As a young, Baby Boomer, I remember President Nixon’s declaration of war on cancer.  Billions of dollars and thirty years later, I became part of the Medical Industrial Complex, and now marvel at the disconnect called cancer research that exists in this country.

In a recent New York Times op-ed by Shannon Brownlee, she posed the following question, “Has the profit motive gotten in the way of finding a cure for cancer or better treatment?”  She goes on to question, “Could it be that at least some of the $100 B we spend each year on detecting and treating this disease is . . . to prop up hospital finances?”

Obviously, with my hospital administrator hat on, that question felt very uncomfortable, but I’m carefully avoiding the obvious answer and will point you in the direction of our already seriously strained health care system, a system that is attempting to preserve the status quo in a time of significant demographic change that, in my opinion, is not sustainable.

It always reminds me of the chilling question posed by one of my professors in Graduate School, “If the town has three brain surgeons and it only needs two, which one doesn’t drive a Mercedes?”  The answer then was, “They all do.”

Concurrently, the issue of funding cancer research continues to raise it’s ugly head, and, reading the opinions of people like Dr. Susan Love, Nancy G. Brinker from the Komen Foundation and David Perlin, director of the Public Health Research Institute regarding this issue, it has become painfully clear to me that the research system in this country is broken as well.

The problem is that it is a system of small science, a system that currently dominates our NIH/NCI, academic medical center approach.  Organizations that have embraced the concept of sharing information, working collaboratively on all levels, and not rewarding individuals for keeping secret their theories and discoveries can easily become causalities in the fiscal environment that dominates our federal research funding mechanism.

We are spending 30% of our health care dollars on the last thirty days of life with little or no possibility that we will cure or improve the status of the dying individuals.  We are continuously, financially stroking those individual divas that discover their secret sauce and then have no incentive to share their findings because it may interfere with their personal grant streams.

We are rewarding unendingly the finances of our oncologists through profit sharing relationships with pharma, but do not see that as a conflict in any way.  We will radiate, administer chemo, and treat unnecessarily or unproductively until death actually arrives.  All of these decisions represent huge health care expenditures.  The majority of our medical schools have still not embraced hospice and palliative care, and the result is also a financial train wreck.

The United States has no science policy and no health care policy except to feed the current system.  If you doubt that, visit the $1B hospital constructed on the campus of NIH that has an average daily census of well under 100 patients as just one example of a broken system.

Someone has to stand up and be counted or this system will crash and burn with no significant steps taken to fight the war or find the cure.