|
|
|||
|
Volume 21, Number 21 November 18, 2002
GOP TAKES CONTROL: IMPLICATIONS OF ELECTION 2002 Election night 2002 brought President Bush and the Republican party the total control of the branches of government they thought they would enjoy the past two years, before Senator Jim Jeffords (I-VT) bolted and gave the Senate to the Democrats.
The new 108th Congress, which will convene in early January, will consist of a Senate with 51 Republicans, 47 Democrats, and the Independent Jeffords, who caucuses with the Democrats. One seat remains outstanding as incumbent Mary Landrieu (D-LA) faces a run-off election on December 7 with Suzanne Haik Terrell, one of three Republicans who held Landrieu below a state-mandated 50 percent threshold. Terrell was the choice of the Administration, but was opposed by Louisiana’s Republican Governor. With another chance to increase their margin, the national GOP will send the President into the state at least twice to see if his campaign magic which seemed to work so well on November 5th can work again one month later.
The new House has 228 Republicans, 204 Democrats, and 1 Independent (Bernard Sanders of Vermont, who caucuses with the Democrats). There is a run-off for a House seat in Louisiana and a special election in Hawaii to replace the recently deceased, but re-elected Democratic Representative Patsy Mink. In both Houses the Republicans made historic gains for the party of the president, which until recently, usually loses seats in an off-year election.
Party Leadership Changes
In the Senate, Trent Lott (R-MS) becomes Majority Leader again. His chief deputy in the 107th Congress, Don Nickles (R-OK) has been term-limited out of his position and Mitch McConnell (R-KY) will now become Majority Whip. For the Democrats, Tom Daschle (D-SD) and Harry Reid (D-NV) will become the Minority Leader and Minority Whip, respectively. Senator Ted Stevens (R-AS), with the retirement of Strom Thurmond, becomes the longest serving Senator of the majority party (since 1972), and thus the new President Pro Tempore.
In the House, Dennis Hastert (R-IL) continues his run as Speaker. Tom DeLay (R-TX) moves into the Majority Leader’s spot replacing his fellow Texan Dick Armey, who retired. Roy Blunt (R-MO), a DeLay confidante, moves into the leadership team as Majority Whip. Deborah Pryce (R-OH), from Columbus, replaces the retired J.C. Watts of Oklahoma as the head of the Republican conference, a position used to publicly espouse the party’s agenda.
On the Democratic side, the changes are more significant. Minority Leader Richard Gephardt (D-MO), shouldering some of the blame for the party’s failed attempt to retake the House, has stepped down from the leadership, probably to begin his campaign for the Democratic presidential nomination. Nancy Pelosi (D-CA) will be the new leader, moving up from the whip position. Representing San Francisco, Pelosi is a prodigious fund-raiser whose voting record is quite liberal. As she comes from a political family, however (her father and brother were Mayors of Baltimore), she is expected to provide vigorous leadership to match the strong direction that DeLay has provided the Republicans. Steny Hoyer (D-MD) will replace Pelosi as Minority Whip. It will be interesting to see how new party leaders, who are viewed as very ideological, will keep their party members in tow and provide the centrist legislation it is perceived the country wants. It also allows President Bush to position himself between the two perceived ideologues.
Committee Shifts
In the Senate, the Republicans assume the chairs of the standing committees. There are three significant changes that will most greatly impact policy. Senator Orrin Hatch (R-UT) replaces Patrick Leahy (D-VT) as head of the Judiciary Committee. This will clear the way for most of the President’s court appointments, although the Democrats may still use the Senate’s rules to prevent certain nominations from going forward. With the decision of Pete Domenici (R-NM) not to retake the chair of the Senate Budget Committee, Don Nickles (R-OK) moves to the head of the line. Nickles, who appears more committed to further tax cuts without great concern about budget deficits, will most likely favor dynamic scoring of tax implications and is more committed to less spending than Domenici. The third change is the replacement of Edward Kennedy (D-MA) by Judd Gregg (R-NH) as head of the Health, Education, Labor and Pensions Committee. With the Higher Education Act up for renewal and other social programs under the Committee’s jurisdiction, Gregg will bring a much more conservative cast to the panel’s work.
