The federal government has just confirmed that spending on noncommercial medical research really did fall in 2013, to $46.7 billion.

That’s down 2.6 percent from the total in 2012, and it’s at the lowest level since 2009. Spending was down 5.3 percent from a peak of $49.3 billion recorded in 2011. Spending on every other category of health care expenses increased.

Meanwhile, the experts are telling Congress that, if nothing in medical science changes, dementia alone is likely to cost the United States more than $20 trillion over the next 40 years — within the time that some of your youngest clients will still be paying the premiums on life insurance policies and long-term care insurance (LTCI) policies that you first sold them this year.

Of course, it’s fashionable to say that advances in medical science simply increase costs, by helping drug companies charge patients more for care, and that all we need to cut costs is for people to eat better and exercise more

Clearly, especially for the people in the long-term care (LTC) planning community, that’s a bunch of hooey.

You sell products and services every day to people who eat right, exercise and are conscientious enough to do what they can to plan for post-retirement health care needs. But some of them still need care for years, or decades. Many because of the ravages of conditions such as Alzheimer’s disease, other forms of dementia, Parkinson’s disease and multiple sclerosis that seem to have some poorly understood connection with the immune system genetics and attacks by microbes.

Even people’s problems with controlling how much they eat and getting themselves to exercise may have a connection with the immune system-related conditions that cause dementia and other nervous system disorders.

It could be that thoroughly understanding any of those conditions could lead to methods to prevent and cure them all.

Scientists have many new tools, such as genetic sequencing machines, that they can use to do forms of research they could not easily do before. 

Of course, all of that research takes money and time, and any new treatments for Alzheimer’s could be very expensive. But drugs only stay on patent for 17 years, and insurers and government agencies can find many ways to hold down spending on drugs that eliminate conditions that ruin people’s lives. Even if, for example, drug companies could really get patients to pay $50 billion per year for anti-Alzheimer’s drugs, or $2 trillion over 40 years, that would be a lot cheaper than spending $40 trillion on actual cases of Alzheimer’s.

Some programs are supposed to increase spending on brain science research, but, even if they succeed, simply increasing spending on the obvious areas of inquiry is not good enough. The cure for Alzheimer’s might come from research on Alzheimer’s, but it might come from an unexpected side effect of research on the flu, or rare fish in Australia. 

Somehow, the country needs to scrape up the money and kind of long-term outlook to provide generous support for basic medical research of all kinds.