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Politics: High Cost Of Healthcare And The Political Fallout
Americans are grappling with a rising cost in healthcare. For the first time in five years, fewer than half of Americans can consistently afford healthcare. That’s according to the latest data from Gallup. The cost of healthcare in the US remains higher than any other large, wealthy country. According to a report from the Department of Health and Human Services, five million fewer people are enrolled in marketplace plans for 2026, compared to last year. That’s as average premium costs rose about 58%.With health care costs increasingly becoming a stress for Americans, voters are now making the issue a top priority at the ballot box. And it’s an issue that crosses party and geographic lines. According to new polling from The Century Foundation, 71% of Democrats, 66% of Republicans and 75% of rural voters agree that reigning in hospital costs should be a top priority for lawmakers. While new polling from Ipsos and Axios suggests that a majority of Americans say they’re more likely to vote for candidates in November who will lower their health costs.How will the issue of healthcare shape the midterms? And how are Americans grappling with the cost of their health?Find more of our programs online. Listen to 1A sponsor-free by signing up for 1A+ at plus.npr.org/the1a.
Politics: High Cost Of Healthcare And The Political Fallout
Americans are grappling with a rising cost in healthcare. For the first time in five years, fewer than half of Americans can consistently afford healthcare. That’s according to the latest data from Gallup. The cost of healthcare in the US remains higher than any other large, wealthy country. According to a report from the Department of Health and Human Services, five million fewer people are enrolled in marketplace plans for 2026, compared to last year. That’s as average premium costs rose about 58%.With health care costs increasingly becoming a stress for Americans, voters are now making the issue a top priority at the ballot box. And it’s an issue that crosses party and geographic lines. According to new polling from The Century Foundation, 71% of Democrats, 66% of Republicans and 75% of rural voters agree that reigning in hospital costs should be a top priority for lawmakers. While new polling from Ipsos and Axios suggests that a majority of Americans say they’re more likely to vote for candidates in November who will lower their health costs.How will the issue of healthcare shape the midterms? And how are Americans grappling with the cost of their health?Find more of our programs online. Listen to 1A sponsor-free by signing up for 1A+ at plus.npr.org/the1a.
NASA Awards More Moon Base Science, Previews New Opportunities
NASA announced Tuesday the selection of three companies to land four new missions on the Moon in late 2028 as part of the agency’s Moon Base Program.
Scientists teach human cells to compute like tiny computers
Researchers have developed a way to program human cells to perform calculations and make autonomous decisions, similar to how computer chips work.
NC budget includes UNC, NC State athletics for sports betting tax distribution
The state’s two major universities were left out of the previous model, which provided tax revenue to college athletic programs.
Who had the best year in college sports? Ranking all 68 Power Four schools from the 2025-26 seasons
An in-depth look at Power Four programs in football, men's and women's basketball, baseball, softball and volleyball
All of Us tests a new approach to collect real-world data for research
The NIH All of Us Research Program has secured thousands of electronic medical records through an innovative use of patient data-sharing networks
Congratulations to the 2026-2027 APSA-Sponsored Congressional Fellows -
APSA is pleased to announce the members of the 2026-2027 Class of the APSA-Sponsored Congressional Fellows! The American Political Science Association (APSA) Congressional Fellowship Program is a highly selective, nonpartisan program devoted to expanding knowledge and awareness [...]
Strengthening Collaboration between Workforce, Health, and Human Services to Meet New Federal Requirements
Human Services Policy Advisors Institute | June 24th, 2026 H.R. 1, or “The One Big Beautiful Bill”, introduced significant changes to work requirements across major health and human services programs. including expanding the populations subject to SNAP time limits, reducing state/territory SNAP waiver flexibility, and creating new work requirements in Medicaid. These changes accelerate the […]
Babson Launches Online Master’s Program in Business Creation · Babson Thought & Action
Babson’s new master’s program focuses on venture creation, as founders graduate with a master’s degree and a launch-ready business plan.
AFSP Illinois Announces July Suicide Prevention Programs for Minority Mental Health Month
/PRNewswire/ -- In observance of National Minority Mental Health Month in July, the Illinois Chapter of the American Foundation for Suicide Prevention...
