The shaky policy foundations of California’s overambitious science bond | Opinion

Californians are being asked to support an $8.4 billion bet on biomedical science. I strongly support investment in medical research, but I oppose this ballot initiative.

This proposal is Senate Bill 895, authored by Sen. Scott Wiener, D-San Francisco, also known as the California Science and Health Research Bond Act. SB 895 would authorize the state to issue bonds to fund immunology and immunotherapy research and create a new institute within the University of California system. The goal of accelerating breakthroughs against devastating diseases is both ambitious and appealing, but good intentions do not guarantee good policy.

Public investment in biomedical science has been one of the most successful strategies in modern American history. The National Institutes of Health (NIH) has helped make the United States the global leader in discovery, supporting work that has extended lives, reduced suffering and strengthened the economy. California’s universities have been major beneficiaries, consistently securing a large share of NIH funding. Support for immunotherapy research has also grown substantially in recent years.

Yet the case for this particular initiative is far less compelling.

First, it continues a troubling shift toward funding research through narrowly targeted ballot measures. California has already established dedicated programs for areas such as regenerative medicine and precision medicine. While each may be defensible individually, together they create a fragmented approach to science policy — one driven more by political appeal than by systematic priority-setting.

This initiative would direct a large share of funding to cancer, Alzheimer’s disease and heart disease. These are unquestionably important, but so are mental illness, kidney disease and many other major sources of disability and cost. A well-functioning research system allocates resources based on scientific opportunity and population health needs, not on which diseases gain traction at the ballot box.

Over time, this approach risks turning research funding into a series of competing campaigns, leaving less visible but equally important conditions behind.

Second, the financing mechanism is poorly suited to the nature of scientific research. According to the state’s Legislative Analyst’s Office, the initiative would commit California to roughly $500 million in annual debt service for 25 years. Bonds are appropriate for projects with predictable returns, such as infrastructure. Biomedical research is inherently uncertain: The path from discovery to clinical application is long — often measured in decades — and many promising lines of inquiry never yield practical results.

The initiative assumes that research investments will generate revenue to help repay the state. That expectation is optimistic. Academic researchers rarely bring products directly to market. Instead, private companies build on publicly funded discoveries and undertake the costly work of development, testing and regulatory approval.

While the economic benefits of research are real, they are diffuse and difficult to capture through direct revenue-sharing.

The proposal’s pricing provisions introduce additional risk. It requires that treatments developed with state support be offered to Californians at a 20% discount. Although attractive in principle, this condition could discourage companies from bringing new therapies to the state. Faced with lower prices in California, firms may delay or limit access. Paradoxically, this feature could undermine the initiative’s central goal.

More fundamentally, the proposal reflects a misunderstanding of how biomedical research creates value. Scientific progress is cumulative and unpredictable. Today’s basic discoveries become tomorrow’s applications, often in unexpected ways. For this reason, research is best treated as a public good — supported through sustained public investment, not financed through borrowing tied to uncertain returns.

California voters should be clear-eyed about what this initiative represents. It is not simply a vote for science, it is a decision to fund research through a fragmented, debt-financed model that prioritizes a few high-profile diseases and assumes financial returns that may never materialize.

There is a strong case for investing more in biomedical research, but this is not the right way to do it. If California wants to lead in science, it should pursue funding strategies that are strategic, coordinated and sustainable — not driven by the ballot box.

Voters should think carefully before approving a proposal that promises breakthroughs but rests on shaky policy foundations.

Robert M. Kaplan is a senior scholar at the Stanford School of Medicine’s Clinical Excellence Research Center. He is a former associate director of the National Institutes of Health and former chief science officer of the U.S. Agency for Healthcare Research and Quality.