April 25, 1966
Dear John:
I very much appreciated your thoughtful letter of March 15 in which you express 
the concern of yourself and other members of the Subcommittee regarding the 
adequacy of the 1967 budget for the National Institutes of Health. I fully 
recognize the strength of your convictions and the sincerity of your views. Accept 
my assurance that they have had my personal and lengthy consideration.
For many months now we have had the Federal budget under constant review. Only the 
other day I talked at length with the Mayors and later with the heads of all 
departments and the major Federal independent agencies about the economic 
situation of the country and the need to practice restraint and make sure that we 
spend only that which we must spend. During our budget reviews last November and 
December we strove to provide the Congress a budget which would meet our 
international commitments, and would also permit us to press confidently forward 
towardthe Great Society. I did not want to stop progress on any front, but it was 
clear that we could not meet all our goals at one time. Therefore, with the 
greatest reluctance, I found it necessary to request the Congress for a slower 
rate of advance in many programs than I would have liked. I still believe that our 
choices were right.
Yet in our Great Society programs -- health, labor, training, education, war on 
poverty, housing and community development -- the 1967 budget proposed 
administration budget expenditures of $12.9 billion, an increase from 1964 of $6.2 
billion. Exclusive of added Viet Nam costs  and unavoidable interest paying 
payments, all other budget expenditures were cut back by $3.7 billion between 1964 
and 1967.
I found the budget choices particularly difficult in the field of health, for as 
you know, I am personally dedicated to the need for the highest quality of medical 
care for all Americans. Taking all Federal programs into account, including trust fund payments for Medicare, Federal health expenditures rise from $5.1 billion in 
1964 to $10.3 billion in 1967. The NIH expenditures are more than 10 percent of 
these total health expenditures.
I share your view that the budget for NIH does not propose to do all the 
researchers -- or you and I -- would like to see done in 1967. But for all NIH 
except construction the budget increase of $93.5 million is the largest single 
increase for NIH proposed by a President in his January budget. No Institute was 
cut below 1966, funds are requested for all newly authorized programs, and as 
explained in the budget document, funds for an artificial heart will be requested 
if important new breakthroughs occur. The amounts requested for health research 
construction will be channeled to new medical schools so that no delay will occur 
in their planned progress toward expanding our enrollment of medical students.
Reasonable men may differ when these difficult choices are made. I understand the 
positive sentiments which motivate your statement of views, and after you have 
considered the balance which must be maintained in our economy and among our Great 
Society programs I know that you will decide in terms of what you think is the 
best national interest.
[handwritten] Lyndon Johnson