Which is more urgent: military drones or a cure for cancer?

A Global Hawk drone

The U.S. government has an answer: drones. Drones and other weapons of destruction are vastly more important than healing people - or at least that’s what one might think, based on our government’s spending priorities. In the most recent federal budget, we spent $821.6 billion on defense, which includes $636.2 billion for the Defense Department, $138.9 billion for veterans, and another $46 billion on foreign military aid. We spent just $29.1 billion for the National Institutes of Health, the epicenter of all our research on new cures for disease. That’s a decline of $1.7 billion from 2012 (thanks to the sequester). In the big picture, then, we spent 28 times as much on defense as we spent on curing disease.

Does anyone in the federal government ever step back and think seriously about what our overall priorities are? Or do they just think about whether to adjust a particular agency’s budget a few percent up or down? Congress returns from recess next week, and they’ll make lots of noise about the budget decisions, and then they'll pass something that makes at most a few incremental changes.

A big problem with our short-term approach to governing is that the forces that want to keep everything the same are always more powerful than the forces for change. The people and institutions that benefit from the current budget are already in place, and always at the ready to lobby against change. We desperately need to review our priorities, at least once in a while, and make a rational decision about how much to invest in the things that government does. Do I expect this to happen? No. But that doesn’t mean we shouldn’t try to make the argument.

Here are just a couple of examples of how current spending plans just can’t be stopped, even if they have gone wildly out of control. First let’s consider the Global Hawk drone program, which the Defense Department itself would like to terminate: the Air Force says it has better equipment for the same job. Ending the program would save $2.5 billion over four years. (That’s $2,500,000,000. It helps to write these numbers out.) How did Congress respond to the Air Force proposal? The head of the Armed Services Committee, Howard McKeon (R-Calif.) rejected the proposal and added $443 million to purchase three more Global Hawks. Not coincidentally, the manufacturer of these drones, Northrop, builds them in the district represented by McKeon.

A bigger example is the Joint Strike Fighter program, the most expensive plane in history, which is now estimated to cost $400 billion by the time it starts flying in 2018 - if it’s not delayed further. This is more than triple its estimated cost in 2001, when it was first approved for $119 billion. Just recently, the Pentagon itself reported 147 “major” quality issues with the program. 

We won’t even have these planes for another 5 years, so obviously this hasn’t improved our security yet. And once it starts flying, the Pentagon estimates this fighter plane will cost another $850 billion to keep going. Who decided this was worth it? Is anyone seriously considering scrapping the whole project, before we spend another trillion dollars on it?

There are many more examples, such as the $436,000,000 we’ve spent building new Abrams tanks that the Army does not want. The Army may not want it, but it’s built in Ohio, and the Ohio members of Congress (both Democrats and Republicans) have fiercely defended it. 

It’s not just Defense, of course - we are still funding the 1925 federal helium program, which Congress seems unable to kill. The helium program was started after World War I, when the U.S. was worried that it wouldn’t have enough blimps. Lobbyists are keeping the program alive.

Let’s go back to the big picture. The leading causes of death in the U.S., according to the CDC’s latest figures, are:

1. Heart disease (597,689 deaths)
2. Cancer (574,743 deaths)
3. Chronic lower respiratory disease (129,476 deaths)
4. Stroke (120,859 deaths)

You might expect that we would be pouring money into research on the biggest causes of death in the country - at least as much as, say, a new fighter plane. But you’d be sorely disappointed: the entire U.S. budget for cancer research at NIH's National Cancer Institute is $4.78 billion. That’s for every type of cancer (and there are hundreds). This budget covers clinical research on new treatments, long-term research on understanding cancer, and everything in between. The budget for heart, lung and blood disease (the number 1 and 4 causes of death) is even smaller, just $2.90 billion. 

These numbers are little more than round-off errors when compared to the entire U.S. budget, which for 2013 is $3,454 billion.  The NCI budget is just 0.14% of the total.

How much should we invest in cures for all disease each year? How about 5% of our budget? Or maybe just 2%? That doesn’t seem like too much. Ask anyone who has cancer, or who knows someone with cancer, if 2% of the budget is too much to invest in cures. I suspect that most of them will say it’s not nearly enough. 

2% of the federal budget is $69 billion. Let’s put that on the table as next year’s budget for NIH. Rather than building weapons, let's use our tax dollars to build new things and make new discoveries. Rather than destroying infrastructure in other countries, let’s invest in our future, and create new treatments that make our lives longer and healthier. 

In the current issue of The Atlantic, James Fallows interviewed Eric Lander, one of the world's leading genome scientists, and asked him when genomics would lead to a cure for cancer. Lander responded:

“If we invest vigorously in this and we attract the best young people into this field, we get it done in a generation. If we don’t, it takes two generations. That’s a very big difference.”

Think about it. If we invest more now, you might see a cure for most forms of cancer in your lifetime. Two generations, though, will be far too late for most of us. How many more people need to die from cancers that we’ll eventually be able to cure?