Public Policy Update
By Lyle B. Dennis
One of the things that makes it difficult to sustain researcher’s interest in public policy – particularly clinician-researchers – is that the process never seems to end. Earlier this year, AASLD and others interested in advancing biomedical research funding had some significant victories – enactment of the American Recover and Reinvestment Act (ARRA) and the FY09 Omnibus Appropriations bill.
The former supplied $10 billion in new biomedical research funding to the NIH ($10.4 million if Comparative Effective Research is included) and the latter increased the base NIH budget by more than $900 million and took NIH off of a Continuing Resolution that held its funding to FY08 levels.
Now, President Barack Obama has released his comprehensive budget recommendations for FY10 (the fiscal year that begins October 1, 2009 and runs through September 30, 2010) and it is time for AASLD to start all over again. Based on what the President is recommending, all of us in the health care research advocacy community have our work cut out for us.
During the 2008 campaign, the President was clear both in speeches and on his website that he wanted to “return science to its rightful place” and to double “scientific research funding over a ten year period.” Clearly there are steps that have been taken to accomplish these twin goals. Appointments of pro-science officials, such as Energy Secretary Stephen Chu, and support for the NIH funding in the ARRA legislation (although it was not initially proposed by the Administration) were key supportive moves.
Less helpful have been the numbers in the President’s FY10 budget request. The Administration is seeking just a 1.4 percent increase in funding for NIH. To reach a level of doubling the NIH budget in ten years would require a 7.2 percent annual increase for that entire period. The difference between the requested amount and the amount that would be needed to match the rhetoric is about $1.5 billion.
The problem with not seeking increases in this range is not so much what will happen in FY10, when there is a lot of funding available as a result of ARRA, albeit for very targeted programs. The problem will come in FY11 when the ARRA money is no longer available. Suddenly, research project grants (RPGs) will “fall off a cliff” (barring an increase in the 17 to 20 percent range for FY11, which seems very unlikely).
Science research, whether biomedical or otherwise, benefits from sustained, robust, and predictable funding increases over a period of time that enable the long and difficult scientific process to advance, for young investigators to be trained with the knowledge that there will be opportunities for them to succeed, and discoveries to be made that will help improve the lives of all people.
Absent that stable environment, we get a system of starts and stops in research that fails to obtain the maximum impact from those increases that are awarded. The years of reductions or level funding serve to scare away young investigators (and sometimes not-so-young investigators) from the field. And, given what the future of liver disease looks like with the growth in the recognition of viral hepatitis, as well as in the incidence of primary liver cancer, hepatology needs every advantage it can get.
So, this is the challenge for AASLD in the coming months. Decisions will be made on funding levels and policies that will impact your funding, your reimbursements, your careers. When the Association calls on you to contact your representatives, or to reach out to the White House, please do not hesitate to do so. It is as much of the new environment of research and medical practice today as your laptop and your Blackberry.
This electronic newsletter is a bi-weekly publication of AASLD and replaces the former bi-monthly print newsletter and weekly e-news. Members are welcome to submit articles and may send suggestions to atracy@aasld.org