Holland & Knight Health Dose: June 30, 2026 | Insights
Senate Committee on Health, Employment, Labor, and Pensions (HELP) Chairman Bill Cassidy released a discussion draft making changes to the 340B Drug Pricing Program.
Meet a PhD student selected for a national Science, Mathematics, and Research for Transformation Scholarship | CWRU Newsroom
Jenna Jaklich is nearly three years away from completing her PhD program in materials science and engineering at Case Western Reserve University, but...
Teen pregnancy prevention cuts hit Wisconsin program connecting health providers and teens
Federal officials have cut off more than $2.4 million in federal funds for 2026-27 and 2027-28 targeting teen pregnancy prevention that would have gone to the Wisconsin health department, according to federal records. The funds would have gone to a variety of nonprofits and agencies in counties with the highest rates of pregnancy and sexually […]
Newsom signs bill to give judges more power to deny mental health diversion
California Gov. Gavin Newsom has signed a bill to overhaul the state's mental health diversion program. Assembly Bill 46, authored by Stephanie Nguyen, D-Elk Grove, addresses concerns about public safety and accountability.
Former Biden WH Press Secretary on SCOTUS ruling ending temporary protected status program: ‘It’s going to be disastrous’
Newsom approves measure to expand judicial power over mental health diversion
Gov. Gavin Newsom signed AB 46, allowing judges to exercise greater discretion over inmates’ release through mental health diversion program
Tulare County group launches scholarship for STEM, business students
The program is still in its early stages, but organizers say they're prepared to launch the scholarships in the spring.
‘Grateful and humbled’
MARSHALL — Two individuals who played important roles in building the Marshall baseball program into one of the state’s best were honored Sunday evening with induction into the Marshall Baseball Hall of Fame. Steve Fleck and Blaine Schnaible became the 20th and 21st members of this select group during a pre-game ceremony prior to the […]
Gavin Newsom signs law limiting mental health diversion for people accused of crimes
A new California law gives just more flexibility to keep defendants in jail rather than releasing them to community-based mental health treatment programs.
Reviews clear Telescope Health of fraud allegations; officials encourage Jacksonville residents to use HealthLink JAX
Multiple reviews have found no evidence of fraud, criminal wrongdoing or misuse of taxpayer dollars by Telescope Health, ending months of scrutiny over the Jacksonville company that operates the city’s HealthLink JAX program for uninsured residents.
ROSES-25 A.12 HAMAQ Science Team Clarified
Hemispheric Airborne Measurements of Air Quality (HAMAQ) is a NASA-funded project under the EVS-4 program using two aircraft (NASA’s B777 & P-3B) to
SGMC Health Welcomes 32 Resident Physicians
SGMC Health welcomes its newest cohort of resident physicians as they begin their clinical training, representing a significant milestone in the continued advancement of the organization’s Graduate Medical Education (GME) program.
Atlanta Hawks celebrate graduating third cohort of women business leaders
The Georgia woman’s leadership empowerment program, which is celebrating the completion of its third cohort, brings in early-career women from typically male-dominated industries in Atlanta for mentorship and professional development.
NM U.S. Rep. Vasquez, a Democrat, urges state Health Care Authority to bring down SNAP error rate
U.S. Rep. Vasquez (D-N.M.) sent a letter Friday chiding NM leaders for errors administering the Supplemental Nutrition Assistance Program.
Hood College Launches Accelerated One-Year Master of Science in Environmental Biology Track
Beginning in Fall 2026, Hood College's Graduate School will offer a new accelerated, 30-credit track within its Master of Science in Environmental Biology program, providing students with a pathway to earn their degree in just one academic year while gaining valuable hands-on research experience.
College Football Analyst Calls Historic Program No Longer 'Relevant'
College football analyst Paul Finebaum didn't hold back on his thoughts on the University of Michigan and its football program. Michigan won the national championship for the 2023 season, but after the win, Jim Harbaugh went to the NFL, and the program was accused of stealing signs. The program ...
