The Government Shutdown, Sequestration & The Future of Medical Research

As you know, these are concerning times. It’s hard to comprehend that the government of the United States of America has been closed for business for nearly a week now. Recently, I had occasion to meet with colleagues in three different settings to discuss common and pressing concerns. The day before the shutdown, I met with the advisory board to the director of the Clinical Center at the NIH. A few days earlier, I met with the board of the Association of Academic Health Centers and before that with a collective of CEOs of major health-related organizations. All of us are deeply concerned about what awaits with respect to federal funding for research, the Affordable Care Act, Health Care Exchanges and more. I imagine these topics are top of mind for you, as well.

Notably, at present, our Health System is in an enviable position, given that most of my colleagues said that their hospitals are seeing a drop in census to 60 percent or less, as well as decreasing revenue. We, on the other hand, grapple with challenges of high demand and have markedly recovered from the financial challenges of last year. This isn’t by happenstance or luck. Our high census is because of our excellent reputation and the outstanding care we provide. And our current financial stability is because of your deliberate and conscientious efforts to see more patients, control resources and improve workflow – all while improving patient satisfaction scores to their highest levels ever. We should take great pride in this, but, at the same time, we must continue to be diligent and focused as we navigate ongoing challenges, such as the current government shutdown and sequestration.

promoimageThis weekend, I shared our concerns in the Detroit Free Press about the $1.5 billion cut to National Institute of Health funding because of sequestration, along with the shutdown (Article). We continue to monitor the impact on our Health System now and in the long term. While current grants have been safe, researchers preparing to submit applications for new grants — including a large number who expected to submit applications in time for a major October 5 deadline – are on hold until the shutdown ends. This may lead to delays in obtaining funding and starting research. Clinical trials already under way at UMHS are continuing, though there may be some slowing in cases where federal agencies process experimental drugs. Some research funded by federal contracts has stopped or may need to, including that of a seven-person team analyzing data from the 2009 pandemic H1N1 flu outbreak for the Centers for Disease Control and Prevention. This group has been told to cease all activities on this project when flu season is right around the corner.

But even without these new threats, it has already been difficult for scientists to get crucial funding for new discoveries. In fiscal year 2013, despite overall growth in federal research funding, NIH funding to U-M fell 1.8 percent. That represents a $9.6 million cut, a significant reduction for those hoping to discover new cures and treatments.

This is a problematic trend. NIH is by far the university’s largest research sponsor, amounting to $509.7 million last year, or more than 38 percent of the total research budget at U-M. And it’s the research conducted on campuses like ours that develops the people and ideas that drive the creation of new products and services, new companies and new industries.

With research funding at risk, research itself is at risk, as is our standing as a global leader in medical innovation. While the rest of the world increases spending for crucial biomedical research — spending is up 20 percent in China and India and 10 percent in Japan and Brazil — U. S. funding has dropped 5 percent. We are falling behind in research spending, and the impact is potentially devastating for our nation’s physical and economic health.

It’s important to note that medical research is a major economic driver, too. The U.S. government invested $3.8 billion in the Human Genome Project and achieved an estimated return on investment of $141 for every dollar spent. That work laid the foundation for significant advances in molecular medicine, energy, bioarchaeology, DNA forensics and even agriculture. According to Robert Wood Johnson Foundation studies, preventing just 5 percent of new cases of chronic conditions would reduce Medicare and Medicaid spending by nearly $5.5 billion each year by 2030. The Information Technology & Innovation Foundation estimates that the impact of sequestration on research will be a loss of up to $200 billion in our GDP over several years.

When we stop investing in research, we’re saying that we as a nation are no longer committed to leading the world in discovery and being on the cutting edge of medical science. We’re saying that we are okay with the fact that our nation — a nation built on pioneering innovation — will no longer be in the lead. We’re saying that we are comfortable becoming increasingly reliant on other nations to develop and produce new drugs, therapies and treatments, even if those nations have different and potentially less stringent regulatory requirements. We’re saying that we are okay with discouraging some of our most prolific and innovative minds from pursuing careers in science and biomedical research because we have decided against funding this work.

Science moves the world forward and medical research offers limitless potential to improve lives and communities. Academic health centers and research institutions like ours are where life-changing science happens. Like you, I take immense pride in being part of the University of Michigan Health System because it means being part of a passionate commitment to making the world a better place, one discovery, one encounter, one family and one patient at a time.