How Budget Cuts Elevated One Government Agency

Not that they asked it to happen that way. An interview with the National Institutes of Health’s Francis Collins.

This March 25, 2009 photo illustration shows the reverse side of a US twenty dollar bill matched up with the north side of the White House in Washington, DC. US Treasury Secretary Timothy Geithner defended the dollar as a key global reserve currency on March 25, following China's call for a new global currency as an alternative to the greenback.
National Journal
Mark Micheli
Nov. 22, 2013, 11:02 a.m.

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Even in an era of in­tense par­tis­an­ship, both parties in Con­gress agree that fund­ing the in­nov­at­ive and lifesav­ing re­search at the Na­tion­al In­sti­tutes of Health, the largest bio­med­ic­al re­search agency in the world, is a good idea. But like a lot of good ideas in Wash­ing­ton these days, that doesn’t mean it’s hap­pen­ing. Des­pite bi­par­tis­an pledges of sup­port, 2013 has been one of the hard­est years for med­ic­al re­search in dec­ades. As a res­ult of se­quest­ra­tion, the Na­tion­al In­sti­tutes of Health’s fisc­al 2013 budget fell by $1.71 bil­lion, or 5.5 per­cent, com­pared with fisc­al 2012. Those cuts were ex­acer­bated in Oc­to­ber by the gov­ern­ment shut­down, which stalled re­search, grant ap­prov­al, and pa­tient care. But there is a slight sil­ver lin­ing.

That stalling of pa­tient care be­came em­blem­at­ic of the de­struct­ive po­ten­tial of the gov­ern­ment shut­down when it was re­vealed that 200 can­cer pa­tients, in­clud­ing 30 chil­dren, were denied ad­mit­tance to the NIH Clin­ic­al Cen­ter—a place that is of­ten the last hope for pa­tients who have ex­hausted every oth­er op­tion. The news in­tens­i­fied the ire of the pub­lic to­ward Con­gress and cre­ated a great­er ap­pre­ci­ation for the NIH’s work, a boost in no­tori­ety through a means NIH Dir­ect­or Fran­cis Collins would gladly have done without.

“If there was a tiny sil­ver lin­ing in the shut down it was that NIH was seen as one of the gov­ern­ment agen­cies harmed that people were most troubled by. No mat­ter what you think polit­ic­ally, the idea that a kid with a bad dis­ease is be­ing turned away from a re­search tri­al at the clin­ic­al cen­ter is not something you wanna look at and say ‘well, it doesn’t mat­ter,’” said Collins. “So we got a bit of a bump there in vis­ib­il­ity. But I don’t ad­voc­ate that it was worth it.”

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