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Eric Davis: Trump makes an empty cancer-cure promise

At his campaign’s kickoff rally in Orlando, Fla., earlier this month, President Trump said that, if he is re-elected, “We will come up with the cures to many, many problems, to many, many diseases, including cancer.” This statement is worth unpacking on several levels.
First, there is no simple, one-size-fits-all “cure” for cancer. Cancer is many different, although often related, diseases. As Philip Kantoff, M.D., the chair of medicine at Memorial Sloan Kettering Cancer Center in New York told Kaiser Health News, “One cannot rightfully say, ‘In the next five years, we’re going to cure cancer,’ because cancer is so many different diseases.” 
Individual cancers mutate differently, sometimes due to the nature of the cancerous cells themselves, sometimes due to differences in the individuals in which those cancerous cells are present. The best therapy for one person’s cancer may not work in another person with pretty much the same disease.
So, with cancer such a complex biological phenomenon, one would expect that a president who wants to “cure cancer” within five years would be supporting substantial increases in federally funded scientific research, both to explore the processes leading to the development and growth of cancers, and to support a wide range of experimental treatments. The record of the Trump Administration’s budget proposals indicates exactly the opposite.
In March, President Trump’s proposed federal budget for fiscal year 2020 included a 12 percent decrease in funding for the National Institutes of Health. The budget for the National Cancer Institute for 2020 would be cut by 19 percent under Trump’s proposal. In fact, all of the budgets President Trump has submitted to Congress since he was inaugurated have included substantial cuts in federal health research spending. 
There is wide support for the National Institutes of Health and the National Cancer Institute on Capitol Hill, among Republicans as well as Democrats. While the Congressional budget process has been messy for the past three years, none of the budgets passed in that time have included the cuts in health research spending that the Trump Administration proposed. However, because this spending is appropriated on a year-to-year basis, scientists working on cancer-related research projects face continual uncertainty regarding the extent and duration of federal support for their activities.
One of the best ways of reducing the incidence of cancer and complications resulting from it is to encourage early detection and treatment. This requires that the persons being screened have health insurance coverage. While the number of Americans with health insurance coverage increased in most states following the passage of the Affordable Care Act in 2010, that trend has reversed itself since Trump took office. In 2018, 700,000 more Americans were uninsured than in the preceding year.
Trump also wants to roll back expansions in Medicaid that were part of the ACA. Research in those states that have expanded Medicaid in the last seven years indicates that the number of people screened for breast and colon cancers, in particular, has substantially increased due to the expanded Medicaid coverage.
President Trump and Attorney General Barr are also supporting a challenge to Obamacare that is pending in the Fifth Circuit Court of Appeals in Texas. The Administration’s position in this lawsuit would eliminate almost all of the protections that have been available to persons with pre-existing conditions — including cancer — since the ACA went into effect. While Trump has said he wants insurance to cover pre-existing conditions, the Administration has not given any indication that it plans to develop a substitute for Obamacare, should the pre-existing conditions protections be struck down in court.
In sum, the Trump Administration’s actions — on the budget and in the federal courts — are not at all consistent with the claims about “curing cancer” that the President made in his campaign speech. Is this at all surprising?
Eric L. Davis is professor emeritus of political science at Middlebury College.

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