Clinton, Congress plan sharp increase in federal funds for biomedical research National health officials request more support as HMOs tighten assistance


WASHINGTON -- In his new budget, President Clinton plans to seek a substantial increase in federal spending on biomedical research, and members of Congress from both parties say they are virtually certain to approve an even bigger increase.

Science and politics point to the same conclusion. When Congress reconvenes this month, lawmakers will be seeking more money for the National Institutes of Health because they believe that researchers can exploit promising scientific opportunities such as advances in cancer treatment. They also believe that such investments will be popular with voters in an election year.

"We are in a golden age of discovery, one unique in human history," said Dr. Richard Klausner, director of the National Cancer Institute, expressing the view of many scientists and lawmakers.

Even before Clinton formally sends his budget request to Capitol Hill early next month, NIH officials have told Congress that the federal government must increase its support of biomedical research because managed-care companies, with their emphasis on the bottom line, have reduced the amount of money available to conduct clinical trials.

In the past, academic health centers used surplus revenues from patient care to supplement the money they received from the government, but such surpluses are drying up.

The budget of the health institutes has doubled in the past decade, to $13.6 billion this year. Nonetheless, lawmakers of both parties say they intend to accelerate the increases, and they talk seriously about trying to double the budget of the NIH in five years. That would require annual increases averaging 15 percent, far more than the latest increase of 7.1 percent, from 1997 to 1998.

Anne Thomas, a spokeswoman for the National Institutes of Health, said NIH officials had begun internal discussions so they could answer questions from Congress about how they would use a big infusion of federal money. In setting priorities, Thomas said, the agency's director, Dr. Harold Varmus, is asking, "Where are the scientific opportunities, and what are the public health needs?"

The Senate voted 98-0 last year to endorse the goal of doubling the agency's budget in five years, but did not say where the money should come from.

Two influential Republicans, Rep. John Edward Porter of Illinois and Sen. Arlen Specter of Pennsylvania, said they were determined to find the money. They are chairmen of the Appropriations subcommittees responsible for health care spending.

In an interview, Porter said that he had discussed the question at length with Speaker Newt Gingrich and that Gingrich "supports doubling the NIH budget in five years, within the overall context of a balanced budget."

The budget request, reflecting the professional judgment of government scientists, includes these proposals:

The number of cancer research and treatment centers around the country should be increased from 57 to 70.

The government should authorize "a fivefold increase over the next five years in the number of people participating" in clinical trials of new techniques for the prevention and treatment of cancer. At present, 300,000 people participate in such studies.

Congress should provide an additional sum of $40 million next year so the government can finance the top 40 percent of applications for research.

Pub Date: 1/03/98

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