The appropriations committee switch from Robert Byrd (D-WV) to Ted Stevens (R-AS) should not be significant beyond party priorities. One thing that will remain is that West Virginia and Alaska will continue to see the flow of Federal money. With regard to science programs in the Appropriations Committee, Kit Bond (R-MO), impending head of the VA, HUD, and Independent Agencies Subcommittee, like the current Chair Barbara Mikulski (D-MD), has championed the doubling of the NSF budget. Arlen Specter (R-PA) retakes the Labor, HHS, Education spending panel and remains committed to continued large increases for NIH. Senator Gregg will also get to chair the Commerce, Justice, State and the Judiciary spending panel to deal with the Census and the research and statistics arms of the Justice Department. Thad Cochran (R-MS) will chair the Agriculture and Rural Development funding subcommittee.
On the House side, with the Republicans maintaining control, there are few committee leadership changes. In a surprise post-election announcement, Representative Larry Combest (R-TX) announced he would resign his seat at the end of May. With Combest leaving Congress, the House Agriculture Committee will have a new Chair. With Dan Burton (R-IN) term-limited, the Government Reform panel will get a new chairman as well. Representatives Christopher Shays (R-CT) and Tom Davis (R-VA) are the leading candidates. On Appropriations, the Interior Subcommittee, which funds the National Endowment for the Humanities and the National Park Service, will have a new leader.
The New Members: Where Are All the Social Scientists?
The new members include national figures and former presidential candidates Lamar Alexander and Elizabeth Dole, new Senators from Tennessee and North Carolina, respectively. Two new Senators have fathers who were prominent national figures, John Sununu (R-NH) and Mark Pryor (D-AR). One new Senator thought he had retired two years ago, but the strange electoral situation in New Jersey has brought Frank Lautenberg (D-NJ) back. With the tragic death of Paul Wellstone (D-MN) and the retirement of Phil Gramm (R-TX), there are no Ph.D. social scientists in the Senate. There is an M.D., Bill Frist (R-TN), and there are two veterinarians, Wayne Allard (R-CO) and John Ensign (R-NV). There are four Senators with MBAs like President Bush; both of North Dakota’s Democratic Senators Kent Conrad and Byron Dorgan, as well as Herb Kohl (D-WI) and Rick Santorum (R-PA). Jack Reed (D-RI) has a Master’s in Public Policy.
On the House side, new Representative Tim Murphy (R-PA) becomes the fourth Ph.D. psychologist in the body, joining representatives Brian Baird (D-WA), Ted Strickland (D-OH), and Tom Osborne (R-NE). New Representative Max Burns (R-GA) brings a Ph.D. in Business Administration, while Tom Cole (R-OK) has a Ph.D. in history. Chris Van Hollen (D-MD) has a Master’s in Public Policy. Tim Bishop (D-NY) has an M.P.A. and was Provost of Southampton College on Long Island. Katherine Harris (R-FL) and Mike Rogers (R-MI) also have M.P.A.s With the retirement of Steven Horn (R-CA) and Dick Armey (R-TX), Representative David Price (D-NC) is the only Ph.D. political scientist or economist left in Congress. There are two physicists in the House, Rush Holt (D-NJ) and Vern Ehlers (R-MI), and one chemist, John Olver (D-MA).
What Does It All Mean
There is a sense that science and research have bipartisan support. This is certainly true for doubling the NIH budget and is increasingly apparent for doubling the NSF budget. The difficulty will occur because of the overall macro budget picture. With the President and his allies in Congress seeking more tax cuts and attempting to constrain overall spending, can the large increases for these science agencies still happen? Add to this increased pressure from the war on terror, the impending war on Iraq, and other national and homeland security considerations. This will constrain spending on other items even more.
Outside of science, the President’s agenda will get a greater hearing, receive more support, and face easier approval. Yet, the Senate’s peculiar rules that can thwart majorities, still give the President’s opponents some hope. It is also true that those in the minority for a considerable amount of time can adopt tactics that prevent majorities from running roughshod.
CONGRESS CLEARS NSF REAUTHORIZATION BILL Early in the morning on November 15 the House of Representatives gave final clearance to the National Science Foundation (NSF) reauthorization bill. The Senate passed the bill the previous day. The legislation, which provides statutory authority to the Agency, now goes to the President for his signature. The actual funding dollars are allocated by Congressional Appropriators.
