Buckraking

Cokie Roberts, the ABC-TV and NPR on-air personality, used to take heat from some journalists for her “buckraking” – taking money from corporate trade groups for speaking gigs. The critics – like my former boss, Chicago Tribune Washington bureau chief James Warren – had the audacity to point out that it was a gross conflict of interest to moonlight for organizations whose issues you will eventually report about. It raised a brief ruckus in the media before Roberts shrugged off the criticism and continued in her lucrative ways.

It now appears the practice has entered the mainstream. No group of companies is more reviled than the nation’s health insurers. There are about 1,300 firms belonging to the America's Health Insurance Plans, and anywhere from 2-3,000 of their executives will be in Las Vegas in June for their annual confab.

The main speaker for the meeting is former President Bill Clinton, whose efforts at health reform in the early 1990s foundered because of militant opposition from the insurance industry. I'm not surprised they've kissed and made up.

What is more surprising is the celebrities the insurance execs have lined up for their main sessions. The moderator for the first day’s panels is Susan Dentzer, the highly regarded health correspondent for PBS’s News Hour. Want to know about “The Tipping Point in Health Care”? They will hear Malcolm Gladwell, the New Yorker journalist, make that presentation at one of the morning sessions. In the afternoon, Fox-TV commentator and Roll Call executive editor Morton Kondracke will give the health insurance execs his outlook for health reform.

Typical of these affairs, each session is branded. So Kondracke’s talk is sponsored by Schering-Plough. Each of the other sessions is supported by major health providers – Merck-Medco, AstraZeneca, Sanofi-Pasteur, Amgen. The insurance companies' annual meeting, it turns out, is sponsored by their contractors, the companies whose fees they're supposed to hold down. I guess it's all one big happy family.

I recently gave a talk at the Society of Toxicologists on conflicts of interest in science. Long after I agreed to speak (in exchange for travel money from that professional society, which is made of up of corporate and academic toxicologists, the people who study if and how chemicals are poisoning us), I received an honorarium offer from Dow Chemical Company. I refused the money. The academic bioethicist who was my counterpart on the panel accepted.

It would have been nice to pocket that extra $1,000. But how would I have felt if the next time I spoke before a group or wrote something in a magazine, I had to disclose that Dow Chemical was among my corporate benefactors? I found it a lot easier to just say no.

Now I’m wondering. The next time I turn on the News Hour and hear a report on the health insurance industry from its health care correspondent, will I hear a disclaimer from that the show’s correspondent that she has accepted speaking fees from the industry’s trade association?

Blotting Out the Sun

It was in 1791, while carrying on a torrid love affair with a blackmailer’s wife, that Alexander Hamilton, the nation’s first Treasury Secretary, penned his classic “Report on Manufactures.” In it, the far-seeing father of U.S. capitalism laid out the case for a “free people . . . promot(ing) such manufactories as tend to render them independent.”

The U.S. has a long history of subsidizing industry. At the dawn of the republic, Hamilton saw the need to subsidize and protect an infant domestic textile industry against the overwhelming power of the British, whose looms then dominated the world.

I suspect that if Hamilton were around today, he’d probably join with the former intelligence chiefs who this week sent a letter to the Wall Street Journal protesting the wildly out of whack priorities of the Republican energy bill. The media, while focusing on the new Pope, has largely ignored the fact this legislation, thought dead a year ago, is once again moving through Congress on a wave of $2.35-per-gallon gas.

Of course, if Hamilton came back as a subsidy-dependent Houston oilman, he might argue as the White House is doing that opening up the Alaska Wildlife Refuge to oil drilling and spending billions more on tax credits and subsidies for the coal and nuclear industries are the wave of the future.

But these technologies will not promote U.S. energy independence. They will leave us even more dependent on foreign oil and environmentally unsustainable sources of power.

Given global warming, the still unresolved problem of storing nuclear waste and the fact that two-thirds of the world’s oil supply lies under Middle Eastern sands, the only way to wean ourselves from foreign oil is to wean ourselves from oil entirely.

