Right-wing ideology vs. public health

Something would be seriously amiss in our nation’s capital these days if the sun were to rise without a new political scandal rocking the Bush administration.

July 10 was a case in point. That day, former Surgeon General Richard H. Carmona told a congressional panel that, due to the demands of political ideology, top Bush administrations officials frequently interfered with his work to produce evidence-based reports to guide the nation’s public health policies and educate the public.



The nation’s doctor

According to the surgeon general’s web site, the “surgeon general serves as America’s chief health educator by providing Americans the best scientific information available on how to improve their health and reduce the risk of illness and injury.”

The surgeon general is appointed by the president (subject to the approval of the Senate) to serve a four-year term. He or she reports to the assistant secretary for health — the country’s chief adviser to the secretary of the Department of Health and Human Services. Among the surgeon general’s responsibilities is the overseeing of the Commissioned Corps of the U.S. Public Health Service, a 6,000-strong body that deploys to places in the country where health care is needed most.



Office marginalized, politicized

Dr. Carmona testified before a hearing of the House Oversight and Government Reform Committee on the topic of strengthening the Office of Surgeon General. In his testimony, he affirmed the reality that the office 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, he suggested.

Carmona reported that he was ordered to mention President Bush three times per page in his speeches, was told to make speeches in support of Republican political candidates and to attend political briefings, and was told to “stand down” from issuing opinions on important public health issues, such as contraception.

The interference touched on many other public health issues. When scientific evidence determined that secondhand smoking is highly detrimental to people’s health, the Bush administration tried to weaken the report’s findings. In fact, the administration attempted to prevent Carmona from testifying against the tobacco industry in a trial that the government itself brought against the industry.

When Carmona found that the health outcomes of people in jail were poor, the administration tried to bury the report because of its political opposition to investing in the health of inmates. Because he refused to unconditionally praise President Bush’s global health initiatives, the administration dragged its feet in allowing the release of his report.

The incidents of political interference in the work of the surgeon general continue to pile up.



New levels of interference

While previous surgeons general have also complained of political interference, when Carmona consulted six of his predecessors, both Republican and Democrat, all agreed that they never had to face the level of interference he has suffered at the hands of the Bush administration.

Carmona refused to mention by name the officials most responsible for interfering in his work. He did state that pressure came from assistant secretaries of health and political appointees outside the Department of Health and Human Services. He offered to inform lawmakers of the worst abusers in a closed meeting.



And now Holsinger

The politicization of the office continues unabated with President Bush’s recent nomination of Dr. James Holsinger Jr. to be the next surgeon general. Two senators have already voiced their opposition, and lesbian, gay, bisexual and transgender groups are outraged by the nomination.

In a 1991 report, “The Pathophysiology of Male Homosexuality,” Holsinger wrote that the sexual practices of gay men are biologically pathological, and declaring that men and women have a sexual “complementarity” that speaks for itself, comparing male and female reproductive organs to pipe fittings.

To name a surgeon general with such an obvious ideological bias creates serious doubts about his capacity to serve all Americans.