The Train Has Left the Station
The Train Has Left the Station
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火车已离站
DOI：
10.1096/fasebj.8.8.8181663
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
T. Edgington
中科院分区：
文献类型：
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作者：
T. Edgington
第8卷1994年5月FASEB杂志469是的！火车已经离开了车站，而科学研究界却不在车上。训练什么?对于白宫专家们提出的医疗改革的优先顺序，我并不质疑他们的意图，但我确实质疑为什么基础生物医学研究（又名生命科学等）不被认为是全民医疗保健理想中必要和实质性的因素。如果政府认为生命科学研究对改善社会健康不是必不可少的，那么政府的支持将比现在进一步减少。来自社会其他角落的资源不太可能足以继续历史上最伟大的实验，将知识引导的进步带到有效的医学诊断和治疗中。我恭敬地提出，克林顿健康计划中缺少生命科学的基石，这在很大程度上与下届选举有关，因为克林顿提出了一个快速而肮脏的解决方案，该解决方案的基础是提供比现状更差的药物。呼吁回到全科医生时代只是强化了联邦政府强加给每一所医学院的现实，他们要求所有医学院毕业生中有50%进入家庭执业。对于由更专业的医学分支提供的日益复杂的生物医学研究的尖端进展，似乎有一种强烈的政策厌恶。然而，这些进步有效地干预挽救和延长生命以及提高生活质量。对于这些怀疑论者来说，有一种政治观念认为，生命科学研究的广泛范围内的优先事项，如分子细胞生物学和其他调查学科，与可以从更高调的宣传问题（如“信息高速公路”）中收集的政治资本相比，相形见绌。生命科学的进步并不像电脑游戏和廉价个人电脑提高的信息处理效率那样对公众可见。尽管生命科学研究对寿命的延长和生活质量产生了深远的影响，但它既没有给社会带来娱乐，也没有立即使社会受益。此外，白宫的现任主人在竞选期间一再重申，“这是经济问题，笨蛋。”在选举年，这一口号是社会的当务之急。生命科学确实在就业、新产业、改善劳动力的健康和生产力以及国家成就方面带来了社会效益。这是美国为数不多的优势领域之一。杀鸡取卵是愚蠢的。是下了这么多金蛋！与一厢情愿的想法相反，生命科学不会仅仅因为它们是“好的”、“有价值的”或“对知识的进步是必要的”而得到支持：这些原因对我们许多人来说是根本的，也是政治正确的学术思想的标志。然后呢?两个非个人的角色正在搅局。首先是政治现实，这一点被科学界的恳求者不切实际地低估了。其次，财政现实几乎像外人一样陷入了政治泥潭。至少看起来是这样，因为财政紧缩既是不作为的传统借口，也是现实。就在我们白宫的新住户赢得选举48小时后，生命科学界的成员会见了即将上任的政府代表。在一个星期内，美国实验生物学学会联合会的成员们准备了三份立场文件，并提交给了即将上任的行政当局的有关工作人员。这表明，新政府对基础生物医学研究问题进行了审议。
Vol. 8 May 1994 The FASEB Journal 469 Yes! The train hasleft the station and the Lt#{232} Sciences research community is not on it. What train? The train of priorities for health care reform assembled by the pundits in the White House, I do not challenge the intentions, but I do question why basic biomedical research (aka Life Sciences, etc.) is not thought to be a necessary and substantial element in the ideal of universal health care. If the perception of government is that Life Sciences research is not essential to the betterment of the health of society, support from government will diminish even further than it already has. And resources from other corners of society will unlikely be sufficient to continue what has been the greatest experiment in history bringing knowledge-guided advances to effective medical diagnosis and therapy. I respectfully submit that this omission of a Life Sciences cornerstone from the Clinton Health Plan has much to do with capturing the next election by proposing a quick and dirty solution based on delivery of what will become less than status quo medicine. The call for a return to the era of the general practitioner simply reinforces a reality being imposed on every medical school by the federal government with their demand that 50% of all medical school graduates enter Family Practice. There appears to be a strong policy aversion to increasing sophistication in the delivery of cutting edge advances from biomedical research that are delivered by the more specialized branches of medicine. However, these advances intervene effectively to save and prolong life as well as to improve the quality of life. To this skeptic there is a political perception that priorities within the broad spectrum of Life Sciences research, such as molecular cell biology and other investigative disciplines, pale next to the political capital that can be gathered from higher profile promotional issues, such as the “Information Wghway” Political realities dictate short-term, publidy identifiable progress. Progress in the Life Sciences is not as visible to the public as are computer games and the improved efficiency of information processing with inexpensive PCs. Society is neither entertained nor instantly benefited by Life Sciences research, although the extension of life span and quality of life are profoundly affected. Further, the current occupants of the White House repeatedly enunciated during the election campaign, “It’s the economy, stupid.” In an election year this slogan is a social imperative. The Life Sciences do deliver social benefits in jobs, new industry, improved health and productivity of the work force, and national achievement. It is one of the few sectors of U.S. preeminence. It is foolish to kill the goose that. is laying such golden eggs! Contrary to wishful thinking, the Life Sciences will not be supported just because they are “good”, “meritorious” or ‘necessary to the advancement of knowledge:’ the reasons that are fundamental to many of us, and the hallmark of politically correct academic thinking. Then what? Two impersonal players are stirring the pot. First, political reality, which has been unrealistically underestimated by the supplicants for the scientific community. Second, fiscal reality has landed in the political quagmire almost as an alien. Or so it seems, as fiscal constraints are both a conventional excuse for inaction as well as a reality. Just 48 hours after our newest residents of the White House won at the polls, members of the Life Sciences community met with representatives of the incoming administration. Within one week, three position papers were prepared by members of the constituent Societies of the Federation for American Societies for Experimental Biology and delivered to the appropriate staff of the incoming administration. This suggests that deliberation was given to the issues of basic biomedical research by the new administration.