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characteristics of the support system term support, and certainly is not a problems in medicine and health. What have resulted in a fundamental insta rational basis for long-term develop is needed is not a system that provides bility of institutions of higher education ment.
for the simple storage and retrieval of at the very time that new and broad Given a more adequate and more documents or indeed of the data and educational and social functions are be stable financial base, institutions of other information they contain. Rather, ing imposed upon them.
higher education could plan their over the system must be capable of providall development in the light of the ing analyses and arrays of information
broad educational and social responsi specifically relevant to broad sets of Remedial Action
bilities they have recently acquired. Be problems perceived from an overall
yond this central core of support, the point of view (5). I turn now to consideration of what project system of grants and contracts The present informational systems I believe must be done to provide a can continue to provide the principal of federal agencies may satisfy agency solid base for the further development means for extension of mission-ori purposes, but they do not satisfy the of the biomedical sciences. Clearly, ented research programs.
broader national need. For example, whatever is planned must be planned Support of mission-oriented research. NIH supports only about 40 percent of in relation to the general problems of Once the institutional integrity of in all biomedical research and about 55 education and institutional develop- stitutions of higher education has been percent of all biomedical research supment. Note must also be taken of the secured by general support programs, ported by the federal establishment. The pressing service-related activities of the mission-oriented agencies of the rest is derived from other agencies--the many of the institutions involved. federal establishment can move more Atomic Energy Commission, the De
I do not present any detailed argu directly toward accomplishment of partment of Defense, NASA, the Naments, only a few broad generaliza their special missions. They can be tional Science Foundation, the Vettions. I trust these will be viewed by more free in selecting the institutions erans Administration, the Department some as informed judgments, since I that are to receive support for research of Agriculture, and other portions of know they will be taken by many as a and development. Also, the terms and the Public Health Service. There is not statement of personal prejudices. conditions of their awards can directly now any simple mechanism for analyz
Institutional support. To meet the reflect the program needs of the agen ing all these activities insofar as they needs and correct the deficiencies of cies' objectives rather than a compro relate to the generalities of biomedical the complex programs I am discussing. mise between the mission needs of an research. The analysis envisaged would substantial funds must be made avail agency and the sometimes overriding not be a simple consideration of the able directly to institutions of higher needs of higher education, as is now biomedical sciences as such but, rather. education for general support of their the case. With institutional integrity would be an analysis of research and basic graduate and professional educa assured, the way begins to open for an training in relation to the broader national functions. These funds must be enlarged and more sharply focused re tional objectives in the field of health. adequate, and must be made available search activity, accompanied in many In this fashion science would assume by mechanisms which permit the insti cases by a much greater measure of its proper place as a competitor for the tution as a whole to grow and to attain national organization than now exists federal dollar. general educational competence as well (4).
Viewed in this light, research activas the greatest possible degree of ex Elements of such organized research, ity can be classified in very broad catecellence. Further, these objectives must when it is performed within an aca gories for central consideration of pribe attained within a system of support demic environment, can enrich the orities in terms of social objectives. that gives the federal sponsor assur academic environment. However, such The allocation of resources then beance that the broad public objectives activity will, I believe, be increasingly comes manageable. One must accept for which the funds are made avail performed in research environments the condition that such allocations able are indeed being well served. peculiarly devised for such complex must reflect a number of value judgIf the federal establishment provides but coherently related research under
ments and are not amenable to simple this type of funding, the amounts will takings, be these in universities, med linear scaling. be substantial. This in turn will impose ical centers, research institutions, na Central consideration of the use of on the university, in the areas of grad tional laboratories, or industry, In this science and technology in the promouate and medical education, wholly case, the further development of the tion of health would be paralleled by new obligations. The universities and undifferentiated base of the biomedical central consideration of their use in medical schools will have to indicate sciences will proceed in academic en relation to defense; space; resources, the size and scope of the central edu vironments devised to provide the es including energy and minerals; food; cational function, upon which their sential coupling of research and edu civil needs, including environment, educational achievement will be judged. cation, and will be supported as an ob housing, transportation, and many Further, methods will have to be de- jective apart from, but complementary problems of our cities; and, finally, the veloped for assessing the quality of the to, mission programs.