Dayton Business Journal: Former Ohio State, Arizona State administrator named Wright State athletic director
Following the university’s first-ever national search for a Division I athletics director, Wright State University has selected a new leader for its athletic program. Wright State has named Brad Chandler as the next director of athletics. “I am incredibly grateful … Continue reading →
Cornerstone University Appoints National Nursing Leader Gay L. Landstrom to Lead Nursing Program
Cornerstone University appoints nationally recognized nursing leader Dr. Gay Landstrom to lead its CCNE-accredited nursing program.
Building Community, Capacity, and Collaboration Through gmhCONNECT | Johns Hopkins Center for Global Mental Health
Doctoral trainee Yesenia Garcia shares her experience at gmhCONNECT, a training and mentoring program for global mental health researchers.
Medicare will start covering weight-loss drugs on July 1 for the first time.
Millions of Medicare enrollees will gain their first-ever coverage for drugs for weight loss under a temporary pilot program that launches July 1.
Medicare will start covering weight-loss drugs on July 1 for the first time. Here’s what you need to know
Millions of Medicare enrollees will gain their first-ever coverage for drugs for weight loss under a temporary pilot program that launches July 1.
Medicare is about to cover GLP-1 drugs for weight loss. Here’s what to know.
The Trump administration will launch its pilot program on Wednesday. It lasts 18 months, and estimated costs to taxpayers have not been disclosed.
Bringing Health Care Training Closer to Home for Rural Students
One program in Oklahoma, Kansas and Missouri is hoping to bring more doctors and dentists to rural communities.
63,000 Long Islanders will lose Essential Plan health coverage July 1. Here's what to do.
Healthcare experts warn that many people kicked off the program will not be able to afford insurance and will avoid seeking care.
Radford University finalizing plan to build new health sciences center on Roanoke’s Jefferson Street
The new building would house all Radford University Carilion programs, a university spokesperson said.
Editorial: Feds find more health care fraud
It shouldn’t be too much to ask that taxpayer-funded social service programs benefit people who actually exist.
Appalachian State strikes again on trolling Michigan football program
It's the gift that keeps on giving. Appalachian State trolled the Michigan football program once again for the loss in 2007.
Jodie Sweetin praises “Better Call Saul ”actor cast as dad in “Full House ”pilot, but Bob Saget was always 'first choice'
Saget was engaged to cohost CBS' "The Morning Program" when he got the call for "Full House," which led to his absence in the original pilot.
We turned 80-year-olds into trained health monitors to save lives and boost senior dignity
As a career geriatrician, I’ve long known that some of society’s finest minds are being underappreciated while living in senior communities. So I helped to develop a new health program to help put older adults on the watch as health monitors.
Federal health agency cancels most of its teen pregnancy prevention grants, including some in Pa.
A spokesperson for U.S. Health and Human Services confirmed to Stateline on Friday that the agency is canceling 53 out of 67 grants, worth about $68 million, under the Teen Pregnancy Prevention Program, affecting grantees in more than two dozen states. A list obtained by Stateline of canceled grants includes those awarded to universities, community […]
Efzimfotase alfa demonstrated improvements in bone health in treatment-naïve pediatric patients with hypophosphatasia achieving median difference of 1.67 vs placebo in RGI-C Score at week 25 in MULBERRY Phase III trial
Positive results from the MULBERRY Phase III trial showed that efzimfotase alfa (ALXN1850), an investigational enzyme replacement therapy, demonstrated a statistically significant and clinically meaningful improvement in bone health in children (2 to
Healthcare groups clash over proposed California billionaire tax
California voters in November are set to decide if the state's billionaires should face a new tax on their assets in order to fund healthcare programs.
Healthcare groups clash over proposed California billionaire tax
California voters in November are set to decide if the state's billionaires should face a new tax on their assets in order to fund healthcare programs.
'All INdiana Politics'
U.S. Sen. Todd Young has said that a proposed $300 billion payment to Iran would not be funded by American taxpayers, and that any ceasefire with Iran must be contingent on the dismantlement of its nuclear program, while Indiana Senators Young and Banks have split on a housing bill now awaiting President Trump's signature.
Texas Mental Health Program Reveals 103% Increase in Veteran Enrollment
Emory University treatment is expanding throughout the state at no cost, but many veterans remain unaware of their services.
