A weekly advocacy message from Mary Woolley: Investment in stronger defense and stronger public health
Dear Research Advocate:
The short answer to what defense and public health have in common is that they are critical long-term investments for the nation. We have been hearing a lot of talk about funding increased investment in defense by taking it "off budget," and now former House Majority Leader, Eric Cantor, is calling for the same approach for investment in research. Cantor made the case today in the Huffington Post for increasing non-defense discretionary spending, specifically by increasing scientific and medical research, citing the “stimulative” economic power of innovation and basic research. Former Majority Leader Cantor’s call may resonate particularly strongly in the current Congress, as members - including Reps. Matt Salmon (R-AZ-05), Kevin Yoder (R-KS-03) and other fiscal conservatives - have also asserted the need to increase NIH funding.
Just in time to get a conversation on the value of long-term investment in health on the radar screen, the American Public Health Association (APHA) is making a powerful case for achieving a healthier nation. Focusing on a different theme each day this week, APHA calls for individual and collective action to elevate the United States from its dismal ranking among peer nations across a range of health indicators. They’ve launched a campaign called “Public Health Nation” to keep the conversation going. Among the dismal statistics APHA cites: the U.S. ranks 34th among peer nations in life expectancy. We are the wealthiest nation, but definitely not the healthiest. Public opinion polls we have commissioned indicate that the public knows something’s wrong, only about a quarter believe the U.S. health care system is the best in the world (January 2015 poll). Read more on the APHA's Public Health Nation campaign here, and check out the guest blog from APHA Executive Director and Research!America board member Dr. Georges Benjamin.
To be sure, public health bears directly on national defense. Shock about the high percentage of recruits deemed unfit for military service alerted the nation some years ago that a healthy populace is a necessary component of a strong defense; this is still an issue of concern, but the wake up call is broader than assuring healthy recruits. Our readiness to combat bioterrorism, pandemics, and even military assaults to our homeland, hinges on the effectiveness of our public health system. We mostly take public health readiness for granted, criticizing it for being less than robust when it is tested; so it requires enlightened leadership and public support to assure it receives a high priority in funding support. As is true for our military defense, we have to be ready to do public health battle on more than one front at a time, whether Ebola or antimicrobial resistance or TB or anthrax, or all of these and more at once.
In this context, it is eye-opening to compare defense spending to public health spending. Let’s look at FY14: Spending at the Department of Health and Human Services for NIH, CDC, AHRQ, SAMHSA, HRSA and other public health-related agencies and programs (but not including entitlement spending) totaled $47 billion, a big number but a number requiring context. It shocked me to discover how federal public health spending compares to defense spending (DOD plus international security assistance spending was $615 billion). In other words, less than 15 percent of what we spend on defense is spent on public health, broadly defined. Mr. Cantor is right: if we can find a way to pay for a robust commitment to defense, we can and should do the same for research and innovation that will help deliver better public health.
Congress comes back in session next week. Time to talk about defense of the nation in broad terms.
Please mark your calendars for April 28, when AcademyHealth, Research!America, American Heart Association and WomenHeart are sponsoring a briefing on Capitol Hill on the various types of research powering the discovery, development, delivery pipeline through the prism of cardiovascular care. Find a flyer about the briefing here.