[Congressional Record Volume 142, Number 93 (Friday, June 21, 1996)]
[Senate]
[Pages S6664-S6665]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. KASSEBAUM (for herself, Mr. Kennedy, Mr. Jeffords, Mr. 
        Pell, and Mr. Hatfield):
  S. 1897. A bill to amend the Public Health Service Act to revise and 
extend certain programs relating to the National Institutes of Health, 
and for other purposes; to the Committee on Labor and Human Resources.


                  THE NIH REAUTHORIZATION ACT OF 1996

  Mrs. KASSEBAUM. Mr. President, I rise today to introduce legislation 
which supports the important work of the National Institutes of Health. 
This bill, the National Institutes of Health Revitalization Act of 
1996, will reauthorize the ongoing work of this outstanding Federal 
research institution.
  We all can take great pride in the exceptional contributions that the 
NIH has made to the improvement of the health of our citizens.
  NIH grants constitute the bulk of support for biomedical research 
throughout this country--almost $10 billion every year, distributed in 
nearly 25,000 separate grants. This unique investment of talent and 
dollars has one simple, overriding goal--the advancement of the health 
of Americans.
  This agency is, indeed, an extraordinary success story. To cite just 
one illustration: An NIH grant made possible the discovery of the BRCA-
1 gene, a genetic marker for an important form of breast cancer. Such a 
discovery offers great promise for new strategies for diagnosis and 
treatment of breast cancer and other serious illnesses.
  As long term commitment to further support of research into the 
mysteries of the human genetic code, this bill authorizes the creation 
of the National Human Genome Research Institute. The elevation of the 
National Center for Genome Research to institute status, while budget 
neutral, will ensure a continued focus of NIH resources for this 
important work.
  Mr. President, in addition to reauthorizing the lifesaving work of 
the two largest institutes, the National Cancer Institute and the 
National Heart, Lung, and Blood Institute, the bill authorizes a number 
of other important institutes and initiatives. Among them is research 
into new and resistant infections such as tuberculosis; and an Office 
of Rare Diseases to support research on over 2,000 uncommon diseases 
that, together, afflict thousands of Americans.
  Another critical area that this bill addresses is the education and 
training of the next generation of clinical researchers, the biomedical 
scientists who perform research that directly involves patients. This 
bill provides for greater support for expert training of young 
biomedical scientists who have elected the difficult, and increasingly 
competitive, careers in scientific inquiry. In addition, it provides 
important resources for the 75 general clinical research centers that 
exist in academic medical centers throughout the country.
  The role of NIH in clinical research is critical, since academic 
health centers in the 21st century will be posed with an unprecedented 
challenge: how to maintain their research mission in the face of a 
fundamentally changed health care system. These changes are the 
consequence of dramatic market shifts that are taking place in health 
care in this country. They have a potentially deleterious effect on the 
irreplaceable work of this country's academic health centers. Cost 
competition has made it particularly difficult for the continuation of 
many of these established institutions that frequently care for the 
sickest, as well as the poorest, citizens of our communities.
  This bill also makes substantial efforts to reduce administrative 
excess and duplicative infrastructure at NIH. It reduces redundant 
committees and reports. Every dollar saved from unnecessary 
administrative burdens is another dollar freed up for support of 
biomedical research.
  By its very nature, ever-expanding scientific knowledge places 
pressure on the limited resources for biomedical research support. 
Accordingly, this bill provides for a Biomedical Research Trust Fund 
within the Treasury. This trust fund is a first small step toward 
affording additional funds for the indispensable research mission in 
this era of shrinking Federal resources.
  In conclusion, Mr. President, reauthorization of the important work 
of the National Institutes of Health represents for the American people 
an investment beyond compare or valuation. I am pleased to welcome 
Senators Kennedy, Jeffords, Pell, and Hatfield as original cosponsors 
of this legislation. I urge my colleagues to support the adoption of 
the National Institutes of Health Revitalization Act of 1996.
  Mr. KENNEDY. Mr. President, I strongly support the NIH Revitalization 
Act of 1996. The National Institutes of Health is the premier health 
care research center in this country and the world. Reauthorizing a 
strong NIH should be a bipartisan goal.

[[Page S6665]]

