Politics

Bad Medicine: Injecting Politics Into Healthcare And Science

1fastdog.

Posted to Politics on Wed Jul 18, 2007 at 08:17:21 AM EST (promoted by port1080). RSS.

As has happened many times in the past, the Bush administration is coming under fire for stifling science in the name of political expediency. This time it's former Surgeon General, Richard Carmona:

"Anything that doesn't fit into the political appointees' ideological, theological or political agenda is often ignored, marginalized or simply buried," he said. "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."

In addition to being muzzled on health issues sensitive to the GOP's base, Carmona was required to mention Bush three times on every page of his speeches, was asked not to attend Special Olympics' functions because of the organization's close relationship to the Kennedys, and was expected to attend political briefings and show support for GOP candidates running for office.
In the past, other Surgeon Generals have been put on a leash for political sensitivities, but that leashing has usually been confined to one particular situation - Ex-Surgeon General David Satcher wasn't allowed to release a report on sexuality and public health due to the high profile attention Bill Clinton gleaned over Monicagate. C. Everett Koop came under pressure during the Reagan administration not to speak out on AIDS (though he refused to bow under and continued speaking). And famously, Jocelyn Elders was basically forced out of her position when she advocated for masturbation education in schools.
But nowhere in the past were such wholesale partisan ideologies forced upon the the Surgeon Generals as the they were on Carmona, a fact that the nominee to replace the former Surgeon General is finding out. The latest nominee is Dr. James W. Holsinger Jr., who found himself under intense scrutiny at his hearing over issues related to homosexuality, his role as the chief medical officer in the Department of Veterans Affairs, and his stance on stem cell research. Holsinger, who has been praised by members of both political parties for some of his past work, pledged that should he become Surgeon General, he'd step down if asked to politicize his office:

"If I were faced with a situation that I felt I could not in good conscience do, I think I have a clear response to that. I would resign"

Tags: edited by Port1080, written by 1fastdog, politics, science, Surgeon General, Richard Carmona, Dr. James W. Holsinger Jr. (all tags)

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10

And another thing

Steve Urkel.

Wed Jul 18, 2007 at 06:08:00 PM EST

3.00 (obnoxious, astute)

Carmona reminds me of the kind of doctor who when acurately informed of the true extent of his patient's drinking, smoking, and whoring he proceeds to give the patient a lecture on the morality of such activities. While many think that's a doctors proper role, some of us hold the view that the doctor is hired to heal the patient when he's sick or injured in a brawls, not to tell the patient what his pastimes should be.

Unfortunately many, if not most, modern doctors are egomanicas, and don't like being put in their proper place. My advice, in general and to Bush, is to find a doctor who smokes cigarettes. Such doctors typically have a broader, more sophisticated perspective on life.

The end.

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Re: And another thing

thefadd.

Fri Jul 20, 2007 at 01:41:18 PM EST

none

I agree with this entirely. I had a condition for which I went to multiple different doctors. Most couldn't give me advice on what to do at all. The one who did give me advice said, "don't drink, don't smoke and don't have sex." I finally found an orgy throwing, pot smoking nutritionist who solved my problem. Thanks, doc.

It is easy to buy small plaster models of what you think life is like.

1

Science

skeptic.

Wed Jul 18, 2007 at 09:56:50 AM EST

none

If there is one human intellectual attainment that I truly respect, skeptic though I am, that would be science, which includes medical science.  The effort to politicize science is deeply offensive as well as misguided.  If your political objectives depend upon falsifying, suppressing, or altering objective scientific data or conclusions, then you need to re-think your politics.

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Re: Science

thefadd.

Wed Jul 18, 2007 at 02:49:01 PM EST

1.00 (obnoxious)

Medical science as it already exists is already highly politicized and it is simply too late to change that. We can shout "We're #1" all day but the obvious fact of the matter is that (many) other countries in the world are healthier than us. They are less fat than us, they live longer and now they grow taller, too. A large reason for that is the corporatization and attendant politicization of medical "science."

If it doesn't make money, it doesn't get a study to fund it. If it doesn't get a study to "prove" it "works" then it isn't accepted into the "medical science" gospel. This is a perversion of the scientific method in the extreme and has led to the creation of an sphere of alternative reality in which the pharma-medical establishment now exists. Easy to implement, cost effective ways of maintaining health and well are eschewed and ignored for not fitting into the studied and "proven" methods.

Ways of medicine like those used in Indian, Russia, Europe and east asia that competed with allopathic medicine in America during the 19th century were politically beaten away by the money making machine that allopathic medicine lent itself to be. There is no greater, more shameful example of this than the cancer industry and its slavish attachment to the biggest money making scam of them all, chemotherapy. If you have cancer, know someone who has cancer, or have bought into the cancer fear machine, I would urge you to check out a scientifically solid and well written book called The China Study.

make it rain you nappy headed ho's

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Re: Science

skeptic.

