After another big drop in unemployment comes the news that the Komen charity will reverse it's decision to stop funding cancer screening via Planned Parenthood. In the absence of proper national public health programmes, it seems that relying on charity means being subject to the whims of donors.

Komen does show that people choose to have their money go to charities that they want. Planned Parenthood's donations increased after the proposed cut in funding from Komen. Even Bloomberg donated $250,000. Should be fine to be privately funded, whether it is through foundations or personal giving.

As I have said before, donate to the charities you desire to have your money.

Hmmm.

Well, I would disagree because I see screening for cancer as being part of public health, making a national function best suited to government, rather than being at the whim of public charitable support. But that's just me.

The only reason that PP donations went up was because people reacted to the decision, which was made public. Supporters of the withdrawl from Komen accused people of making it 'political' (which is a joke, frankly, given how things happened and the real reason for the withdrawl).

Should people really have to get so annoyed in order to fund something like breast cancer screening?

Also, breast cancer is a very popular cause, and will easily attract funding. It is a winner in the 'whim of donors' game. Problem is that other no less worthy, but not so well publicised or not easily 'sold' causes are losers.

I've done a fair amount of work for Komen in the past. They have a national organization in Texas with ties to GWB and the Republican party. I've been to several of their events, including the national leadership conference in Wash D.c. about 4 years ago where Romney spoke. I actually remember a snippet of his speech where he said the issue isn't how much federal money goes to cancer research, but how well it is spent. That's stayed with me these several years, but I digress.

They also have local affiliates (which have Board autonomy, within reason) throughout the country. In general the locals, particularly here in the northeast, are liberal leaning. They don't suffer from my compassion fatigue. The mission is 1/3 research and 2/3 helping the under-served community, including the poor, minorities, and local immigrant populations. The local affiliates, especially in liberal parts of the country like here, have been lobbying the national organization to change course. I haven't spoken to any insiders, but my guess is that the locals were in danger of losing 1/2 of their local funding over this, since so much of the funding comes from women.

I think this is healthy. Unlike a government that can run a program on auto pilot for years and years, a private organization has to be nimble and balance competing interests. Donor have a right to control their funds. The various institutions that mediated this conflict (national office, local affiliates, news media) show the vibrancy of a free society.

danivon wrote:Hmmm.

Well, I would disagree because I see screening for cancer as being part of public health, making a national function best suited to government, rather than being at the whim of public charitable support. But that's just me.

The only reason that PP donations went up was because people reacted to the decision, which was made public. Supporters of the withdrawl from Komen accused people of making it 'political' (which is a joke, frankly, given how things happened and the real reason for the withdrawl).

Should people really have to get so annoyed in order to fund something like breast cancer screening?

Breast cancer screening is the norm here in the US, much more so than in the UK. We start earlier and we do it more frequently. At issue is that certain communities often don't get free screening because of health or language barriers, and not because the law prevents it. That's Komen's focus.

I think Komen is likely to be hit hard by this, and that's actually a big shame. They were being abandoned by those appalled by the move away from PP and those may not come back. Now they've gone back, those who donate to them and are anti-abortion may also abandon them (some are already calling for a boycott).

The annoying thing is that the money from Komen to PP was ringfenced already and could not be used on anything other than cancer. Also, thanks to federal funding rule changes, PP's money that does fund abortion services is also ringfenced so Komen's money was 'double-insulated' from abortion.

Actually, I think it would be good if a different organisation took up the gauntlet of funding cancer research. Komen apparently spent about $1M trying to sue people for organising events with a "xxx for the Cure" label, as if they are the only people allowed to raise funds for cures and it's only breast cancer that needs curing. They also seem to spend a lot of money on marketing and selling tat with a small percentage of sales going to the cause (a frequent problem for charities is that they get dragged into retail). As a man, I get uncomfortable with the marketing of breast cancer as a 'Women' thing anyway. Men get it too (and male-only cancers get far less attention, unfortunately), men can be affected by women having Breast Cancer too.

Still, you are talking about donations for cancer research, I was talking about donations for cancer screening. These are totally different things.

Besides, I have a view that charities/voluntary groups are not realy part of the private sector. There are three sector to the economy really:

Public - government (of all levels).
Private - non-governmental, for profit
"Third Sector" - non-governmental non-profit

All three have links to each other. But the difference between them are important.

Still, you are talking about donations for cancer research, I was talking about donations for cancer screening. These are totally different things.

I'm talking about both. Under the Komen structure, funds raised by the national organization are largely spent on research. Of the Funds raised by the local affiliate, 1/4 go back to the national organization, about 1/2 goes to local organizations for grants to other local organizations such as PP. Those moneys are typically used for screening and equal access for the under-served communities. So whereas the national organization is more focused on research, the locals are more focused on screening and prevention for the under-served.

Ray Jay wrote:Breast cancer screening is the norm here in the US, much more so than in the UK. We start earlier and we do it more frequently. At issue is that certain communities often don't get free screening because of health or language barriers, and not because the law prevents it. That's Komen's focus.

Indeed. Unless you have a family history, or a suspect symptom, free cancer screening is not available on the NHS until you are 40. There are campaigns to lower the starting age. Still we have one of the fastest rates of improvement in outcomes for breast cancer in Europe (not sure about comparison with the USA), in part I suspect due to a lot of extra public money going into treatment and prevention.

