Surgeon General Sees 4-Year Term as Compromised
morr...@mailinator.com
July 11, 2007
Surgeon General Sees 4-Year Term as Compromised
By GARDINER HARRIS
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 "water down" 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 organization's
longtime ties to a "prominent family" that he refused to name.
"I was specifically told by a senior person, 'Why would you want to
help those people?' " Dr. Carmona said.
The Special Olympics is one of the nation's premier charitable
organizations to benefit disabled people, and the Kennedys have long
been deeply involved in it.
When asked after the hearing if that "prominent family" was the
Kennedys, Dr. Carmona responded, "You said it. I didn't."
In response to lawmakers' 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. Carmona's
statements. "It has always been this administration's position that
public health policy should be rooted in sound science," Mr. Hall
said.
Emily Lawrimore, a White House spokeswoman, said the surgeon general
"is the leading voice for the health of all Americans."
"It's disappointing to us," Ms. Lawrimore said, "if he failed to use
this position to the fullest extent in advocating for policies he
thought were in the best interests of the nation."
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 bachelor's 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. Holsinger's nomination because of a 1991 report he wrote that
concluded that homosexual sex was unnatural and unhealthy. Dr.
Carmona's testimony may further complicate Dr. Holsinger's nomination.
In his testimony, Dr. Carmona said that at first he was so politically
naïve that he had little idea how inappropriate the administration's
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.
"I was told to stay away from those because we've already decided
which way we want to go," 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.
"And I said to myself, 'I realize why I've been invited. They want me
to discuss the science because they obviously don't understand the
science,' " he said. "I was never invited back."
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 government's
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 Department's tobacco
litigation team, was in the audience during Dr. Carmona's testimony.
"What he said is all correct," she said. "He was one of the most
powerful witnesses. His testimony was very important."
Dr. Carmona said that he felt that the duty of the surgeon general,
often called the "nation's doctor," was to tackle many of the nation's
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 "so that we can have, if you will,
informed consent."
"I was told to stand down and not speak about it," he said. "It was
removed from my speeches."
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.
"However 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," 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.
"The correctional health care report is pointing out the inadequacies
of health care within our correctional health care system," he said.
"It would force the government on a course of action to improve that."
Because the administration does not want to spend more money on
prisoners' health care, the report has been delayed, Dr. Carmona said.
"For us, the science was pretty easy," he said. "These people go back
into the community and take diseases with them." He added, "This is
not about the crime. It's about protecting the public."