The Politics of Disease

HALPER, THOMAS

The Politics of Disease Cancer Crusade: The Story of the National Cancer Act of 1971 By Richard A. Rettig Princeton. 408 pp. $15.00. Reviewed by Thomas Halper Chairman, department of political...

...Like a Victorian novel, it is peopled by Great Men—Presidents, congressmen, bureaucrats, scientists, physicians, businessmen—who often seem in thrall to a Great Woman—the redoubtable Mary Lasker, a patrician figure of considerable wealth, impressive personal charm and extraordinary political acuity...
...he asked Congress to spend $50,000 on the project...
...By 1981, the Federal cancer effort will have consumed approximately $10 billion...
...Health researchers in other areas complain, for example, that despite assurances to the contrary, NCI funds have grown at the expense of virtually all other National Institute of Health programs...
...This exposure to diagnostic x-ray," said the director of biostatis-tics at Roswell Park Memorial Institute, "will probably result in the worst iatrogenic [i.e., medically-caused] epidemic of breast cancer in history...
...A war against cancer, after all, seems about as unambiguously good as any organized human endeavor is likely to be...
...Not pausing even to consider the matter, Congress took no action and the proposal died...
...All of this would appear to insure a happy ending...
...In that quaintly trivial skirmish did the U.S...
...The new "cancer empire," Rettig observes, was not principally the product of Presidential, congressional, bureaucratic, or scientific effort...
...it owed its existence instead to "a unique constellation of private citizens grouped around Mary Lasker...
...Richard A. Rettig's Cancer Crusade is the story of Washington's intensified involvement, and a complex, utterly fascinating tale it is—full of idealism and practicality, opportunism and indifference, selfless dedication and egocentric ambition...
...Although not a gifted stylist, he has organized his material with considerable skill, and like all capable storytellers, has the knack of letting the narrative appear to "tell itself...
...Although their foes were numerous, the Lasker circle's advantages were decisive: money, prestige, contacts, persistence, a public in terror of the disease and accustomed to bringing its fears to government, and a political sagacity of intimidating proportions...
...Yet problems have emerged, and the once sacrosanct cancer empire is now subject to increasing criticism...
...H. R. Gaylord wrote President Taft to urge that he request a congressional appropriation to study cancer of the thyroid in trout...
...Individual programs have caused trouble as well, most notoriously the Breast Demonstration Project that gave mammograms to 280,000 women...
...His message, more critical than optimistic, has grave implications?about public policy-making in general, about means undermining ends, about the blemishes of human nature disfiguring even the noblest of human ventures...
...government's concern with the most dreaded of human afflictions begin...
...This conferred semiautonomous status on the NCI, gave it a unique and direct link to the White House, and vastly increased its funding...
...Reviewed by Thomas Halper Chairman, department of political science, Baruch College, CUNY In 1910, Dr...
...The President, a renowned angler, was persuaded that such an investigation "may give us light" on the cause of cancer in man...
...The entire curative emphasis, in fact, is increasingly under attack from those who note that most cancers seem to have environmental causes, and that a stress on prevention promises more cost-effective results...
...Opponents also charge that NCI's focus on categorical research targeted at cancer has slighted fundamental research directed at basic knowledge of life processes, knowledge that may be necessary before curative breakthroughs can be achieved...
...Cancer has been on the Federal government's agenda since the 1937 creation of the National Cancer Institute (NCI), but Rettig's chief concern is the National Cancer Act of 1971...
...A senior social scientist with the Rand Corporation, Rettig's prose is serviceable and refreshingly jargon-free...
...Returning to haunt NCI, too, is a great mass of bloated rhetoric that likened the "cancer crusade" to the moon shot or, as Congress modestly put it, envisioned a cure "as an appropriate commendation of the two hundredth anniversary of the independence of our country...

Vol. 61 • January 1978 • No. 3


 
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