Attacks on science are nothing new in our society. Physicians, public health officials and others in health care have been pushing back against antivaccine myths -- often perpetuated by celebrities with no background in science or medicine -- for years.
John Meigs, M.D.
More recently, a handful of professional basketball players touted the idea that the earth is flat(www.denverpost.com). That was almost comical, and one of the athletes did, indeed, later say he was joking.
But there's nothing funny about a far more sinister -- and potentially devastating -- scheme to damage science, research and medicine in the United States. And this plan's source isn't as easily dismissed as a D-list actress. These attacks are coming from our own federal government.
President Trump recently released a budget blueprint that seeks to increase defense spending by $54 billion at the expense of nearly everything else. The outrageous proposal prompted one Nobel Prize-winning scientist to ask, "When Did We Start to Value Killing Over Living?"(time.com)
The administration's proposal makes across-the-board cuts to an array of agencies that impact health:
- The HHS budget would be sliced by 18 percent, or $15 billion, including millions of dollars that would be diverted from the CDC and given to the states.
- NIH funding also would be cut 18 percent, or roughly $6 billion. In addition, NIH would be forced to reorganize, and a center dedicated to global health likely would be eliminated.
- The Department of Energy's Office of Science -- which is responsible for genomic science research, among other things -- would take a $900 million cut.
- The Environmental Protection Agency is in line for a 31 percent cut that would eliminate dozens of programs.
If none of that hits close enough to home for you, consider what the administration has in mind for the Agency for Healthcare Research and Quality (AHRQ), the federal agency charged with improving the safety and quality of the U.S. health care system. The administration proposes folding AHRQ into NIH, where it likely would disappear(www.statnews.com).
Why does it matter? Here's one example(www.ahrq.gov): From 2010-13, AHRQ's research and tools related to medical errors helped the U.S. health care system prevent 1.3 million errors, saved 50,000 lives and avoided $12 billion in unnecessary spending.
In addition to research that helps a wide range of health care professionals make informed health decisions, AHRQ provides vital support to the U.S. Preventive Services Task Force(www.ahrq.gov) (USPSTF), which makes evidence-based recommendations specifically for primary care.
And although some of the agencies in line for cuts are massive, multibillion-dollar entities, AHRQ already is underfunded, with a budget of only $430 million per year, or 0.1 percent of the federal budget.
AHRQ has been on the chopping block before, and the AAFP has always and will always fight for it. AHRQ and the USPSTF provide guidelines and information we use every day to decide which tests, orders and/or treatments are right for our patients.
So what can we do about it? For starters, we can speak up. Earth Day is April 22, and the AAFP is one of more than 170 organizations supporting the March for Science in Washington, D.C., that day, as well as more than 400 contemporaneous satellite marches around the world that are intended to raise awareness of the "critical ongoing need for scientific evidence, education and investment."
March organizers say, "People who value science have remained silent for far too long in the face of policies that ignore scientific evidence and endanger both human life and the future of our world." They are calling on "political leaders and policymakers to enact evidence-based policies in the public interest."
As family physicians, we certainly value science and evidence. If we don't speak up, who will?