South Korea's World Cup Exit Stuns Football, Entertainment Industries
South Koreas World Cup Exit Stuns Football, Entertainment Industries Hong Myung-bos squad finishes third in group; entertainment programs face awkward invitations amid lack of inspiring content
UAPB School of Business and Management celebrates class of 2026
The School of Business and Management (SBM) at the University of Arkansas at Pine Bluff recognized the achievements of its graduating Class of 2026 during its annual Graduates Banquet recently at the STEM Conference Center. The event, coordinated by Cynthia Sims, SBM project/program specialist, brought together students, faculty, administrators, alumni, family members and supporters to […]
Health care program in Boston working to ensure homeless women get care they need - Boston News, Weather, Sports
BOSTON (WHDH) - A health care program in Boston is aiming to ensure that homeless women in the area are getting the care they needRead More
3 million Americans have dropped Obamacare health coverage over past year, after Republicans let federal subsidies expire
KFF expects the total number of people in the government healthcare program to continue to decline throughout the year, potentially to a low of about 17.5 million from 19.2 million now.
The Chicago Bears are getting their own Hallmark Christmas movie
The Chicago Bears are the latest NFL franchise to get the Hallmark Christmas movie treatment. The team announced Thursday that it is partnering with Hallmark Media, the NFL, and Skydance Sports for Holiday Touchdown: A Bears Love Story, which will premiere during Hallmark Channel’s 17th annual Countdown to Christmas programming event this holiday season. “My…
Harker Heights library places focus on games, science and literacy this week
Enrich your summer with a visit to the Stewart C. Meyer Harker Heights Public Library. The library offers activities and programs for patrons of all ages.
Scientists in Synagogues grant program to name finalists in July - Lutheran Alliance for Faith, Science and Technology
Sinai and Synapses has launched a $5,000 Scientists in Synagogues grant program promoting Judaism and science. Finalists will be named in July.
City of Palms new downtown parking program: How local business react to the change
The Fort Myers City Council recently approved a change impacting parking rates at all three of downtown Fort Myers' parking garages. As it stood, visitors would receive one hour of free parking followed by a hourly rate. Now, the change has made it so visitors are entitled to two free hours followed by a hourly rate. Local business owners and managers said it's a good idea giving visitors more time to bask under the royal palms and indulge in some shopping. But one general manager points out a problem that did not start yesterday, but years prior.
How the dairy industry pushed Trump for migrant labor, and won
President Donald Trump was expected to announce the expansion of a guest-worker program to the dairy industry at a Wisconsin event. Instead, the news came out in a press release, angering immigration hard-liners.
City of Covington awards final round of fiscal year 2026 Small Business Incentive program funding
The City of Covington continues its commitment to supporting entrepreneurs, revitalizing commercial corridors, and strengthening neighborhood business districts through the Covington Small Business Incentive Program. The Covington Board of Commissioners has approved the fourth and final round of Fiscal Year 2026 Small Business Incentive Program funding, awarding $28,000 to support four projects across the city....
Applications open for Hawaii County Kona low business recovery program
Eligible businesses can use the money for recovery needs, including equipment repair, temporary relocation costs and water damage.
Asheville grants $855K to business accelerator, extends recovery program through 2028
Asheville grants $855,000 to Optimist Ventures, an accelerator for Asheville entrepreneurs affected by Hurricane Helene.
Applications open for Hawaii County Kona low business recovery program
The reward from the county can be used for recovery needs, including equipment repair, temporary relocation costs and water damage.
People complete workforce pilot program designed to address maternal health inequalities
Federal health agency cancels most of its teen pregnancy prevention grants
A spokesperson for U.S. Health and Human Services confirmed to Stateline on Friday that the agency is canceling 53 out of 67 grants, worth about $68 million, under the Teen Pregnancy Prevention Program, affecting grantees in more than two dozen states.
Senators call for military healthcare program to cover autism therapy as a basic benefit
A letter to Defense Secretary Pete Hegseth follows an NBC News investigation into the military healthcare program’s restrictions on applied behavioral therapy.
