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Jewish World Review May 31, 2000 /26 Iyar, 5760

Morton Kondracke

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Investing Billions In Health Research Can Save Trillions -- FEDERALLY SPONSORED medical research costing billions of dollars already has saved hundreds of billions in medical outlays and could save trillions over time, two new studies indicate.

Reports by Congress' Joint Economic Committee and the advocacy group Funding First argue that doubling the budget of the National Institutes of Health over a five-year period would pay multiple dividends not only in lives saved but also in dollars.

The reports were issued as Congress considers whether to stay on track toward doubling NIH's budget with a $2.7 billion increase for fiscal 2001. NIH's current budget is $16 billion.

Prospects seem good that the additional $2.7 billion will be approved this year, but the five-year goal could use public endorsements from Vice President Al Gore and Texas Gov. George W. Bush (R). So far, they've only made favorable remarks privately.

As examples of past research success, the JEC report cited a $71 million research project on testicular cancer that has produced a 65 percent cure rate, saving about $180 million per year in medical bills and lost productivity.

A laser treatment for blindness caused by diabetes costs $181 million and saves nearly $1.5 billion a year. Medical alternatives to coronary bypass surgery, developed at a cost of $36 million, are saving between $400 million and $800 million a year, according to the report.

These are relatively small examples. The JEC report figures that antibiotic treatments for tuberculosis save $5 billion a year; the conquest of polio, $30 billion; depression drugs, $6.5 billion; and ulcer-fighting drugs, $600 million a year.

Partly because of federally backed research, the death rate from AIDS has fallen by 60 percent. Multi-drug "cocktails" cost up to $15,000 a year per patient, but hospital treatment for an advanced AIDS patient can cost $100,000 a year.

Tamoxifen, a breast cancer drug, costs $1,050 per victim a year, but the JEC study reported that the average cost when women undergo surgery or other invasive treatments is $14,000 a year.

The JEC calculated the direct cost of illness in the United States - meaning outlays for treatment - at $1.3 trillion and "indirect" costs at $1.7 trillion, including reduced ability to work and premature death.

"The NIH is fighting this $3 trillion battle with a budget of just $16 billion," said the JEC report, "less than one percent of annual illness costs."

Funding First, a group headed by former Sen. Mark Hatfield (R-Ore.), sponsored an ambitious set of studies designed to measure the economic value of the increased life expectancy rates produced by medical research.

Using various models, including the amounts that companies, individuals and governments will spend to alter the risk of death, the economists figured that Americans think it's worth between $3 million and $7 million to save a life.

Extrapolating, Funding First concluded that "increases in life expectancy in just the decades of the 1970s and 1980s were worth $57 trillion to Americans. The gains associated with the prevention and treatment of cardiovascular disease alone totaled $31 trillion."

The group also concluded that "medical research that reduced deaths from cancer by just one-fifth would be worth $10 trillion to Americans - double the national debt."

Cancer is one of the diseases that the JEC listed as among the "coming revolutions in medicine," where research is offering the promise of decisive progress toward cures. Directly and indirectly, cancer costs the economy about $110 billion a year.

I'm particularly interested in another "revolution" - in battling degenerative diseases of the brain, especially Parkinson's disease, which afflicts one million Americans and carries an estimated cost of $3 billion a year. As readers of this column know, my wife suffers from Parkinson's.

NIH has just issued a report saying prospects are good that the disease could be cured within five years if adequate resources are devoted to the research, estimated at $1 billion over five years starting with $71 million this year.

In the process of curing Parkinson's, NIH reported, progress could be made in conquering less-understood diseases such as Alzheimer's, Lou Gehrig's disease and spinal injuries.

This year, the Senate appears ready to approve the $2.7 billion increase for NIH as proposed by Sen. Arlen Specter (R-Pa.) and approved by the Senate Appropriations Committee.

The House Appropriations Committee, however, is calling for only a $1 billion increase. Last year, the House acceded to the Senate number and chances are good that the pattern will be repeated, according to research advocates.

What happens in future years, however, is open to question because two major boosters of medical research, Rep. John Porter (R-Ill.) and Sen. Connie Mack (R-Fla.), are both set to retire.

Mack, chairman of the JEC and a cancer survivors, said in issuing his report that "America landed a man on the moon. We pioneered computer technology. America won the cold war. Now it is time to win the war against the diseases that plague our society." Money can do it.

JWR contributor Morton Kondracke is executive editor of Roll Call, the newspaper of Capitol Hill. Send your comments to him by clicking here.


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