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Ever since the Apollo moon landing in 1969, technical folk have been asked, "If we can get to the moon, why can't we ..." with the questioner filling in his or her favorite cause. I've heard this asked about fighting poverty, cleaning up the cities, building reliable automobiles, cleaning up the environment, and even bringing about world peace. Health matters seem to be quite common, as in, "If we can get to the moon, why can't we cure cancer?"
Because curing cancer is harder than getting to the moon, that's why.
In 1961, President Kennedy announced that we'd "put a man on the moon and bring him back safely by the end of the decade." This had a great advantage over most other Presidential pronouncements: he established a clear, measurable goal instantly understandable by everyone. This made decision-making easy - "Will it help us get to the moon?" If not, don't do it.
At the time of his announcement, his advisers believed that our technologists understood only five or six percent of what was needed to get to the moon. After a two-year survey, they found to their surprise that about two-thirds of the needed technologies were already available! As we all know, the Apollo project succeeded admirably.
Part of our problem today lies in how the National Aeronautics and Space Administration (NASA) has operated since their great triumph. Readers with long memories will remember TV cameras showing us what was going on inside the Houston command center during the flights to the moon. There were rows and rows of expensive engineers sitting at expensive computer consoles helping the flight to stay on course.
When NASA was given the mission of developing and managing the space shuttle, which was supposed to be a much cheaper way to get into orbit, the plan failed miserably. Shuttles made far, far fewer flights than expected at ludicrously greater cost. They have not been replaced as they've come to the end of their useful lives, in part because NASA's only mooted replacement was what amounts to a return of Saturn V-style rockets of a half century ago; too embarrassing for any president or Congressional budget appropriator to contemplate.
Part of the reason for this failure lies in the difference between a "project" and a "process." A project, by definition, is something you do more or less once. Since there weren't going to be very many flights to the moon, it made sense to have hundreds of people involved in managing and supporting each flight.
A "process," in contrast, happens over and over. Instead of re-thinking their overall methodology, NASA continued to need a great many engineers to handle each shuttle flight. This contributed enormously to the overall mission cost, which made it much harder to attract customers, which made shuttle flights fewer than expected, which increased the cost of keeping all those expensive people on the payroll during the long months between flights, and so on in a ruinously costly vicious cycle.
NASA never made the transition from a project mentality to thinking of flight operations in terms of process as airlines do. Looked at in terms of its original goals as the next step in the conquest of space, the shuttle was a dismal failure. Instead of Americans being able to exploit the resources of the moon and the solar system, we've ceded space to the Japanese who're planning to send robots to the moon and to the Chinese who recently put a crew of astronauts into earth orbit.
President Nixon got carried away with "Why can't we" rhetoric and declared "war on cancer" in 1971. He asked Congress to spend what was a lot of money at the time, and got $100 million. In 2008, Newsweek wrote an article "We Fought Cancer.And Cancer Won."
... Cancer is on track to kill 565,650 people in the United States this year-more than 1,500 a day, equivalent to three jumbo jets crashing and killing everyone aboard 365 days a year.
Part of the reason the Apollo project succeeded was that it lasted only eight years. That wasn't long enough for the usual bureaucratic barnacles to attach themselves to the budget. Over the decades since then, the spirit of innovation that filled in the remaining 1/3 of the technologies needed to get to the moon has been lost and NASA has become plodding, risk-averse, and hugely inefficient.
The war on cancer has gone on long enough that the forces of reaction and mediocrity have taken over the grant-making process, just as one would expect. Newsweek wrote:
Indeed, there is no more common refrain among critics of how the war on cancer has been waged: that innovative ideas, ideas that might be grand slams but carry the risk of striking out, are rejected by NCI [National Cancer Institute] in favor of projects that promise singles. "We ask the scientists all the time why aren't we further along," says Visco. "Part of the answer is that the infrastructure of cancer is to keep things moving along as they have been and to reward people doing safe research. Exciting new ideas haven't fared well." [emphasis added]
The whole national research apparatus has been taken over by the forces of mediocrity and safe funding.
Thus, one reason we can't cure cancer even though we can get to the moon, aside from cancer being arguably a harder problem, is that the war took so long that the funding process lost sight of the goal.
My liberal friends enjoyed asking, "If we can get to the moon, why can't we cure poverty?" They won't admit it, but we have cured poverty: we won. By world standards, there are essentially no poor people in America. We're a rich country. The average American garbage grinder eats better than 2/3 of the world's population.
But why do we read so much about the poor? That's simple - we set up a bureaucracy to fight poverty and we give the bureaucrats a lot of money. The bureaucrats spend our money setting up web sites to tell us how hard they're fighting poverty. They keep redefining poverty so that we won't notice that poverty has already been cured - we might want to cut their budget. They are still fighting a war that's been over for decades, and sending us the bill.
President Obama realizes that poverty is an important political talking point. Unfortunately, instead of telling us the truth, he's trying to embed the wastage even more than it already is by changing the definition of poverty so that "official" poverty will automatically go up when the economy expands and down when it contracts as during the Obama Depression.
The fact remains that we did cure poverty, even if the politicians won't admit it. The only reason they can say we can't with a straight face is that they keep changing the definition to suit their interests.
What about making the trains run on time? American railroads are sufficiently unreliable that a great many people use them only when they have no other choice. Making trains run on time is not a technical problem - the Japanese famously coordinate trains all over the country. Incompetence isn't even necessarily inherent to being government run - the French TGV is a government-run system, and it's almost as good as the Japanese.
No, what we have is a political problem: we've lost the ability to fire incompetent government employees who don't take the trouble to do their jobs well, so service can never be better than mediocre on average.
The only reasons that the Apollo project succeeded were because it had a clear goal and that it didn't last long enough for the bureaucrats to take over from the engineers. Once the bureaucrats took hold, the agency stagnated - just as with everything else our government has tried to do ever since.