Andy Grove is a dreamer. Even though his speech is slurred and his body movements out of control from Parkinson's disease, the cofounder of Intel and former UC Berkeley Ph.D., gave an astute diagnosis and prescription for government incompetence in three agencies -- the NIH (which funds scientific research), the FDA (regulates drugs), and the CMA (sets prices on healthcare) -- at an inaugural Ernest Kuh lecture series at UC Berkeley's School of Engineering on April 5.
Starting with the technological advancements made according to Moore's law, named after Intel cofounder Gordon Moore, Grove argued that a lack of transparency in price-setting policy by the CMS (Consumer Medicare and Medicaid Services), creeping complexity in FDA rules, and lack of focus in NIH's research priorities, have slowed advancements in healthcare. With a 14-year development period for new drugs, venture capitalists -- "the most efficient engine in translational medicine" -- are hobbled, says Grove, a firm proponent of democracy and capitalism.
Recently, I became familiar with the arbitrariness and lack of transparency in the NIH research grant process Grove identified, when I helped a friend apply for a scientific grant. After spending months writing a research proposal so that it adhered to NIH guidelines, and months waiting for a reply, the denial was just plain weird. Three scientists had reviewed the proposal: two supported it and said the proposal had merit. One scientist said the researcher lacked any undergraduate publications and therefore didn't merit an NIH grant. Thus, the grant proposal was denied even though nothing in the NIH procedures had required an undergraduate publication as a criteria for a grant.
As one example of how government might change its practices, Grove cited the trove of papers on clinical research the government keeps in a warehouse in Bethesda, Maryland. He thinks this data -- Big Data, he calls it -- should be digitized and made open and available to all medical researchers while protecting the personal identity of the individuals from which it is collected. He calls this data a "king's riches" that could translate to a better understanding of disease and treatment. He also called for more transparency in research funding, the creation of a federal health-related trade office, and requiring health economics courses for all engineering and pre-med students.
It's hard not to empathize with someone who is fighting death right in front of your face. You wonder how much of his urgency in wanting to accelerate the federal processes for drug research, approval, and pricing has been affected by his own encounters with prostrate cancer and Parkinson's. In the end, it doesn't matter why Grove has focused on healthcare reform. His insights into how we could expedite discovery in healthcare by applying what works for microchips might improve the lives of mere flesh-and-blood mortals as well.