An unhealthy abuse of power

An unhealthy abuse of power

Opinion piece in the Financial Times reveals the role of the US Surgeon-General

On the eve of confirmation hearings for a successor to the surgeon-general, Dr Richard Carmona told a congressional committee this week that Mr Bush’s people tried to “water down” a report he wrote on secondhand smoke. Words such as “gagged”, “muzzled” and “censored” were used to describe what the Bush administration did to its former surgeon-general.

The surgeon-general, who works for the Department of Health and Human Services, publicises health risks. He is often called “America’s family doctor” but the metaphor is misleading. Few family doctors infuriate half their patients, as surgeons-general have tended to do.

The same pattern is repeated again and again: a doctor of some professional distinction, vetted for pro-administration sympathies, gets confirmed and quickly becomes a political “maverick”. The problem is simple: the surgeon-general is both a political post, with a good deal of clout, and a “caring” post, which puts it above criticism. Naturally, the temptation of power without accountability arises.

A broader conception of the job is not the only thing that surgeons-general want. They want to pursue their agenda of “science” without “political interference”. Dr Koop told a reporter recently: “There should be a law that says this person would be apolitical and when he is appointed, he will not be answerable to the president for what he says about health or anything else.”

This is a misrepresentation. For it is not “science” that people obey when health policies are implemented. It is power. The science in the 1964 surgeon-general’s report linking smoking to lung cancer stopped relatively few people from smoking. Smoking rates only began to fall steeply only in the 1980s with the introduction of judicial decrees and legislation. State power enforced the surrender of a certain amount of liberty in exchange for a certain amount of cleanliness, health and longevity. Policies on sex education, abortion and cloning are similarly matters of politics, not science. The surgeon-general is not at the intellectual pinnacle of the medical profession. He is at the political pinnacle of the medical profession. None of the surgeons-general in the past generation has been among the country’s authoritative scientists. Their authority derives only from the administration they represent.
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In a political struggle between the presidency and the surgeon-general, the presidency prevails. What was revealed in testimony last week was not the politicisation of the surgeon-general’s office but its de-politicisation. Dr Carmona’s superiors, by reasserting their control over health policy, made it more accountable. That does not mean they made it more competent. If it is competence you want, you have your vote for that.

Source: The Financial Times, 13 July 2007
Article Link: http://tinyurl.com/2gw26w