J. Steven Landefeld

Biomedical Research and Illness: 1900–1979

At a time when expenditures for biomedical research and for medical care are higher than ever before, some critics doubt the wisdom of allowing them to continue to rise. These critics question the contribution that medicine and research have made to health progress in the twentieth century. Such arguments, however, fail to distinguish between research and technology development or the delivery of service. Efforts to control biomedical research as a way of holding down health care costs would be misdirected and counterproductive to health and economy.

Measuring the contribution of biomedical research to the production of health

Abstract Technologically induced increases in health care costs have compelled policy-makers to ask hard budgetary questions about the value of biomedical research. Specific examples can be given to illustrate the returns from biomedical research on a disease-by-disease basis, but this information does not give a comprehensive enough perspective. The purpose of this paper is to estimate the historical contribution that biomedical research has made to the prolongation of life. Using a production function approach and various statistical models of the lag process, we estimate 23–48% of the decline in mortality over the 1930–1978 period can be attributed to biomedical research efforts. The lower bound estimate translates into a net return of

A Comparison of Anticipatory Surveys and Econometric Models in Forecasting U.S. Business Investment

83 billion for our society, illustrating the past wisdom of investment in biomedical research. In recent years, however, the year-to-year decline in mortality rates has slowed, suggesting that mortality may not be an adequate output measure to justify expansion in research expenditures. Without alternative output measures, policy-makers and planners will have a difficult time in evaluating research benefits and making decisions on the allocation of future resources.

The Role of Statistics in the United States’ Economic Future

This paper compares the performance of several anticipatory surveys of u.s. business investment with each other and with projections generated by large-scale econometric models. The Commerce Department survey outperformed both the McGraw-Hili and Merrill Lynch surveys. The relatively strong representation of small and medium size firms in the Commerce survey appear to be the major factor in its superiority over the other surveys. The Commerce Department survey of business expectations also outperformed forecasts derived from either the Data Resources Inc. or the Wharton econometric models.

Taking the Pulse of the Economy: Measuring GDP

The national accounts were developed to address the paucity of comprehensive and consistent data confronting decision makers during the Great Depression. Over the intervening years, the accounts have served macroeconomic policy makers well, contributing to the unprecedented period of post-World War II economic growth and prosperity. Despite this success, there have been continuing calls — including those by the founder of US accounts, Simon Kuznets — for an expansion of the accounts to cover household production, environmental externalities, and other near-market and non-market activities that affect households’ wellbeing. One of the most eloquent critiques of the focus on GDP as a measure of society’s progress was made by Robert F. Kennedy: Too much and too long, we seem to have surrendered community excellence and community values in the mere accumulation of material things. Our gross national product, if we should judge America by that, counts air pollution and cigarette advertising, and ambulances to clear our highways of carnage. It counts special locks for our doors … Yet the gross national product does not allow for the health of our children, the quality of their education, or the joy of their play … it measures everything, in short, except that which makes life worthwhile. And it tells us everything about America except why we are proud that we are Americans.1 Robert F. Kennedy, Address, University of Kansas, Lawrence, Kansas, 18 March 1968