Almost everyone at the House Appropriations Committee gets a chuckle from Rep. Edward J. Patten (D-N.J.), who more than once has taken his afternoon naps in full view on the House floor.
Patten, however, wasn't napping the other morning when the committee was crammed into its little meeting room in the capitol to talk about an $84.5 billion appropriations measure.
The committee was meeting to put final approval -- to "mark up," in the parlance -- the fiscal 1981 appropriation for labor, health and human services programs.
At just the right moment, as the committee agreed to accept some mysterious language that went unexplained, Patten got his chuckle. "All those who have arthristis, raise their right hand," he said, thrusting his right hand toward the ceiling.
It was humorous, but there was a point to his wit -- and everyone there knew it. They had just agreed to direct the National Institutes of Health to give greater attention to arthritis research, although they earmarked no new money for that.
Such is the congressional process. The reference to arthritis was the only change made in the NIH appropriation, which will provide $3.6 billion to NIH for its huge program of biomedical research next year.
The language was proposed by Rep. Sidney R. Yates (D-Ill.), who explained later that an older brother and a dear friend in Chicago suffered severely from arthritis and he wanted something done about this ailment.
"I feel NIH needs to put more emphasis on this and my language calls attention of NIH to the fact that arthritis is at least of equal importance with other diseases they are researching and that it deserves to be treated better financially," Yates said.
Over the years, the NIH appropriation and its activities have grown because of the same sort of interest that other legislators showed in other ailments. Cancer, heart, lung, diabetes, eyes, teeth -- you name it -- have their advocates.
The legislators were responding to their own families' ailments, to constituents' ailments, to the pressures of the powerful "disease lobby" -- a conglomerate of associations professors, scientists and citizens with an interest in cures and research money.
In a sense, those days are part of the past, and the Yates effort on half of arthritis a sort of aberration. Through the efforts of legislators such as Rep. David R. Obey (D-Wis.) Congress is moving increasely toward letting the experts at NIH set the research priorities.
"You're seeing more restraint," said one congressional staff aide."All the members had to be a little queasy about the ways of the past. They knew they didn't know what was the right way to spend money out there at NIH."
That depiction closely tits what happened this year in the labor-health appropriations subcommittee headed by Rep. William H. Natcher (D-Ky.).
The real trench warfare over this NIH appropriation had been fought in Natcher's subcommittee long before he took the final bill to the full committee, recommending $126 President Carter requested.
That decision was reached after weeks of hearings and testimony from government and public witnesses. The Carter budget proposed spending more to "stabilize" research grants and assure scientific continuity. But it also proposed a reduction in grants to train researchers.
When a subcommittee consensus developed that NIH needed more money than Carter sought, members queried NIH officials as to where it could be spent best.
That, of course, is kind of "no-no" of the system, but it happens with almost every appropriating subcommittee and every federal agency. The bureaucrats don't mind dealing behind the president's back if it means their agencies will get more money.
Most of the increases went to research in the major disease areas, with $35 million directed back into the training grants that Carter, Health and Human Services Secretary Patricia R. Harris and the NIH director Dr. Donald S. Fredrickson, proposed cutting in this difficult year of economic restraint.
"There is absolutely on this subcommittee a feeling that the research money is well spent," Natcher said the other day. We have had pressure from all over the United States to increase one problem of another, but we have tried to identify the programs that work well and fund them at least at the same level as fiscal 1980."
Even in the period of budgetary restraint, all sides end up winning on this NIH appropriation.Carter got what he wanted, NIH got what it wanted, the disease lobby fared better than it might have expected four months ago when the fiscal meat ax was being hefted. Universities and private researchers who feared sizable cuts at NIH could breathe easier.
But this is only a part of the battle in the long, drawn-out appropriations process. Natcher's bill will be debated by the full House this Wednesday. If approved without change, as is likely for the NIH portions, it will go to the Senate.
The focus then will be on the upper chamber, which traditionally had been somewhat more responsive to the disease lobbyists and the special pleaders.
Just to cite one area: the House did not yield but it was under pressure to earmark considerably more money for development of interferon, an enormously expensive drug with potential for cancer treatment.
Natcher's subcommittee report gave no new directives for an increase in interferon testing.But, as one appropriations staffer said, "There's an interferon lobby out there that would like us to spread around $50 million on it this year. It will be interesting to see how the Senate deals with that."