In an Op-Ed in the NYT, Representative Andy Harris (R, Maryland) lays out three main issues that he would like to address regarding the functions of the National Institutes of Health.
Dr. Harris [Wikipedia] was a Physician Scientist prior to running for Congress and was the PI of NIH Grant R01 GM036044-04. This grant ran from 1986-2007 and was competitively renewed three times. This, in my mind, gives us much more reason, than is usual for a Congress Critter, to hear the man out.
The Op-Ed proposes to alter the infamous age-of-first-R01 award. Even the NIH [see post at RockTalking] itself agrees that the age of 42 might be too old. Consequently, when Harris recommends:
Congress should also mandate that the median age of first research awards to new investigators be under 40 within five years, and under 38 within 10 years. Failure to meet these benchmarks would result in penalties for the N.I.H., including possible funding cuts.
I am in full agreement. I might even want more aggressive benchmarks. Telling NIH that they must address this is fine because pretty much all stakeholders have been agreeing this is ridiculous. There is very little that I have heard in the way of any serious argument that this increasing age of first-R01 award is a good thing. Now….what I really want to see is the inter-quartile range. What we see is the median and it simply doesn’t square with my seat of the pants estimate. It looks really old to me, meaning I know a lot of people that got their start in their early to mid thirties (yes, within the last 15 years, thanks) and very few that got their first R01 at 43 or older. It may be the case that the distribution is nearly Gaussian….or it could be really skewed. It would not surprise me in the least if the 25th percentile is age 36 and the 75th percentile is age 45, for example. I want to see the entire distribution, ideally, but the inter-quartile range would be a good substitute.
The next item is standard right winger, Republican fare when it comes to federally funded science and I oppose it. Strongly. Rep Harris’ version:
To make sure it meets those goals, we should insist on the development of an N.I.H.-wide strategic plan — not just for targeting younger researchers, but for prioritizing different avenues of research overall. Today we see too many grants going to things like creating a video game for moms to teach them how to get their kids to eat more vegetables, or studying the creation of a social security system in southern Mexico. Such projects may have value to some, but is creating a video game really more important than researching a cure for Alzheimer’s?
It is easy for anyone to point to some “ridiculous” grant award or study topic that revs up their base. Whether you are opposed to research into topics that are “solved” in the Republican mind with prohibition and moral tut-tutting (HIV/AIDS, drug abuse), in the Democratic mind with hippie veganism and anticorporatism (diabetes, heart diseasee) or in the waccaloon mind by denial (ban all animal research, for example) isn’t really important. I can show you how stupidly irrelevant some basic research is, Sarah Palin can dismiss drosophila models or PP and St. McKnight can insist that only “vertically ascending science” is relevant to real advance. We’re all wrong. The tremendous strength and success of the NIH-funded research enterprise relies intimately on the relative absence of top-down control. Investigator initiated science is the best way, of a myriad of options. Period. When we try to be “efficient” by picking winners in advance, we hinder scientific advance. It is really surprising Dr. Harris doesn’t realize this, even if Representative Harris feels compelled to advance the standard right wing attack against science that discomforts their constituencies of Big Business and Social Conservative Theocrats.
The final agenda item of Rep Harris is, I believe, the true agenda. The bone thrown to young investigators is only a sweetener, I would bet. He wants to end the “tap”.
For one thing, we need to eliminate a budget gimmick, known as the “tap,” that allows the Department of Health and Human Services to shift money out of the N.I.H. budget into other department efforts. The N.I.H. lost $700 million to the “tap” in 2013 alone. Instead, the money should be placed under the control of the N.I.H. director, with an explicit instruction that it go to young investigators as a supplement to money already being spent. If we don’t force the N.I.H. to spend it on young investigators, history has shown that the agency won’t.
And what is this, you ask? Datahound to the rescue:
DJMH: The HHS Secretary has the authority to transfer funds for Program Evaluation. This has been down routinely for more than a decade to fund AHRQ and other agencies and to support program evaluation at NIH.
See http://www.nih.gov/about/director/crsrept.pdf
The NIH and other Public Health Service agencies within HHS are subject to
a budget “tap” called the PHS Program Evaluation Transfer, authorized by section
241 of the PHS Act (42 U.S.C. § 238j). It is used to fund not only program
evaluation activities, but also functions that are seen as having benefits across the
Public Health Service, such as the National Center for Health Statistics in CDC and
the entire budget of the Agency for Healthcare Research and Quality. These and
other uses of the evaluation tap by the appropriators have the effect of redistributing
appropriated funds among PHS agencies. The FY2005 and FY2006 L-HHS-ED
appropriations set the tap at 2.4%, as does the FY2007 Senate bill. The House bill
returns the maximum tap to 1.0%, the level specified in the PHS Act. Since NIH has
the largest budget among the PHS agencies, it becomes the largest “donor” of
program evaluation funds and is a relatively minor recipient.
Okay….you think to yourself, why would a Republican Congressman be so het up over this? Well, if you do some judicious googling about AHRQ you find things like this.
The U.S. House Committee on Appropriations released their draft 2013 Labor, Health and Human Services funding bill. In their summary, the number one stated intent is the following:
“Defunding ObamaCare – The legislation contains several provisions to stop the implementation of ObamaCare…One extreme cut that was thrown in the draft was not just defunding, but total termination of the Agency for Healthcare Research and Quality, a tiny agency under the Department of Health and Human Services. AHRQ has a budget of $405 million.
That looks to be more than half of the “tap” that Rep Harris wants to close. And this brings us to wonder if Dr. / Rep Harris has any opinions on the ACA?
Looks as though he is not a fan. Nope, not a fan. At all.
So, Dear Reader, I confess I come away from Rep Harris’ Op-Ed with a feeling that the true agenda here is a very familiar right-wing Republican one that goes after part of the Affordable Care Act and attempts to gain additional direct say over what grants the NIH funds. The part about supporting younger scientists is merely a convenient ploy to sweeten the deal and attract the unwary. I don’t believe it is the true purpose here.
DrugMonkey 