The most-emailed story in the New York Times right now is about former Surgeon General Richard Carmona's congressional testimony how the Bush Administration "repeatedly tried to weaken or suppress important public health reports because of political considerations."
One reason the story caught my eye was the accompanying photo of Dr. Carmona in the Navy-like uniform of the surgeon general. He was wearing several things that you don't often see on Public Health Service people, such as the Purple Heart; Vietnam service ribbons; what I think may be an Army combat-medic badge; and at least one paratrooper badge.
It turns out that before college and medical school, Dr. Carmona was a Green Beret medic in Vietnam, having enlisted as a high-school drop-out. He seems to be quite a success story. (Some of this information comes from the Department of HHS Web site, but we'll see how long the information stays up in view of Dr. Carmona's testimony.)
Reasonable people might differ about some of the policies about which Dr. Carmona testified. And sometimes it might be inappropriate to have the president's judgment about the proper agenda for the government be overwhelmed by pressure from special interest groups and the media.
But overall, what Dr. Carmona described sounds suspiciously like a pattern of willfully refusing to face inconvenient facts. For example:
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.”
* * *
... 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.”
In his prepared testimony, Dr. Carmona said that when he consulted with previous surgeons general about the partisan atmosphere in which he had to do his job, he was told that:
... the reality is that the nation’s doctor has been marginalized and relegated to a position with no independent budget, and with supervisors who are political appointees with partisan agendas. Anything that doesn’t fit into the political appointees’ ideological, theological, or political agenda is ignored, marginalized, or simply buried.
The problem with this approach is that in public health, as in a democracy, there is nothing worse than ignoring science, or marginalizing the voice of science for reasons driven by changing political winds. The job of Surgeon General is to be “the doctor of the nation”— not “the doctor of a political party.”
According to the Times, the White House tried to pin the blame on Dr. Carmona:
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.”
Hey, if it comes down to having to believe either a White House spokeswoman or a guy with Dr. Carmona's record, I know who I'll be listening to.
I've been a Republican all my life. Until the 2006 election, I think I'd voted for a total of exactly one Democrat. I regard President Bush as an intelligent man of vision, integrity, and courage.
But I can't help but think the president knows this sort of thing has been going on in his administration, and that he believes it's appropriate. It's really hard for me to understand why that would be.
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