The bill authorizes NSF funding for the next five years, ramping up to $9.839 billion by FY 2007. NSF current funding for FY 2002 is $4.886 billion. The final two years of the authorization are contingent “on a determination that the Foundation has made successful progress toward meeting management goals consisting of: A) strategic management of human capital; B) competitive sourcing; C) improved financial performance; D) expanded electronic government; and E) budget and performance integration.” The bill also states that “Congress shall take into consideration whether or not the Director of the Office of Management and Budget has certified that the Foundation has, overall, made successful progress toward meeting those goals.”
Having passed through the three committees with jurisdiction – House Science, Senate Heath, Education, Labor and Pensions (HELP), and Senate Commerce, Science, and Transportation – and having negotiated the differences between the panels, the bill seemed ready for final passage before the election. However, a hold was put on the bill by a Republican in the Senate, reportedly at the direction of the Office of Management and Budget (OMB), which was unhappy with certain provisions such as naming it the NSF “Doubling” bill. With the elimination of “Doubling” from the title and the addition of the contingencies noted above, OMB gave clearance for its enactment.
The legislation provides specific authorizations for the Information Technology program, the Nanoscale Science and Engineering program, the Plant Genome Research program, the Mathematics and Science Education Partnership program, the Robert Noyce Scholarship program to recruit and train math and science teachers, and the Science, Mathematics, Engineering and Technology Talent Expansion program, which will provide grants for students majoring in these subjects.
Also included in the final text are provisions establishing centers for research on mathematics and science learning and education improvement. These centers “will conduct and evaluate research in cognitive science, education, and related fields and develop ways in which the results of such research can be applied in elementary and secondary school classrooms to improve the teaching of mathematics and science.” The bill as passed removes the provision in the Senate HELP committee version that would have made the Math Science Partnership program a formula grant in FY 2006.
The legislation includes provisions enhancing and codifying the confidentiality of information supplied to the Foundation. The National Science Board is mandated to prepare a report on how the increased funding will be utilized and the impact of these increases on grant size and duration, on the nation’s scientific and technological workforce, and on increasing participation of institutions of higher education in NSF’s programs.
Other Lame Duck News: Spending Bills Left Hanging Until New Congress
The 107th Congress returned for a lame-duck session on November 12. The expectation is that the session will end by November 22. The eleven appropriations bills that fund the non-defense part of the government remain un-enacted. The House has passed and the Senate will go along with another Continuing Resolution to keep funding these programs and agencies at FY 2002 levels until January 11. The new Republican controlled 108th Congress will convene on January 7. There is some expectation that an effort will then be made to get these bills enacted, probably as part of a large omnibus appropriations bill. It is also likely that the Senate will defer to the wishes of the House and the Administration and keep spending under control. What this will mean for the large increase proposed by the appropriations committees for NSF and the final year of National Institutes of Health doubling is unclear, although the latter is favored by the administration and was a Bush campaign promise.
After a long delay, the Homeland Security bill is on track for passage. With the Republicans taking control of Congress in January, the Democrats had to abandon their attempts to block the bill in an effort to protect Federal workers. The bill still includes provisions for an Undersecretary for Research and Development. (See Update, July 22, 2002). The President has announced that White House Office of Homeland Security director Tom Ridge will head the new Cabinet department.
bush announces intent to nominate hoffman to national science board
Following up on his October 17 statement of intent to nominate eight individuals to the National Science Board (see Update, October 21, 2002), the President issued a release on November 12 indicating that he also intends to nominate Elizabeth Hoffman, President of the University of Colorado system, to the Board.
If confirmed by the Senate, Hoffman would serve the remainder of a six-year term that expires on May 10, 2008. In addition to serving as system President, she also holds a tenured faculty position in the Department of Economics at the Boulder campus. Hoffman earned her B.A. in history from Smith College before going on to the University of Pennsylvania, where she received both the M.A. and Ph.D. in history. She also earned a second Ph.D. in economics at the California Institute of Technology.
NCHS LACKS RESOURCES TO PROVIDE MUCH-NEEDED HEALTH STATISTICS
Due to budget constraints, the National Center for Health Statistics (NCHS) is facing a number of challenges in continuing to provide the Nation with the quantity and quality of health statistics so many policy makers have come to rely on. NCHS, part of the Centers for Disease Control and Prevention (CDC), is the Nation’s principal health statistics Agency, providing data to identify and address health issues. The Agency’s data systems are key elements in America’s ability to identify health problems, develop health policy and public health interventions, and monitor the progress, accordingly.
