NIH Changes Threaten Duke Medical Center

hallcity

hallcity

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The Trump Administration is dramatically cutting federal funding for medical research in a sneaky way — reducing the amount paid for indirect costs of medical research. The effect won’t be subtle.
www.nytimes.com

Trump Administration Cuts Put Medical Progress at Risk, Researchers Say

Grants from the National Institutes of Health come with additional money for overhead. A planned $4 billion cut would leave colleges with large budget gaps.
www.nytimes.com www.nytimes.com

Josh Marshall (@joshtpm.bsky.social)

From what I hear from multiple people in the space, the latest NIH indirect costs for medical research grants will basically mean the end most academic medical centers.
bsky.app bsky.app

If this stands, the effect on Duke will be enormous.
 
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hallcity said:
The Trump Administration is dramatically cutting federal funding for medical research in a sneaky way — reducing the amount paid for indirect costs of medical research. The effect won’t be subtle.
www.nytimes.com

Trump Administration Cuts Put Medical Progress at Risk, Researchers Say

Grants from the National Institutes of Health come with additional money for overhead. A planned $4 billion cut would leave colleges with large budget gaps.
www.nytimes.com www.nytimes.com

Josh Marshall (@joshtpm.bsky.social)

From what I hear from multiple people in the space, the latest NIH indirect costs for medical research grants will basically mean the end most academic medical centers.
bsky.app bsky.app

If this stands, the effect on Duke will be enormous.
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It's not just Duke. I've long made the joke that the easiest way to cut healthcare costs is to close all the hospitals. I didn't think anyone would actually take me up on that suggestion.

My best advice - don't have a serious medical issue for the next 4 years.
 
I wonder if/how this is being covered in the non-mainstream media that many people get their information from.

Note: I despise the term "mainstream media" but it is the best way to describe it in this situation.
 
ClemmonsDevil said:
I work in medicine and my girlfriend works in academia (women's studies and poli sci professor) and no one should be ok with constraints placed on legitimate research. This is Orwellian.
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With all respect (honestly), I don't think Orwellian is the word you're looking for.
 
Just for the record, Duke's current F&A rate agreement specifies that Duke receives 61.5% of costs as indirect costs. Duke received approximately $550,000,000 in federal grant money from the NIH last fiscal year. For technical reasons, the actual rate received is less than 61.5%, but Duke would are still be looking at a loss of something something like $200,000,000 if this actually happens.

Just to be clear, the endowment cannot cover that. Duke would have to fire personnel and potentially even close entire buildings if this happens.

F&A alone absolutely dwarfs athletics money. This would be nothing short of catastrophic for every research university in the country, and would overnight turn the United States from a research leader into an also-ran.
 
dudog84 said:
With all respect (honestly), I don't think Orwellian is the word you're looking for.
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"Orwellian is an adjective which is used to describe a situation, an idea, or a societal condition that George Orwell identified as being destructive to the welfare of a free and open society."

This feels like what I was trying to say and is definitely my understanding of the term. Am I incorrect?
 
Phredd3 said:
Just for the record, Duke's current F&A rate agreement specifies that Duke receives 61.5% of costs as indirect costs. Duke received approximately $550,000,000 in federal grant money from the NIH last fiscal year. For technical reasons, the actual rate received is less than 61.5%, but Duke would are still be looking at a loss of something something like $200,000,000 if this actually happens.

Just to be clear, the endowment cannot cover that. Duke would have to fire personnel and potentially even close entire buildings if this happens.

F&A alone absolutely dwarfs athletics money. This would be nothing short of catastrophic for every research university in the country, and would overnight turn the United States from a research leader into an also-ran.
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And note that Duke has better liquidity and finances in general than most other hospitals, so in some ways is better positioned to deal with this than many others. The pandemic was very challenging for health care (both operationally and financially) and hospitals were finally starting to rebound a bit and rebuild reserves. Last I looked I think Duke has about 300 days cash on hand so could theoretically (but not realistically) operate BAU for close to a year off of reserves. Many hospitals are much, much lower than that.

