Currently, it looks like Robert F. Kennedy Jr. will become HHS secretary and change a lot of things at the HHS. There will likely be both good and bad changes.
It’s a time when the ideas that lay around matter. What changes do you think should be made? What clever policy ideas should be adopted?
If a product derives from Federally-funded research, the government owns a share of the IP for that product. (This share should be larger than the monetary investment in the grants that bore fruit since the US taxpayer funds a lot of early-stage research, only a little of which will result in IP. So, this system must account for the investments that didn’t pan out as part of the total investment required to produce that product.)
Fund grants based on models of downstream benefit. Four things that should be included as “benefits” in this model are increased health span, increased capacity for bioengineering, an increased competent researcher pool, and a diverse set of researchers. Readers from backgrounds like mine may balk at “diversity” as an explicit benefit; however, diversity is vital to properly exploring the hypothesis space without the bias imposed by limited perspectives.
Classify aging as a disease/disorder for administrative purposes. Set the classification to be reviewed/revised in 20 years after we have a better picture. (Whether it should be considered a single disease from a reality-modeling perspective is uncertain, but being able to target it in grants will give us more research that will help us model it better.)
Encourage inclusionary zoning at a Federal level.
Create a secure government-wide password manager. (If necessary, the HHS is large enough to do this alone, but the benefit would scale if used by other agencies.) Currently, HHS passwords may not be placed in password managers, leaving the HHS open to phishing credential stealing attacks. The project could be open-sourced to allow private firms to benefit from the research and engineering.
Make all health spending tax-deductible, whether or not it is funneled through an insurance company. (This is probably the domain of Congress, but maybe there is something HHS can do.)
Reduce the bureaucracy/red tape for TANF recipients.
Combine FEMA and ASPR
Work with the Census Bureau to collect and publish statistics on human flourishing in the US and push/advertise to make those numbers top-line numbers that the electorate (and thus politicians) pay attention to. Improving these statistics can be a “benefit” in the grant funding proposal above. HHS can also work to create conditional markets to predict how different decisions will affect those statistics.
There are different kinds of diversity.
It seems to me like the decision of the Ida Rolf Foundation to start funding research had good downstream effects that we see in recent advances in understanding fascia. That foundation being able to fund things that the NHI wouldn’t fund was important. Getting a knowledge community like the Rolfers included in academic researchers is diversity that produces beneficial research outcomes.
If you follow standard DEI criteria, it doesn’t help you with a task like integrating the Rolfing perspective. It doesn’t get you to fund a white man like Robert Schleip.
I would suspect that coming from a background of economic poverty means that you likely have less slack that you can use to learn about knowledge communities besides the mainstream academic community. Having the time to spent in relevant knowledge communities, seems to me like a sign of economic privilege.
Maybe, you could get something relevant by focusing on diversity of illness burden within your researcher community as people with chronic illnesses might have spent a lot of time acquiring knowledge that produces useful perspectives, but I doubt that standard DEI criteria get you there.
I like vaccines and suspect they (or antibiotics) account for the majority of the value provided by the medical system. I don’t usually see discussion of what can be done to promote or improve vaccines, so I don’t know much about it, but the important part is they remain available and get improved and promoted in whatever ways are reasonable.
Beyond that, a major health problem is obesity and here semaglutide seems like it would help a lot.
Saying “whatever ways are reasonable” is ignoring the key issues.
Robert F. Kennedy Jr. believes that all vaccines should require placebo-blind trials to be licensed the most other drugs do.
Whether or not that’s reasonable is the key question.
Do you believe that Medicaid/Medicare should just pay the sticker price for everyone who wants it?
Though I agree that vaccines and antibiotics are extraordinarily beneficial and cost-effective interventions, I suspect you’re missing essential value fountains in our medical system. Two that come to mind are surgery and emergency medicine.
I’ve spoken to several surgeons about their work, and they all said that one of the great things about their job is seeing the immediate and obvious benefits to patients. (Of course, surgery wouldn’t be nearly as effective without antibiotics, so potentially, this smuggles something in.)
Emergency medicine also provides a lot of benefits. Someone was going to die from bleeding, and we sewed them up. Boom! We avoid a $2.5 million loss. Accidental deaths would be much higher in the US without emergency medicine personnel.
Another one to look into would be perinatal care. I haven’t examined it, but I suspect it adds billions or trillions to the US economy by producing humans with a higher baseline health and capacity.
I think our collective HHS needs are less “clever policy ideas” and more “actively shoot ourselves in the foot slightly less often.”
To the extent that our needs are “actively shoot ourselves in the foot slightly less often”, there’s the question of why we currently shoot ourselves in the food. I suspect it’s because of the incentives that are produced by the current policies.
This is true. But ideally I don’t think what we need is to be clever, except to the extent that it’s a clever way to communicate with people so they understand why the current policies produce bad incentives and agree about changing them.