U.S. Sen. Dick Durbin, D-Ill., recently sponsored a bill that would change how the federal government funds biomedical research. Called the American Cures Act, the bill would create a trust fund of sorts and mandate annual increases in the research budgets for the National Institutes of Health, the Centers for Disease Control and Prevention, the Department of Defense health programs and Veterans Affairs at a rate of inflation plus 5 percent. The goal, it seems, is to put an end to the repeated proposed increases for funding that do not even match inflation and have led to a loss of purchasing power for a decade.
The announcement came March 11 during a speech Durbin gave at the Center for National Policy in Washington. “In the last two centuries, U.S. government support for scientific research has helped split the atom, defeat polio, conquer space, create the Internet, map the human genome and much more. No nation has ever made such a significant investment in science, and no nation’s scientists have ever done more to improve the quality of life on Earth,” Durbin said. “But America’s place as the world’s innovation leader is at risk as we are falling behind in our investment in biomedical research.”
In many ways, Durbin is absolutely right.
Research-funding levels in general and investments in the NIH and National Science Foundation specifically are not keeping pace with those of our global competitors. It should come as no surprise to many that, while the U.S. invests more in biomedical research than any other country (dollar for dollar), the gap is closing as countries — including China, Singapore, Australia, Germany and India — are investing increasingly larger percentages of their gross domestic products in research than the U.S. is.
The question, however, is how this proposed trust fund would be financed and whether such a funding stream is a good idea.
The details about where Durbin plans to find the money are sketchy at best. During his speech, he proposed a nearly $1 increase in the tobacco tax and suggested that increase alone would cover half of the spending needed to develop this new funding stream. But the source (or sources) of the other half remains unclear.
Plus, what happens when the funding streams dry up? Today, segments of the CDC and the Food and Drug Administration are funded on similarly well-intended, but not completely reliable, alternative revenue sources, putting those budgets in peril.
Finally, and perhaps most importantly, what about unintended consequences? While supporters of the Durbin bill today are confident this wouldn’t happen, many policy analysts worry that funding the NIH through an alternative stream ultimately would reduce main-line appropriations. Meaning, appropriators will see a trust fund in place and begin decreasing the base investments in the NIH, figuring that the alternative funding will more than adequately fill the coffers. Should this happen, and, as many fear, should the trust fund income be less than expected, the NIH could end up in an even worse position than it is at the present.
Durbin is an outspoken champion for biomedical research, and we all should commend him for his support and his effort to find creative solutions to today’s research-funding problem. But the reality is that his plan does little more than put a Band-Aid on a wound that needs to be stitched.
The appropriations process has been hijacked by partisanship and near-sighted fiscal policies. The only real way to ensure reliable, long-term investments in the NIH is to fix the broken system by eliminating unnecessary and damaging austerity measures (like the sequester and discretionary spending cuts) and returning to the regular appropriations process.