What the Next President Can Do

Well, no. McCain once angrily tossed Philip Morris lobbyist Charlie Black out of his office; today Black is one of his closest political advisers. To get nominated in the Republican Party—and to make his tax attacks on Obama stick—McCain feels he must oppose all new taxes, even one he once championed. His excuse is that he worries Congress would just use the money for other purposes, as so many state legislatures have. Instead of asserting that this would never be tolerated in a McCain presidency—that he would bring down his wrath on the wayward members of Congress—McCain punted on any new cigarette tax.

Until now, Obama has also been disappointing on cancer. While he often mentioned that his mother died in her early fifties of ovarian cancer, it was usually in the context of her having to worry about her insurance not fully covering treatment, a common problem. And though Obama won passage in Illinois of a law making insurers cover colorectal screenings, he missed both LIVESTRONG forums and didn't make cancer a campaign priority.

Then last Friday, on the day of the Stand Up to Cancer telethon, Obama finally stood up. He pledged to double funding over five years for the National Institutes of Health (which houses the National Cancer Institute), expand clinical trials, end discrimination by insurance companies against those who have had cancer (and thus can't change jobs) and improve coordination among federal agencies. McCain also used the occasion to address cancer on his Web site for the first time, but he's sketchier on the details and hasn't committed to big funding increases or any cancer initiatives beyond smoking-cessation programs.

Politicians have been slow on the cancer front partly because it's a downer, and partly because most don't seem to understand how perilous the research situation has become. It's not just that fewer than two in 10 applications for NIH grants are funded—down sharply under President Bush. It's that the wrong researchers often get the money, as Thomas Cech, president of the Howard Hughes Medical Institute, has pointed out. The system, he writes, is "risk averse." Older researchers with old-boy-network contacts receive a disproportionate amount of the funding. Cech notes that younger, less-connected but more creative researchers, the ones most likely to find cures, are leaving medical research in droves because they can't get funded.

That's where Stand Up to Cancer comes in. The funds raised by all the celebrities will be what Jerome Groopman of the Harvard Medical School calls "catalytic money" devoted to highly innovative grants and to "dream teams" of doctors who work in collaboration rather than along parallel lines. For a disease that destroys families and costs the economy $200 billion annually in lost productivity, it's the least we can do.

The new president shouldn't promise that we'll cure cancer in 10 or 20 years. That's not realistic. But he must set plausible goals, like doubling survival time for major cancers. The War on Cancer that Richard Nixon declared in 1971 has been a failure. McCain or Obama can succeed if they get passionate about the havoc that cancer wreaks, make gutsy budget and tax decisions and resolve not to claim they've "beat it" when they haven't.

© 2008