Health Care Plan Premiums Approved for 2027
The State Teachers Retirement Board set premiums for the STRS Ohio Health Care Program for calendar year 2027.
White House mandates move away from overdose prevention in US health programs
Experts say move signals greater political interference into public health and will exacerbate opioid overdose crisis
MSU Vet Tech program awarded $150k NIFA-USDA grant
Morehead State University's nationally ranked veterinary technology program was recently awarded significant financial support to help it maintain its place as the #1 program of its kind in Kentucky. The National Institute of Food and Agriculture (NIFA), part of the United States Department of Agriculture (USDA), awarded MSU's vet tech program a $150,000 NIFA-USDA grant for equipment to support small and large veterinary technology education and workforce competency at MSU. Learn more about veterinary technology programs at MSU by emailing Staton at a.staton@moreheadstate.edu or calling 606-783-2328. Find out more about MSU's veterinary technology program by calling 606-783-2662.
Moderna highlights expanding mRNA platform at Science Day
Moderna's Horizon programme contains a variety of mRNA assets in varying stages of development, including a preclinical in vivo candidate.
Summer Science Program
Explore information about the Summer Science Program at Arkansas Children's Hospital, a career readiness program for college students, including eligibility and how to apply.
Council Explores AI, Quality Improvement and Patient Safety to Advance Community Health
The MHA Council on Health Access and Community Impact held its final meeting of the program year June 4 to examine emerging opportunities and challenges shaping healthcare delivery and advancing community health.
Ball State Teacher Preparation Programs Earn Top Ratings in Science of Reading Reviews
By Ball State Communications— MUNCIE, Indiana — Ball State University’s elementary education, early childhood education, and special education teacher preparation programs have earned top marks in two reviews focused on how well future educators are prepared to teach reading through evidence-based,
Chairman Guthrie, Health Vice Chair Harshbarger, Congresswoman Miller-Meeks Lead Site Visit to Iowa Hospitals to Highlight Benefits of the Rural Health Transformation Program
The Committee on Energy and Commerce is the oldest standing legislative committee in the U.S. House of Representatives and is vested with the broadest jurisdiction of any congressional authorizing committee.
Nevada takes step toward becoming corporate litigation hub with business court pilot program
The Clark County District Court this week announced it has restructured its departments to include a dedicated business court. The restructuring is expected to bring down case adjudication times, and it could help an ongoing effort to transform Nevada into a premier destination for corporate litigation. Judges Maria Gall and Joe Hardy–Departments 9 and 15, […]
Who are Texas A&M's All-Time Quarterback recruits?
According to 247Sports, here are the top 10 ranked Texas A&M quarterbacks recruits in program history.
Study analyzes youth sports and committing violence
The study used survey data on 3,849 adults who participated in the National Sports and Society Survey.
Study analyzes youth sports and committing violence
The study used survey data on 3,849 adults who participated in the National Sports and Society Survey.
Study analyzes youth sports and committing violence
The study used survey data on 3,849 adults who participated in the National Sports and Society Survey.
Nevada Global Business travels to Tokyo
Students explore Japan’s economy, culture and business practices through company visits and immersive learning in the Nevada Global Business program.
How an Iowa junior college became a sports giant
DMACC athletic programs are quietly dominating through coaching and player performance
Prosperity Council’s Report Challenges Kotek to Signal That Oregon Is Open for Business
The 15-member panel of business and labor leaders proposed four modest tax code changes, replacing the Climate Protection Program, and some less controversial reforms.
Sharonville mom raising money for UC Health's ICU patient program after she nearly died
It's been a year since a Sharonville mom suffered a medical emergency days after giving birth to her second child.
Clark | You should be supporting club sports
Club sports programs excel with a low barrier to entry, strong communities, and intense competition.
UCLA comparative literature department to offer health humanities minor in fall
UCLA will offer a minor in health humanities starting this fall. The minor, housed under the comparative literature department, is an interdisciplinary program that examines how health and medicine are shaped by literature, culture, history and social experience, according to the department’s website.
Kentucky State hosts students for agriculture and health science camp
Students from across the country are at Kentucky State University for a summer program focused on agriculture, health and environmental science.
This autism therapy is covered by many insurers. Why does the military’s plan restrict it?