That, unfortunately, isn’t on the table. There’s almost nothing in the new energy bill for sustainable energy supplies like solar, wind, geothermal and biomass fuels. Rep. Bill Thomas, Republican chairman of the House Ways and Means Committee, threw in a $18 million tax credit for solar installations. That’s right -- $18 million. That’s a rounding error in this pork barrel legislation.

Meanwhile, the Bush administration laid out its priorities last February in its Energy department request. Research into all forms of sustainable energy will get just $353 million next year, $32 million less than this year. That’s less than 20 percent of what Rep. Tom Delay of Texas was able to get done for his constituents alone. His ethics woes didn’t prevent him from inserting a $2 billion subsidy for off-shore drilling in the Gulf of Mexico.

This fiddling while oil burns is already having a major impact on our economy. Expensive gas is like a huge tax increase on the middle-class and working poor, who must cut back on other spending to pay the tab. But it’s the long-term impact on the economy that would most frighten someone like Hamilton.

If he were around today, he’s probably write a “Report on Energy.” In it, he would point out that the global supply of sustainable energy has increased 15-fold in the past decade and that our major trading rivals are making huge strides in these emerging technologies. Over that time period, the U.S. share of that infant industry fell from about 40 percent to barely above 10 percent. Virtually all the growth was in Japan, which now accounts for nearly half the world supply, and Europe, where wind energy has become a major way to avoid burning carbon-based fuels like coal, oil and natural gas.

Our future as a free people, he might argue, rests on our catching up.

You Get What You Pay For

Science is objective, right? The scientific method requires that results be reproducible before they are considered fact. If two scientists testing the same hypothesis by the same methods come up with different results, then either the theory is wrong, or, as they say at the end of nearly every scientific article, more testing is required.

Of course, in the real scientific world, with its conflicting agendas and competing theories, studies on controversial topics almost always come up with varying results, often depending on who sponsored the study. That doesn't mean the world is inherently unknowable. In these cases, scientists who want to be objective must go with what is called the balance of evidence. This is especially true if they work at regulatory agencies like the Environmental Protection Agency and the Food and Drug Administration where decisions have to be made with less than perfect knowledge.

This brings us to a fascinating report in today's Los Angeles Times on a study that just appeared in a government-sponsored environmental health journal on the effects of a common plastic on human hormones. The study evaluated 115 academic studies of bisphenol A or BPA, which is found in virtually everything made of hard plastic and can now be found in the blood of nearly every American.

The analysis showed that 94 of the 115 studies published on BPA in recent years found the chemical mimics estrogen, blocks testosterone and harms lab animals. Many toxicologists are especially concerned that toxics that mimic sex hormones do serious damage to sensitive areas like the brain or sex organs in developing fetuses and children. Frederick vom Saal of the University of Missouri, author of the study and a long-time proponent of the idea that BPA is harmful, told the Times that the evidence was now overwhelming.

Well, anytime you are dealing with a chemical that is in everything from baby bottles to plastic water containers, you can be sure that the companies involved will be deploying their own scientists. In this case, the American Plastics Council paid the Harvard Center for Risk Analysis to conduct its own study (the Harvard Center, by the way, is where John Graham, head of the regulatory affairs office in the Bush administration, came from).

Their analysis, conducted last year, found that the evidence is weak. Vom Saal had an answer for that, too. In his paper, he divided up the studies in his sample into those funded by industry and those funded by government or other non-industry sources.

Here's what he found. Of the 11 studies funded by industry, none found any elevated risk to humans. But of the 104 other studies, over 90 percent showed that the chemical had harmful health effects.

I have no idea if regulators will agree that the jury is no longer out on whether the buildup of BPA in the environment poses a risk to humans. But the "theory" that he who pays the piper calls the tune is starting to look like an incontrovertible scientific fact.

The Bush photo-op

President Bush two days ago posed before a file cabinet filled with Social Security Treasury bonds suggesting they were nothing but worthless paper. The New York Times this morning properly took him to task. Where's the next stop? Will he go to Beijing and tell the Community Party leaders that the $700 billion they've invested in U.S. T-bills are worthless?

