The proof is in the budgeting

When we last discussed Representative Andy Harris it was in the wake of an editorial he published in the NYT. It consisted of a call to put hard targets on the NIH for reducing the average age of the first R01, standard Golden Fleece style carping about frivolous research projects and a $700M “tap” of the NIH budget. I speculated that this last was the real target because the “tap” is money appropriated to the NIH that then goes to “program evaluation” and the AHRQ. There is the possibility that this is a covert attack on the ACA (“Obamacare”).

The recent appropriation to the NIH passed by the Congress is interesting because it addresses these three issues. According to Jocelyn Kaiser at ScienceInsider:

The report also directs NIH to pay more attention to the age at which new NIH investigators receive their first research grant… but lacks that specific target.

So toothless verbiage, but no more.

Lawmakers also address a perennial concern: that the amount NIH spends on specific diseases doesn’t take into account the burden that disease creates or death rates. The report “urges NIH to ensure research dollars are invested in areas in which American lives may be improved.” It also tells NIH “to prioritize Federal funds for medical research over outreach and education,”

“urges”. Again, this is totally impotent. Two strikes on Rep Harris.

One recent concern about NIH’s budget—that each year some money is skimmed off for other Department of Health and Human Services (HHS) agencies—is remedied in the bill. It says that the $700 million that NIH is set to contribute to the “tap” this year will come back as $715 million for the agency.

Well that seems like Rep Harris got a win on the tap, no? And his goal was what again?

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.

“lost”. “supplement to money already being spent”. This creates the strong impression that Rep Harris was trying to increase the NIH budget by $700M. And yet. The overall NIH appropriation only increased by $150M.

So in point of fact Rep Harris took three strikes.

Or so it appears.

Of course, if his agenda was to go after those agencies that received their support from the tap, perhaps he didn’t strike out after all. We’ll have to see if those agencies got all their money in this budget and, more importantly, if they remain this way in subsequent years. It is not impossible that breaking the previous recipients of the “tap” down into individual line items in the budget will allow them to be eliminated one by one.

One thing is for sure, Rep Harris didn’t do anything concrete to help out the young investigator issue at the NIH in this budget appropriation.

UPDATE: Actually I screwed this up. If there is no net decrease in the budget and the NIH no longer loses $700M to the tap obligations, I guess this is a net gain. My bad.