From Vinay Prasad's Observations and Thoughts (substack), First defund bad science; then invest in good science "If you believe in science funding, you should sacrifice silly ideas."
If I were in charge of science funding, I would increase annual spending by several orders of magnitude. I would take 5% of the trillion plus dollars that CMS spends yearly and use it to conduct pragmatic randomized trials that test things CMS is paying for that lack evidence. If, as our work on medical reversal would predict, 40% of those practices are in error, the savings will be hundreds of billions.
At the same time, I would not increase spending at this moment. The current system is so broken that merely increasing science funding would merely mean more waste. The media talks about science like every dollar we spend is valuable. It is not. Let me give two examples. . .
Unfortunately, there isn't sufficient money to increase science funding, assuming you could get past the reform part, which I doubt. People are people, and funding bring corruption and waste.
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