THE WALL STREET JOURNAL THURSDAY, FEBRUARY 4, 1999


Clinton Strikes Out on Health Research
The president's budget this week boasts of the Clinton commitment to
biomedical research by generously funding
the National Institutes of Health budget.
It "renews the commitment" that the president made to vastly expanding
biomedical research. This funding, the
administration notes, has "made the United States the world leader in
medical research."
If you buy that rhetoric then you can accept the president's definition
of "is"-as






i
Politics & People



L By Albert R. Hunt
in there "is no sexual affair" -or "alone" -as in whether he was "alone"
while having oral sex.
The truth is the president has beaten an unconscionable retreat in his
NIH budget. last year, prodded by outside
gr~oups like Research America, a bipartisan group of legislators
committed themselves to doubling the
health-research budget over the next five years. The first installment
was a 15% hike to $15.1 billion for the current
fiscal year. In signing that legislation, the president praised it as a
"critical downpayment" for his 21st-century
research fund for America, and while he proposed a 50% hike over five
years, he indicated support for doubling that
budget.
In the 2000 budget, however, he seeks only a 2% increase, not even
enough to keep pace with inflation; this
would be the smallest Increase in the NIH budget this decade.
Health-research experts say this budget would stifle
the NIH's momentum, lessen the prospects for major breakthroughs in the
next decade, leave scores of promising
grant proposals unfulfilled and discourage bright young
from entering the biomedical research  short period of time. As a
general rule, fiel -                              that's a
legitimate concern, though it
The proposed NIH budget signals "a  rarely bothers politicians when
they're cease fire in the war agajnst cancer,
rushing to fund highway spending or a Parkinson's, Alzheimer's and other
dis-  pork-laden defense projects.
eases," complains Sen. Connie Mack (R.,     But in the case of NIH,
these fears are Fla.). In a rare agreement with his
conser-  unfounded. Most of the grant applications, vative colleague,
j)emocrat Tom Harkin of  according to
peer-review participants, are Iowa calls the Clinton proposal "corn-
worthy. Yet through most of this decade, pletely
inadequate to fund potential new  only a about a quarter were funded;
with breakthroughs."                      increased
appropriations, that level has
The president is playing a political me. The day after his budget was
released, he met privately in Boston with
Ted Kennedy and several health-research advocates and, defensively,
explained that other than tax cuts and defense
spending the NIH is the only area where sufficient Republicans support
generous increases Thus, he suggested, the
research money would ultimately be there anyway. The problem is that
last year he sought an 8.5~ raise and the end
result was almost 15% With the president comlng in so low this year, it
may be very hard to ratchet it up another
15% hike.
Moreover, this administration's rhet oric on research invariably exceeds
its commitment. In health research,
payoffs are longer term. The most appreciative constituencies are those
that benefit from discoveries which usually
are years away.
Medical scientists charge this is an especially bad time to be stingy.
"This is one of the unique moments in
biomedical research where we're on the verge of exciting developments,"
says Dr. William Brinkley, head of a
federation of medical biologists and Vice President of Graduate Sciences
at the Baylor College of Medicine. The only
catalyst for these advances are NIH grants.
Some conservatives and even experienced lawmakers like Pete Domenici
question whether the NIH can
efficiently absorb massively higher expenditures in a
risen to slightly over 30%. Experts insist it is very easy to maintain
high quality at those rates.
John Porter, an Illinois Repubilcan congressman, who chairs the House
Appropriations subcommittee dealing
with NIH, says that based on extensive research, there is "resounding"
evidence the money would be spent wisely.
But under the Clinton budget, he estimates some 1,500 proposed grants
from medical centers around the country will
be denied. More than a few researchers with existing grants wouldn't be
able to cover inflationary adjustments. And
the cutbacks would be a disincentive to young scientists to get into
this field.
Potential breakthroughs are real. Re-
searchers in the areas of cancer, diabetes and AIDS, where extraordinary
progress has been made, see bigger
possibilities on the horizon. In brain-related areas, the Charles A.
Dana Foundation forecasts "major advances" in
treating Huntington's disease, Alzheimer's, Lou Gehrig's disease and
Parkinson's, as well as the development of new
drugs for strokes and spinal cord injuries. It's a good bet that more
than a few of any advances will emanate from NIH
grants.
These are real investments. A major Duke University study a few years
ago

dm(~~i?nIgstmraat;~r ~ among the elderly If that trend accelerates, the
potenh.ai savings in Medicare costs are
substantial.

~ I;~~acrtMhaesti;veeasrtn~nldt. ~ ~ bw%hsindhetha~An~eer(~raanl

spending on basic medical and spience research: "By the end of the 199O~
America will have added fl million ne~
jobs while
the European Union, with        e third more
population will have    he
said. "We have the same savings rate, the same education levels and It's
not that we're smarter; our advantage is that
America makes the Investment in basic science."
A federal budget, with all its limitations and flaws, is a partial
roadmap of a society's priorities. A number of Mr.
Clinton's initiatives-the efforts to deal with Social Security, funding
for more teachers-are laudable; arguably too there
Is a case for some tax cuts in this booming econom~ Ut none are more
important than conti~~mg a major and bold
effort to fund research for medical breakthroughs that will make us a
much healthier and more productive society.
Here the Clinton b~dget fails miserably.