knowledge base and general educacentral educational enterprise that is Allocation of resources. Other re tion, supported. For example, medical quirements must be met if the mix of One cannot hold a brief for any high schools that receive general support undertakings noted above is to be pro degree of specificity or precision at funds because of an urgent financial ductive. The first requirement is a bet this stage of development of a central crisis in their funding must realize that ter information system, one capable of program analysis and planning activthis is possible for a year or two in providing an ongoing analysis of the ity. One must recognize that our poan acute emergency but is not a normal nature and extent of scientific effort in litical system now makes resource alor indeed an adequate base for long areas of direct relevance to broad locations for science that are quite
General Prospects and Problems
explicit, but does so by a series of judgments made in relative isolation from each other. It does not seem very bold to say that this decision process can be improved, and that allocations can be made among science areas, with some consideration given to the probable value of science to society. Since allocations to individual areas of science can never be absolute in the absence of unlimited resources, the allocation process must permit comparative assessment of competing fields. Finally, for broad acceptance by the public, the allocation process must provide input not only from science, the generator of new knowledge, but also from technology, the applier of new knowledge, and from the consumer, the user of technological applications.
Such a proposal is tantamount to suggesting the designation of a series of cognizant agencies for information assembly and analysis. These would not reflect departmental or agency operational structure.
Some central apparatus. However, for effective utilization of the organized flow of information produced by such cognizant agencies, such information would have to be collated at a high point in the Executive Branch, a point at which the critical policy and allocation decisions that would influence program development in science and education, and in the use of science for other social purposes, would be made. These decisions are so important that the level for collation of information could be no lower than that at which the National Security Council and the Council of Economic Advisors operate.
With a suitable central apparatus it might be possible to diminish the present chaotic competition for research and development funds among the major areas of scientific endeavorthe competition between the needs of research and education and to consider these needs in relation to broad social needs and national purposes. The evolution of an increasingly firm sense of national capabilities and priorities would permit clearer expression of our national purposes in the pursuit and utilization of new knowledge.
I fully realize that we now have many central mechanisms for program review and policy advice, but, without considering each one in detail, I would hold that no one of them, nor indeed a combination of all, is adequate for our future needs and purposes.
But to return to the future of the biomedical sciences, the sequence of thoughts that I would like to leave with you is as follows.
1) The socioeconomic burden of disease is inordinate.
2) The economic cost, the most direct indicator of which is the unit cost of medical care, continues to rise geometrically with time.
3) The conquest of serious disease and attainment of the essentials for a better quality of life are not visionary goals. They will, however, require a substantial expansion of research under circumstances that provide comparably well-developed support for educational and service programs.
4) A prime essential for such accomplishments is the development of central analysis and planning functions that are adequate to the task of ordering national priorities and serve as a basis for the allocation of resources among broad fields of science and within the biomedical field.
5) There must be developed, in parallel with the expansion of research and the development of central analysis and planning functions, an adequate public information program that portrays not only achievement but also prospects and problems.
I would emphasize that each area of science has its own special problems. Biochemical science is no exception. It shares some of its problems with medical education and medical service.
These problems stem from a public awareness of our deficiencies in knowledge. The public has immediate experience of disease, disability, and death. Moreover, it has become exquisitely sensitive to certain deficiencies in our system of medical education. Such public knowledge, even though only partial, is too frequently the basis of emotional outpourings that result from nonavailability of physicians at times of medical need, or from individual failures of diagnosis and therapy.
Furthermore, members of the general community have reason to be dissatisfied with the results of scientific "tours de force" presented as scientific spectaculars but having little relevance to their own problems. They have seen new drugs produce defective children, and they have been told that the triumphs of molecular biology can lead to a social evil as well as to social good. They rightly care less about the niceties of bureaucratic structure than
about the productivity of the total enterprise, and they have a right to have the fields of science, education, and service, as these relate to medicine, presented to them in a more unified and understandable fashion. They have a right to a more realistic presentation of the goals that members of the scientific community have set for themselves, and of the prospects of success, as well as a right to some conception of the mechanics of the process, including some appreciation of the projected time base. While they may not need to know more about the distribution of these activities within the academic and federal structures, they have a right to demand that bureaucratic considerations of departmental autonomy, institutional individuality, and freedom of the individual scientists will not, in themselves, impose barriers to the development of a sound science and the rapid translation of new knowledge into a readily available medical capability.
