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Americans are living longer, more productive lives thanks to advances directly stemming from federally funded medical research. Death rates from coronary heart disease and stroke have dropped 60 percent in the past 50 years, and the proportion of older people with chronic disabilities has dropped by nearly one-third in the past 25 years as a result of this research. Today, for people waiting for life-altering cures and treatments for cancer, Alzheimer’s disease, and diabetes, research means hope. While sustained growth in federal support for medical research is essential, so, too, is a talented and diverse biomedical research workforce.
A provision in the House Appropriations Committee’s Fiscal Year 2016 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill shows that while members of Congress understand the importance of medical research by increasing funding for the National Institutes of Health, they would undermine the very research workforce that will turn that funding into tomorrow’s cures.
Specifically, the House bill proposes to reduce the salary limit for researchers at medical schools and universities funded by the Department of Health and Human Services. Under the FY 2016 Labor-HHS appropriations bill passed by the House Appropriations Committee on June 24, the salary limit would be reduced to Level III of the Federal Executive Salary Schedule—an 8 percent decrease in the maximum amount that the NIH can provide to a research institution to support an investigator’s salary. This cut follows a 10 percent reduction mandated in the FY 2012 Labor-HHS funding bill.
Researchers are the core of the entire medical research enterprise, and without them, countless patients face longer odds of survival or protracted treatment and recovery times. Lowering the extramural salary limit particularly disadvantages the most productive investigators, who have a sustained track record in breakthrough discoveries, and will have a chilling effect on the ability of research institutions to recruit and retain gifted scientists. The cut is an especially powerful deterrent to recruiting physicians—such as surgeons, oncologists, cardiologists, psychiatrists, and other specialists—into research at a time when the NIH itself has raised alarms about too few new physicians entering research careers. Physician scientists, after all, are essential to transferring laboratory-based discoveries safely to patients and bringing clinical observations back to the laboratory.
The nation’s medical schools and teaching hospitals—institutions that conduct half of all extramural research funded by the NIH—assume a disproportionate share of the burden from the reduced salary caps. This proposal forces schools and hospitals to make up the difference between a researcher’s actual salary and the amount reimbursed for time spent on research projects. Moreover, it comes at a time when research institutions’ discretionary funds from clinical revenues and other sources are increasingly constrained. The additional stress on institutional budgets would mean fewer resources would be available to support research efforts.
For example, as institutions and departments draw more from internal funds such as clinical revenue to make up for reduced salary stipends, they will have less funding for critical activities such as providing bridge funding to investigators who may be between grants and offering seed grants and start-up packages for young investigators. A recently published study found that in 2013, medical schools invested 53 cents of their own funding for each dollar of external research support they received. Reducing the salary limit on NIH grants will force these institutions to spend even more.
The United States has created an environment where research thrives and the world’s brightest minds advance medicine in ways that seemed impossible just years ago, but we must continue to nurture this environment. It is essential to our nation’s long-term health and standing in the global research economy that we adopt policies to ensure that American research institutions retain the most talented, productive, and diverse group of biomedical and behavioral researchers. This is not the time to step back.
Ann C. Bonham, PhD, is the Chief Science Officer for the Association of American Medical Colleges.