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St. Louis region shows the budget priority fights confronting Trump, Congress

Dr. Timothy Eberlein, director of the Alvin J. Siteman Cancer Center at the Barnes-Jewish Hospital and Washington University in St. Louis (left) greets Sen. Roy Blunt, R-Mo. after a Senate hearing on medical research on March 8, 2017. (Photo by Chuck Raasch,St. Louis Post-Dispatch.)

WASHINGTON (AP) — As Congress confronts bottom-line priorities, the St. Louis region is a good example of how the spending choices it will make this year have competing, long-term effects. While members of the Congressional delegation have lauded President Donald Trump’s push to increase defense spending by $54 billion as good for weapons programs like the St. Louis-built Navy EA/18 Super Hornet jet, others caution that a defense boost should not come at the expense of increased funding for medical research at the National Institutes of Health. That is also an important regional factor because of major medical research institutions in St. Louis and its surrounding suburbs.

Researchers told a Senate hearing Wednesday that federal research spending is helping them make leapfrogging gains in everything from cancer research to development of a more effective flu vaccine.

 “I don’t see how (National Institutes of Health) funding would not be affected” if Trump’s spending priorities win out and Republicans repeal the Affordable Care Act, which had research funding attached, said Sen. Patty Murray, (D-Washington), the top Democrat on the Senate Appropriations Subcommittee that oversees NIH funding.

Sen. Roy Blunt, (R-Missouri), chairs that subcommittee, and he said after the hearing that he believes Trump does not have the votes necessary to stave off a filibuster in the Senate if his domestic cuts go too deeply. “I just don’t see 60 senators voting to do that and so I think the president is going to have to work with us to find some other way” to raise defense spending without cutting vital programs, Blunt said. “It doesn’t mean we can’t prioritize.”

Congress, led by Blunt and Murray among others, has recently done that in medical research. In 2015, it boosted NIH research funds by $2 billion, the first raise in a dozen years, and could raise it by another $2 billion this year if it passes spending bills left undone with a continuing resolution last fall.  It was paid for by eliminating almost three dozen other government programs.

The increase in medical research spending has been held out as one of the few areas where Democrats and Republicans got together on critical priorities in the final years of the Obama administration. Total spending for the medical research – at about $34 billion annually at NIH before the recent increases – could be boosted by another $4.4 billion a year if Blunt and Murray prevail, and through the additional $4.8 billion in spending over 10 years as prescribed by the 21st Century Cures Act signed into law late last year.

Dr. Timothy Eberlein, director of the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, was one of four researchers testifying before Blunt’s committee about recent gains in medical research.

Washington University provided about 25 percent of the final code of the breakthrough Human Genome Project, Eberlein said. That scientific mapping of human genes has put medicine “on the cusp of fundamentally changing how we think about treating cancer by using targeted therapies that avoid unnecessary expensive treatments,” he said.

Eberlein said that “by combining genomic mutational analysis of an individual’s cancer, we are now doing clinical trials that treat many solid tumors such as breast, brain, melanoma, lung and head cancers using a vaccine tailored to eradicate the patient’s scientific tumor with minimal side effects and morbidity.”

He said that as the research progresses, it may be possible to treat four out of five cancer patients with surgery and radiation therapy alone, foregoing expensive and often debilitating chemotherapy. That would greatly reduce health care costs, he said.

Testifying the first time before Congress, Eberlein said that “we need sustained, stable federal support to get there.”

Sen. Dick Durbin, (D-Illinois), another member of the subcommittee, said he was worried that the pressure to cut domestic spending to fund Trump’s defense boost could derail bipartisan accord that increased federal funding for medical research leads to substantial cuts in health-care costs down the road.

“If it comes at the expense of some funding like medical research, then we are not really serving the people we represent,” Durbin said.

Blunt cited a study that predicted that the United States could eventually spend twice what it now spends on defense just to take care of Alzheimer’s patients.

Dr. Thomas Grabowski, Jr., director of the Integrated Brain Imaging Center at the University of Washington, said that if researchers can find ways to slow the onset and progression of Alzheimer’s by five years through early intervention and “precision medicine” similar to what has been used to fight cancer, “we would cut Alzheimer’s dementia in half,” and with it, cut by half the cost of treating those with the disease.

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St. Louis region shows the budget priority fights confronting Trump, Congress