Maria Shriver, in conjunction with the Alzheimer's Association, has launched a new campaign against Alzheimer's Disease (AD). But she doesn't want simply to treat AD, she wants to beat AD. And in setting such an ambitious goal, she is invoking the memory of her famous uncle, John F. Kennedy, the greatest goal-setter in modern American history.
It was JFK, of course, who declared in 1962 that America would put a man on the moon by the end of the decade--and we did. To this day, Kennedy's Apollo space program is the gold standard for governmental effectiveness. When people think about the "can do" America that seems to be slipping away, the moon landing comes up as a nostalgic beacon of hope and optimism. So when Shriver declared to Diane Sawyer on ABC News Monday night, "We can launch an expedition on the brain, much like President Kennedy launched an expedition to the moon," she summoned up powerful resonances.
In fact, by taking her beat-is-better-than-treat message to venues ranging from "The View" to "This Week" to Time magazine, Shriver is likely to change the frame of the healthcare debate--that is, change it from its current focus on bean-counting finance to a renewed focus on heroic medicine.
Here's why: After two years of Verdun-like fighting over healthcare policy, both parties will wake up in 2011 to realize that the battle was fought over a relatively minor aspect of the overall topic of medicine: healthcare for the uninsured. We can say that the uninsured were a moral blot on us all, but we can also say that at any given time, the problem of actual illness--our own and that of others--is a greater concern.
AD is a case in point. Currently, 5.3 million Americans suffer from AD, and that number is expected to triple in the next 40 years. The ailment is not only a personal and family tragedy; it is an enormous national expense--$170 billion and rising fast. And that rapid cost-increase will not be affected by the shifting fortunes of partisanship, nor by changing the financing mechanism for AD treatment. To put it bluntly, it doesn't much matter whether AD treatment for tens of millions of American is financed by the government, or by insurance companies, or by personal health savings accounts. If the money has to be spent, it will be spent. American compassion, not to mention AARP, will make sure of that.
Yet Shriver has a different, and better, idea: "bend the curve" on AD costs by curing the malady itself. As she told Sawyer: "We've got to find a cure to this disease, otherwise it will bankrupt every family in this country, and it will bankrupt us as a nation."
Few would disagree, of course, that cure is better than care. Or would they? For decades now, the policy emphasis on Washington has been on "universal coverage," pro and con. But in the multi-decade rumble over national health insurance--by no means over, even after the enactment of Obamacare--both parties have focused so intensely on healthcare finance that they have lost sight of curative medicine itself. Perhaps everyone will be covered--but covered for what? If there's no cure for the disease, coverage doesn't mean much.
Indeed, we spend a mere $500 million a year on AD research--and why, according to the NIH, we have no effective treatment; the anti-AD effort is under-capitalized. Indeed, of the $2.6 trillion that we spend on healthcare in the US, barely more than $100 billion goes to medical R&D.
Once upon a time, political leaders thought differently. Franklin D. Roosevelt wanted to cure polio, and so in 1938, he set in motion the March of Dimes. Seventeen years later, we had the Salk Vaccine. The issue back then was obvious: Nobody wanted insurance for polio, they wanted the elimination of polio. OK, that was long ago and far away. Yet even as recently as the 80s and 90s, a joint public-private commitment created treatments for AIDS, making AIDS in the West, at least, a mostly manageable disease.
It's that goal-oriented approach to medicine that Shriver wants to rekindle. Can we do it? The truth is, we have to. We have to reorient ourselves, as a society, toward curing disease, as opposed to paying for disease. Among other considerations, it's cheaper.
Indeed, one can even see the outlines of a future "grand compromise" in Shriver's efforts. That is, we can link a cure for AD--or at least a push-back for its onset--with a raising of the retirement age. That's a deal most senior citizens would get behind.
As we admire Shriver for her determination and vision, we can also note that a cure strategy for AD would be good politics. From left to right, from blue to red, everyone wants to be healthy. And the voters, across the ideological spectrum, stand ready to reward the politicians who help them find a better life and a dignified old age. The pols haven't quite received that message yet, but Maria Shriver will help make sure that they will.
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