American health sciences are not faring well in an initial draft of President Trump's 2018 budget proposal. Released Thursday night, the draft proposal includes a $US5.8 billion ($7.6 billion) cut to the National Institutes of Health, accounting for nearly 20 per cent of its entire budget. The Department of Health and Human Service, which includes the NIH, FDA, Indian Health Service and the Centres for Medicare & Medicaid Services, was earmarked for $US15.1 billion ($19.7 billion) in cuts. And the National Science Foundation, which awards billions in research grants each year, was nowhere to be seen.
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Before the dread sinks too deeply into the pit of your stomach, it's important to remember that this is just a blueprint. We won't see a full draft of Trump's budget until May, and after that, it's really Congress that ultimately decides how to spend the federal government's money. No US federal budget in recent history has gotten the Congressional stamp of approval without a significant amount of argument and compromise.
But this preliminary outline of the nation's future spending is a good indicator of where Trump's priorities are. And if the Republican's disastrous Obamacare replacement plan wasn't already proof enough, it seems pretty clear that the health of Americans is not all that high up on the list.
The proposed NIH budget, for one, would mean deep cuts to biomedical research funding — basic science that leads to breakthroughs in treating disease. The federal government funds somewhere around 60 per cent of all scientific research in the US, and much of that funding comes from the NIH and the NSF. Slashing the NIH's budget would likely slow the pace of scientific research, at a time where grant competition has already intensified as funding for research has essentially plateaued.
The plan calls for a "major reorganisation" of the 27 NIH institutes and centres. It does not delve into many specifics about what those changes would look like, other than abolishing the Fogarty International Center, a $US69.1 million ($90.1 million) program devoted to establishing health research partnerships with other nations, and folding the freestanding Agency for Healthcare Research and Quality into the NIH.
The NIH typically receives bipartisan support. In the 2017 fiscal year, which began in October, it was set to receive an up to $US2 billion ($2.6 billion) increase to its $US32 billion ($41.7 billion) 2016 budget, though federal spending has been frozen at 2016 levels as Congress has been unable to finish its 2017 plan.
The NIH accounts for a large slice of the HHS' proposed budget cuts.
The draft budget would also increase spending on substance-abuse services by $US500 million ($652.1 million) to deal with the opioid addiction crisis. It calls for the creation of an emergency fund to respond to disease outbreaks, though does not detail how much money would be set aside for it or where that money might come from.
The draft does not specifically account for the National Science Foundation, which has a budget of $US7.5 billion ($9.8 billion), though it might fall under a miscellaneous spending category that has not yet been detailed. Also absent from this draft were details on Medicare and Medicaid funding.
These proposed cuts to vital health and science institutions are, of course, in addition to deep cuts at the EPA and NOAA. Together, the blow to science helps Trump achieve the $US54 billion ($70.4 billion) cut necessary to offset his proposed rise in military spending, to $US603 billion ($786.5 billion) in 2018.
All that defence spending, though, might start to feel a little silly when Americans are all sick and dying because they failed to fund the agencies that protect their health.