  This bill reauthorizes the present Institutes, and provides a 
framework for the NIH to respond more effectively to the health issues 
of today and the future.
  Clinical research is addressed by incorporating many of the 
provisions of the Hatfield-Kennedy clinical research enhancement bill. 
General Clinical Research Centers, which serve as an infrastructure for 
clinical research and training, are authorized. Clinical Research 
Career Enhancement Awards and Innovative Medical Science Awards are 
created to support individual careers and research projects in clinical 
research. In addition, existing research assistance, training and loan 
repayment programs are expanded to include those involved in clinical 
investigations.
  The human genome project which has been so productive becomes the 
National Human Genome Research Institute. The Office of Rare Diseases 
is formally established. A national fund for health research is created 
to provide additional financial resources. A number of other changes 
are made to streamline the administrative processes at NIH.
  All of us recognize that a number of concerns require further 
discussion. NIH's desires for maximum flexibility have been addressed. 
We must also meet the research and treatment needs of particular 
diseases. I look forward to working together to find ways to address 
Parkinson's disease, the pediatric research initiative, and diabetes.
  We must also find ways to deal with the impact of managed care on 
medical training, education, and research. That problem that was the 
topic of our final NIH hearing this year.
  Investment in health care research is one of the soundest investments 
we can make in the Nation's future. The NIH Revitalization Act of 1996 
is designed to maintain and strengthen our return on this investment, 
and I look forward to working with my colleagues on both sides of the 
aisle to secure its enactment.
  Mr. HATFIELD. Mr. President, I am honored to join my friend and 
colleague from Kansas, Senator Kassebaum, in sponsoring legislation to 
revitalize the crown jewel of medical science in this country, the 
National Institutes of Health. Senator Kassebaum deserves the Nation's 
gratitude for her commitment to biomedical research and her efforts to 
ensure that the wealth of this country is measured by the health of its 
citizens.
  The NIH has enhanced the health of our Nation immeasurably, and 
through the efforts of its scientists and staff continues to place us 
on the cutting edge of biomedical research. Yet, as all of us in this 
body know so well, all institutions must evolve if they are to continue 
to thrive. The legislation introduced today provides the elements 
necessary for the NIH to evolve successfully in the years to come.
  Every year, medical researchers uncover more mysteries of the human 
body. Because of their efforts, today we have therapies, drugs and 
technologies that were unimaginable just a decade ago. Of great 
importance to all Americans is the outcome of our investment in 
biomedical research. We want to know, what has been cured lately? How 
have the billions we invest in NIH each year reached Americans and 
eased their suffering? How has the chasm between the scientist in the 
laboratory and the physician administering treatment been bridged? To 
address that gulf, I believe we must heighten our support for 
translational--or clinical--research. To that end, I introduced S. 1534 
this year, the Clinical Research Enhancement Act of 1996. This bill 
will increase funding for clinical research, improve training for 
persons planning clinical research careers, and modify the focus of the 
NIH to make it more receptive to clinical research proposals.
  I am very pleased that Senator Kassebaum has included components of 
S. 1534 in her legislation. The bill authorizes the General Clinical 
Research Centers which are the frontline troops not only in the 
training of clinical researchers but in performing many of the clinical 
studies in our academic medical centers. The 75 current centers have 
never been authorized despite their continued congressional support 
since 1965.
  The bill also establishes two new award programs: the Clinical 
Research Career Enhancement Awards and the Innovative Medical Science 
Awards. These awards will provide both young and established 
investigators with the resources needed to bridge unfunded periods 
while promoting continued clinical research and training. At present 
training opportunities for persons considering clinical research 
careers are few and fragmented.
  The bill also expands loan repayment opportunities for young 
physician scientists to pursue research careers. Currently the average 
medical school graduate has a debt of $63,000. This burden has resulted 
in a decline of physician researchers to just 2.2 percent of the 
physician population of the United States.
  Last year, Congress acknowledged the importance of biomedical 
research when it restored proposed cuts to the NIH budget for 1996. As 
a result, we are now enjoying a 5.7-percent increase in funding for the 
NIH. However, we have far to go in stabilizing funding for medical 
research, and we must now turn our attention toward insuring 
sustainable growth in the coming years.
  I am pleased that Senator Kassebaum's legislation also includes my 
bill, S. 1251, to establish a national fund for health research. This 
fund will supplement annual appropriations to the NIH by contributing 
public and private donations to enhance research grants. While the 
language in this bill does not specify a funding source, I am hopeful 
that when the bill comes to the floor we will have several options to 
consider to secure its financial future. I have proposed a 25-cent 
increase in the tobacco tax, as well as a voluntary Federal income tax 
checkoff in the past, and would be willing to look at other options in 
the future such as some sort of managed care set-aside. I believe this 
proposal marks the beginning of a longer-term strategy for biomedical 
research funding and I am gratified by its inclusion in this bill. 
Senator Tom Harkin has been my long-time partner in this matter and I 
know he is as pleased as I am that the foundation for the fund has 
today been further advanced.
  Finally, Senator Kassebaum has included one additional piece of my 
legislative portfolio, S. 184, a bill to establish an Office for Rare 
Disease Research at the NIH to assist our citizens who have the 
misfortune of suffering from uncommon diseases. This legislation has 
already passed the Senate this year, only to languish in the House. I 
am hopeful that this vehicle will carry it through to enactment.
  This legislation, Mr. President, is essential for the continued 
effective functioning of the National Institutes of Health, and for the 
continued health of our citizens. I believe this legislation deserves 
our strong support and I urge my colleagues to endorse its contents. At 
this time, I would like to publicly commend Senator Kassebaum's staff, 
David Stevens, Kent Bradley, and Ann Rufo, for their work in crafting 
this revitalization package. They have been mentors to my staff and 
have represented Senator Kassebaum with great dedication and commitment 
in putting this vital piece of legislation together.

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