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Medical research suffers as budget woes unresolved

By Mary Woolley and Robert L. Bixby In passing a spending bill for 2016, Congress seemed to acknowledge that medical research had been cut too deeply for over a decade and agreed to boost funding for it in the coming months. But without reforms to address the basic structural problems in the federal budget, downward pressures on research and other important national priorities can be expected to continue.

By Mary Woolley

and Robert L. Bixby

In passing a spending bill for 2016, Congress seemed to acknowledge that medical research had been cut too deeply for over a decade and agreed to boost funding for it in the coming months. But without reforms to address the basic structural problems in the federal budget, downward pressures on research and other important national priorities can be expected to continue.

Consider what's at stake:

Cutting-edge immunotherapy work at Penn Medicine's Abramson Cancer Center to help achieve the goals of the "moonshot" initiative to cure cancer. Immunotherapy is considered a viable approach to treating the most aggressive kinds of brain cancer.

Revolutionary studies underway across the country to slow the scourge of Alzheimer's, diabetes, heart disease, and other devastating conditions.

Precision medicine, a large-scale effort to deliver the right treatment to the right person at the right time.

This type of groundbreaking research is rooted in our nation's long-standing commitment to science and innovation. Yet federal government support for medical progress was sorely compromised over the last decade as policymakers tightened the purse strings. With our nation's budget policies on an unsustainable path, fiscal responsibility is essential. It should not be implemented, however, in an indiscriminate manner.

Unless elected officials change course, projections from the nonpartisan Congressional Budget Office show the budget squeeze on medical research and other worthy priorities worsening in the years ahead. For those who are concerned about this, it is important to understand why the debt is projected to grow at an unsustainable rate.

Based on congressional and campaign rhetoric in recent years, one might assume that the fundamental problem lies in the "discretionary" spending that Congress approves each year for defense and most domestic programs, medical research included.

But discretionary spending represents only a slice of the federal budget pie, and it is not a critical factor in the government's projected deficits in the years ahead. On the contrary, this spending is scheduled to drop to historically low levels relative to the size of the economy in coming years.

The key problem areas are not discretionary spending at all, but rather the big federal entitlement programs and an inefficient tax system. The aging of the population and the continued growth of health-care costs mean the government must spend significantly more each year just to provide the same level of service to more people.

In addition, Social Security and Medicare are largely supported by payroll taxes, and there are now fewer people in the workforce to support each retiree. These two programs, along with Medicaid, already claim 46 percent of the federal budget. While they are critical programs to millions of Americans, Congress needs to make substantial changes to put them on sustainable paths.

As for the federal tax code, it gives up hundreds of billions of dollars a year in government revenue through special provisions that favor certain individuals, industries, and activities, but it seldom receives as much scrutiny as outright spending. Washington needs to revamp the tax code to reduce its complexity, support economic growth more effectively, and weed out tax subsidies that don't really support top national priorities.

Medical research is a fundamental national priority that has been cheated by our elected officials' unwillingness to confront and resolve the major problems with our federal budget. Let's tackle those problems head-on.

Mary Woolley is president and CEO of Research!America. mwoolley@researchamerica.org

Robert L. Bixby is executive director of the Concord Coalition. bixby@concordcoalition.org