Logan Cabiao started applied behavior analysis therapy for autism when he was 2. Several years later, TRICARE, the military’s healthcare program, imposed major coverage restrictions.
FlashPoint: How a Christian political media network became a platform for Indiana’s Lt. Gov.
By Sydney Byerly The Indiana Citizen June 25, 2026 When Indiana Lt. Gov. Micah Beckwith called Islam a “demonic death cult” during an appearance on the Christian political program FlashPoint in May, the remarks drew swift backlash from faith leaders across Indiana. It also highlighted the growing influence of the Christian media network that amplified
Making Our Own Luck
We are cross-posting a piece that former NIH official Kris Willis wrote for Macroscience. Kris is now the President and Founder of the Woodley Park Institute, for which I’m a board member. Picking winners or hedging bets? Federal science agencies have long wrestled with the question of how to ensure their billions of dollars of grants and contracts result in maximum benefits for Americans. On the surface, it might seem that a goal-oriented, interventionist style of management would be the best policy: prioritize our most pressing problems and distribute funding accordingly.This top-down strategy creates a unique hazard, though: bad choices can send resources in the wrong direction, resulting in slow progress that impedes the delivery of tangible benefits to citizens. Moreover, if decision makers pursue an applied advance when the underlying scientific principles remain poorly understood, they risk costly failures and a loss of support for the research enterprise at large. Examples include Nixon’s 1971 War on Cancer, undertaken on the premise that a cure could be achieved in less than a decade, the drive to build an operational commercial fusion plant by the mid-1990s, and the National Plan to Address Alzheimer’s Disease, which failed to produce the effective treatments and prevention strategies promised by 2025. The contrasting laissez-faire approach is to hedge your bets. If the path to an advance is impossible to predict, then the wisest choice might be to distribute funding to as widely as possible. The main risk of this strategy is that spreading funding thinly may limit the resources available to the most promising research, resulting in the same negative outcomes as the interventionist approach: limited support for the most promising topics, slow progress, and delayed returns. In reality, at science agencies like the National Science Foundation and National Institutes of Health, program managers navigate between these two extremes, setting some funds aside to target high-priority areas and using the rest to cover the widest possible range of meritorious proposals. This middle path seems like the most rational way to proceed, but it still requires making choices. How much should be set aside for high priority topics? What should those topics be? How should we define merit? Expert opinion can provide a helpful guide, but leading experts can have remarkably different opinions about what matters and what should be prioritized. Moreover, experts and administrators alike can be risk averse, giving an edge to high-profile, well-established concepts. What’s really needed is a data-driven framework to help guide decision-making, one that doesn’t simply repackage prestige or incumbency. Recognizing breakthroughs years in advance Many breakthroughs fail to attract funding or recognition at the earliest stages of development. Katalin Karikó, for example, spent years struggling to win grants for work on mRNA that would eventually win her and Drew Weissman a Nobel Prize. Similar stories can be told about Jim Allison’s groundbreaking studies leading to the development of cancer immunotherapy, Stan Pruisner’s demonstration that prions can self-replicate without DNA, or Robin Warren and Barry Marshall’s proof that Helicobacter pylori, not stress, causes ulcers. Yet at some point, the scientific community recognizes and responds to transformative breakthroughs like these. How does that change happen? And what if science funders could identify the areas that are on the cusp of a breakthrough? Those questions led my collaborators and me to study how scientists responded to past breakthroughs. Based on patterns in that data, we developed a means of predicting future breakthroughs, using biomedicine as a proof of concept. It’s worth taking a moment to describe how our approach works. Briefly, our prediction process begins by grouping the 18 million or so peer-reviewed papers in PubMed, the authoritative database of biomedical research, into roughly 50,000 unique topics. A small subset of these topics are so widely acclaimed as breakthroughs that they have been recognized with a major prize like a Nobel or a Lasker Award. We theorized that studying the development of these outliers over time, especially before they gained acclaim, was the key to identifying future instances of them. After defining topics, we chose 21 representative breakthroughs and asked what they looked like before they won prestigious prizes. To answer that question, we re-ran our topic-mapping algorithm repeatedly, winding back the clock one year each time, stringing together the years to follow the progress of each field as it grew and advanced. We found that in each case, the years leading up to a discovery followed a pattern: a burst of papers on a