I think the current administration also forgets that it isn't just a bunch of liberal PhD types whose livelihoods are supported by medical research. For every one of them, there are a number of other people in supporting positions, including those who mop the floors, clean the bathrooms and work in the cafeterias. And obviously the set back to the progress of medical treatment and research, which is kind of important (sarcasm).
 
ClemmonsDevil said:
"Orwellian is an adjective which is used to describe a situation, an idea, or a societal condition that George Orwell identified as being destructive to the welfare of a free and open society."

This feels like what I was trying to say and is definitely my understanding of the term. Am I incorrect?
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Not really, but I responded by PM.
 
ClemmonsDevil said:
"Orwellian is an adjective which is used to describe a situation, an idea, or a societal condition that George Orwell identified as being destructive to the welfare of a free and open society."

This feels like what I was trying to say and is definitely my understanding of the term. Am I incorrect?
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I tend to think Huxley was right but what do I know..
CrazyNotCrazie said:
I wonder if/how this is being covered in the non-mainstream media that many people get their information from.

Note: I despise the term "mainstream media" but it is the best way to describe it in this situation.
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"With thunderous applause."

As a one time Duke employee that was partly funded by a NIH grants nothing good can come of this. Even if things go back to normal all future budgets will now have to account for the possibility and not like in the past where it was you got money or you didn't. You can't maximize productivity or resources for research. You can't do cutting edge stuff that, realistically, has a high failure rate.
 
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The president of my wife’s university sent out a message that the change in indirect % is illegal (what else is new) and they will be filing suit very shortly. For what it’s worth.
 
acdevil said:
The president of my wife’s university sent out a message that the change in indirect % is illegal (what else is new) and they will be filing suit very shortly. For what it’s worth.
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I have no doubt it's illegal. But even the threat is concerning. Legal (albeit somewhat slower) means exist to accomplish the same basic goal. Also, delays can permanently destroy certain types of research. The USAID mess is already causing serious loss of field data and screwing up years of prior investment in global health field research.
 
Phredd3 said:
I have no doubt it's illegal. But even the threat is concerning. Legal (albeit somewhat slower) means exist to accomplish the same basic goal. Also, delays can permanently destroy certain types of research. The USAID mess is already causing serious loss of field data and screwing up years of prior investment in global health field research.
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I agree. I think the message he was getting out to the labs was basically “Keep doing what you have been doing. We’ll do what we can on the legal side.”
 
The good news is that many other medical centers are in the same metaphorical boat. There's going to be a lot of pushback on U.S. Senate and House members...congressmen may be a an odd bunch, but nearly all of them understand the importance of $$$ flowing into their state and district.
 
budwom said:
The good news is that many other medical centers are in the same metaphorical boat. There's going to be a lot of pushback on U.S. Senate and House members...congressmen may be a an odd bunch, but nearly all of them understand the importance of $$$ flowing into their state and district.
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My wife is in a clinical drug trial at the University of Colorado medical facility. I used to do a lot of legal work for them and still have some contacts.

The future of this clinical drug trial appears to be uncertain. It makes me sad, both on a personal level and, more generally, out of concern for the future of medical research.
 
On a related note, Duke was recently dropped by Cigna as Cigna Care Designation providers. They are wayyyyy too expensive to go to even for in network care. Sometimes the cost is double to see a Duke provider vs. UNC or WakeMed. As an example, a Nasal Endoscopy that takes 3 minutes is $1,100 at Duke. No joke.
 
budwom said:
The good news is that many other medical centers are in the same metaphorical boat. There's going to be a lot of pushback on U.S. Senate and House members...congressmen may be a an odd bunch, but nearly all of them understand the importance of $$$ flowing into their state and district.
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Considering this is going to hit almost every single major research university in almost every state almost everyone of them should be doing something. And it's not just academic work. They is the entire pharma lobby getting on the phones.
 
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