PHILADELPHIA -- A new Congressional Budget Office (CBO) report detailing possible targets for deficit-reducing funding cuts includes
Photo: NIH
The National Institutes of Health is the country's largest source of scholarly research grants.
both an option for slashing National Institutes of Health (NIH) grants for scholarly research and support for graduate medical education.
The 256-page document "Reducing the Deficit: Spending and Revenue Options" is a working paper for various House and Senate members and committees exploring ways to dramatically reduce the budget -- particularly those portions of it related to health care. [Download the document]
3,000 institutions
The NIH is the Godzilla of funding for the nation's sprawling community of health care-related researchers. Eighty percent of its $31 billion annual budget underwrites research grants for more than 350,000 scholars at more than 3,000 universities, medical schools, and research institutions.
An additional 10 percent of its budget funds NIH's own in-house research projects conducted by more than 5,000 scholars and scientists.
More than half of all the federal government's non-defense discretionary spending on health-related research and development is consumed by the NIH's 27 different institutes and centers.
'Inefficiencies' and 'wasteful efforts'
The CBO report points out that the NIH budget has tripled from 1997 to 2010 and that "with such a broad range of personnel
The CBO working paper explors ways to dramatically reduce spending. Click image to download document.
and activities and a large increase in funding, inefficiencies and duplicative or wasteful efforts are likely... Thus some costs would probably be reduced or eliminated without harming high-priority research."
But the report also argues that "Reducing NIH's funding would probably result in decreased support for extramural research" and "deep cuts to its budget could disrupt funding for (academic research) programs already underway."
Another section of the report suggests that $69 billion could be saved over the 2012-2021 period by greatly reducing federal payments that underwrite graduate medical education (GME) at teaching hospitals.
$10 billion a year
The CBO estimates that $10 billion in federal funds were spent to support educational activities at academic medical centers in 2010. It's report argues that CME funding cuts are justified because "federal payments under current law exceed hospitals' actual teaching costs."
The report cites a Medicare Payment Advisory Commission (MedPAC) analysis that concluded cuts in the CME funding program would not "unduly affect hospitals' teaching activities." Elsewhere the CBO also says that as a result of the cuts "residents would bear more of the cost of their medical training.
In a section arguing against such CME cuts, the CBO authors note that "to the extent that some teaching hospitals use a portion of their additional payments to fund care for the uninsured individuals, decreasing those payments could reduce the number of patients that hospitals treat or lower the quality of care that those hospitals provide."
