[Albert Hunt] Republican budget cuts at heart of medical research

President Barack Obama’s call for “investments” in education, infrastructure and science and health research is dismissed by most congressional Republicans as a fig leaf for more big-government spending.

That underlies the House’s decision Feb. 19 to slash $61 billion from an array of discretionary spending programs in the current fiscal year budget.

This may make proponents feel good, yet, as almost all budget experts acknowledge, these measures have little to do with addressing America’s fiscal challenges. That would require focusing on entitlements, taxes and defense spending.

If all domestic discretionary spending, about 12 percent of the budget, was eliminated ― no Department of Education, no FBI agents, no air-traffic controllers ― there still would be a deficit of more than $1 trillion this year.

And some of the cuts entail risks.

These range from slicing foreign aid even as China is expanding its assistance and influence; cutting the staffing at the Securities and Exchange Commission when it has new regulations to enforce and is striving to thwart the next Bernard Madoff; reducing nutritional support for low-income pregnant women and their babies, which demonstrably reduces future health care costs.

There is no more telling illustration than the National Institutes of Health, the center of U.S. medical research and the largest such institution in world. House Republicans want to cut NIH funding for the current year by more than $1 billion, to $29.5 billion. Obama proposes a small increase in NIH funding.

While this 5 percent reduction is less severe than other proposals in the Republican budget, it reverses a 15-year bipartisan effort to support medical research. The NIH budget has almost tripled over the last decade and a half.

This was achieved with considerable support from Republicans such as John Porter, who served 21 years as a congressman from Illinois.

“America’s economic destiny depends upon maintaining and enhancing our lead in technology, innovation, science and research,” says Porter, now chairman of Research! America, an advocacy group in Alexandria, Virginia.

He is horrified by what House Republicans want to do to NIH. “These are blind cuts that take us exactly in the wrong direction; they are wrong-headed and short-sighted,” he says.

Paul Ryan, the chairman of the House Budget Committee, demurs; a spokesman for the Wisconsin Republican says the agency has received substantial funding increases in recent years, that the Democrats’ “spending spree” must stop and that priorities need to be set.

With the economy as a priority, says the legendary investor Peter Lynch, health-research spending should be at the top of the agenda. “The NIH has been one of the great elements of our economy,” says Lynch, who managed Fidelity’s Magellan Fund from 1977 to 1990, when assets grew 630-fold. “We should be expanding, not reducing this investment.”

If funding were doubled over seven years for most government programs or agencies ― such as the Pentagon or health or housing projects ― there would be enormous inefficiencies and fraud as they tried to absorb such a rapid escalation. Almost every serious analysis says the NIH did this without these abuses. More than 70 percent of its budget is devoted to peer-reviewed research grants, of which only about one in five qualified applications are approved. For every dollar of public funding for scientific research, the drug industry gets a $3 return, according to one study.

And the progress in battling disease, especially in recent years, has been noteworthy, with the U.S. leading the way. Heart disease and deaths from strokes are decreasing. For the first time, in 2007, cancer deaths declined. Much of this is owed to the NIH.

“NIH-funded research has revolutionized how we think about cancer,” Francis Collins, the agency’s director, has said, noting that much treatment has gone from reactive to proactive.

Congressman Ed Markey, a Massachusetts Democrat, made an impassioned plea on the House floor last week to restore this funding, warning of subsequent health-care costs if research is slowed in areas like Alzheimer’s. The Markey proposal was ruled out of order on procedural grounds.

The House Republicans tend to duck if asked about cutting research for cancer, or Alzheimer’s, or Parkinson’s. Yet it would be very difficult to cut 5 percent from the NIH budget without taking some from the $5.1 billion received by the National Institute on Cancer, or the $1.1 billion for the National Institute on Aging, or the $1.96 billion for the National Institute of Diabetes and Digestive and Kidney Diseases.

Future advances in areas like brain science are especially threatened. NIH research is “absolutely indispensible” to breakthroughs in neuroscience, says Guy McKhann, the founding director of the Mind/Brain Institute at Johns Hopkins University in Baltimore and the former chairman of the department of neurology at the university’s medical school.

McKhann, who once worked at NIH, says young researchers would be most affected by any cuts. “They have excellent training and are ready to start serious research on their own, but there’s not enough money and there’s already pressure for them to go into private practice; there is no replacing them,” he says.

Lynch says that if there are cutbacks these young researchers would have another option that “endangers” America’s lead in this economically critical area: They can go to places like Singapore and China, which are ambitiously expanding health research.

The House action reflects the breakdown of bipartisan support for battling diseases that know no political boundaries. The NIH commands universal respect, as does Collins, its director. He led the Human Genome Project and has been called one of the most accomplished scientists of our time.

This is only the first volley in the budget wars; the Senate, with Republican support, is likely to restore most of the NIH cuts. If Congress subsequently deals with the real deficit issues ― contrary to conventional wisdom, a “grand bargain” involving entitlement cuts and tax increases may evolve ― the meat-axe approach to medical research can be taken off the table. 

By Albert Hunt

Albert R. Hunt is the executive editor for Washington at Bloomberg News. The opinions expressed are his own. ― Ed.

(Bloomberg)