WASHINGTON -- Two minutes into a speech Tuesday morning, Rep. Matt Salmon (R-Ariz.) turned to the subject of his hair. He had shaved his head recently to honor the top official at the research department at the University of Arizona, who had died from pancreatic cancer. It was growing back.
There was poignancy to the gesture -- and a reason to mention it -- since Salmon was addressing a joint event by the American Cancer Society Cancer Action Network and Stand Up To Cancer in the Cannon House Office building. After explaining his buzz cut and recounting how the disease had affected the lives of those he knew, loved and respected, Salmon made a plea.
"I'm kind of an unlikely candidate to be here today probably for a lot of reasons," he said. "I've been recognized by numerous groups as one of the most tight-fisted people in the entire Congress. ... That having been said, I believe with all my heart and soul that if the federal government doesn't lead the way on conquering cancer that it won't get done."
The audience, including hundreds of activists there to lobby lawmakers for biomedical research, was gleeful. A self-described fiscal hawk who once said he welcomed the idea of a government shutdown was calling for billions of dollars to be spent on their cause.
They'd have more reason to cheer soon after that. Addressing legislation that the audience was there to advocate -- a $6 billion increase in funding for the National Institutes of Health over two years ($1 billion of which would go to the National Cancer Institute) -- Salmon insisted it was insufficient. The NIH, he explained, should see its budget grow to $40 billion by 2021 from roughly $30.1 billion, offset with cuts elsewhere.
"I want to fight this fight," said Salmon. "I've lost one too many friends to this dreadful disease and I don't want to see another person succumb to this."
The cheers grew louder 10 minutes later, when Rep. Kevin Yoder (R-Kansas) took the mic. No shrinking violet on deficit hawkery, Yoder outlined a future for NIH that would make even the most audacious advocate blush.
"Why aren't we spending $60 billion in NIH research?" said Yoder. "Honestly. I'm not a big fan of deficit spending. I'm not a big fan of deficits. Certainly, as a conservative Republican, I believe the fiscal health of our nation is one of the most critical issues long term. But I think I can go to my 16-month old daughter and I can say, 'I borrowed money in your name to cure cancer' and she would thank me."
The audience was standing at that point. Rare, after all, are cases in which House Republicans openly advocate for more government spending. Rarer are those in which they say to put the bill on the nation's credit card. But there are few causes less objectionable than fighting cancer. And, before a star-studded audience that included NBA great Kareem Abdul-Jabbar, and actors Pierce Brosnan and Marcia Cross, all of whom spoke as well, speaker after speaker pledged their political and personal devotions to biomedical research.
The question just below the surface was whether that devotion could withstand the political pressures lingering just outside Cannon Room 345.
At roughly the same time as Salmon and Yoder were striking unorthodox notes, House Republicans formally released their proposed budget. The document gives nods of appreciation to the NIH and to scientific research in general and echoes many of the same warnings that emanate from the biomedical research community.
"The United States leadership role is being threatened, however, as other countries contribute more to basic research from both public and private sources," the budget text reads. "Federal policies should foster innovation in health care, not stifle it. America should maintain its world leadership in medical science by encouraging competitive forces to work through the marketplace in delivering cures and therapies to patients."
But there are no additional funds devoted to the NIH by the House GOP. Instead, the budget calls for cutting down "bureaucracy and red-tape." Moreover, House Republicans dramatically diminish the pool of resources from which NIH and other government agencies must draw. Under the GOP blueprint, non-defense discretionary spending falls $44 billion below current budget caps in fiscal year 2017. In fiscal 2018, it would be $64 billion below those caps. In fiscal 2019, it would be $72 billion lower.
Will Allison, a spokesman for the House Budget Committee, noted that the appropriations committee would have the final say over how much money within those totals would go to NIH. The GOP budget, he noted, "assumes no savings in NIH.” In other words, it doesn't call for a cut.
But simply maintaining NIH's funding level is tantamount to diminishing it, since the agency's spending power would decrease with inflation. That's the predicament the institutes already face. Dr. Harold Varmus, the outgoing head of the National Cancer Institute, told attendees on Tuesday that while President Barack Obama's budget would give the NIH a 3 percent increase in funding for the next fiscal year, it would still only "bring us back to the numbers we had in real dollars in 2010." Sen. Ben Cardin (D-Md.), speaking after Salmon, noted that if NIH was granted $6 billion over the next two years, it would simply take "us back to the 2003 level, adjusted for inflation."
And so, while deficit-conscious Republicans spent Tuesday morning waxing about a plush, well-funded NIH, some Democratic speakers tried to inject a bit of caution, without completely trampling the good vibes. Sen. Dick Durbin (D-Ill.) one of the most vocal champions of increasing funding for biomedical research, recounted how more than a quarter-century ago, he helped build political pressure to outlaw cigarette smoking on airplanes. He then mentioned the speeches he'd just witnessed.
"I was struck as I watched, as one said, knuckle-dragging conservative Republicans come up here -- that's what he called himself, I'm not making fun of him -- and say he was on our side," Durbin said, referencing the description that Salmon had given himself. "And I thought, this is another moment just like that moment 25 years ago, when we banned smoking on airplanes.
"We have reached the point where we have to decide whether we are going to be discouraged by the powers that be in the political forces of dysfunction in Washington, or whether we are going to barrel through them on a bipartisan basis and make an investment in medical research," Durbin said.