Cutbacks Threaten Biomedical Research

Article excerpt

Biomedical research, long considered a cornerstone of American medicine, threatens to become a silent casualty of the reorganization of the country's health care system, caught between the nation's relentless search for cheaper medical care and budget-cutting fervor among politicians.

American research has produced myriad discoveries _ from new treatments for strokes to drugs for premature babies with damaged lungs.

But in today's lean times, nobody seems able or willing to pay for it: not legislators intent on balancing budgets; not hospitals whose revenues are shrinking in an age of managed care; not the new breed of for-profit health maintenance organizations that will pay hospitals to treat their clients, but not a penny more.

Most research takes place at medical schools and hospitals, where it is paid for by a crazy quilt of sources. Billions of dollars each year from the National Institutes of Health are supplemented by millions more from medical schools, hospitals, insurers, corporations and foundations. And today, all these sources are declining.

"What is happening now is a nightmare," said Dr. Herbert Pardes, dean of Columbia University's medical school. "Every funding stream we have used to pay for research is being hacked apart."

The drying up of research money will hit particularly hard in New York City, with its half-dozen huge medical centers, each chock full of laboratories. Each plays host to an army of research physicians and other scientists who received more than $600 million from the National Institutes of Health last year.

In the corridors of New York's medical centers, the signs of trouble are everywhere: longtime researchers quitting their labs to enter private practice, discouraged young doctors unable to find research money or jobs, prestigious medical schools unable to afford to hire the researchers that they welcomed just three years ago. More and more, the hospitals are requiring the researchers who are also physicians to pay their own way, seeing patients in clinics part time to bring in money.

Health economists say the repercussions will be felt outside the lab as well, as technicians are dismissed from shrinking projects, successful scientists move out of state and the city's medical centers become unable to pay their bills. Part of each researcher's grant goes to the medical center to subsidize the more mundane aspects of maintaining its infrastructure, like covering heating bills and paying janitors. …