I am convinced that the trend of research, education, and service, as these relate to medicine, will, even more in the future than today, be the concern of the people who are consumers of the final product, and that this concern will increasingly be reflected in congressional attitudes. If this view is generally correct, then I would judge that, although there will be no riots in the streets, there could be generated high public pressures for change, which could be misguided.
I would hope that we can accomplish the necessary organizational and bureaucratic changes through rational processes within the scientific community and the branches of government rather than at the hands of a disenchanted public.
References 1. Advancement of Medical Research and Educa
tion, through the Department of Health, Education, and Welfare; Final Report of the Secretary's Consultants on Medical Research and Education: DHEW (Bayne-Jones Report) (Government Printing Office, Washington, D.C..
1958). 2. Federal Support of Medical Research: Report
of the Committee of Consultants on Medical Research to the Subcommittee on Departments of Labor and Heakh, Education, and Welfare of the Committee on Appropriations, United States Senate, 86th Congress, 2d Session (Boisfeuillet Jones Report) (Government Printing
Office. Washington, D.C., 1960). 3. Public Law 86-798, 15 September 1960. 4. The Advancement of Knowledge for the Na
tion's Health: A Report to the President on the Research Programs of the National Institutes of Health, Office of Program Planning. NIH (Government Printing Office, Washing
ton, D.C. - 1967). 5. Science, Government, and Information (Gov
ernment Printing Office, Washington, D.C., 1963); A. Weinberg, Reflections on Big Science (M.I.T. Press, Cambridge, Mass., 1967).
Mr. DADDARIO. Gentlemen, you have both given us two extremely important statements which are difficult to come to any judgment about so quickly. They give this committee and its staff the thought-provoking advise which it needs and which I believe to be of immense help to us. Difficult as they are to understand, I believe them both to be extremely good and helpful for our particular purpose.
We do start off with the idea that you both agree with, that the executive branch is in urgent need of suitable organization. You gave us some suggestions as to how this might be done. This does need to be analyzed. But you both touch on the importance of doing some other things. I think you are both in agreement that the National Science Foundation and its role ought to be enhanced, that it ought to have more money, and that it can do more than it is presently doing. How much funding should it have and if this were to be obtained what do you believe it would accomplish, insofar as making the organization a more practical reality.
Dr. BENNETT. Well, I will be glad to comment, Mr. Chairman. I can't give you the exact number of dollars that would fulfill my minimum suggestion.
Mr. DADDARIO. The figure which has been given here by Dr. Handler, and others, not only during these hearings but in others, has been that we should look to the day when National Science Foundation is funded to the amount of $1 billion.
Dr. BENNETT. Well, the figure you will find in the longer paper which I submitted which als I mentioned represents a consensus, points to the day when in terms of funds that directly support research that NSF would supply approximately one-third of these, whereas the last detailed figures available to me which I believe were for fiscal year 1968, it was 15 percent. So this would involve an approximate doubling at the present time, on the present overall level of support, of the National Science Foundation budget and this would be very close to $1 billion.
Because I want to emphasize, of course, that the amount of the National Science Foundation budget that goes for the direct support of research is only about $220 million from their almost $500 million budget. It varies between $400 million and $500 million. The rest of it goes for teacher-training programs and things of that sort that are not as directly related to the support of academic research.
So, I think that $1 billion is a good approximation of what we would be talking about in the existing situation. Obviously it would have to increase above that if it was maintained at the level of onethird of the overall support of academic science.
Mr. DADDARIO. By the support in this amount, you can develop within the National Science Foundation the ability to do a lot of things which they are not doing. Also it would then be placed in a proper position insofar as its responsibilities are concerned, including the requirement that you have said was placed on it in the first instance and which it has never been able to achieve because of this lack of funds.
Dr. BENNETT. It would open up that possibility, but in addition it would make is possible for many of the mission-oriented agencies to disengage themselves from the acquired responsibility for the general stabilization of universities which they are able to do only partially and enable them then to concentrate better on the accomplishment on their respective missions.
But the pluralistic system of support for research is quite different from the pluralistic attempt to support these institutions as institutions. I think that it would make possible a transition of this responsibility to NSF where it would be placed squarely and where NSF would be able to fulfill this responsibility:
Mr. DADDARIO. We see this disengaging situation developing in a very graphic way at this time. The unfortunate situation is that as the disengaging takes place there is not sufficient funding for the National Science Foundation to truly fulfill this role.
