Last night came and went, bringing with it what anyone who watches politics pretty much expected. The country is in a mood of "out with the old, in with the new". It is Spring and the electorate is cleaning (the) House (and the Senate). There is an anti-incumbency fever about. There is no sign that it will abate before November.
The Alliance for a Stronger FDA (the Alliance) had a very interesting posting the other day called "Gloom, Change and Rumor Up on the Hill" that pointed up that given the fact that 25 cents of every dollar spent in the U.S. is spent on something that is regulated by the Food and Drug Administration and that requests for increased funding may be in danger. After examining statements made on the Hill, the posting read the tea leaves this way – "the President's budget request is now considered "to generous" and that Congress needs to markup the bills to effectuate greater cuts. For the FDA's sake, we hope this is not the case."
The posting then turned its attention to the fact that the FDA-knowledge pool on the Hill was being drained a bit. First there was the failure of Senator Bob Bennett to secure his party's nomination in Utah. The Alliance points out that he had been a great friend of the agency both as the head of the Senate Appropriations Committee and later as Ranking Member of the U.S. House Committee on Agriculture. His would-be replacement on the Republican side is also leaving the Senate. David Obey, the Democrat in charge of the U.S. House Appropriations Committee is also leaving.
This week, things edged a little bit further. Arlen Specter lost his bid for nomination in Pennsylvania. A frequent FDA critic, he had nonetheless pushed the last Administration for more funding for the agency so that it could do its job of saving lives.
Dr. Rand Paul won his bid to have a chance at representing Kentucky. I could find no policy statements about the FDA exactly, but he does have a lot of labels attached to him that do not bode well for FDA. These labels express a philosophy of less government intervention in the lives of citizens, not more. That could mean less scrutiny of dietary supplements and/or regulation of tobacco products – two new areas of expansion for the agency. As a physician, one would assume that healthcare will not only be an interest of his, should he be elected, but that others might look to him to be a leader in health policy.
And as for funding, back to the first concern of the Alliance, today the Washington Post reports that Democrats are becoming "queasy" over deficit spending. That is a clear "symptom" of the "fever" being experienced by the electorate and there is little reason to think that this symptom will diminish before November, and in fact, hasn't hit its peak.
There are two take-aways from this. First, after a period of years under the Bush Administration where at times the Congress had to ask FDA to ask for increases, now that the FDA has its act together, the Congress may be in a far less generous mood. That means that funding to provide the FDA with support for its huge responsibilities may not appear, causing the FDA to trim its sails, or at least begin prioritizing what it wants most to do, and what can wait. The second take-away is broader – for all of those who are involved in health care advocacy, come November, the pool of people who were highly knowledgeable about the issues are going to be replaced with newbies who may have an agenda. Developing one's tools and messages for such an outcome might be wise and doing it now, rather than later, might even be smarter.