MEDICAL RESEARCH: Advocates Lobby for Federal Spending

      Today's New York Times profiles the ongoing subcommittee hearings on the National Institutes of Health budget, "an annual telethon of sorts" as hundreds of people testify about the need for more research funding for "the most common cancer to the rarest genetic disorder." The Times reports that on the first of a five-day hearing in the House Appropriations subcommittee on labor, health and human services and education, doctors pleaded yesterday "for more money for research in general, and their interests in particular," and patients filed through "Mother Teresa's Waiting Room" calling attention to "hundreds of ailments." Under the current budget, Congress gave the institutes a $2 billion increase, bringing the total allocation to $15.6 billion. While Congress does not direct appropriations by disease, patient advocates are vying "for a brass ring with a more subtle effect: a mention in the report that accompanies the subcommittee's bill." The NIH "pays close attention to the report," and the wording used, according to Michael Stephens, a former staff director of the subcommittee. "There is a code in the words," he said, noting that the committee might indicate that they are aware of a disease, or urge Congress' special consideration, or even boldly state that a particular amount should be diverted for a particular disease (Stolberg, 4/14). Jim Kelly, the retired quarterback for the Buffalo Bills, was angling for the latter designation yesterday, testifying before the committee about his 2-year-old son's crippling affliction, Krabbe's Disease. The funding allocated for the disease, which only affects a handful of children, "just scratches the surface" of what is needed, he said. Rep. John Porter (R-IL), chair of the subcommittee, said, "While we don't fund by disease ... it seems we should be able to fashion some language in this year's report to bring some attention to this" (McCaffrey, AP/Nando Times, 4/14). Christopher Reeves and Doug Flutie, who has an autistic son, are also both expected to appear before the panel (Times, 4/14).

How Much is Enough?
      Writing in the current issue of Business Week, University of Chicago professor and Nobel Laureate Gary Becker says funding for increased medical research could come out of the federal surplus. Becker laments that "both Republicans and Democrat have missed the opportunity to increase the amounts spent on basic medical research." Becker pointed to an estimate by two University of Chicago economists that found between 1970 and 1990 the sharp decline in heart disease-related mortality "produced benefits many times larger than total spending on medical research over that period." They concluded that a 1% decline in mortality from cancer or heart disease "would be worth almost half a trillion dollars to Americans," meaning that collectively, Americans would be willing to pay that amount even for "small reductions in their chances of dying from disease during their middle or old age." Arguing that much higher federal research spending is warranted, particularly on specific diseases, Becker said that such spending fuels pharmaceutical companies' investments "because they piggyback on advances in basic knowledge." Charging that government spending on basic medical research falls behind as a "bloated government ... caters to powerful interest groups," Becker concludes: "A doubling of annual government funding of medical research would have only a small effect on the overall federal budget. Yet greatly expanded basic research is likely to have an enormous payoff by reducing deaths" (4/19 issue).