Why Hard Science and Medicine Is Getting Mushy
Arthur Caplan, one of America’s top medical ethicists, is worried about pollution. Not the kind that ruins our oceans or makes it hard for us to breathe, but the kind that poses a threat to the “trustworthiness, utility, and value of science and medicine.”
Caplan, who directs the Division of Medical Ethics at NYU Langone Medical Center, wrote a blistering essay in last week’s Mayo Clinic Proceedings, saying, "The pollution of science and medicine by plagiarism, fraud, and predatory publishing is corroding the reliability of research. Yet neither the leadership nor those who rely on the truth of science and medicine are sounding the alarm loudly or moving to fix the problem with appropriate energy."
He goes on to cite three causes of publication pollution, which can undermine these areas of “hard science” that should be sacrosanct.
- The proliferation of journals that recruit authors who pay to get their articles published. Despite having substandard or no peer view, these "predatory publishers" now comprise an estimated 25 percent of all open-access journals. "Not only do they provide opportunities for the unscrupulous in academia and industry to pad their curriculum vitaes and bibliographies with bogus articles and editorial appointments, they also make it difficult for those involved in the assessment and promotion of scholars to discern value from junk," writes Dr. Caplan.
- Research misconduct, like falsifying or fabricating data or concealing serious violations. Fourteen percent of scientists report that their colleagues falsify data, and 72 percent report other questionable practices, according to one 2009 study published in PLoS One.
- Plagiarism, which, according to a 2010 Nature article was "staggering," requiring editors to spend "inordinate amounts of time" checking submissions they receive.
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Smaller refunds in the first few weeks of the current tax season were shaping up to be a political problem for Republicans, but new data from the IRS shows that the value of refund checks has snapped back and is now running 1.3 percent higher than last year. The average refund through February 23 last year was $3,103, while the average refund through February 22 of 2019 was $3,143 – a difference of $40. The chart below from J.P. Morgan shows how refunds performed over the last 3 years.
Number of the Day: $22 Trillion
The total national debt surpassed $22 trillion on Monday. Total public debt outstanding reached $22,012,840,891,685.32, to be exact. That figure is up by more than $1.3 trillion over the past 12 months and by more than $2 trillion since President Trump took office.
Chart of the Week: The Soaring Cost of Insulin
The cost of insulin used to treat Type 1 diabetes nearly doubled between 2012 and 2016, according to an analysis released this week by the Health Care Cost Institute. Researchers found that the average point-of-sale price increased “from $7.80 a day in 2012 to $15 a day in 2016 for someone using an average amount of insulin (60 units per day).” Annual spending per person on insulin rose from $2,864 to $5,705 over the five-year period. And by 2016, insulin costs accounted for nearly a third of all heath care spending for those with Type 1 diabetes (see the chart below), which rose from $12,467 in 2012 to $18,494.
Chart of the Day: Shutdown Hits Like a Hurricane
The partial government shutdown has hit the economy like a hurricane – and not just metaphorically. Analysts at the Committee for a Responsible Federal Budget said Tuesday that the shutdown has now cost the economy about $26 billion, close to the average cost of $27 billion per hurricane calculated by the Congressional Budget Office for storms striking the U.S. between 2000 and 2015. From an economic point of view, it’s basically “a self-imposed natural disaster,” CRFB said.
Chart of the Week: Lowering Medicare Drug Prices
The U.S. could save billions of dollars a year if Medicare were empowered to negotiate drug prices directly with pharmaceutical companies, according to a paper published by JAMA Internal Medicine earlier this week. Researchers compared the prices of the top 50 oral drugs in Medicare Part D to the prices for the same drugs at the Department of Veterans Affairs, which negotiates its own prices and uses a national formulary. They found that Medicare’s total spending was much higher than it would have been with VA pricing.
In 2016, for example, Medicare Part D spent $32.5 billion on the top 50 drugs but would have spent $18 billion if VA prices were in effect – or roughly 45 percent less. And the savings would likely be larger still, Axios’s Bob Herman said, since the study did not consider high-cost injectable drugs such as insulin.
