The Republican presidential candidates have already proven that medical science can be a dangerous subject in a debate. Remember the exchange between Donald Trump and Ben Carson about whether vaccines cause autism? Good times.
Life sciences issues aren’t likely to be the centerpiece of Tuesday night’s Fox Business Network/Wall Street Journal debate, which is supposed to focus on business and economic issues. But the moderators could very well slip in some questions about medical science and policy — and in doing so, they could help us learn a lot about how the GOP candidates think, and whether they’ve thought about these issues at all. Most of them still haven’t spelled out specific ideas about how they would curb rising drug prices, nor have they said much about their positions on medical research funding.
Here are some medical science and policy questions to watch for:
To all candidates: What would you do about rising prescription drug costs?
This is an especially tough one for the Republican candidates because of what they don’t want to do: embrace anything that could be construed as “price controls.” Sure, Hillary Clinton and Bernie Sanders can propose letting Medicare negotiate drug prices. Easy for them to say. The Republican candidates have to be able to criticize the notion of “price controls” — and then think of something else that they would do instead.
Senator Marco Rubio has called out some drug companies for “pure profiteering,” and New Jersey Governor Chris Christie has suggested cracking down on price-gouging.
Carson, in remarks that have been largely overlooked, told an Iowa audience last month that “there’s a lot of manipulation that is going on” when it comes to drug prices, according to a video released by the Campaign for Sustainable Rx Pricing. Carson added that “these are things that I would be very interested in studying and coming up with real solutions.”
Other GOP candidates haven’t dealt much with the issue — or said what they would do about it.
Tuesday’s debate could be a chance for the other candidates to say whether they have anything else to offer.
To all candidates: Do you believe vaccines are dangerous in any way?
Trump was the one who suggested in the September debate that vaccines cause autism, and Carson gently corrected him. But then he, Trump, and Senator Rand Paul all expressed concern that the frequency of vaccinations poses a threat to children — an argument that has also been rejected by medical professionals.
If the question comes up again, and the candidates can’t say unequivocally that vaccines aren’t dangerous, they’ll have to endure a new round of criticism from physicians and researchers about their inability to stick to medical science.
Medical research funding
To all candidates: Do you believe the National Institutes of Health should get more money?
After years of congressional budgets that have effectively eroded NIH funding by more than 20 percent, researchers are hopeful they might see a boost. It could happen. Jeb Bush has already called for an unspecified increase in funding in his health care plan. But there are also competing pressures for Republicans to prove they won’t allow wasteful spending. Bush nodded to those pressures when he said the agency should come up with a “more robust strategic plan,” eliminate “unnecessary, duplicative research,” and stop funding research on topics like “rabbit massages.”
If the question comes up, the other candidates would have to go on the record about whether they support more research funding — and all would have to say whether there are any important strings they would attach.
Trump and NIH
To Trump: Do you really think Michael Savage would be a good NIH director?
During an October interview, conservative radio talk show host Michael Savage offered himself up to Trump as a candidate to run the NIH — and Trump didn’t knock down the idea. “Well, you know you’d get common sense if that were the case, that I can tell you, because I hear so much about the NIH, and it’s terrible,” Trump told Savage, a nutritionist whose remarks on autism, AIDS, and other medical subjects have previously sparked controversy. A question at the debate would give Trump a chance to clarify whether he was serious — and what, exactly, he thinks is terrible about the NIH.
Bush and biotech
To Bush: Why didn’t your investment in biotech pay off?
As Florida governor, Bush made a big bet on biomedical research and spent as much as $1.3 billion in state, city, and county funding to turn the state into a research hub. Yet the investment didn’t lead to the job boom he had hoped for, as documented by Reuters and the Los Angeles Times. This is one of the bigger vulnerabilities of Bush’s economic record, so he’d have to come to Tuesday’s debate prepared to answer questions about it.
Rubio and drug companies
To Rubio: How would you separate the “bad actors” from the drug companies that are doing good work?
When Rubio made his comments in New Hampshire in October about “pure profiteering,” spokesman Alex Conant later insisted that he was only talking about certain drug companies and that “it is no secret that there are some bad actors who put profits ahead of patients.” But Rubio still hasn’t said exactly what he would do about the problem, and a well-targeted question might force him to explain whether he has a policy solution that would crack down on the “bad actors” without discouraging research and innovation among the rest.
Paul and budget cuts
To Paul: A lot of Republicans say it’s time to increase NIH funding. Why did you want to cut it?
There’s growing support in Congress to boost NIH’s budget for the first time in years — with key Republicans backing the move — but Paul has been one of the agency’s most consistent critics. In a 2012 budget proposal, he called for reducing NIH funding to 2008 levels, arguing that the private sector also funds research and development. He also rails frequently about NIH-funded studies he considers wasteful, including one about how social relationships among college freshmen can contribute to weight problems. The debate could give him a chance to clarify whether he’s concerned about the overall erosion of NIH funding and what research he considers important.
Carson and end-of-life care
To Carson: You have said the government spends excessively on medical care at the end of a person’s life. What should the government be doing differently?
Before he was a presidential candidate, a STAT review found, Carson raised provocative questions about whether society should keep spending so much on medical care for the terminally ill, and whether doctors should always prolong people’s lives just because they can. His campaign insists he was raising rhetorical questions, not proposing reforms, but social conservatives are likely to want to hear more about whether such remarks reflect the kind of policies he would advocate if elected to office.