Skimping on brain food -- April 5, 2013 column

By MARSHA MERCER

President Barack Obama says “the next great American project” will be mapping human brain activity.

The budget he will send Congress Wednesday calls for $110 million for his brain initiative in fiscal 2014, which begins Oct. 1.

Even Newt Gingrich and Eric Cantor support brain research. Former Republican House Speaker Gingrich said Obama “deserved credit for taking an important step in the right direction.”  And House Majority Leader Cantor said in a statement it’s “exactly the type of research we should be funding…it’s great science.”

Before we go all gooey about gridlock thawing in Washington, a new space race or our 21^st Century Camelot, let’s take a deep breath. The president proposes, Congress disposes. And $110 million -- bold?

Don’t get me wrong. You’d have to be living in a cave not to support the effort to unlock the mysteries of the brain. We need this research, and we need it now. But it’s hardly a done deal. There’s plenty of time for Republican mischief making. And about that federal effort of $110 million a year – that doesn’t say bold or audacious.  It says modest. Piddling.

I get the rationale for starting small. Maybe it’s the best the president can hope for in the Honey- I-Shrank-Uncle-Sam era. But in modern America, $110 million is small potatoes.

It’s Justin Bieber’s net worth. He’s 19.

It’s the listing price of a penthouse apartment in New York City last year. OK, the apartment was near Carnegie Hall, but still.

It’s even just three-tenths of 1 percent of the National Institutes of Health’s annual budget, according to Francis Collins, the director.  

He said in a live chat via Twitter that NIH is in a “pickle” after budget cuts over 10 years that lopped 20 percent of purchasing power for research. Sequestration is draining $1.5 billion from NIH this year, he said.

So don’t let cold-eyed budget hawks tell you $110 million is a large sum. The Human Genome Project got about $300 million a year from Uncle Sam. Total federal investment was $3.8 billion. The project to map the human genome took 13 years.

Obama likes to tell audiences that every dollar spent on the genome project generated $140 in economic output.  Not bad.

Republican Cantor suggested “reprioritizing the $250 million we currently spend on political and social science research” for the brain initiative. It almost sounded as if Cantor was doubling the president’s bid on brain research. Wouldn’t that be fun? More likely, Cantor was trying to show he’s for the brain, conservatively speaking.

Obama envisions his initiative as “giving scientists the tools they need to get a dynamic picture of the brain in action and better understand how we think and how we learn and how we remember. And that knowledge could be – will be – transformative.”

After a decade of war, no politician will, or should, ever say we’re doing all we can to help our wounded warriors with traumatic brain injury and post traumatic stress disorder. No one can tell families struggling to help loved ones that we should wait to look for ways to treat, cure or even prevent Alzheimer’s, autism, epilepsy, Parkinson’s and strokes.

And yet, such practical applications of the BRAIN project -- Brain Research through Advancing Innovative Neurotechnologies – are far off. Obama didn’t mention a timeline or even a definite goal.

Three federal agencies will contribute money to the research in the year that begins Oct. 1: National Institutes of Health, $40 million;   Defense Advanced Research Projects, $50 million; and the National Science Foundation, $20 million.

Some say this isn’t the right time begin a new project because of budget woes, but Collins says research has progressed to the point where putting it on hold is wrong.

The federal government will work with four foundations on brain research. The Allen Institute for Brain Science has agreed to spend $60 million annually on projects related to the initiative; Howard Hughes Medical Institute, $30 million annually; the Kavli Foundation, $4 million a year over 10 years; and  Salk Institute for Biological Studies, $28 million.

It’s a good start, but it’s not enough.

“I wish we could go faster,” Collins said on the live Twitter chat. “Maybe we’ll be able to ramp it up.”

© 2013 Marsha Mercer. All rights reserved.

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Why applauding, kissing and hugging Gabby Giffords isn't enough -- Jan. 26, 2012 column

By MARSHA MERCER

The outpouring of respect, empathy and, yes, love for Gabrielle Giffords on Capitol Hill was heartfelt, inspirational – and inadequate.

The congresswoman from Arizona who was critically wounded a year ago by a would-be assassin rightly received thunderous applause, hugs and kisses Tuesday at the State of the Union address and a teary farewell Wednesday when she resigned from the House.

Democrat Nancy Pelosi, the former House speaker, called Giffords “the brightest star among us, the brightest star Congress has ever seen,” and Republican Eric Cantor, the majority leader, said he spoke for all his colleagues when he said, “We are inspired, hopeful and blessed for all the incredible progress Gabby has made in her recovery.”

On Jan. 8, 2011, Giffords was holding “Congress on Your Corner,” a meet-and-greet event, in Tucson when a gunman opened fire, killing six people, including a 9-year-old girl who just wanted to meet her congresswoman, and wounding Giffords and 12 others.

The horrific attack stunned the nation and Congress. There’s nothing like having a colleague shot in the head at close range on a Saturday morning back home to focus the mind of even the most cynical member of Congress. Every House member and senator knew he or she could have been the target. Ordinary citizens knew we could have been exercising our civic right at the wrong time.

Watching Giffords now, we marvel at how far she’s come, and we know that the unspeakable could happen to any of us or to our loved ones. We too could struggle to speak clearly, to walk haltingly and to cope with a right arm that doesn’t work the way it used to. Any of us.

Giffords is one of those rare and luminous elected officials who rose above the political fray. As an obscure Democratic House member, she had a reputation for working across party lines and, old fashioned as it sounds, for wanting to do what was right for her constituents and the country.

She now is a beacon of hope for the 1.7 million Americans a year who suffer traumatic brain injuries.

Medical experts say Giffords has been lucky. She has received America’s finest health care – from intensive care to rehabilitation. As a federal employee wounded on the job, she has coverage for rehabilitation services for as long as necessary.

Many other traumatic brain injury patients are not so fortunate. Much depends on what kind of insurance someone has, if any, where one lives, what medical facilities and even whether family advocates are nearby, according to the Brain Injury Association of America.

The bottom line is that while Medicare, Medicaid and most insurance plans cover brain surgery and intensive care, insurers tend to skimp on rehabilitation programs, which affect a patient’s quality of life, USA Today reported in March.

Hundreds of thousands of patients who lack coverage are discharged each year from hospitals to nursing homes or to languish in their beds during critical early months when their brains are more receptive to healing, USA reported.

The military’s treatment of brain injuries also has been criticized, but ProPublica, a non-profit investigative news organization, recently quoted a neurological surgeon who said military care of brain injuries is “a hundred times better than what goes on in the civilian sector.”

Gabby Giffords wants to change that. She believes anyone who has suffered a brain injury should have access to the same high quality care she has been fortunate to receive.

And so, members of Congress can applaud, hug and kiss Giffords all they want, but it’s not enough.

To support Giffords’ struggle in a meaningful way, lawmakers should endorse, not repeal, the Affordable Care Act, also derisively known as ObamaCare. The law says some rehabilitation services must be included in essential benefit packages that go into effect in 2014 for Medicaid and companies participating in insurance exchanges.

The Obama administration has said it’ll leave details of those packages to the states, but to honor Gabby Giffords, the packages should specifically cover rehabilitation for traumatic brain injuries. It’s the right thing to do.

© 2012 Marsha Mercer. All rights reserved.