Thu Jul 19, 2007 at 12:06:43 PM EST

none

It seems very pessimistic for you to claim that it is too late to change the existing politicization of science - and you're the person who thought it was obnoxious for me to predict a coming collapse of civilization.  Where's your irrepressible optimism now, thefadd?  I tend to believe that if civilization survives (which it may, despite my pessimistic expectations) then we as a society can eventually figure out how to be truly scientific without allowing political or economic distortions of scientific findings.  It could take a while.  Anyway, your caveat about the distortions of current Western medical science are duly noted.

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This wasn't the stifling of science.

MayorBob.

Wed Jul 18, 2007 at 10:11:13 AM EST

none

It was pure, Grade A assholish political bullshit.  At least we know what George Bush and his administration think about physically challenged kids -- they're the "Kennedy Kidz" -- and thus worthy of being publicly rebuffed.  I guess the offspring of Bush's base don't suffer from some of the serious conditions the kids in the Special Olympics deal with.

The bit about Carmona being required to make three (undoubtedly positive) references to George Bush whenever he made a public appearance is reminiscent of the Armstrong Williams affair.  I guess the Bushies have become a little thriftier with the public funds.  After all, they paid Williams almost a quarter of a million dollars to shill shamelessly for Bush.  Here, they're just making sure Carmona does it as part of his normal duties.

Illegitimi non carborundum.

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Holsinger: Clueless or disingenuous?

1fastdog.

Wed Jul 18, 2007 at 10:27:14 AM EST

none

Consider the following on stem cell research:

JH: I have to confess, Senator Kennedy, that I have -- since the 2002 hearing -- not had a lot of reason to stay involved in the stem-cell discussions, so I am not as informed on both the science on current stem-cell work as well as some of the new alternative processes that are coming. I simply do not feel comfortable giving you my opinion when I don't feel I've had the proper time to study it.

and abstinence education

PM: You don't have an opinion on abstinence-only curricula at all?

JH: Oh, I think abstinence is one of the mechanisms that we can use around unplanned pregnancies.

PM: What about STDs?

JH: And STDs as well, but I'm just saying that I have not studied the literature to be able to give you an informed answer. That's all I'm saying.

I realize that the above quotes are only small blocks out of a lot of testimony, but to remark that he's not up to speed on two of the most hot-button and controversial issues that pit science -vs- political dogma, well, those are pretty damning statements whether they're disingenuous or just plain clueless.
The person representing the top Healthcare professional in America damn well ought to have, not only an opinion, but also a full-fledged understanding of all of the latest information available. It's unacceptable that in this day of easily available information, Dr. Holsinger is not "able to give you an informed answer."

Somewhere in my soul, there's always Rock -n- Roll... Joe Strummer

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Re: Holsinger: Clueless or disingenuous?

zyxwvutsr.

Wed Jul 18, 2007 at 11:08:52 AM EST

none

I realize that the above quotes are only small blocks out of a lot of testimony...
Put in context Holsinger's response is not only appropriate, but shows that Senator Murray has less interest in evaluating the nominee's qualifications than in playing up to the cameras for political gain:
PM: Well let me ask you a specific one. For the past decade, the federal government has spent more than a billion dollars on unproven, dangerous, abstinence-only programs -- it's been the most dramatic funding increase during the last six years -- and a 2004 report by the House committee on government reform revealed that many of the most common abstinence-only curricula contained errors, contained distortions, contained stereotypes. If you had that scientific report in front of you, what would you say to the administration?

JH: Well, if it was one that I was supposed to sign off on, then I wouldn't be able to. I mean, if there were distortions...

PM: Tell me what you think of the abstinence-only study.

JH: Well, I don't -- I have not had an opportunity to study them, or the science surrounding abstinence education, so until I was able to do that, I could not give you an informed opinion.

PM: You don't have an opinion on abstinence-only curricula at all?

JH: Oh, I think abstinence is one of the mechanisms that we can use around unplanned pregnancies.

PM: What about STDs?

JH: And STDs as well, but I'm just saying that I have not studied the literature to be able to give you an informed answer. That's all I'm saying

In other words, Holsinger didn't bother to study an obscure congressional report that had little or nothing to do with the core functions of the office of the Surgeon General. He was pressed to answer a bullshit question ("If you had that scientific report in front of you...") and I think he responded correctly.

Senator Kennedy noted that Holsinger opposed a bill in the Kentucky legislature that would have made stem cell research illegal. But the introduction of that bill (and Holsinger's opposition, voiced during testimony before the legislature) occurred five years ago. In the intervening time Holsinger was busy doing other things, so it is not at all surprising that he didn't keep up on the minutiae of the topic.  Furthermore, it is not universally acknowledged by the medical community that stem cell research is likely to yield the host of miracle therapies that its supporters often claim.