The data collected by NCHS allows the Agency to:
NCHS data is used in various and many ways that are not often directly associated with the Center, including: birth data, growth charts, immunizations, firearm-related mortality in children and teens, nutrition monitoring, folic acid fortification decisions, exposure to environmental chemicals, monitoring of cholesterol and hypertension rates, overweight and diabetes rates, disabilities rates, changes in the health care delivery system, documentation of racial and ethnic disparities in health access to care, hospital stays for childbirth, and over-crowded emergency departments.
More importantly, NCHS data is used by a variety of individuals and entities: policymakers, including Congress; epidemiologists; biomedical and health services researchers; public health professionals; individual physicians; actuaries; and businesses.
After having been under-funded for nearly a decade, NCHS’s core data systems are facing an uncertain future. Unfortunately, NCHS lacks sufficient resources to preserve existing data systems and make necessary changes to ensure their continued viability. In addition, the Agency also faces the challenge of addressing shifts in the population, adapting to new technology for data collection, and chasing a moving target in monitoring the health care system. There are four core data systems of NCHS:
National Health Interview Survey
NCHS is currently in the process of putting a system in place to produce quick-turnaround data easily accessible to its users through the National Health Interview Survey (NHIS). The new system will allow the NHIS to operate in a fundamentally different way by mid-decade. At present, NCHS and other Federal statistical agencies are engaged in a mandatory, multi-year effort to identify the sample for household surveys for the next decade. This sample needs to reflect the changing demographics identified in the decennial census. The Center is also in its second year of a multiyear project to overhaul the basic systems through which NHIS data are collected, processed, and made available to users.
At its current funding level, CDC and NCHS will have to make tradeoffs within the base funding for NHIS, resulting in a reduction in the sample size of the ongoing NHIS by approximately half. This means that although NHIS will continue to provide the data at the national level necessary for tracking important health events, it will be unable to provide detailed quarterly tracking data or to meet all expected needs for data on racial and ethnic sub-populations. NHIS, due to its current size, is one of the primary tools for looking at these disparities.
National Health and Nutrition Examination Survey
NCHS also conducts the National Health and Nutrition Examination Survey (NHANES), a key element in an overall strategy for monitoring the Nation’s health. Through NHANES, NCHS provides data from direct analysis, making measurement of risk factors such as cholesterol and blood pressure, assessment of environmental exposures and their health effect, and the extent of health problems such as diabetes.
National Vital Statistics System
A cornerstone of the public health system is the collection of vital statistics. The Agency is confronting the additional challenge posed by the lack of needed infrastructure in states for the collection of vital statistics. Currently data collecting systems in place in many states are unsustainable, making it possible that the overall technology platform for vital statistics will collapse in the near future. There exists a great need for a collaborative, Nation-wide development of a fully electronic, web-enabled system for obtaining data from birth and death certificates. Without the necessary resources, these systems will break down as there is a move to new certificates and systems come on line at different paces, in non-standard ways, in different states.
National Health Care Survey
NCHS is currently undertaking a long-range transformation of the National Health Care Survey (NHCS), which provides information on the delivery of care to individuals, the structure and functioning of the health care delivery system, and the changing roles of health providers. The Center recently redesigned the National Nursing Home Survey, with input from a HHS-wide planning effort and outside experts, to address current priorities for data to support policy and research in long-term care. The Survey is scheduled to go into the field in 2003, dependent on the Agency’s budget. Not only does NCHS need to conduct the survey in 2003, but it also needs to begin implementing work intended to redesign surveys of other long-term care providers, most notably home health agencies and hospice care providers.
INTERNATIONAL STUDIES ON HEALTH AND ECONOMIC DEVELOPMENT SUPPORTED BY FIC There is increasing interest in improving the understanding of the role public health plays in contributing to economic development since the release of the Commission on Macroeconomics and Health (CMH) Report by the World Health Organization in December 2001. The CMH Report describes how countries can benefit economically from improved health and health systems, as well as the economic damage that can occur in countries that suffer from high disease burdens. In addition, the recent emphasis on health at the World Summit on Sustainable Development clearly demonstrated the awareness on the part of the public and private sector about the importance of good health to overall development objectives.
