An Open Letter to Senator Roy Blunt: Save Medical Research By Voting No on the BCRA

Dear Senator Blunt,

I am a geneticist in St. Louis, one of your constitutents, and I urge you to vote no on the Senate’s Better Care Reconciliation Act. This act would not only make health care coverage unaffordable for 22 million Americans, as the CBO has estimated, but it would also sabotage medical progress itself through its impact on health care coverage for the millions of people with pre-existing conditions.

Here’s how this would happen. One of the main goals of biomedical scientists like myself is to use advances in genetics to make medical care more effective and less expensive. As we make progress, a growing number of young, seemingly healthy people will discover that they have a genetic risk for a serious disease. In terms of medical care, this is a good thing, because such people can often get treatment before serious symptoms develop.

However, one consequence of early testing to prevent disease is that a seemingly healthy person is suddenly labeled as someone with a pre-existing condition. Without robust insurance protections, those people are doomed to a lifetime of unaffordable health costs. Under the Senate plan, which allows states to waive the requirement that insurance companies cover a broad range of essential health benefits, people at risk for a genetic disease would face a terrible choice: Risk your affordable health coverage by getting a test that may save your life, or skip the test and hope you don’t get sick.

For example, consider a teenager who knows that a sometimes fatal genetic heart condition, such as Long QT syndrome, runs in her family. A genetic test, together with a few other medical tests, will tell her if she has the condition. If the tests are positive, she’ll begin taking a drug that will dramatically lower her risk of dying. But she would also, as someone with a diagnosis of a serious disease, be excluded from affordable health insurance for the rest of her life, if the Senate plan is enacted into law. This disincentive to seek early care harms not only those with genetic diseases, but also all of us, by making genetic medicine more difficult to develop and implement, and thereby undermining medical progress.

Senator, you have consistently been a strong supporter of medical research, and I and my Missouri colleagues are grateful for your support. We urge you to show your support for medical research again by voting no on the Better Care Reconciliation Act.

Sincerely,

Michael White, Ph.D.

Francis Bacon’s argument for books, libraries, and universities

The long quest for some funding may be easing a little, perhaps leaving some time and mental space to continue writing regularly here. In the mean time, enjoy this example of Francis Bacon’s remarkable gift for metaphor, from his Advancement of Learning, Book 2:

For as water, whether it be the dew of heaven or the springs of the earth, doth scatter and leese itself in the ground, except it be collected into some receptacle where it may by union comfort and sustain itself; and for that cause the industry of man hath made and framed springheads, conduits, cisterns, and pools, which men have accustomed likewise to beautify and adorn with accomplishments of magnificence and state, as well as of use and necessity; so this excellent liquor of knowledge, whether it descend from divine inspiration, or spring from human sense, would soon perish and vanish to oblivion, if it were not preserved in books, traditions, conferences, and places appointed, as universities, colleges, and schools, for the receipt and comforting of the same.

And here Bacon defends basic research:

First, therefore, amongst so many great foundations of colleges in Europe, I find strange that they are all dedicated to professions, and none left free to arts and sciences at large…

And this I take to be a great cause that hath hindered the progression of learning, because these fundamental knowledges have been studied but in passage. For if you will have a tree bear more fruit than it hath used to do, it is not anything you can do to the boughs, but it is the stirring of the earth and putting new mould about thee roots that must work it.

Don’t defend science by making people defend their religion or politics

In my latest Pacific Standard  column, I write about how to go about standing up for science in our highly polarized society. Two points are important:

First, the public, across the political spectrum has a remarkable amount of trust in scientists. (See my column for a link to the data.) This is amazing, because as a group, American scientists’ political affiliations match their demographic: city-dwelling people with post-college education are overwhelmingly liberal, including scientists. (And, full disclosure, including me.) And yet the majority of the public, including conservatives, see scientists as non-partisan. So let’s not squander that trust!

Second, science issues that we might think are highly polarized are either only polarized in America (e.g., conservatives in other countries accept climate change, most religions are fine with evolution), or not as polarized as you might think (e.g., opinions on GMOs and vaccines are not heavily split along political lines).

So as we go about trying to defend science in the Trump era, where highly ideological people like Scott Pruitt might be put in charge of important science agencies, let’s engage the public in a way that doesn’t force them to defend their political loyalties, as best we can. The worst thing that can happen to science (not to mention the planet) is for conservatives to believe climate change science is only a liberal thing, or for the far left to believe that support for vaccines is a conservative thing.

This doesn’t mean scientists should disengage from politics – just the opposite. We should take on politicians and actors in bad faith who undermine good science. But when we do so, we should make it clear that it’s about science, not partisanship.

Immigrants are Critical for American Science

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My great-grandfather, a political refugee from Latvia, was a bacteriologist for Merck.

The Trump administration’s ill-conceived and implemented executive order harms all sorts of people, like Iraqis who risked their lives to help the US military, and US citizens whose spouses, parents, and children are not citizens. The policy is inhumane and will likely damage our national security.

It also harms science, as many are pointing out. (See Ed Yong in the Atlantic for stories of scientists who are directly affected.) Immigrants play an enormous role making American science great. I made the case for this in a Pacific Standard piece two years ago – and it’s a good day to reup the argument:

Science has always been most successful when countries exchange ideas, talent, and resources, which is why one of the National Research Council’s “ten breakthrough actions” recommended to Congress is to “ensure that the United States will continue to benefit strongly from the participation of international students and scholars in our research enterprise.” Our scientific preeminence relies heavily on migrant scientists, and that’s a good thing.

Reupping:Why reproducibility initiatives are misguided

I’m reposting this two-year old piece, because it’s worth reminding ourselves why exact replication has, with minor exceptions, never been an important part of science:

In my latest Pacific Standard column, I take a look at the recent hand-wringing over the reproducibility of published science. A lot of people are worried that poorly done, non-reproducible science is ending up in the peer-reviewed literature.

Many of these worries are misguided. Yes, as researchers, editors, and reviewers we should do a better job of filtering out bad statistical practices and poor experimental designs; we should also make sure that data, methods, and code are thoroughly described and freely shared. To the extent that sloppy science is causing a pervasive reproducibility problem, then we absolutely need to fix it.

But I’m worried that the recent reproducibility initiatives are going beyond merely sloppy science, and instead are imposing a standard on research that is not particularly useful and completely ahistorical. When you see a hot new result published in Nature, should you expect other experts in the field to be able reproduce it exactly? Continue reading “Reupping:Why reproducibility initiatives are misguided”

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