[Infowarrior] - Surgeon General Sees 4-Year Term as Compromised

[Richard Forno]

Surgeon General Sees 4-Year Term as Compromised

By GARDINER HARRIS
Published: July 11, 2007

http://www.nytimes.com/2007/07/11/washington/11surgeon.html?_r=1&hp=&oref=sl
ogin&pagewanted=all

WASHINGTON, July 10 ‹ Former Surgeon General Richard H. Carmona told a
Congressional panel Tuesday that top Bush administration officials
repeatedly tried to weaken or suppress important public health reports
because of political considerations.

The administration, Dr. Carmona said, would not allow him to speak or issue
reports about stem cells, emergency contraception, sex education, or prison,
mental and global health issues. Top officials delayed for years and tried
to ³water down² a landmark report on secondhand smoke, he said. Released
last year, the report concluded that even brief exposure to cigarette smoke
could cause immediate harm.

Dr. Carmona said he was ordered to mention President Bush three times on
every page of his speeches. He also said he was asked to make speeches to
support Republican political candidates and to attend political briefings.

And administration officials even discouraged him from attending the Special
Olympics because, he said, of that charitable organization¹s longtime ties
to a ³prominent family² that he refused to name.

³I was specifically told by a senior person, ŒWhy would you want to help
those people?¹ ² Dr. Carmona said.

The Special Olympics is one of the nation¹s premier charitable organizations
to benefit disabled people, and the Kennedys have long been deeply involved
in it.

When asked after the hearing if that ³prominent family² was the Kennedys,
Dr. Carmona responded, ³You said it. I didn¹t.²

In response to lawmakers¹ questions, Dr. Carmona refused to name specific
people in the administration who had instructed him to put political
considerations over scientific ones. He said, however, that they included
assistant secretaries of health and human services as well as top political
appointees outside the department of health.

Dr. Carmona did offer to provide the names to the committee in a private
meeting.

Bill Hall, a spokesman for the Department of Health and Human Services, said
that the administration disagreed with Dr. Carmona¹s statements. ³It has
always been this administration¹s position that public health policy should
be rooted in sound science,² Mr. Hall said.

Emily Lawrimore, a White House spokeswoman, said the surgeon general ³is the
leading voice for the health of all Americans.²

³It¹s disappointing to us,² Ms. Lawrimore said, ³if he failed to use this
position to the fullest extent in advocating for policies he thought were in
the best interests of the nation.²

Dr. Carmona is one of a growing list of present and former administration
officials to charge that politics often trumped science within what had
previously been largely nonpartisan government health and scientific
agencies.

Dr. Carmona, 57, served as surgeon general for one four-year term, from 2002
to 2006, but was not asked to serve a second. Before being nominated, he was
in the Army Special Forces, earned two purple hearts in the Vietnam War and
was a trauma surgeon and leader of the Pima County, Ariz., SWAT team. He
received a bachelor¹s degree, in biology and chemistry, in 1976 and his M.D.
in 1979, both from the University of California, San Francisco. He is now
vice chairman of Canyon Ranch, a resort and residential development company.

His testimony comes two days before the Senate confirmation hearings of his
designated successor, Dr. James W. Holsinger Jr. Two members of the Senate
health committee have already declared their opposition to Dr. Holsinger¹s
nomination because of a 1991 report he wrote that concluded that homosexual
sex was unnatural and unhealthy. Dr. Carmona¹s testimony may further
complicate Dr. Holsinger¹s nomination.

In his testimony, Dr. Carmona said that at first he was so politically naïve
that he had little idea how inappropriate the administration¹s actions were.
He eventually consulted six previous surgeons general, Republican and
Democratic, and all agreed, he said, that he faced more political
interference than they had.

On issue after issue, Dr. Carmona said, the administration made decisions
about important public health issues based solely on political
considerations, not scientific ones.

³I was told to stay away from those because we¹ve already decided which way
we want to go,² Dr. Carmona said.

He described attending a meeting of top officials in which the subject of
global warming was discussed. The officials concluded that global warming
was a liberal cause and dismissed it, he said.

³And I said to myself, ŒI realize why I¹ve been invited. They want me to
discuss the science because they obviously don¹t understand the science,¹ ²
he said. ³I was never invited back.²

Dr. Carmona testified under oath at a hearing before the House Oversight and
Government Reform Committee headed by Representative Henry A. Waxman,
Democrat of California. The topic was strengthening the office of the
surgeon general. Dr. C. Everett Koop, surgeon general in the Reagan
administration, and Dr. David Satcher, surgeon general during the Clinton
administration and the first year of the administration of George W. Bush,
also testified.

Each complained about political interference and the declining status of the
office. Dr. Satcher said that the Clinton administration discouraged him
from issuing a report showing that needle-exchange programs were effective
in reducing disease. He released the report anyway.

Dr. Koop, said he had been discouraged by top officials in the Reagan
administration from discussing the AIDS crisis. He did so anyway.

All three men urged major changes in the way the surgeon general is chosen
and the way the office is financed.

Dr. Carmona described being invited to testify at the government¹s
nine-month racketeering trial of the tobacco industry that ended in 2005. He
said top administration officials discouraged him from testifying while
simultaneously telling the lead government lawyer in the case that he was
not competent to testify. Dr. Carmona testified anyway.

Sharon Y. Eubanks, director of the Justice Department¹s tobacco litigation
team, was in the audience during Dr. Carmona¹s testimony.

³What he said is all correct,² she said. ³He was one of the most powerful
witnesses. His testimony was very important.²

Dr. Carmona said that he felt that the duty of the surgeon general, often
called the ³nation¹s doctor,² was to tackle many of the nation¹s most
controversial health topics and to issue balanced reports about the studies
underlying them.

When stem cells became a focus of debate, Dr. Carmona said he proposed that
his office offer guidance ³so that we can have, if you will, informed
consent.²

³I was told to stand down and not speak about it,² he said. ³It was removed
from my speeches.²

The Bush administration rejected the advice of many top scientists on this
subject, including that of the director of the National Institutes of
Health, Dr. Elias Zerhouni.

Similarly, Dr. Carmona wanted to address the controversial topic of sexual
education, he said. Scientific studies suggest that the most effective
approach includes a discussion of contraceptives.

³However there was already a policy in place that did not want to hear the
science but wanted to preach abstinence only, but I felt that was
scientifically incorrect,² he said.

Dr. Carmona said drafts of surgeon general reports on global health and
prison health were still being debated by the administration. The global
health report was never approved, Dr. Carmona said, because he refused to
sprinkle the report with glowing references to the efforts of the Bush
administration.

³The correctional health care report is pointing out the inadequacies of
health care within our correctional health care system,² he said. ³It would
force the government on a course of action to improve that.²

Because the administration does not want to spend more money on prisoners¹
health care, the report has been delayed, Dr. Carmona said.

³For us, the science was pretty easy,² he said. ³These people go back into
the community and take diseases with them.² He added, ³This is not about the
crime. It¹s about protecting the public.²