In about a week, Californians will be casting their ballots, and among the many initiatives is Proposition 38, which seeks to raise a lot of money for medical research. But beyond the measure itself, there is the broader political question of how the initiative process is being used to support private interests.
Proposition 38, if approved, would sell $8.4 billion in state bonds to raise funding specifically for immunology and immunotherapy research. It specifies that half the funding goes toward cancer, heart disease, and Alzheimer's research.
"And immunotherapies are the cutting-edge form of medical treatment that harness the body's own immune system to stop these diseases," said Yes on 38 spokesperson Robin Swanson. "And so, this bond measure steps in and provides funding for this critical medical research, which is really important right now in the face of federal cuts."
That's the interest of Dr. Gary Michelson, a billionaire philanthropist who made his fortune inventing hundreds of surgical devices. But now he's interested in creating something new: a research facility at the former Westside Pavilion shopping mall near the University of California, Los Angeles, called the California Institute of Immunology and Immunotherapy (CIII).
"It's the intention of this institute to have an internal, self-funded incubator accelerator to play 'Shark Tank,' if you will. We're going to have the world's leading immunologists and say, 'Yeah, let's invest in that and start a new company,'" Michelson said at a 2024 symposium about the institute which, at that point, existed only on paper.
"Right now, we are in the phase where we are raising funds," he said. "And philanthropy is one source of that. I really would like to find some business partners."
But it seems those business partners may now be the California taxpayers. Michelson's foundation has funded the campaign to the tune of about $40 million to get Prop. 38 on the ballot. And in the measure's language, it dedicates half the money - $4.2 billion - to a single "unnamed" non-profit. But the criteria for selecting that non-profit was written to exactly match Michelson's new institute, so no other entity in the state could possibly qualify.
Dr. Sarah Hill, political science professor at California State University, Fullerton, analyzes the state's voter initiatives and says bond money is usually reserved for long-lasting infrastructure projects because it incurs debt that lasts for decades.
"And it's bond money being used for research, which is kind of unusual," said Hill. "So, it's unusual policy, and you get this kind of unusual outcome as well, of one non-profit being eligible for half the money."
The other half of the money would be handed out in a traditional, competitive process for those applying for grants to study specific projects. But that wouldn't be the case for the CIII, which critics say would also be exempt from California's public disclosure laws. Servicing the bond debt is expected to take $500-600 million from the state's general fund for 20 years or more.
Dr. Robert Kaplan, a research senior scholar at Stanford University, is concerned that lawmakers will be reluctant to fund any other kinds of medical research when so much is going to only one field of study.
"One of the important things about science is that you need a lot of different people with different ideas," said Kaplan, who authored the opposition statement to the initiative. "And so, there's kind of a marketplace for ideas, where the best minds are competing with one another to get the research funding. And then, they're evaluated on their progress and only those who succeed are rewarded with continuing funding. And that model, there seems to be a lot of discussion in the scientific literature, but that model seems to be the best one."
Ulimately, Prop. 38 will be decided by the voters on the issue of curing disease, but it also may be ushering in a whole new way for those with big ideas and enough resources to use the ballot box to convince the public to pay to make them come true.
"And I think it just raises so many questions about this process. That, at this point in the process, is about who has the money to get it on the ballot and to push for it," Hill said. "It's frustrating to watch."
"That's exactly what you want people to spend their money on, which is curing cancer," said Swanson. "So, we're proud to have gotten funding in that way."
Supporters of Prop 38 say it could end up costing the taxpayer nothing because 10% of any profits from medical breakthroughs would be refunded back to the state. But Kaplan said those kind of monetary benefits are not guaranteed and usually take decades to be realized.
