What do we get when Congress cuts federal spending across-the-board? Does it bring lower taxes, smaller deficits, and less bureaucracy?

How about worse health care, less medical innovation, and lost lives?

The budget sequester that Congress enacted in 2011 began to take effect this year with spending cuts for most federal programs. So far, the majority of Americans have seen little change. Some may even applaud the idea of forcing the federal government to make due with less.

But the sequester is about to exert an especially sinister effect that lies just outside of public view. It could cripple medical research.

The National Institutes of Health is the largest single source of biomedical research funding in the world. It supports work at most universities in the United States and at many around the world.

That's not just important to the physicians and researchers who work at those institutions. It's vitally important to everyone. NIH funding stands behind the development of almost every major drug that has emerged over the past 50 years. You can see the impact of this agency every time you open your medicine cabinet. It has also brought us countless medical devices and procedures. And led to 83 Nobel prizes.

As a federal agency, NIH will feel the sequester's effects just like all the others. That means a budget cut of 5%, or $155 billion, during the current fiscal year.

The cut will affect every field of medical research. The agency will award about 700 fewer research grants and admit about 750 fewer patients for experimental treatments in its Clinical Center. It will also reduce most outstanding grants by an average of almost 5%. And it will spend less on training future researchers.

What kinds of research will be affected? The cuts will impact studies into causes and treatments of almost every major disease. Cancer, heart disease, stroke, diabetes, Parkinson's disease, Alzheimer's disease and autism are but a few. Cutting-edge advances, like those in genetics, will take an especially hard hit.

We can only guess how many patients would be helped, and lives saved, by the research that will be delayed. And the NIH cuts could also impose an economic cost. Thousands of jobs could be lost at universities and research institutions, including many in the Philadelphia area. By one estimate, NIH research supported 432,000 jobs in 2011. And countless patients may need expensive care for diseases for which treatments could have been found sooner.

Medical research generates huge returns on investment. One analysis found that the NIH effort to map all human genes, known as the Human Genome Project, generated $798 in economic activity and created 310,000 jobs while costing $3.8 billion. (Click here to read the report.) In the end, the cost of the NIH cuts could add up to many times more than the short-term budget reduction.

And American competitiveness stands to suffer. While medical research support shrinks in the United States, it is growing elsewhere. NIH director Francis Collins points to increases of 20% a year in China and India, 10% in Brazil, South Korea and Japan, and 8% in Germany. A new generation of medical researchers may find better opportunities abroad.

And if Congress fails to act, the situation will get worse. The 5% cuts could continue for a decade.

The NIH sequestration budget cuts are not good for anyone. We could be feeling the damaging effects in money and in lives for a long time to come.