But let's not put all the blame on Bush. He took his cue from none other than Alan Greenspan, who spoke at length last August at the Fed's annual retreat in Jackson Hole, Wyoming about Social Security as if the trust fund didn't exist (see Gooznews, Aug. 29, 2004, "Greenspan/Bush: Repudiate the National Debt!").

Yet paying off the national debt -- to the future retirees, the Chinese and all the other T-bill holders -- is a major, looming problem. The share of national income going to taxes (general revenue from income and corporate taxes, not Social Security revenue from the payroll tax) will have to rise from its historically low levels. The tax cuts of recent years have eviscerated the government's ability to pay its bills.

In that regard, it was interesting to note the op-ed in yesterday's Times by Bruce Bartlett, one of the right-wing intellectuals behind the anti-tax movement of Grover Norquist and Stephen Moore's Club for Growth. He called for a value-added tax so the government can pay its bills. While he dressed it up on the rhetoric of the Republican's inability to shrink government, I suspect all but the most ideologically committed anti-taxers (put the president in that category) are beginning to realize that protecting the full faith and credit of the United States isn't such a bad idea.

Is there a stem cell line for ethics?

The Washington Post reported this morning that the National Institute of Health's top stem cell researcher resigned last week because of the agency's new ethics rules. The paper also reported, in a parenthetical aside, that James F. Battey, a 20-year veteran of the agency, is in the running for the top job at California's $3 billion stem cell research program.

What's the real story here?

According to Battey, "the new rules imposed an insurmountable problem (because) I manage a family trust. . . It contains assets I'm told I'd have to divest. That would cost a lot of money, and I can't do that to my family."

Maybe he should switch to a discount broker. There's nothing in the new rules that prohibits him from investing in stocks. He just can't invest in stocks of companies that do business with NIH, which are primarily drug, biotechnology and medical device companies.

Moreover, other high government officials don't have problems complying with strict ethics rules. Federal Reserve Board chairman Alan Greenspan, for instance, limits his investments to Treasury bills to avoid entanglements with firms that might be affected by his actions, which, of course, is every firm. Corporate officials who join the government routinely place their assets in blind trusts -- another method for avoiding conflicts of interest.

Other professions don't have qualms about enforcing strict conflict of interest rules. Take journalism. (I know, I know. After two weeks of Terry Schiavo, you're probably saying to yourself a la Henny Youngman, "please.") Business reporters can't invest in companies they report on. If they do and they get caught, it's grounds for immediate dismissal.

One can't help but think something else is at work here. Might the fact that the Bush administration placed severe restrictions on stem cell research to appease the religious right have anything to do with Battey's decision? Might recent reports that the top job at the California Institute for Regenerative Medicine (CIRM), the state's new stem cell research agency, will pay somewhere between $300,000 and $600,000 a year have anything to do with it?

If Battey thinks he is jumping out of the conflict-of-interest frying pan by moving to California, he may be in for a surprise. Former U.S. assistant secretary of health Philip R. Lee and public interest attorney Charles Halpern recently filed a petition with the new agency demanding it adopt strict conflict-of-interest rules and comply with California's open meetings laws.

At CIRM's most recent meeting, interim director Zach Hall said the new agency was in the process of creating conflict of interest rules. He called the new NIH rules "the gold standard."

I've laid out the rationale for the new rules in this space before (see the 2/6/2005 Gooznews, "Protecting the View from Mt. NIH"). But the gold standard probably does need a bit of tweaking. This morning's Post article was filled with petty examples of overzealous interpretation of the rules -- a scientist having to turn down a $200 train ticket to attend a meeting; another worried about his ability to serve on a professional society's board.

But these examples were then used to make sweeping generalizations about NIH scientists being cut off from dealing with business if they can't accept consulting fees or stock options. There's nothing in the new rules that prohibits NIH scientists from working with private firms. The rules still allow for cooperative research and development agreements -- where the government and a private entity enter into a specific contract spelling out each's contribution to a medical research endeavor.

What's prohibited is government scientists cutting side deals. By staying free from those entanglements, NIH scientists will not only remove the taint of scandal that still hangs over the agency, but they will stay focused on their real jobs -- coming up with causes and cures of disease.