Mind you lthough there are some studies that are showing that too much/too early screening carries extra risk (too many false results meaning unnecessary surgery/treatment or complacency).

As in the US, however, there's no law to prevent women getting a screening if it's not going to be provided by the NHS, they just have to be able to pay for it. We also have cancer charities who appear to be able to raise lots of money. However, we don't have as much of the problem with at-risk women over 40 are unable to get a screening, so less of the focus is on paying for that, and more is on funduing research or on dealing with people with cancer (Macmillan being the main one for the latter).

We keep missing each other's posts..

I understand what Komen's mission is. I know they are set up to fund both. That doesn't mean I have to agree with the fact that screening is not seen as a public health issue over there.

Of course, public money doesn't actually mean government control. For example, a lot of cancer research in the UK is funded through charities (Cancer Research being a primary one). It gets money from donations and from government. Government subsidises some of the facilities in universities that are used for research. It's not an all-or-nothing Government v Charity debate, as far as I can see. Both can work together.

I agree with the boiled down argument via you from Romney that it's important how money is spent (although how much is also important - you can spend $10 at 90% efficiency and you'd still achieve less than spending $20 at 50% efficiency). But let's not be naive and think that it's only 'federal government' that falls prey to this, and not other sectors.

dan

I agree with the boiled down argument via you from Romney that it's important how money is spent (although how much is also important - you can spend $10 at 90% efficiency and you'd still achieve less than spending $20 at 50% efficiency). But let's not be naive and think that it's only 'federal government' that falls prey to this, and not other sectors.

I wonder if that the metrics Romney has in mind to measure efficiency are valid?
Applying standards that one might use in business or administration to research funding decisions is difficult. Original research to find a point upon which a working hypothesis can be built can take an awful lot of trial and error or experimentation or testing... . And basing research upon a goal is perhaps a naive way of approaching a problem.
Funding a cure for cancer for instance...What if we find there really is no cure? (Or therefore never find a cure?) But by learning all about cancer we learn ways to avoid cancers? Or ways to live with cancer better.

Certainly 'investing' in research is not as cut-and-dried as investing in something tangible like plant. What sounds like a promising line of enquiry could end up being a cul-de-sac, while something apparently unrelated could end up having synergy. Cancer is a particularly tricksy problem,with various different avenues that could be pursued - prevention, control, elimination.

For example, who 20 years ago would have predicted that many cervical cancers could be prevented by immunising against a herpes virus?

danivon wrote:you can spend $10 at 90% efficiency and you'd still achieve less than spending $20 at 50% efficiency). But let's not be naive and think that it's only 'federal government' that falls prey to this, and not other sectors.

I don't think anybody would ever argue that. However, they wouild argue that when the "other sectors" becomes inefficient it is remedied by removing your moving donations to another, more efficient, entity. That option is not available with Government.

Don't pretend that the recent decisions from Komen and the reactions from others to them had anything to do with efficiency though, ARJ. Komen don't market themselves as efficient, so much as they do as 'Pink!' and for doing stuff for teh boobies.

Seems to me that charity can be as political as government, based on this week. If the guys at Komen had decided that stem cell research was morally wrong and wanted to pull funding (even if they used as roundabout a way as they did over PP and abortion), but cancer researchers were looking at stem cells as a promising line, would that be about 'efficiency'? No, it would be down to 'market' preferences, which is fine for consumer goods, but is not really going to improve the science.

danivon wrote:Don't pretend that the recent decisions from Komen and the reactions from others to them had anything to do with efficiency though

I'm not and please show me anywhere that I ever even implied that. Since I doubt you will, I will just take it as an attempt to steer the conversation away from the fact that gov't ineffiency is harder to combat because of the impossibility of defunding it.

danivon wrote:Seems to me that charity can be as political as government, based on this week.

Dude every single group of humans that is more than 2 people is political be it a government, a charity or a kids sports league. The only difference is how much politics controls/influences decisions.

Archduke Russell John wrote:

danivon wrote:Don't pretend that the recent decisions from Komen and the reactions from others to them had anything to do with efficiency though

I'm not and please show me anywhere that I ever even implied that. Since I doubt you will, I will just take it as an attempt to steer the conversation away from the fact that gov't ineffiency is harder to combat because of the impossibility of defunding it.

I just wondered why all the talk about 'efficiency' when we are talking about a situation where charitable giving has been blown in the wind of public opinion. Not an attempt to steer the conversation away from the flaws of private and third sector controls?

Government itself is not possible to 'defund' (if you remove the government, it will be a very short time before another arises, which will be funded somehow). But that doesn't mean that particular budgets can't be defunded, or that governmnent cannot set up a more arms length relationship between politics and investment into research.

danivon wrote:Seems to me that charity can be as political as government, based on this week.

Dude every single group of humans that is more than 2 people is political be it a government, a charity or a kids sports league. The only difference is how much politics controls/influences decisions.

Indeed. I think cancer research is important. I think that women's health is important. They certainly have the potential to affect many more lives in a more deep way than your local little league baseball set-up. Oh, and there's millions of dollars involved too.

As it goes, I think we need a triumvirate approach to funding research. Private companies will look for where they can profit. Charities will look to fulfil a particular mission. Government can represent the wishes (and also the less popular needs) of the nation as a whole.

Still, I'm 100% that public health is part of 'general welfare'