The Honorable Mark O. Hatfield
History is composed of moments of opportunity for bold, creative, new risky solutions to meet national needs. The National Highway System provided a statewide infrastructure to support our national defense interests, and as a result we now have a National Highway Trust Fund. The GI Bill of Rights created avenues for soldiers to pursue higher education and became the model for other forms of financial aid such as Pell Grants. During World War II, the Doctor Draft Act provided free medical school training with the understanding that graduates would continue in military service. In the mid-1960’s the Medicaid Trust Fund was established, and more recently, Congress created the Violent Crime Reduction Trust Fund for crime prevention programs.

Medical research competes annually with other worthy domestic spending priorities for its share of our national budget. On the whole, funding for medical research has grown steadily since its inception, but it has been threatened from time to time. I believe that medical research is the responsibility of the national government, it is integral to the values for which we defend the country and one in which the federal government is uniquely positioned to take the lead. In my view, the opportunity exists to create some strategic options, but I am not naïve about the challenges. Long-term strategic options aren’t favored in the congressional environment unless they come in the crux of a crisis. Medical research is on the crest of significant opportunity if we choose to maximize it. I believe we must seek to do so now.

Dr. Leon E. Rosenberg
I am often told that medical research is regularly favored over other areas of scientific research, and that, therefore, it is not fair to advocate on behalf of the medical research enterprise. I am told too, that the system isn't broken so why attempt to fix or improve it. My answers: people with disease and disability do not think we are doing all we can do on their behalf; the amount we, as a nation, spend on medical research--from public and private sources--is miniscule compared to what we spend on health care; and there are many ways to make a good system better.

Medical research has fared better than most other areas of science because people care so much about the quality of their lives and hope that medical research, in its broadest sense will help them live longer and healthier lives. We must respond to that public yearning by taking a broad, not narrow, view; by realizing that the physical sciences form a foundation for the life sciences, and the life sciences, in turn, for the medical and clinical sciences.

I do not accept the view that it is time for advocates of medical research to get out of the way and let others have a chance. Rather, I think we should ask whether the nation's investment in medical research is all it should be--in size, form, source, purpose, implementation, and accountability--and whether we keep uppermost in our minds the good of the people.

© 1999 American Association for the Advancement of Science