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Re: Holsinger: Clueless or disingenuous?

1fastdog.

Wed Jul 18, 2007 at 01:26:12 PM EST

5.00 (astute)

I don't care what context you put it in, he still admits that he's not up to speed on two of the most controversial topics in the science/political spectrum.
He could've very easily addressed the same topics outside of the defined parameters on specific papers, but plead ignorance instead. So he either doesn't know, which is bad news indeed, or he's being disingenuous, which again, is bad news of a different variety.

so it is not at all surprising that he didn't keep up on the minutiae of the topic
Physicians are supposed to keep up on the minutia of medicine and medically-related topics. To not do so is to invite disaster for both doctor and patients alike.

it is not universally acknowledged by the medical community that stem cell research is likely to yield the host of miracle therapies that its supporters often claim.
Never said it was, but we'll never know unless the research goes ahead, eh?

Somewhere in my soul, there's always Rock -n- Roll... Joe Strummer

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Re: Holsinger: Clueless or disingenuous?

zyxwvutsr.

Wed Jul 18, 2007 at 03:29:47 PM EST

2.00 (illiterate)

...he still admits that he's not up to speed on two of the most controversial topics in the science/political spectrum
Neither of which have anything to do with the mission of the office of the Surgeon General. Note that neither of the senators mentioned thus far asked Holsinger about HIV/AIDS policy or childhood obesity or smoking. Don't you wonder why not?
Physicians are supposed to keep up on the minutia of medicine and medically-related topics
Oh, bullshit. You really think that every physician has detailed knowledge about stem cell research?
...we'll never know unless [stem cell] research goes ahead, eh?
I suppose you completely missed the part during Kennedy's questioning when Holsinger said, "I'm in favor of doing stem-cell research."

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Re: Holsinger: Clueless or disingenuous?

1fastdog.

Wed Jul 18, 2007 at 04:42:52 PM EST

4.50 (informative, interesting)

Note that neither of the senators mentioned thus far asked Holsinger about HIV/AIDS policy or childhood obesity or smoking. Don't you wonder why not?

No, I don't.
Apparently there's nothing there that sets off any red flags with regards to the above. If you've got the inside skinny on his positions that our dear lawmakers should be looking at, do tell.

You really think that every physician has detailed knowledge about stem cell research?

Most of my family and relatives work in medicine under a very wide umbrella of treatment therapies, and I can assure you that any physician worth his/her salt is strongly aware of the latest progress or lack thereof on stem cell research. Patients ask their attendings about stem cell research everyday - especially those with chronic conditions. Family physicians get the same questions everyday, also. Everybody has someone in their circle of family or friends with some kind of condition, be it acute or chronic, be it easily treatable or not, and someone aways wants to know if stem cell research will do away with whatever modality those people are now on. I hear about it almost every day. I see it almost every day. I quiz my own endocrinologist about the latest developments in stem cell research whenever I see him, just to see if he's got info that I don't have - he's always got something. If you're comfortable with a physician that's not up to speed on the latest developments, that's your prerogative.

I suppose you completely missed the part during Kennedy's questioning when Holsinger said, "I'm in favor of doing stem-cell research."

Not at all, but you already knew that, as I was responding to your comment regarding stem cell research not being a proven commodity. But hey, keep moving the goalposts if you feel the need to.

Somewhere in my soul, there's always Rock -n- Roll... Joe Strummer

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Re: Holsinger: Clueless or disingenuous?

zyxwvutsr.

Fri Jul 20, 2007 at 09:59:10 AM EST

none

Apparently there's nothing there that sets off any red flags with regards to the above. If you've got the inside skinny on his positions that our dear lawmakers should be looking at, do tell
I take it, then, that your position is that a nominee's opposition to the Bush Administration's stem cell position should be the sole litmus test for the confirmation of a surgeon general?
If you're comfortable with a physician that's not up to speed on the latest developments, that's your prerogative
Holsinger is not a practicing physician, but a public health administrator. He does not see or have to give advice to patients.

Though both the surgeon general and the National Institutes of Health (NIH) fall under the Department of Health and Human Services, it is the NIH that administers federal stem cell research, not the Office of the Surgeon General.

...keep moving the goalposts if you feel the need to
I'm not sure why you wrote that. I was merely suggesting that there are other reasons why someone like Holsinger might not think the federal stem cell controversy should be a priority for him.

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Special

Steve Urkel.

Wed Jul 18, 2007 at 05:56:28 PM EST

none

Given Bush's ability to work with Teddy Kennedy on majorly stupid pieces of legislation like NCLB and the immigration amnesty bill, tha the White House has held many functions promoting the Special Olympics and honoring Eunice Kennedy Shriver, and because of this, it's impossible not to find Carmona's claims in this regard to be highly suspect.

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