BUCKETS FOR BIOTERRORISM BUT LESS FOR CATALOG OF ILLS
10 Dec 2002
Source: New York Times, February 5, 2002.
Buckets for Bioterrorism, but Less for Catalog of Ills
By SHERYL GAY STOLBERG
WASHINGTON, Feb. 4 -- While President Bush is proposing a major increase in spending to defend against bioterrorism, other public health programs, like preventing chronic diseases and birth defects and controlling infectious diseases, would be cut under the 2003 budget the White House unveiled today.
Excluding money for bioterrorism, the federal Centers for Disease Control and Prevention, the nation's public health agency, would receive roughly a $340 million cut under the president's budget, bringing its nonbioterrorism budget to about $4.1 billion, down from more than $4.4 billion last year.
"To be perfectly candid with you, we had to make some tough decisions," Tommy G. Thompson, the secretary of health and human services, said this afternoon at a briefing.
Over all, the president is requesting $489 billion for the Health and Human Services Department, a 6.3 percent increase over 2002. The vast agency, which oversees the nation's welfare and Medicare programs as well as the National Institutes of Health, the Food and Drug Administration and the disease control centers, accounts for nearly one-quarter of all federal spending, Mr. Thompson said.
In his proposal, the president lives up to his commitment to complete a five-year initiative begun by the Clinton administration to double the budget of the National Institutes of Health. Mr. Bush has requested an increase of $3.7 billion, or 15.7 percent, for that agency, raising its overall budget to $27.4 billion.
Mark B. McClellan, a member of the president's Council of Economic Advisers, said the increase reflected Mr. Bush's belief that the institutes, which finance pioneering biomedical research, provide taxpayers with a high rate of return on their investment.
But the increase is not distributed evenly across the various institutes that make up the N.I.H. Nearly half of it, or $1.5 billion, is devoted to new research on bioterrorism, primarily at the National Institute on Allergy and Infectious Diseases.
That agency, which is trying to develop a new vaccine against anthrax, would receive the biggest raise, an increase of $1.4 billion over its $2.5 billion budget in 2002. The second-biggest increase would go to the National Cancer Institute, which would receive an additional $515 million, raising its total budget to $4.7 billion.
The budget calls for the disease control centers to spend $1.6 billion on bioterrorism preparedness next year. That is a decrease of $661 million from 2002, but the drop reflects the agency's purchase of $757 million worth of pharmaceuticals and vaccines, a one-time expenditure in the aftermath of the attacks on Sept. 11.
The disease control centers' bioterrorism budget includes $100 million for a new laboratory at the agency's branch in Fort Collins, Colo., as well as $940 million to improve state and local preparedness, the same amount the agency will spend in 2002.
While public health officials view bioterrorism preparedness as important, they cautioned today that it should not come at the expense of other programs. They note that just five Americans have been killed by bioterrorism over the last year, while thousands die each year of chronic illnesses and infectious diseases.
"We will be very concerned if we are funding one thing at the expense of another," said Dr. Georges C. Benjamin, president of the Association of State and Territorial Health Officials. "If you really want to push people towards better health, you have got to keep these programs in place."
At today's briefing, Mr. Thompson described himself as passionate about disease prevention, and he pledged that his agency would "aggressively take on preventing the onset of diseases such as diabetes," which can often be prevented through diet and exercise.
But the budget proposal calls for a $57 million cut in the disease control center's program for chronic disease prevention and health promotion. Infectious disease control, meanwhile, would be cut by $10 million, at a time when public health officials are particularly concerned about the threat of new and emerging infections.
Financing will remain flat for a number of programs, including those devoted to childhood immunization, environmental health, preventing birth defects, and sexually transmitted diseases, including AIDS.
Marsha Martin, executive director of AIDS Action, argued that Mr. Bush was sending "a clear message that our nation's public health has fallen off the administration's radar screen."
Ms. Martin added, "Homeland security also means investing in prevention and care services for people at risk and living with H.I.V."
The administration had already announced much of its major new spending for health care in today's budget, including $190 billion over 10 years to "modernize" Medicare and create a prescription drug benefit for the program's elderly beneficiaries.
Prospects for major action on Medicare are considered poor this year, given the deep divisions between Republicans and Democrats, budget constraints and the coming midterm election. Mr. Thompson said today, however, that he remained optimistic.
"I understand everyone has written the obituaries for Medicare reform this year," he said. "I haven't."
The administration repeated its proposal, first raised in the presidential campaign, to use tax credits to help the uninsured buy coverage -- $89 billion over 10 years. The White House also considers community health centers to be an important way of reaching the uninsured, and Mr. Thompson proposed a $114 million increase for such centers in the new budget, raising their financing to $1.5 billion.