Yet much remains unknown about exactly how health contributes to economic development and what conditions are needed to maximize its contribution. Low- and medium-income countries with scarce public resources have difficulty finding the capital necessary to fund and provide good public health systems. They need better information about how to allocate resources to the health sector in order to get the best return and how those allocations contribute to their long-term and sustainable development.
The Fogarty International Center (FIC) of the National Institutes of Health (NIH) led the development and launch of a new program to address this knowledge gap. The first awards through this research program, the International Studies on Health and Economic Development (ISHED), were made in 2001 through the co-sponsorship of five NIH partners and the Global Development Network of the World Bank. The five NIH sponsors are: FIC, the National Institute on Aging, the National Institute on Mental Health, the National Institute of Child Health and Development, and the Office of Behavioral and Social Science Research.
The goal of the ISHED program is to generate a strong base of evidence about the relationship between health and economic development. Eleven awards were funded in the first competition; six are two-year planning grants and the other five are 5-year awards. The combined commitment from FIC and the other NIH partners is approximately $2.2 million for the first year of the five-year duration. Total support for this program will be approximately $10 million over the five year span. A second competition is planned for 2005.
ISHED-supported experts are working throughout the world to establish a body of research in the under-studied field of health and development linkages, and to increase capacity for such research in developing countries that will lead to eventual policy improvements. ISHED research focuses on the microeconomic and macroeconomic relationships between health and development to improve understanding of causality, relevant variables, and efficiency in improving public health. Through the ISHED program, the NIH supports data development and enhancement, methodological improvements and modeling aimed at measuring health and economic relationships, analysis of health financing and delivery systems, and research and institutional capacity-building.
ISHED-eligible researchers include both U.S. and foreign investigators from non-profit, for-profit, university, and governmental organizations.
Current ISHED Projects
Duncan Thomas of UCLA and his collaborators are using a longitudinal database in Indonesia to analyze linkages between health status and labor market outcomes. The recent economic crisis in Indonesia provides a rare opportunity to conduct a natural experiment to assess immediate and medium-term effects of crisis on health and labor outcomes. The project is paying special attention to how health and economic transitions occur among older populations. The primary data are four waves of the Indonesian Family Life Survey, which has low attrition, a range of socio-economic and demographic variables, and extensive health measures — including community and health facilities.
In Guatemala, Reynaldo Martorell of Emory University is integrating new and existing data to examine the effects of nutrition in early childhood on adult productivity through the accumulation of human capital. The study extends data collected from families in four Guatemalan villages into early adulthood. The populations examined in the study underwent a controlled nutrition supplementation program between 1969 and 1977 and an extensive first round of data was collected. A second wave of surveys was conducted during the teenage and early adult years of the population, and the ISHED research will provide a third wave of data to analyze adult productivity effects of the intervention program throughout the entire population, including out-migrants from the villages. The research addresses an important issue that has not been convincingly resolved in existing literature: the effects of early childhood nutrition on adult productivity and health at individual, family, and community levels.
In combination, Thomas’s and Martorell’s studies offer significant insights into the connections between health and productivity established at particular times in the life cycle. Martorell’s focus on early childhood development and Thomas’s focus on later impacts on productivity will, in combination, greatly augment overall understanding of the potential contribution of good health to healthy economies.
A different type of research is being performed by Angus Deaton of Princeton University under the ISHED program. Deaton’s research addresses the relationship among poverty, inequality, and health in South Africa. The unusual feature of the research approach is the recognition of health as a component of well-being and the investigation of its relationship to other measures of economic well-being. The study constitutes a sweeping and innovative approach to core issues in economic development. To date, the measurement of this relationship has been inconsistent with micro-level measures of the connection. Questions that Deaton’s ISHED project are addressing include:
The overall goal is to produce a careful analysis of macroeconomic and microeconomic linkages to health. When completed, the research will contribute significantly to the fundamental question about the degree to which health influences macroeconomic outcomes.
ISHED research is intended to identify the many ways in which healthy people contribute to healthy economies and stronger development. Researchers are trying to differentiate the role of investments in individuals (such as better nutrition) that lead to greater productivity and higher incomes, from investments in disease prevention (such as spraying against malaria transmission or de-worming of schoolchildren) that lead to lower morbidity and mortality. The results are expected to inform national and global decision-makers so that the most effective healthcare interventions may be put in place that will benefit individuals and societies.
(Rachel Nugent, Program Director with the Fogarty International Center, contributed to this article.)
|
What are you looking
for?
|
||
