NYTIMES
February 5, 2006
Budget Reflects Competition for Money
By ROBERT PEAR
WASHINGTON, Feb. 4 — President Bush wants to spend more on bird flu and the physical sciences next year, but would freeze the budget of the National Institutes of Health and would slightly cut federal support for research on cancer and heart disease, two of the leading killers of Americans, budget documents show.
The president's budget, to be unveiled on Monday, shows the hard choices facing Congress and the nation as the wars in Iraq and Afghanistan continue and Medicare, Medicaid and Social Security take up a growing share of the federal dollar.
Mr. Bush is requesting a second installment of money to protect the nation against the threat of pandemic influenza: $2.65 billion in 2007, on top of the $3.3 billion that Congress provided for this year.
Budget documents from the Department of Health and Human Services say Mr. Bush would use the new money to buy flu vaccine for every person in the United States and to provide antiviral drugs to one-fourth of the population in an emergency. Health officials see the disease, first reported in Asia, as a serious threat. The World Health Organization says that 161 people have been infected and that 86 of them have died.
Mr. Bush's budget follows up a commitment in his State of the Union address to double spending on basic research in the physical sciences over 10 years as a way to "keep America competitive."
The president will request $6 billion for the National Science Foundation in 2007, an increase of 7.8 percent over this year's level, and is seeking $4.1 billion for the science office at the Energy Department, an increase of 14 percent, according to budget documents.
The science foundation, an engine of high-tech innovation, supports the work of many mathematicians, physicists, chemists, engineers, computer scientists and biologists.
Patrick White, director of federal relations for the Association of American Universities, which represents 60 large research universities, said, "We are very pleased to see what the Bush administration is doing for the physical sciences."
Congress doubled the budget of the National Institutes of Health over five years, from 1998 to 2003, and Mr. Bush often takes credit for completing that increase. But Mr. White said the administration "now seems to be neglecting the N.I.H."
Under the president's budget for 2007, the institutes would get $28.6 billion, the same as this year. Mr. Bush proposes small cuts for 18 of the 19 institutes — all but the National Institute of Allergy and Infectious Diseases, which is leading research on bird flu and biological terrorism.
In his 2007 budget, Mr. Bush is seeking $4.75 billion for the National Cancer Institute, which is $40 million less than its current budget and $71 million less than it got in 2005. He is requesting $2.9 billion for the National Heart, Lung and Blood Institute, which is $21 million less than the current budget and $40 million less than in 2005.
The budget says, "Chronic diseases such as heart disease, cancer and diabetes are the leading causes of death and disability in the United States, accounting for 70 percent of all deaths."
But the president's budget would cut spending for programs that seek to prevent chronic disease and promote healthy behaviors. Congress provided $900 million for those programs in 2005. Mr. Bush requested $840 million for 2006; Congress provided $839 million. Mr. Bush is now requesting $819 million for 2007.
Kim A. Elliott, deputy director of the Trust for America's Health, a nonprofit advocacy group, praised the president's commitment to bird flu preparations. "The president and his political appointees listened to the professional judgment of scientists and medical and public health experts," Ms. Elliott said.
But in response to a question about the budget, she said, "We are not spending enough on efforts to prevent chronic diseases and to find cures."
Mr. Bush is requesting $8.2 billion for the Centers for Disease Control and Prevention in 2007, which is $179 million below this year's level.
Under the president's budget, the centers would spend $824 million to help state and local health departments prepare for a terrorist attack or an outbreak of infectious disease. That is the same amount provided this year and 10 percent less than in 2005.
Over all, the president's budget for 2007 is expected to total $2.7 trillion. In his first term, federal spending rose 33 percent — in part because of the Iraq war and domestic security costs — while federal revenues grew 8 percent. Revenues declined from 2000 to 2003, but surged last year, as the government collected more individual and corporate income taxes and payroll taxes in a growing economy.
Administration officials, Congressional aides and lobbyists offered this preview of likely budget proposals at other agencies:
¶Mr. Bush is expected to request $16.8 billion for the space agency, an increase of 1 percent. Cost overruns on the shuttle have squeezed the money available for other space programs.
¶In place of various federal job programs, Mr. Bush will ask Congress to establish "career advancement accounts." The White House said that 800,000 people a year — workers and people looking for work — could use these accounts to pay for training or tuition costs if they went back to school to gain new skills.
¶For the fourth year in a row, Mr. Bush will ask Congress to require some veterans to pay more for medical care. Middle-income veterans with no service-connected disability would face higher co-payments for prescription drugs and a new fee for the privilege of using government health care.
"These people are already paying substantial annual deductibles and fees and co-payments for medical services and prescription drugs," said Richard B. Fuller, legislative director of the Paralyzed Veterans of America. "The new charges would force some veterans out of the V.A. system because they can't pay or choose not to pay the new costs."
At the Department of Health and Human Services, officials have sought savings in many popular programs. Budget documents show that the administration wants to cut spending for the Office of Minority Health and the training of health care professionals.
Moreover, the documents say, Mr. Bush will propose eliminating programs to treat people with traumatic brain injuries and to improve emergency medical services for children.
The administration said it had found no evidence that these programs improved "the health or well-being" of the intended beneficiaries.