J. Evan Sadler, MD, PhD
The U.S. economy is suffering, job growth is inadequate, unemployment continues at 9.8 percent, and voters clearly want the situation to change — the mid-term elections have shifted the landscape dramatically. Approximately 35 new members of the House and four senators have not previously held any elected office — numbers not approached since 1948 — and they are bound to shake things up.
What does the nation expect and want? Historically, support for biomedical research has always been strong and funding for it has been protected by all previous administrations, but the new Congress may change direction in response to demands by new Members of Congress for smaller budget deficits and less government spending. For example, we’ve heard proposals to decrease most non-defense discretionary spending by 20 percent, to 2008 levels, which represents a decrease of about $100 billion. Disbanding the National Science Foundation (NSF) has been mentioned as one component of this package, and the National Institutes of Health (NIH) is prudently preparing for substantial budget reductions. Most agree that such cuts would have a trivial impact on budget deficits. Even so, the desire to appear fiscally responsible could overwhelm the traditional bipartisan enthusiasm for basic research. Given the widespread financial hardship affecting so many citizens, the resulting damage to biomedical research may not garner much attention.
The clinical practice of hematology also faces uncertainty. Congress still must find and agree to a long-term solution to physician payment. Practices must now adapt to new health-care delivery models, such as Accountable Care Organizations and Patient-Centered Medical Homes. There will also be increased pressure on physician practices to reduce costs and increase quality of care.
Despite these concerns, there never has been a more promising time for hematology research, whether basic, translational, or clinical. Thanks to advances in the past few decades, the tools available today make it possible to address fundamental questions that once could barely be stated, and the pace of discovery has been astonishing. Few would deny that basic research is the engine of discovery and that preeminence in such discoveries underlies our country’s dominance in biotechnology and other health-related industries. Faced with tough budgetary choices, we should not inadvertently cede our leadership in medical discovery, which is the foundation for advances in medical care.
What can ASH do? Of course we can sustain our support for research and clinical training at all levels, continue disseminating advances in hematology research in Blood and through our portfolio of scientific meetings, and meet with leaders at NIH to develop promising avenues for future research. But the critical decisions about national priorities are made on Capitol Hill and by voting citizens. ASH is engaged at this frontier as well, through the Committee on Government Affairs and the Grassroots Network, to inform Congress and the public. The influx of so many new faces at all levels of government adds a new challenge: we’re strangers to each other. If you know these new legislators, whatever their political affiliation, get involved — we need your help to ensure that ASH remains a trusted resource to inform policy decisions on hematology research and patient care.
To join the Grassroots Network and the Society’s advocacy efforts, please contact firstname.lastname@example.org visit http://grassroots.hematology.org/blood/home.
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