A few days before leaving office in January 1961, outgoing President Dwight Eisenhower (who had more than a little experience with military affairs) warned his country of the dangers posed by a new world.
Crises there will continue to be. In meeting them, whether foreign or domestic, great or small, there is a recurring temptation to feel that some spectacular and costly action could become the miraculous solution to all current difficulties. A huge increase in newer elements of our defense; development of unrealistic programs to cure every ill in agriculture; a dramatic expansion in basic and applied research ⎯ these and many other possibilities, each possibly promising in itself, may be suggested as the only way to the road we wish to travel.
But each proposal must be weighed in the light of a broader consideration: the need to maintain balance in and among national programs ⎯ balance between the private and the public economy, balance between cost and hoped for advantage ⎯ balance between the clearly necessary and the comfortably desirable; balance between our essential requirements as a nation and the duties imposed by the nation upon the individual; balance between actions of the moment and the national welfare of the future. Good judgment seeks balance and progress; lack of it eventually finds imbalance and frustration.
. . .
This conjunction of an immense military establishment and a large arms industry is new in the American experience. The total influence ⎯ economic, political, even spiritual ⎯ is felt in every city, every State house, every office of the Federal government. We recognize the imperative need for this development. Yet we must not fail to comprehend its grave implications. Our toil, resources and livelihood are all involved; so is the very structure of our society.
In the councils of government, we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military-industrial complex. The potential for the disastrous rise of misplaced power exists and will persist.
We must never let the weight of this combination endanger our liberties or democratic processes. We should take nothing for granted. Only an alert and knowledgeable citizenry can compel the proper meshing of the huge industrial and military machinery of defense with our peaceful methods and goals, so that security and liberty may prosper together.
President Eisenhower went on to broaden that warning to the coming technological revolution that had been born of the war efforts of the 1940s. Specifically, Ike said:
The prospect of domination of the nation’s scholars by Federal employment, project allocations, and the power of money is ever present and is gravely to be regarded.
Yet, in holding scientific research and discovery in respect, as we should, we must also be alert to the equal and opposite danger that public policy could itself become the captive of a scientific-technological elite.
It is the task of statesmanship to mold, to balance, and to integrate these and other forces, new and old, within the principles of our democratic system ⎯ ever aiming toward the supreme goals of our free society.
Alas, statesmanship ain’t what it used to be. Time and again we see that any time large and powerful industries become too closely associated with government policy making, the lines between entities becomes obscured and it becomes difficult to tell who is actually formulating public policy.
A recent 60 Minutes story
on CBS, gave us a little glimpse at how the pharmaceutical industry pushed through the Medicare prescription drug bill a few years back, which effectively prohibits the federal government from trying to use the clout of the Medicare system to get lower prices for drugs. That little provision, which costs the American taxpayers billions of dollars, was pushed through by concealing actuarial figures and deft legislative maneuvering. And the government point people who aided the industry were rewarded.
Tom Scully, the administration’s Medicare chief who negotiated the bill, soon left the government for a lucrative position with a Washington law firm where he is a lobbyist for pharmaceutical companies. As for one of the Congressional point persons, Representative Billy Tauzin from Louisiana soon left Congress to accept a job as president of the Pharmaceutical Research and Manufacturers of America (PhRMA). Of course, Billy says he did it out of gratitude for the drugs that helped him beat cancer, but I’d bet the $2,000,000 annual salary that went with the job might have helped convince him.
As was noted in the CBS story, there is currently legislation pending to require the federal government to negotiate lower rates for drugs covered by Medicare, just as they do for other health-care services. What are the chances that provision will become law? Well, even if it gets through Congress, President Bush has promised to veto it. As Representative Dan Burton said of the pharmaceutical lobby:
I mean, they — they have unlimited resources. Unlimited, and when they push real hard to get something accomplished in the Congress of the United States, they can get it done.
The only surprise about the 60 Minutes
story was that it made it on the air at all. One rarely sees such objective reporting about an industry that spends millions of advertising dollars.
To be fair, regulators occasionally show concern about the blurry lines in health-care policy between government on the one side and the Big Pharma/Big Health crowd on the other. The Washington Post recently reported
on inquiries into the conduct of 103 scientists with links to pharmaceutical companies while they were employed at the National Institutes of Health. Of course, it’s a little premature to say that anything will come of it, as the “inspector general for the Department of Health and Human Services, said his office is looking into the cases ‘to determine whether investigation is warranted.’”
It’s worth noting that even those preliminary steps of inquiry are only happening because members of Congress ⎯ who may be a little more sensitive to appearances of impropriety than is a lame duck administration ⎯ have insisted that something needs to be done. Apparently, there is a suspicion that the NIH is neither adept nor aggressive in policing itself.
Of course, the undue influence of private entities upon public policy is not restricted to Big Pharma/Big Health Care crowd. Recently, Leonard Pitts, the great columnist for the Miami Herald, addressed the rampant conflicts of interest
that plague health and science policy making in the Bush Administration.
After 2002, when a National Cancer Institute statement reporting no link between abortion and breast cancer was changed by the Bush administration to say evidence of a link was inconclusive, after the administration cut language on global warming from a 2003 report by the Environmental Protection Agency, after a government scientist was forbidden in 2001 and 2002 from discussing health hazards posed by airborne bacteria emanating from animal waste at large factory farms, after 60 scientists ⎯ 20 of them Nobel laureates ⎯ signed a statement in 2004 accusing the White House of manipulating and distorting science for political aims, after all that, Team Bush has once again been caught censoring science it dislikes.
I refer you to this week's testimony before the House Committee on Oversight and Government Reform. The committee produced paperwork documenting many dozens of instances in which the former chief of staff of the White House Council on Environmental Quality edited scientific reports on global warming. He cut definitive statements and replaced them with doubtful ones in order to portray climate change as something less than the settled science most experts consider it to be.
And what connections with industry tainted the Administration’s actions in the case of that global warming report? The official responsible for the “editing” came to the White House from a position with the American Petroleum Institute, the industry’s lobbiest. Then, not long after his “editing” on the report, the official left government to go work for the most major of major oil companies.
The incidents highlighted by Mr. Pitts are all-too-common, and yet nothing ever seems to be done. The prevailing attitude among the offenders is that they know what is best for us by virtue of their expertise derived by being an insider. That leads to an insufferable arrogance. As Mr. Pitts wrote, the danger of too close a tie between the regulators is bad policy, but another result is an erosion of public trust in the very institutions that should protect us:
I could give you many reasons this makes me angry. I could speak about the people’s right not to be propagandized by their own government. I would point out that this facts-optional approach shreds the government's credibility.
But here’s what really burns my toast: These people think I’m stupid. And they think you’re stupid, too. What else can we conclude of a government that treats us with such brazen disdain?
They think we’re a bunch of doofuses, dimwits and dolts who will never notice that they’ve placed the interests of their cronies above our own.
For the record, I am not stupid and I resent being treated as if I am.
It can’t be stated better than that.