Today, we will review the mission and programs of several of the major health agencies under the purview of this subcommittee. I hope this discussion will serve to demonstrate the irrationality of the budget policies currently being pursued by the House majority.
"Today, we will review the mission and programs of several of the major health agencies under the purview of this subcommittee. I hope this discussion will serve to demonstrate the irrationality of the budget policies currently being pursued by the House majority.
"The agencies here today accomplish work that is critical to the heath of all of us. This includes the basic medical research supported by NIH, CDC's efforts to detect and control dangerous diseases, HRSA's programs to expand access to health care, and AHRQ's work to improve the quality of health care. It also includes the research and demonstration work of CMS that tries to develop ways of delivering better and more effective health care at the same or lower cost.
"Much of this work is also vital to the health of the economy. For example, independent of all the many health benefits, NIH research is vital to maintaining our nation's leadership in emerging fields like biotechnology that mean good jobs and economic growth.
"According to one estimate, every dollar invested in NIH generates well over two dollars in economic activity.
"Many of the things these agencies do also help to reduce health-related costs while improving health. For example, AHRQ studies how to deliver health care more effectively, and both AHRQ and NIH sponsor research into which treatments work best for which patients.
"CDC supports screening for diseases like cancer and HIV, education and outreach to help people better manage chronic conditions like diabetes and asthma, and efforts to expand immunizations that can prevent serious infectious diseases.
"HRSA works to expand the availability of primary care in underserved rural and urban communities - care designed to find and treat problems before they become crises. HRSA also works to expand the number of health professionals delivering that primary care in the places where they are most needed.
"Despite the importance of these and other missions, the budgets for many of these programs have seriously eroded over the last decade. In many cases funding has failed to keep up with costs, and for some programs funding has been cut in actual dollar terms.
"For NIH, the purchasing power of its appropriation has dropped about 16 percent since 2003, after adjustment for rising costs of biomedical research. The number of NIH research project grants has fallen from a peak of just over 37,000 in 2004 to about 34,600 last year.
"NIH's work alleviates pain and saves lives, which is why we worked together in a bipartisan way to provide the funding that made it the gold standard for biomedical research not only in the United States, but in the world. But we are now in jeopardy of ceding that leadership to other countries.
"At HRSA, the basic health professions training programs have been cut by $37 million since FY 2010 - and that is in actual dollars, before any adjustment for costs or need. Discretionary appropriations for health centers are down $623 million - 28 percent - since FY 2010.
"Thankfully, that cut has been offset with funds made available through the Affordable Care Act. But the intended purpose of those funds was to expand sources of primary care, not backfill for cuts in appropriations for ongoing operations.
"Adjusted for inflation and population growth, the overall HRSA appropriation has lost $2 billion in purchasing power since 2002.
"At CDC, discretionary funding is down by more than $700 million since FY 2010, including cuts of $149 million to chronic disease prevention programs and $104 million to programs that improve the capacity of state and local health departments to respond to emergencies.
"Under the ten-year caps on discretionary spending that are already in law, it will be extremely difficult to turn this situation around. In fact, before the decade is out, the cuts we have made will take non-defense discretionary spending to the lowest level as a share of GDP on record, and records go back 50 years. Yet, some people are demanding further reductions in the caps, which would mean the shortfalls just get worse.
"And because the Majority refused to act last week, we now have sequestration - an indiscriminate five percent cut to everything, on top of all these cuts that have already been made. The sequester will take another $1.55 billion from NIH, $325 million from CDC, and so on. All of this will be bad for the health and well-being of American families.
"So I hope our witnesses today will convey to us what their agencies do, why it is important, and how their efforts will be impacted by all the cuts on the table. Thank you. I look forward to your testimony."
Source: U.S. Department of HCA
