Joe Biden: What the hell are we doing?

In San Francisco during J.P. Morgan week, the vice president called for the end to a siloed healthcare system to help accelerate the battle against cancer and announced what he will do after his tenure in public office ends.


In a simple, powerful and heartfelt speech at StartUp Health Festival on Monday in San Francisco, Vice President Joe Biden captured the deep helplessness of a father with a sick son navigating a siloed healthcare system.

Biden, who later in the day also spoke at the J.P. Morgan Healthcare Conference, is the champion of the Cancer Moonshot program that recently won billions of dollars through the passing of the bipartisan 21st Century Cures Act in Congress. The goal of the Cancer Moonshot is to end cancer as we know it. Biden’s son Beau, a decorated Iraq war veteran and attorney general of Delaware, passed away in May 2015 after being diagnosed with Stage 4 glioblastoma. He was only 46.

Beau was receiving two CT scans a day to measure the response of the anti-PD1 injection as well as a nano virus that would be directly injected into the tumor in his brain, Biden recalled. While he was being treated at Jefferson Memorial Hospital and Walter Reed Hospital in Washington, D.C., his doctors were at MD Anderson Cancer Center in Houston, Texas, but they could not get access to Beau’s medical information quickly enough.

“I have the entire United States Air Force at my disposal,” Biden said underscoring the frustration of one of the most powerful people in the world paralyzed by an industry in which data doesn’t flow freely. “Howard [Krein, Biden’s son-in-law and Beau’s friend] would get on his cell phone, take photographs and send it down [to Beau’s doctors in Houston]. Can you imagine any high-tech company in the world you know is successful having to do that? Any business you know? What the hell are we doing? What the hell are we doing?”

That collective siloed nightmare is something Biden hopes the industry is going to wake from. And the Cancer Moonshot is going to help the industry get there with its dual goals of a sense of urgency to tackle this humanity’s killer and usher in culture change.

“What I am trying to do with the Moonshot is not just bring a sense of urgency but bring a change in the culture in medicine,” he said. “You all don’t play well in the sandbox.”

He also chided the industry for pursuing research but not publishing results, or putting the information behind journals that have expensive annual subscription fees.

“Over 60% of you don’t even file reports,” Biden said.

He pegged this attitude against transparency to an old way of thinking where battling cancer was necessarily an individual exercise contained in conducting experiments in isolation in research laboratories.

“The model of scientific breakthroughs in the history of the fight against cancer was individual achievement,” he said. “It was spent in the laboratory finding the silver bullet because there was nothing to cooperate about.”

But Biden wants to accelerate the battle and increase the probability of success by harnessing collective resources that are available today.

“No one anticipated that we would have astrophysicists working with oncologists working with biotechnicians working with immunologists and virologists etc,” he said.

While cooperation will bring a new arsenal in the battle against the disease, so will efforts like the National Cancer Institute Drug Formulary, part of the Cancer Moonshot program. Per the website of the National Cancer Institute, the formulary is  “public–private partnership with 20–30 pharmaceutical and biotechnology companies to expedite cancer researchers’ access to investigational agents and approved drugs.” Through this “researchers will be able to obtain compounds through one preapproved ‘formulary’ list and test them for new purposes or in new combinations, thereby alleviating the need to negotiate with each company independently for individual research projects, a process that can take as long as 18 months.”

Biden declared that the formulary would be open on Tuesday.

While as VP, Biden has been able to push for funding for the Cancer Moonshot program through Congress, as a private citizen in 10 days time, he plans to continue his battle to fell cancer. A text of the prepared remarks he was set to give to the J.P. Morgan Healthcare conference audience showed that he has even formulated a tentative name for that effort.

“When I leave office in two weeks, I will be starting an organization that may be called the Biden Cancer Initiative, with similar goals to the Cancer Moonshot—to make 10 years’ worth of progress in five—by changing the way we do business in cancer research and development, and in providing cancer care,” he was due to say.