new, rapidly evolving topic, many of which quickly became influential. These characteristics—the percent of papers that are new, the percentage of papers that are brought in from other topics, and the influence of each individual paper—can all be measured separately for any given topic. Together, they act as a predictive signal that is detectable an average of five years before a transformative discovery is made, and up to thirty years before the discovery receives a major prize. Scanning the current research landscape for topics that display this signal allows us to predict what work will likely produce a future breakthrough. Each year we analyzed includes four or five signals, a number that appears to have remained constant across a twenty year time frame. In their classic work on the sociology of science, Bruno Latour and Steve Woolgar established that the desire to participate in a major discovery is an important motivator for scientists as they consider whether they should take up (or abandon) a research problem. Although further work is needed, the simplest explanation for our results is that this behavior is widespread enough to detect at scale. A foundational advance, or something like it, draws the attention of scientists and causes them to change the direction of their research. They vote with their feet, staking their own reputation and careers by publishing on and citing the new idea. That upswell of interest is the foundation of our breakthrough signal. What kind of research does our model identify as a breakthrough? After building a model based on the patterns in our 21 preselected breakthroughs, we tested it by identifying all early signals of discovery from 1994 through 1997. Of the 18 signals we found in that time period, 17 can be traced forward in time to a breakthrough. Examples include super-resolution fluorescence microscopy (see the image above), the directed evolution of proteins and enzymes (Chemistry Nobel, 2018), and sequencing the human genome (National Medal of Science, 2008). The discovery of the role of leptin signaling in obesity is a particularly interesting case study. Around 1950, scientists noticed the existence of a type of lab mouse that suffered from a unique inherited form of obesity. When given the freedom to choose their own diet, these mice ate more than normal and preferred food that was high in fat. Researchers had few clues as to why the animals overate; early experiments pointed to the existence of a soluble ob factor found circulating in the bloodstream that regulated appetite, but its identity was unknown. In 1994, Jeffrey Friedman and colleagues identified and sequenced the ob gene, noting that the protein it encoded appeared to fit the profile of a circulating factor. A year later, a trio of high-profile publications demonstrated that ob was a hormone that regulated body weight and fat deposition by regulating appetite. One of these was co-authored by Friedman, who christened it leptin from the ancient Greek word for thin. Using our model, the data from 1996 make it clear this advance would become a breakthrough. Scientists had flocked to study the biology of the new hormone, generating the flurry of new papers and citations required to produce a signal. One of these demonstrated that serum leptin concentrations reflected the amount of adipose tissue in the human body, providing clinical validation of the earlier mouse studies. Before the identification of leptin, scientists were unable to point to a specific molecule that controlled appetite and adiposity, so that it was impossible to rule out non-physiological causes of obesity; its characterization fundamentally changed our concept of weight gain. In 2010, Friedman and fellow pioneer Douglas Coleman were awarded a Lasker for the discovery. Our work also identifies breakthroughs in clinical practice and behavioral and social sciences, even though these areas are less likely to draw the attention of major prize committees. One example that falls into this category is the introduction of endovascular aneurysm repair, a minimally invasive surgical procedure for the treatment of abdominal aortic aneurysm, a leading cause of death among Americans over the age of 65. Relative to the previous standard of care, it reduces in-hospital mortality by almost four-fold. In 2017, Timothy Chuter received the American College of Surgeons’ prestigious Jacobsen Innovation award for his multiple refinements to the technique. Another under-recognized breakthrough identified by our model is the development of standardized survey instruments to assess the quality of life for HIV+ patients. The antiretroviral cocktails introduced in the mid-1990s reduced AIDS mortality, but treatment came with serious side effects. The new evaluations showed that patients whose disease progressed had worse physical functioning than Americans with other chronic diseases, while those who were asymptomatic maintained a health-related quality of life on par with the overall US population. This evidence made it possible for patients and activists to argue that even in the absence of a total cure, and in spite of the side effects, alleviation of symptoms was a worthwhile priority for clinicians. My colleagues and I have failed to identify any significant recognition for the physicians and health policy experts who pioneered this advance, although in 2016, researchers called for the World Health