is I believe.

I asked Gemini AI and it says the NIH spent $7.3 billion last year.

Would it be a big deal to double that?

Do we just keep increasing spending until the marginal value of further spending goes to zero so long as the next incremental dollar "isn't a big deal?"

In another timeline they're doing a "Cancer Moonshot" right now.

It is a bit simplistic to assume that more money translates into better research outcomes.

Alzheimer's is a warning tale. Lots of money flowed into research of this condition, and was mostly wasted on a flawed hypothesis supported by scientific VIPs who had a face to lose in case it proved incorrect.

We don't necessarily need more money in research, but smarter ways of spending it. The current grant system rewards established players and reliable production of mediocre (or even fraudulent) papers over honest failure and actual innovation too much.

The bottleneck isn't research funding, it's getting past the FDA

> The bottleneck isn't research funding, it's getting past the FDA

Incidentally, that's the first point on his proposals to make the industry more healthcare first (slide 15)

He also links this https://www.writingruxandrabio.com/p/the-bureaucracy-blockin...

The bottleneck is capitalism, in which only things that turn a profit are deemed worth doing.

Which alternative economic system has done better on pharma R&D?

>Not just the US medical system, but Europe and China also don't have better treatments until a rich guy came along. It seems that it's not for a lack of ideas, just that some of these ideas couldn't be funded. Is it that this type of bone cancer is super rare and the cost just isn't worth it? Or are we just under-funding at the level that several ideas with a likely positive ROI aren't able to get funded?

Cancer research, and all research in general, is massively underfunded. The US spends $7 billion dollars per year on the National Cancer Institute. The EU spends about as much as well. That's $14 billion per year for all cancer, never mind bone cancer. This just isn't a lot of money. That's like 6 days of running the US DoD. For cancer.

There are so many diseases that can be solved if money isn’t an issue. The problem is even if this wealthy guy cures his own cancer the treatment will never be available to us. We still do not have cheap genetic targeting and immunotherapy. The average person will be bankrupt just from the discovery.

I’m of the opinion most types of cancer can be targeted and cured. There’s just not enough money in it to produce the cure. The entire industry is locked behind a paywall.