An Ounce of Prevention is Worth a Pound of Cure: Are We Sacrificing Health for a Balanced Budget?
|Author:||Alliance for Aging Research|
|Type:||Get Mad Column|
|Related Topics:||Federal Funding, Health, Medical Innovation, Policy, Quality of Care|
Last summer, lawmakers were not just feeling the heat of the August sun in Washington when Congress passed the Budget Control Act of 2011(BCA). Under pressure to raise the country’s debt ceiling, the BCA allowed the president to do so by up to $2.8 trillion, but only by requiring the deficit to be slashed by $2.3 trillion over the next decade. Not a bad trade, right? Think again. The methods used to make these cuts could take a fat slice out of the federal budget that pays for research to prevent diseases we all fear as we grow older like cancer, Alzheimer’s disease, diabetes and heart disease.
Too Many Cooks in the Kitchen
Right from the start, the BCA set $841 billion in funding caps amounting to cuts on programs including those at the National Institutes of Health (NIH), the National Science Foundation (NSF), and the Centers for Disease Control (CDC). $44 billion of these cuts began in fiscal year 2012, and they will accelerate over 10 years to $119 billion in fiscal year 2021.
There are two ways that the BCA could achieve the remaining reductions. The first way was to create a 12-member congressional “Super Committee” to develop a plan on how to implement these decade-long cuts. Their plan would have to reduce the deficit by $1.5 trillion. Congress pursued this avenue last fall. The members of this committee were selected by the Republican and Democratic leadership in both the House and Senate. Once appointed, this group had until November 23, 2011 to cook up and serve their proposal to the rest of Congress for a vote one month later.
The second way that the BCA could achieve reductions is through a process called sequestration. Sequestration is a mechanism through which automatic, across-the-board spending cuts are made. Sequestration was added to the BCA as a painful fallback option to force the “Super Committee” to agree on a plan. Sequestration would be initiated in January of 2013 if the committee plan failed to become law.
Despite having a table full of options at their disposal to raise funds and cut other programs, the dozen Congressional leaders tasked with striking a bipartisan deal announced that they could not reach an agreement. Logjams caused by debates over the need to preserve programs like Medicare and Social Security and the desire of some lawmakers to avoid raising taxes on high earners contributed in part to the breakdown of this committee’s work. As a result, their failure will likely trigger sequestration in less than a year. If enacted, half of the cuts in 2013 will come from spending on defense. The remaining half will come from the NIH and other spending considered “discretionary.” It is expected that sequestration would cut science and research across the government by about 8 percent.
Changing a Recipe for Disaster
The president’s fiscal year 2013 budget arrived on Capitol Hill on February 13, 2012. Adhering to the caps adopted in the BCA, under the president’s budget the NIH would receive $30.86 billion in fiscal year 2013. This equates to flat-funding and is hardly considered good news going into a potential sequestration scenario. The 8 percent funding cut that the NIH would incur under sequestration could have some devastating consequences. It is expected that the NIH would be able to provide between 2,500 to 2,700 fewer grants for research per year. Research into better means of intervening and preventing the diseases and conditions of aging would not be spared cuts and it could not happen at a worse time.
According to the U.S. Census Bureau, the number of people age 65 and older will more than double between 2010 and 2050 to 88.5 million; and those 85 and older will increase three-fold, to 19 million. As the 65+ population increases so will the prevalence of diseases disproportionately affecting older people. We do not yet have the knowledge needed to predict, preempt, and prevent the broad spectrum of diseases and conditions associated with aging. We do not yet have sufficient knowledge about disease processes to fully understand how best to prevent, diagnose, and treat many diseases and conditions of aging, nor do we have the knowledge needed about the complex relationships among biology, genetics, and behavioral and social factors related to aging.
It is not certain that sequestration will actually happen. The Democratic-controlled Senate and the Republican-led House could reach a deal and pass a new bill to reduce the deficit in other ways between now and January of 2013 that would override the BCA’s sequestration. In an ideal world they could agree to get rid of the sequestration altogether, however, President Obama has stated that he would not support untying the sequestration plan without another deal to take its place. So the burden is on Congress. As we get closer to that January 2013 date, a new plan to replace sequestration is less likely to become a reality.
If you are reading this publication it is because you believe that science and research into what causes and may prevent disease like cancer, Alzheimer’s disease is important. We ask you to take action on this belief because you can do something about this simmering problem facing the country. Join with advocates like the Alliance for Aging Research and urge Congress to make NIH funding a priority and recognize the serious impact that sequestration will have on the scientific community. If you cannot take action, please take this as some food for thought and encourage others to help.
Living Longer and Loving It!
Sign up for the Alliance's quarterly newsletter and get timely information on advancements in science, treatment, and health policy that help you "Live Longer and Love It."