When the Cure Doesn’t Serve the People, the System Fails the Constitutional Test
Public money, on its face, should yield public benefit. But every year, the federal government sends almost sixty billion dollars to universities like Harvard for research and development, most of it through the Department of Health and Human Services.
A university takes federal funding, makes a breakthrough, and licenses it to a drug company. Nothing stops that company from setting a high price, because while the research was public, the product isn’t.
Taxpayers fund the research, then get stuck paying again at the pharmacy. For many, the cost of needed treatment puts the remedy out of reach.
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We drift because we forget our purpose.
The Constitution names six national goals: Union, Justice, Domestic tranquility, Liberty, the common defense, and the general welfare. Every law and every dollar must serve at least one. When a policy misses the mark, it serves power, not people.
The point of American governance is to serve the people. That philosophy is the reason we were born at war. Why we owe allegiance to no king. Why we have our uniquely structured Constitution.
We lose sight of aligning our effort with these national goals. We need to get back on track.
So today, we’re asking whether public funding for private research still serves the general welfare. Does it help all of us, or just a few? To answer that, we go back to the beginning, with a boy named Jimmy, a Boston hospital, and a small act of hope that changed cancer research.
Jimmy’s Radio Miracle
In May 1948, a boy named Einar Gustafson wanted to watch his favorite baseball team, the Boston Braves. Einar had a problem: he didn’t have a television. But he had a bigger problem. He was in the Children’s Hospital ward in Boston, dying of leukemia.
At the time, leukemia was effectively a death sentence. It had been first identified a hundred years earlier, but there was still no treatment, just blood transfusions and comfort care. Then came Dr. Sidney Farber.
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Farber was a pathologist at Children’s Hospital. He’d grown tired of trying to learn why a patient didn’t respond to treatment after they had died and decided to try something new. He devised an experimental blood treatment he thought would block the food cancer cells needed to grow. His small study of just 16 children showed that 10 of them improved. The remissions didn’t last, but the fact that they happened at all was groundbreaking. It was the first time a chemical agent had ever worked against a non-solid tumor.
Farber had introduced the world to chemotherapy, or now the more common term, just “chemo” treatment for cancer.
That same year, Farber and a member of the Variety Children’s Charity were looking for a way to raise money for research. They needed a face for the cause. They found it in Einar, but to protect his identity, they called him “Jimmy.”
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So they told his story on a national radio broadcast. They said Jimmy wanted a television to watch his Braves. They said cancer research needed support. The country responded. In just eight minutes of airtime, Americans sent in $231,000, more than three million in today’s dollars. The Jimmy Fund was born.
That money launched the Children’s Cancer Research Foundation, which later became the Sidney Farber Cancer Center, and eventually the Dana-Farber Cancer Institute, now Harvard University’s principal cancer research center.
But Farber didn’t stop at the lab. He kept pressing Congress, explaining that major breakthroughs would take national funding and sustained effort. And Congress listened. Between 1957 and 1967, the National Cancer Institute’s budget more than tripled.
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Then, in 1971, President Richard Nixon called on Congress for an extra $100 million, nearly $700 million today, to launch an intensive campaign to find a cure for cancer. Later that year, he signed the National Cancer Act, declared a formal War on Cancer, and pumped billions into cancer research nationwide. The act expanded the National Cancer Institute’s power, created new research centers, and marked the first time the federal government treated cancer as a coordinated national challenge.
Since the increased 1971 national commitment, the American people have sent more than $1 trillion to universities for medical research. Progress slowly advances. This year, Harvard Medical tested an anti-tumor vaccine with promising results.
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We could look at this story as either a success or a failure. A success in that private contributions provided seed money that helped create a medical breakthrough. We have made great advancements. A failure that significant public obligations showed diminishing returns. We have not cured cancer, and American life expectancies have not increased in the last 20 years.
But that is too short-sighted.
It’s not that we should rely only on private funding commitments, or that public funding for private institutions is irresponsible.
Likewise, the crux of the matter is not that public funding is essential to make progress in research and development.
The decisive point is: does our effort advance our progress towards achieving one or more of our national goals? Let's ask the hard questions clearly.
Justice and the General Welfare
Can we definitively say that giving universities money for research and development improves the general welfare?
Can we say the effort advances justice?