Organization to set targets for good health-related quality of life as part of its framework to end the AIDS pandemic. From forecasting to funding How should science funders use our predictions? Any serious discussion of what we should do with this new capability needs to begin with an understanding of its limitations. We can’t (and shouldn’t) invest all of our resources in the small number of topics predicted to produce breakthroughs. Innovative new fields are born from existing ones; they rarely arise de novo. If funders don’t maintain a diverse portfolio, the breakthroughs of tomorrow will have no antecedents. Think of this as eating the seed corn, or killing the goose that lays the golden egg. There are also multiple goals of funding beyond basic scientific discovery, including translating discoveries into clinical practice, developing new technologies, supporting economic development, and training new scientists. The investments needed to accomplish these goals are likely different from those required to support emerging breakthroughs. Finally, we must be aware that we may not capture every instance of a breakthrough. The concept is fuzzy, and not every significant discovery is recognized with a major award. Further, breakthroughs are rare, meaning that our dataset is, by necessity, small. This makes formal estimates of accuracy challenging. Although our overall success rate appears to be high, any one signal may turn out to be a false positive. We found one apparent example: the development of the third generation COX-2 inhibitors, Vioxx and Celebrex, which were much celebrated in the early 2000s as effective but non-addictive pain relievers, meets all the algorithmic criteria of a breakthrough. Five years after it received FDA approval, researchers demonstrated that Vioxx was associated with serious cardiovascular complications, and the manufacturer voluntarily pulled the drug from the market. Celebrex remains available, although like other NSAIDs, it carries an FDA warning for increased cardiovascular risk. Decision makers who were overly focused on the breakthrough potential of this research might have wasted substantial resources nurturing an area that ultimately proved to be a failure—but so would those who relied on expert opinion at the time. That said, the potential benefits of funding the next mRNA vaccine or cancer immunotherapy years earlier than we might have are large. When we can’t assume the outcome of an action, it’s worth conducting an experiment. Can targeted support for areas that are poised to produce a breakthrough increase the return on scientific investment without cannibalizing future advances? With the necessary administrative infrastructure in place, conducting this experiment would be straightforward. First, identify all the breakthrough signals between 2018 and 2023, select half at random, and commit to a decade of investment. For biomedicine, a six year window should yield about 30 topics with the potential to produce a breakthrough. Providing strong support to half of these might be accomplished for $300 million a year. That’s roughly half of the recent annual budget of the NIH Common Fund or around 20% of the fiscal year 2025 budget for ARPA-H. After five years, then again at ten, compare to see which group — the one that was actively managed, or the control — produced more breakthroughs, and on what timescale. Although we used biomedicine as an example, the same experiment could just as well be run for physics, materials science, or any other discipline. Any attempt to undertake such an experiment should keep three points top of mind. First, we can predict the topic of future breakthroughs, but the people and vision for how to move the work forward are still important. In practice, this means success requires active program managers with the expertise to develop the science and the authority to do so, including by recruiting investigators. Second, we would be wise to learn from the failures of past attempts to fund transformative research. High among these are funding modestly repackaged work, confusing the genuinely novel with the merely unfamiliar, and relying too much on incumbent investigators. All of these risks can be mitigated by thoroughly and intelligently integrating high quality data into portfolio management. Finally, we need to have patience. Even with strong funding support, producing a breakthrough takes time. If supporting breakthroughs is the best way to nurture the birth of new fields, we also need to accurately describe and properly manage the other two stages, so that we invest wisely throughout the productive lifetime of ideas and divest once they reach the point of diminishing returns. We would benefit from more study of all of these phases, especially the transition from one to another. More research could answer questions like: When does a breakthrough become an established field? How do the availability of funding, the size and characteristics of the available workforce, and the accumulation of evidence that disagrees with prevailing models affect a field’s decline? Exactly how do old ideas give birth to new ones, and can we speed up the process? The more we understand about the dynamics of scientific progress, the better we can maximize the odds that our curiosity leads to results. I’d call that finding a way to make our own luck.
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