The election results from Tuesday are crystal clear: the “shellacking” of the Democrats means that we have at least 2 years of gridlock ahead of us and, if the Tea Party rhetoric is to be believed, at least 2 years of close attention to budgets.
How that will affect health care remains to be seen, but the effect will almost certainly be less dramatic than politicians have promised. Health care reform will be difficult to roll back, and changes in congressional oversight won’t mean sea changes at executive branch agencies such as the Food and Drug Administration. That doesn’t mean that millions won’t be spent on lobbying or that some incremental changes may happen. But it does mean that the health PR environment we’re in isn’t likely to change dramatically.
With one exception.
Any time budgets come under scrutiny, there is one organization that always faces increased scrutiny: the National Institutes of Health. Even before Tuesday’s vote, the NIH had lost at least three key congressional supporters to retirement or primary losses. Now, the agency’s large budget may prove tempting for red-ink-fighting congressional freshmen.
The implication of further cuts is clear: research and progress against disease would be seriously compromised. We’ve been here before; I remember sitting in a meeting with leaders of the National Institute of Diabetes, Digestive and Kidney Diseases and their advisors a few years ago, when budgets suddenly flattened across NIH. The dilemma was acute: prioritize funding existing grantees and risk driving a generation of young researchers out of academia, or invest in new investigators at the risk of hobbling established, productive labs. It was gut-wrenching to watch, knowing that the breakthrough of tomorrow might be on the chopping block today.
There is no one in the life sciences that disputes the huge and positive impact of the NIH in driving innovation, and money spent by the NIH isn’t a cost, it’s an investment in the future, paying dividends both economically and in terms of global health.
On Tuesday night, pundits were all asking “what does it all mean?” Here’s my take: In this coming era of gridlock and disunity, we must stand together to make sure that the zeal for fiscal restrain doesn’t threaten the bedrock of medical innovation. Let’s make sure we keep the NIH safe.