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Federal Cancer Policy: The Big Picture and its Consequences
By Greg Brozeit

The cancer community needs to reverse the current decline in the federal commitment to research and ensure that cancer patients receive fair benefits when the prescription drug benefit of the Medicare Modernization Act goes into effect in 2006. This week we examine administration’s fiscal year 2006 budget proposal and recent revelations about the increasing costs for the Medicare program.

In the coming weeks Myeloma Minute Advocacy section will outline issues and action plans including:

  • How to better understand the federal legislative process and political environment.
  • How to communicate our common goals to Congress, the administration, and the public.
  • How to strengthen and work with effective coalitions.

Federal Cancer Policy: Budget Proposal Disappoints

Funding for medical and cancer research in the administration’s fiscal year 2006 budget proposal dramatically worsens a declining trend in federal support. Released on February 7, 2005, it recommends:

  • For the National Institutes of Health (NIH), $28.845 billion, an increase of $196 million (0.68%). 
  • For the National Cancer Institute (NCI), 4.842 billion, an increase of $17 million (0.35%).
  • The total number of NIH grants will decrease from 39,148 to 38,746, an overall decrease of 402 grants.

These figures are disheartening considering the administration’s previously-stated goal of eliminating suffering and death due to cancer by the year 2015. President Bush and Congress deserve our thanks for completing the doubling of the budget of NIH between the years 1998-2003. Those increases alone, however, will not achieve the 2015 goal.

In the two years since the completion of the doubling, federal spending for medical and cancer research has increased by an average of about 2% in each of the past two years. However, due to inflation, previously designated spending for projects, and other administrative costs to streamline NIH, the minimal increases have translated into decreasing research activity. The bottom line is: When these obligations are met, less is left over to do new research.

President Bush said, “In order to win the war against cancer, we must fund the war against cancer,” in announcing his intention to complete the five-year doubling of the NIH budget on September 22, 2002. When then-candidate Governor Bush invoked the spirit of President Kennedy’s stirring vision for the space age in calling for “a medical moon shot to reach far beyond what seems possible today and discover new cures for age-old afflictions,” it gave hope to disease research advocates throughout the world.

It is clear that the current budget proposal will not accomplish these lofty goals. Since the administration’s budget proposal serves as a template for Congress, we must begin now to change the minds of those in Washington to once again make cancer research a national priority. This is the beginning, not the end, of a long, logical process. 

The One Voice Against Cancer Coalition ( OVAC ) issued a statement, “share[ing] the Administration’s goal of eliminating suffering and death from cancer by the year 2015. The groups within OVAC are therefore extremely disappointed with the President’s FY 2006 budget proposal, which falls well short of what is needed to reach that goal in the areas of cancer research, education, prevention, awareness, treatment and control. 

“While we are still reviewing the details of the proposal, we will work hard to convince Congress and the Administration to adopt the community’s suggestions, which are based on the professional judgment of those working in the trenches to make that 2015 goal a reality.”

To learn more about this issue, see the New York Times article: Bush Budget Calls for Cuts in Health Services.

Federal Cancer Policy: Medicare Estimates Continue to Rise

Centers for Medicare and Medicaid Services (CMS) Administrator Mark McClellan confirmed the revised cost estimates for the new Medicaid prescription could be as high as $1.2 trillion over ten years according to a Washington Post report. This figure is three times the original cost estimate of $400 billion that was approved when President Bush signed the bill into law in late 2003.

The New York Times reported that the administration’s estimates over 10 years at $720 billion. The lower figure as compared to the Washington Post report was explained as a cost savings through better information technology and expected cost changes due to the expectation of better and more efficient therapies that are expected to come to market in the next 10 years.

However, if federal support for research wanes, as the administration’s budget recommends, the question remains how CMS can achieve that goal. Questions still need to be answered about the type and range of drugs that will be covered, especially for cancer patients.

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