Cash Therapy

Complaints from Ph.D. holders about poor job prospects have become increasingly common these days. Indeed, a Ph.D. is the most advanced academic certification one can obtain, requiring a significant investment of time, effort, and brainpower. It’s easy to argue that Ph.D. holders deserve to be compensated accordingly because they acquire highly specialized skills. However, this is not how the economy functions. Ph.D. holders often don’t get paid well because their skills are not something that others are willing to pay a premium to obtain. Basic research is not driven by market demand, so the mismatch between expertise and pay is almost inevitable. This is why science is largely subsidized by governments, fueled by the cultural belief that scientific inquiry has intrinsic value, even when it doesn’t lead to immediate economic returns. The prevailing notion is that non-profitable science holds the potential to revolutionize technology and medicine, improving the quality of life in the long term. But this isn’t an objective truth—it’s a value judgment, a hopeful gamble on the future.

However, when someone is paid for an extended period by the government for their ideas rather than their direct utility to others, they may start to believe that ideas hold intrinsic value on their own. This can be a dangerous illusion. The real value of ideas lies in their potential to create tangible impacts, not merely in their existence. Like all potential, if an idea is never realized, it has no ultimate value in the real world.

Medical literature is filled with "potential therapies" for cancer, Alzheimer’s, diabetes, and obesity. Yet only a small fraction of these therapies—perhaps just a few percent—ever significantly alter clinical guidelines or have a real-life impact on patients. As argued by John Ioannidis, due to biases in the research process and the misuse of statistical methods, many published findings are either false or exaggerated. This reproducibility crisis means that much of what is produced in science doesn’t translate into meaningful therapeutic advancements. Yet, these flawed scientific endeavors still consume vast amounts of money. Conducting experiments, maintaining cell lines and animals, and publishing results—all these activities require substantial funding. Even when a drug, say a new treatment for Alzheimer’s, finally proves to be “effective,” its impact might only improve the prognosis by a few months. Some might argue that even such modest progress justifies the investment. But we must remember that economics is the study of resource allocation, especially when those resources have alternative uses. We should ask whether such marginal improvements in clinical outcomes are worth more than simply giving patients an equivalent sum of money that was spent on the research. If we conducted a randomized controlled trial of "cash therapy"—giving patients the research money directly—we would probably find a statistically significant improvement in their quality of life.

Cancer, Alzheimer’s, and diabetes are fields that receive millions, if not billions, of dollars in research funding each year. Yet, for decades, the fundamental therapeutic strategies and overall prognoses have seen relatively little change. Surgery and chemo-radiotherapy are still the dominant treatments for cancer. Alzheimer’s is managed largely through symptomatic care, with no drugs proven to delay its progression. Diabetes has seen the development of GLP-1 agonists, but these are far from a cure. Scientists must remember that if their ultimate goal is to improve patient well-being, "cold hard cash" therapy is always competing with their work.

It’s true that the utility of scientific findings may not be immediately apparent, and their value may not be fairly assessed until years, even decades, later. But it’s also possible that some scientific findings will never yield any utility, at least not within a timeframe that matters to human civilization. In this sense, science is a gamble. Let’s not claim that earning a Ph.D., conducting research, or studying diseases like cancer is always an important activity that deserves automatic recognition and financial compensation. Scientists must always remain aware that the outcome of their endeavors may not be justified by the resources they consume.

Ultimately, we need to re-evaluate how resources are allocated in science. If the vast majority of research results in marginal real-world impact or remains entirely theoretical, then we must ask whether this gamble is truly worth it. Perhaps it’s time to be more discerning about which areas of science receive funding and to consider alternative ways of improving patient outcomes. If cash therapy proves more effective than some of our most expensive research projects, it might be time to reconsider our priorities.