Dr. BENNETT. This is absolutely correct, and the reason that I suggested the 3-year indicative plan would be to display for Congress as well as the agencies how these shifts would take place, so that we wouldn't have the situation which I personally have seen where funds for high energy physics were removed from the Department of Defense budget but then appeared in the NSF budget and the reaction of one particular congressional subcommittee, not this one, and indeed not in this House, was that someone was trying to play tricks on them by putting something over into another budget. If they had enough beforehand that this was part of an integrated plan and understood that no one was trying to hide the fact that this support would now be from National Science Foundation rather than the Department of Defense, I think the reaction would have been quite different.
And the whole purpose of this indicative plan-3-year plan that would be updated each year—is to demonstrate that the budgeting is indeed integrated and that there is a long-range plan for shifting these responsibilities to more appropriate places within the existing agencies.
Mr. DADDARIO. Mr. Winn, you had a question-or Mr. Mosher?
Mr. MOSHER. Dr. Bennett, you certainly have been in a position to see the National Science Foundation in operation and I would like to have your comment on a statement made by a previous witness here, when he referred to "bureaucratic timidity in the National Science Foundation. I believe that was the phrase he used, and the implication was that the National Science Foundation has been particularly timid in speaking to the Congress, it hasn't been aggressive enough in trying to tell Congressmen what its goals are. Perhaps NSF's inadequate financing stems in part just from that simple fact, that the National Science Foundation hasn't been up here lobbying enough on the Hill.
Do you want to comment on that?
Dr. BENNETT. I would comment on it only to say that I agree with that general view of the past, but being well acquainted with the new Director for the National Science Foundation and in the most complimentary fashion I can, I would like to say that insofar as personalities can reverse this trend, I think Dr. McElroy will be able to do it.
Mr. MOSHER. You would say that NSF has a job to do in educating the Congress, would you agree with that?
Dr. BENNETT. I would certainly agree with that, yes.
Dr. SHANNON. I don't think it is simply a question of educating the Congress. I think that the greatest barrier to getting its story across over
the now almost 20 years of its existence has been in the definition of its responsibility. This has been dominated by a meaningless term called "basic research.” Such a term cannot be used as the basis for either budget development or program performance. It does not carry with it a sense of responsibility for an essential program. Both Dr. Bennett and I pointed out that this appropriation, i.e., NSF, should be the primary source to provide for the stabilization and future development of the essential science necessary for the development and maintenance of our great universities, and that this budget should be adequate to support a lively program in graduate education, and that the needs of science in these areas are derivative of these very real program needs. In such a sense the NSF acquires broad social purpose and adequate funds to fulfill such a purpose.
Over the years many of us have felt that this probably is the most restricting deficiency in NSF, the definition of what its function really is. A clear purpose does not come out in its own reports, it does not come out in congressional hearings, and basically an acceptable purpose that is also generally understandable has not been perceived by the leadership within NSF. Yet it now has all the authorities required to fulfill these essential roles.
So, I would say, or the thrust of my comments I won't interpret those of Dr. Bennett—is that the definition of the purpose for which NSF is there requires certain inquiry and redefinition, in more understandable terms.
Mr. DADDARIO. Dr. Bennett, in reply to Mr. Mosher, you, in praising the new director, Dr. McElroy, believe that it would not be the case with him that he will not be timid. I would expect that his role would be enhanced considerably because of the restructuring of the National Science Foundation which gives him a deputy and four assistants and by providing these people, he can play a tremendous role in bringing the National Science Foundation into the perspective or into the scheme of things which you people believe is necessary.
Dr. BENNETT. I would certainly agree that his ability to carry these things out will be greatly enhanced by this restructuring, the implementation of which of course was held in abeyance until his selection. The additional authority and this restructuring, insofar as these particular factors can play a role, will be much more favorable than they have been in the past.
Mr. DADDARIO. Both of you have offered organizational suggestions or recommendations and you lead us in various directions. You have also talked about the stabilization and further development of science, the need for programs in graduate education.
You have touched on this, Dr. Bennett, in your supplementary statement. I think it would be helpful to the committee for you to look ahead a bit and give us your idea of what you believe we are going to need to do in this area. If I understand your figures, it is going to be in such a high order that the accounting, the explanation, and the ability to do this and have the public support it, is going to need handling by the Congress in a way that it has not done before.
I would like both your comments on that, if I might.