Like so many of our colleagues, we were alarmed by the news coverage this weekend that indicated officials from the Centers for Disease Control and Prevention (CDC) had been directed to avoid using seven words and phrases, including ‘evidence-based’ and ‘science-based,’ in the preparation of their annual budgets. As the voice of health services research and an advocate for the use of evidence to improve and inform decision-making, such a ban is an anathema to everything we hold dear.
We were not alone. The story blew up on social media and prompted responses from the heads of the National Academies, Congressional Democrats, and a flurry of ‘sign on letters’ from our peers in the scientific community. (We added our name to this one, organized by Results for America.)
As the dust begins to settle, there’s a slightly different narrative emerging, one that points not to an official ban, but to ‘guidance’ from the Department of Health and Human Services (HHS) designed to help the agencies more successfully position their work within the White House’s Office of Management Budget and Congressional appropriators. While this may not, in fact, constitute an all-out ban, the very fact that the degree to which a program seeking funding may be science- or evidence-based could be perceived as a liability is deeply concerning.
There is also some irony in this story breaking mere weeks after the introduction of bipartisan legislation to advance the recommendations of the Commission on Evidence-Based Policymaking, and just days before stories of the Department failing to publicly post 10,000 comments on a proposal that could affect access to abortion and care for transgender patients, while also monitoring of emails of Environmental Protection Agency employees who have been publicly critical of the Administration.
As a nation, we face complex, multifaceted challenges that force our federal policymakers to make difficult decisions that affect the lives and livelihoods of millions of people. These decisions require more, not less, science and evidence, more transparency, and more effective communication and translation of evidence into policy and practice. Instead, we find a science community under threat from both reduced funding for our work, increasing and inappropriate attempts to influence the work and its results, and suppression or removal of key data sources. This is unacceptable.
We were pleased to see a swift and clear response from the community and policymakers to the “7 words” reports, as well as denials from HHS and CDC officials. However, advocacy for science and evidence-based decision-making requires that we remain alert to extreme attacks like this one and the more procedural and (somewhat) predictable challenges of federal appropriations, contracting and regulatory affairs. That is what we do for our members!
Here are just a few of the issues we are watching at AcademyHealth:
- Appropriations. The government continues to operate on a continuing resolution for fiscal year 2018, and there’s real potential for a government shutdown this Friday, December 22. Without a broader budget deal to raise the austere spending cuts, lawmakers will be forced to make even deeper cuts to important agencies that support health research and public health.
- Taxes. The Congress is poised to pass a tax bill that will have longstanding consequences—intended and unintended—on individuals and nonprofit organizations alike. While the final bill has addressed earlier concerns related to graduate student stipends, it leaves many questions about what lawmakers will cut in the future—research? entitlement programs?—to cover the bill’s hefty price tag. And of course, what the repeal of the Affordable Care Act’s individual mandate does to the health care marketplace, and ultimately, Americans.
- Data. AcademyHealth has already responded to proposals to either eliminate, or seriously constrain, certain types of data collection (e.g. data on LGBT, data on geographic disparities).
The defense of evidence and science is fundamental to AcademyHealth and our field. We must speak out, loudly and effectively. To do so, we need your help! If you are reading this and are not a member, join! If you are already a member, THANK YOU, and please consider an additional financial contribution.