Does the Bush administration have more compassion for stem cells than for women?  Recent testimony by former Surgeon General Richard Carmona revealed that a host of federal policies affecting women’s health care – from abstinence-only programs, to stem cell research, emergency contraception and abortion – prioritize politics, ideology and theology over women's health.    

    Dr. Carmona testified before the House Committee on Oversight and Government Reform that spending policies are dictated by “preconceived political agendas” which “fly in the face of good science.”  Yet naysayers with their do-good science were ignored, says Carmona, because the administration “did not want to hear the science but wanted to, if you will, ‘preach abstinence’ which I felt was scientifically incorrect.” 

    The surprising part is just how unsurprising this all is.  The funding scheme for abstinence-only programs provides a particularly deplorable example.  Despite mountains of evidence clearly showing that these extreme programs are ineffective and harmful, federal funding continues at over $200 million a year and growing.  Under the Bush administration, abstinence-only subsidies have gushed forth -- creating a deluge of funding for far-right religious groups, amidst a dearth of federal oversight. 

    Other Surgeons General agreed and testified that while Dr. Carmona’s experience was extreme, political meddling with the Office of the Surgeon General was by no means exclusive to the Bush Administration.  The surprising part is just how unsurprising this all is.

    The fact that this administration views public health policy through conservative blinders is not altogether unexpected.  The funding scheme for abstinence-only programs provides a particularly deplorable example.  Despite mountains of evidence clearly showing that these extreme programs are ineffective and harmful, federal funding continues at over $200 million a year and growing.  Under the Bush administration, abstinence-only subsidies have gushed forth -- creating a deluge of funding for far-right religious groups, amidst a dearth of federal oversight.  Politics, ideology and theology take priority over women’s health in this administration testified Carmona.

    Former Surgeon General David Satcher testified about a similar trend towards politicizing health care during his tenure in the sex-plagued As far back as 2001 he found no scientific evidence that abstinence-only education is effective, and recommended that children instead be given age-appropriate comprehensive sexuality education.  However, his report was released only later during the Bush administration, and without the administration’s support.  “You know the politics of sex in Secretary of Health and Human Services Tommy Thompson commenting to him.   

    The Surgeons General likewise faced pressure not to talk about political hot-button health issues such as HIV/AIDS.  The administration discouraged Dr. Satcher from releasing a report that supported needle exchange as a way to slow the spread of this deadly disease.  During the Reagan era, Surgeon General C. Everett Koop had to resist administration pressure not to talk about HIV/AIDS. 

    On a lighter note, it’s worth mentioning that poor Dr. Carmona was required to make three positive references to President Bush on every page of every speech he made.     

    With the office of Surgeon General now empty, the president's nominee Dr. James Holsinger faces Congressional review.  Now is the time to ask the hard questions about the role of the nation’s top doctor.  Not only is there cause for concern about Dr. Holsinger’s qualifications and his disturbing remarks about homosexuality made years back, but as the recent testimony reveals, the real question is what he, and others, will do to resist the politicization of the nation’s public health policies.  

    Reforming the Office of Surgeon General is just one important step in the battle to prioritize science in public health care decisions.  As several Surgeons Generals’ testimony exposed, the public health cost of federal programs that are based on politics rather than science is too high.  It’s time to liberate the Office of the Surgeon General and to prioritize policies that promote health and not ideology. 

(Portions of this post appeared in a July 17, 2007 op-ed in The Boston Globe.)