There Is No Secret Plan ... And No "Secret Sauce" Either!

When budget fights loom in Congress, I am often asked: what do you think will happen ... what will Congress agree upon? Implicit in the question is that there is some predictable logic in how these things are settled or that there is a secret plan that Congressional leadership will roll out when the time is right. Unfortunately, there is nothing predictable or logical about the political process that accompanies budget and spending issues. I feel confident, as well, that there is no secret plan, certainly not this year. Speaker Ryan and Senate Majority Leader McConnell don’t have any more certain idea than we do about the final outcome.What I call “the iron triangle of deficit reduction” is a useful tool for understanding why this year is going to be even harder to predict. The iron triangle holds that deficit reduction can only come from three sources: changes in mandatory programs (entitlements), cuts in discretionary programs (defense plus non-defense), and increases in tax revenue.The iron triangle illustrates the degree to which the priorities of President Trump and the Republican Congress, however desirable some of them may be, compete with each other and cannot all be achieved without further deficit spending or truly massive cuts in domestic discretionary spending. We can eliminate two points of the triangle: tax reform is supposed to be revenue neutral and the President has pledged not to touch Social Security and Medicare, by far the largest entitlement programs and among the fastest growing.That leaves discretionary spending to make up the difference -- enough to offset growth in mandatory spending and reduce the annual budget deficit. This would be hard in its own right, but even more difficult given the President and Congress’ other priorities: more spending on defense (already more than half of all discretionary spending); dramatically increasing the border security workforce; building a border wall; and putting a massive infusion of funding into infrastructure projects. All these would, presumably, have to be offset by cuts in domestic discretionary spending or be deficit financed (unlikely).From the President’s point of view, this squeeze on spending is okay -- the money will be found by eliminating some agencies and programs and drastically cutting most others. And the cuts would indeed have to be enormous to conform to the iron triangle. In the current political environment, this could happen. However, past efforts to cut so much from federal spending have run into a roadblock from both Republicans and Democrats: Members want deficit reduction but also want to vote for programs that are popular back home or represent what they consider core functions of government.For our purposes, all these thoughts come back to one question: how will this affect FDA and what do we, as advocates, need to do to assure an FDA that can fulfill is many vital and growing responsibilities. At a minimum, we want to keep FDA off the lists of programs to be eliminated and programs to be drastically cut. Beyond that, we need to make the case that FDA is a core function of government: that a large group of people -- every single American -- reaps the rewards from a relatively small group of people at the FDA who are working to make sure food is safe and medical products are safe and effective.Note: The Analysis and Commentary section is written by Steven Grossman, Deputy Executive Director of the Alliance for a Stronger FDA