Certainly, national infrastructure benefits the whole country. Medical research depends on nationwide clinical trials, standardized data sharing, drug-approval pipelines, and outreach to rural and underserved areas. Only the federal government has the mandate and capacity to serve everyone. We don’t serve the general welfare if cures stay bottled up in Boston.
But if we pay for research and development, and private companies turn the patents into private property and set prices that most families can’t afford, then the investment the American people made to advance justice and general welfare falls short.
The prostate-cancer drug Xtandi is a classic example. Our money helped discover it, but the company that holds the license lists the therapy at more than one hundred twenty-nine thousand dollars a year. More than ten thousand dollars a month! Far beyond the reach of most American families.
Patient advocates have multiple times asked the government to use its lawful authority to force wider access. NIH refused both times. In total, this authority has never been used in the forty-plus years it has existed.
Let me say that again.
In more than four decades, the federal government has never once stepped in to come to the aid of the American people to lower the price of a publicly funded drug.
When a publicly funded drug ends up on the market at a price well beyond what the average American family can afford, the spending fails the general welfare test. It also fails the justice test, because wealth divides the rich and poor, urban and rural, insured and uninsured.
Yes, inequality exists everywhere. But America was built to be different, on purpose.
Part of the reason America exists is justice. Every state in the union agreed that if the people fund medical research, then a poor man and a rich man should have equal access to the benefit.
So… it seems the way we structure public funding for cancer research at Harvard and other universities doesn’t align with our national goals.
How Would We Change That?
Right now, universities take our money in the form of federal research grants, but only part of that money goes to the actual research. The rest, sometimes nearly half, goes toward overhead. This includes administrative costs, building maintenance, and salaries for university staff who never touch the lab.
At Harvard, that indirect rate is nearly 70 percent for research conducted on campus. The indirect rate for research conducted at other Harvard facilities is still high, 26 percent.
So when the American people send a million dollars to find treatments for cancer, four hundred thousand might go toward the effort. The rest feeds the institution.
Second, we have a problem with private ownership of public money. Since 1980, universities have been allowed to patent inventions made with public money. They can then license those patents, often exclusively, to drug companies. There’s no requirement that the final product be affordable or widely available. The government has the power to step in when the public is denied the benefit, but in over forty years, it has never once used it.
Third, we admit where trials fall short. There are rules encouraging inclusion across race, gender, and geography, but enforcement is weak. Most trials still happen at elite hospitals. Rural Americans, tribal communities, and low-income patients are left out.
Again, the structure of public funding for cancer research doesn’t align with our national goals. It doesn’t reflect justice or promote general welfare.
A better system would start with a simple rule: 100 percent of public money goes to the research. If a university believes in the work, it can cover its own administrative costs. The taxpayer’s role is to fund discovery, not to subsidize building cafeterias and paying deans.
Next, any treatment developed with public dollars must be subject to a universal access guarantee. That means open licenses for nonprofit hospitals and VA clinics, and a price ceiling for commercial sale. If a private company uses public research to build a profitable product, the benefit must reach the people who paid for it.
Finally, we demand equity in clinical trials. That means conducting research across the country and proving that results apply to everyone. If we measure every dollar spent by whether it serves the people, across race, income, and geography, then we align with the Constitution.
The effort isn’t intended to punish universities or end research.
The effort intends to ensure that the commitment the American people make to justice and their general welfare serves the nation in return.
Wait…What Happened to Einar?
Einar Gustafson, or “Jimmy,” lived. He left the hospital and went home. He stayed out of the public eye until 1998, when he revealed his identity at a Jimmy Fund event in Boston. By then, he was in his sixties, working as a potato farmer in Maine.
We don’t lack commitment or generosity. We don’t even lack funding.
What we lack is purpose and structure.
Our question isn’t whether we should fund research. We already do. It’s not whether we can make breakthroughs. We already have.
Our question is whether we’re serious about what our Constitution says that funding is for.
This story isn’t about punishing Harvard. It’s about the promises we made when we became a country. It’s about justice, the general welfare, and holding ourselves to our highest standard.
If our effort doesn’t serve justice and reach the people who paid for it, then we are failing to achieve the goals America stands for.
So, should we continue to fund cancer research at Harvard and other universities?
May God bless the United States of America.
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