STANFORD UNIVERSITY MEDICAL CENTER
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March 26, 1973 -

Stanrorp Unrverstry ScHOOL oF MEDICINE
Department of Genetics

Honorable Paul G. Rogers
House of Representatives
Washington, D.C. 20515

Dear Mr. Rogers,

Thank you again for the opportunity to testify on the "National
Health Research Fellowship and Traineeship Act of 1973".

As is almost (too) universal, my testimony was prepared in some
haste -- and your shrewd colleagues were able to probe some of my conflicts
very well in the discussion after my formal statement.

The one thing I am troubled avout is the provision for obligatory
contingent repayment, which sets a major precedent. I sympathize with
its objectives, and would like to see some mechanism for achieving them.
However, I think the procedures need to be very carefully analyzed. To
raise one simple issue, is the subsidy a non-taxable gift if it has such
contingent strings?

What I would advocate is that the present bill simply reinstate
the existing program of training grants in the basic sciences. The
impoundment issue could be met by entitling the existing programs to
continuation until such time as HEW has established procedures for review
and award to more qualified successors (if any). This continuation is an
emergency measure, say for two years, pending a legislative study of the
new directions that these programs might take.

The bill would meanwhile direct the Secretary of HEW to formulate

programs, with consultation with the people (like us) in the field for

the implementation of policies designed to further

. (1) rationalize and justify the "magic numbers" that Mr. Heinz referred to

(2) assess the degree and manner in which loan-based programs could

replace the present grant subsidies. I can see far more equity in a system

of repayment based on later income than any other -- and then one has to

say, doesn't the progressive income tax already assure the government that

it will recapture its investment without further fuss!

In any event, this is an extremely complex matter when applied to the
sciences:

I hope I have conveyed the facts of the way in which science differs
from the professions and from business in its economic structure. The
professional lawyer or doctor is in the marketplace, exchanging specific
services for fees in bargains (more or less hindered) with specific clients.
The scientist has foregone that claim -- and there would be too much
friction in the knowledge system for this to work any other way. He is

-~2-

LT. J. P. KENNEDY, JR. LABORATORIES FOR MOLECULAR MEDICINE, DEDICATED TO RESEARCH IN MENTAL RETARDATION

MOLECULAR BIOLOCY HEREDITY NEUROBIOLOCY DEVELOPMENTAL MEDICINE
Honorable Paul G. Rogers -~2- 3/26/73

serving, and is paid by, the social system as a whole, for functioning
according to his best lights. That patronage, appropriately, goes much
further.in providing the scientist with facilities for his work than
in boosting his salaries.

The salary structure of basic science is such that the people in
the very top of the field and say 20 years after their doctorate, barely
match the average incomes of doctors after 10. I personally view this as
eminently fair bargain, taking account of my love for my work -- but I
also have to say that it may appear differently on the average level of
scientists’ incomes.

 

In this light, the patronage of would-be scientists during their
training*is a matter of special social concern. Private scholarships were
not remarkable in principle before World War II; the trend of history has
inevitably substituted the federal government as patron -- a position of
enormous power and also of great responsibility.

Mr. Heinz asked about the "magic number". Of course, it is difficult
to give quick answers to this important question. Suppose the director
of OMB had, and exercised, the power to eliminate Congressional Staff --
and then demand a rigorous justification for just how large that staff
should be? Except that we are far more helpless, we are in a somewhat similar
position. The "magic number" is certainly not zero, and its actual levels
historically had evolved from year to year in confrontations and compromises
with other competing demands. This is by no means to preclude periodic
review of the justifications -- hopefully by a process whose assumptions
are revealed, and which at least attempts to answer the detailed staff work
of the agency. .

If the issue is the overall scale of the health research budget, the
administration's actions would be more credible -~ NIH itself, with vital
communication from the knowledgeable people at the front lines, could
devise the most conservative strategies to protect the institutions of science
from the most destructive impact of economic exigency. The present style
of the OMB fiats (which is merely Latin for "DOIT", now - and don't stop
to think, which we also hear in other revolutionary contexts) whether
intended or not is likely to result in a radical restructuring of scientific
effort whose net harm far outweighs the actual level of overall budgetary
reorientation.

Dr. Kornberg said, somewhat melodramatically, that "the lights are going
out in laboratories". This is an accurate reflection of the mood of earnest
youngsters notwithstanding the relative robustness of the overall R&D budget.

Sincerely yours,

Joshua Lederberg
Professor of Genetics

JL/rr