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Fiscal cliff imperils medical research

Fiscal cliff imperils medical research Kenneth S. Polonsky, MD

In our last communication on these pages ("Implementing health care reform," Sept. 7), we discussed the monumental shifts in health care in this country. Results of the presidential election are hastening these changes, and the national debate is focusing on how to provide access to medical care for uninsured Americans while controlling costs. Heightening the urgency of cost containment is the looming fiscal cliff of spending cuts and tax increases.

Amid all this, one critical element that has received insufficient attention is the need to protect our investment in biomedical innovation and to make scientific discovery a centerpiece of our health care system.

The United States is the world leader in medical science, and many of the discoveries that drive advances in patient care and health outcomes are made at universities and medical schools. The payoff from scientific discoveries is boundless.

For example, statins, drugs used by millions of Americans to lower cholesterol levels and the risk of heart disease, resulted from basic research at a U.S. university.

At the University of Chicago Medicine, clinician-scientists have developed novel approaches to head and neck cancer treatment that substantially improve patient survival. They are studying the DNA of cancer to tailor therapies to individual patients, making treatments more effective and less toxic. They are using genetic methods to identify children with diabetes who can be treated with oral medication rather than insulin injections, enhancing metabolic control and quality of life. After the Center for Care and Discovery opens in 2013, they will be in an even better position to translate research discoveries into improved care for patients.

Beyond public-health benefits, scientific discovery also stimulates local economies, particularly in Chicago, which boasts outstanding research universities.

Less than 1 percent of the country's $2.5 trillion health care tab is spent by the National Institutes of Health on biomedical research. Yet, NIH funding helped to generate about 500,000 jobs and $68 billion in new economic activity in 2010, according to United for Medical Research, a coalition of biomedical research advocates. Last year in Illinois, $779 million in NIH grants, including $198 million to the University of Chicago Medicine, supported nearly 15,000 jobs.

But all that is threatened. Proposed federal spending cuts would slash more than 8 percent from the NIH budget. The negative impact these cuts would have on science cannot be underestimated. Adjusting for the rate of inflation in the medical research sector, the NIH has lost ground over the past 10 years, and the number of project grants has dropped annually since 2004. This all translates to fewer jobs, fewer scientists and physicians choosing medical research as a career, and fewer discoveries that can improve human health.

We have the opportunity to reinvent the largest health care system in the world, to make it more efficient and more responsive to the needs of patients. However, unless we continue to invest in our biomedical research enterprise and to deliver scientific breakthroughs that lead to prevention, diagnosis and treatment of disease, the new health care system will fall short of its full potential and public health will suffer.

Kenneth S. Polonsky, MD
Executive Vice President for Medical Affairs, University of Chicago
Dean, Biological Sciences Division and Pritzker School of Medicine

A version of this article originally ran in the Chicago Tribune on November 30, 2012.