Doctor: HMOs Harming Research

6:52 PM (ET) 7/14/97

PORTSMOUTH, N.H. (AP) -- Medical cost-cutting imposed by managed care organizations is choking off a vital source of money for medical research, a scientist says.

Health maintenance organizations and similar groups are forcing academic medical centers to cut the fees they charge by making them compete against community hospitals for patients, said Dr. James Muller.

The problem is that part of the money academic centers take in from patients is used to support research and teaching, expenses that community hospitals don't have, he said.

"Heart research is taking a double hit" because it is also poorly supported by federal grants, he said.

In a heart research program he ran until June 30 at Harvard Medical School, patient fees supplied $600,000 a year for research too preliminary to attract grants, to pay young scientists and provide a funding source between grants, he said.

Because of cost-cutting, that fell to $200,000 a couple years ago, too little to keep his program going, Muller said.

That's why he quit Harvard to head the Kentucky Heart Institute at the University of Kentucky in Lexington, he said Sunday in an interview at a meeting sponsored by the American Heart Association. Income for his new program is guaranteed by a $10 million endowment, he said.

Muller said the funding problem is affecting major academic medical centers elsewhere.

"The long-term struggle for better health requires more research, and what's being destroyed . . . is the research structure," he said.

Nationally, academic centers rely on income from patients for about a tenth of their medical research funding, he said. The money is more important than that fraction would indicate because it's needed to keep research programs going between grants, he said.

Muller stressed that he believes managed care organizations are doing a beneficial thing by driving down medical costs.

"There's no villain here," he said.

Dr. Jan Breslow, president of the American Heart Association, said the income from heart patient fees "is disappearing and there's no provision for replacing those funds. "

That could stall the search for better treatments, he said, especially in combination with what he called chronic underfunding of heart research by the National Institutes of Health.

Muller said one solution would be a bill recently introduced by Sen. Daniel Patrick Moynihan of New York that calls for a tax on health insurance premiums. That would generate an estimated $4 billion a year, he said.