Ambitious, But Toward What End?

The New Yorker recently ran a profile by Ryan Lizza on Barack Obama's rise to political prominence. Entitled "Making It: How Chicago shaped Obama," the article portrayed a man of overweaning ambition, who picked his friends and mentors with a constant eye on political upward mobility, and discarded them when they no longer served his purposes.

The writer interviewed a number of people I knew from my days in Chicago. As I read the article, some of their perspectives on Obama didn't sound like the people I once knew. One of those was Marilyn Katz, an antiwar activist since the late 1960s who now runs a political public relations firm with close ties to Mayor Richard Daley. This evening, I was one of many people who received an email from Marilyn containing a complaint she sent to the author of the New Yorker profile. You may find it interesting:

Of all the ways possible to explore the extraordinary person and journey of Barack Obama, I found it fascinating that Ryan Lizza would spin a tale of the 'canny politician,' who chose and discarded venues and friends as they fit his political ambitions in a city dominated by insider politics, intrigue and personal gain.

Nothing could be further from the truth, (although given that I was misquoted in the article even after informing your fact checker about it in advance) perhaps the 'truth' is not what Mr. Lizza was seeking; rather it was the crafting of a tall tale and a compelling read.

When I met with Mr. Lizza, we talked about the new Chicago, now one of the nation's most well-knit communities, where decision-making is shared among traditional political leaders and the scores of community, women's, ethnic, and environmental organizations that comprise its vibrant city life.

We talked about - and I referred your reporter to - the core of people who came of age during (and whose politics were forged by) the civil rights and anti-war movements of the 1960s. These are the people who elected Harold Washington in 1983, changing the city's old-school politics forever. Many now lead its City Council and Congressional Delegation, having evolved into crucial leaders of the progressive network that enabled a talented young political leader to build a base that stretched across the state in record time.

Mr. Lizza and I talked about the critical importance of the grassroots political networks from which this young political leader emerged, in the wake of the invasion of Iraq, to build a base for his successful senate run. That Lizza opted to build his story out of the comments of two people who see things otherwise speaks more to story craft than to the truth.

While I don't recognize the reality of Barack or the Chicago he presents in his piece, ironically the tale that Lizza spins is an interesting one, even worth considering. It would not be a bad thing if Obama were the crafty, calculating politician that he describes. These are not times for 'accidental presidents.' The presidency of the United States has always been fought for by ambitious men – in the best of times those ambitions being in pursuit of a vision of the future about which they are passionate. Those who seek the presidency are by their very nature filled with an extraordinary sense of possibility and responsibility.

What makes Barack Obama stand out for me and others – what millions have recognized in him, is that while he is ambitious, his politics are not the 'politics of ambition,' a disease from which the nation has suffered too long. A disease that has led us into short-term thinking and long-term disasters from which I hope we will be liberated in November.

--Marilyn Katz

Health Care Still Sliding as Issue with Voters

The headline on the new Wall Street Journal/NBC News poll shows Sen. Barack Obama with a slight lead over Sen. John McCain. His troubles with white male voters continue to drag down what ought to be an overwhelming lead given the economic conditions in the country.

Most notable to me was the decision to devote just one paragraph in the story (its last) to issues. It read this way:

Concerns about the Iraq war and the economy dwarf all other issues, including terrorism, illegal immigration, the mortgage mess, the environment and global warming.

Where's health care? So I went to the actual poll data and found this ranking of the issues (respondents were asked to name which two issues they considered most important in this year's election):

The economy .................................. 47

Iraq................................................ 30

Energy ........................................... 28

Health care...................................... 23

Immigration ................................... 18

Family values issues ........................ 14

The environment............................... 9

Trade ............................................... 7

A year ago, health care was widely seen as the primary domestic concern of the American people. Now, the nation's faltering economy and soaring energy bills have pushed it off center stage.

Northwest Indiana

As I awaited the results from Indiana last night, I was stunned by the lack of curiosity about Lake County, Indiana shown by the commentators on CNN. I spent a year of my life reporting for the Hammond Times, now the Northwest Indiana Times, so I know a bit about that turf.

The area, fondly known as "the region" to its inhabitants, is a microcosm of American society. Gary, its largest town, is a predominantly poor black city. But the predominantly white counterparts along the southern tip of Lake Michigan to the west -- Hammond and East Chicago -- are also very poor and working class, dilapidated communities that surround downsized steel mills.

But there are about 25 other towns in the county, and the further south you go (Crown Point, the county seat, and my favorite, Merrillville), the whiter and more middle class it gets. In the far south of the county, it is farm country.

I mention this because while awaiting the results, the on air commentators asked no questions about how the "white" areas of the county were voting. When Hammond mayor Tom McDermott was given national air time, all they could ask him about was the delay in reporting the vote. He repeatedly said that he had sent in his vote totals to the county board of elections, and he was upset as anyone that they hadn't been reported to the nation.

But he let slip that Clinton won by 600 votes in Hammond. No one followed up on that comment. 600 votes? There were probably 20,000 votes or so out of Hammond. That means that Obama did very well there. Perhaps the growing black and Hispanic population in that small city accounted for his showing.

Ultimately, Clinton did well enough to hold onto her slim victory in the state. But I suspect it was the more upper middle class areas of Lake County that preserved her margin. Last night's vote in Indiana, and especially in a town like Hammond, suggested to me that white working class Democrats, who have been one of the pillars of the Clinton candidacy, will, in these tough economic times, ultimately support an Obama candidacy.

Last Night's Debate

I nominate ABC News debate moderators Charles Gibson and George Stephanopoulos for the worst performance by political journalists in a starring role in modern American political history. After 45 minutes of last night's debate, the questions from the alleged journalists had covered bitterness, Rev. Wright, bitterness again, Rev. Wright again, dodging bullets in Kosovo (I guess that passed for equal opportunity bullshit), and then, to top it all off, a question about Sen. Obama's relationship with Bill Ayers, who was a member of a radical fringe group 40 years ago. Then Stephanopoulos, a former Democratic Party apparatchik in the first Clinton administration, bated both candidates to publicly take the "no new taxes" pledge, one year before the Bush administration's massive tax break for the rich (enacted on the eve of war) is about to expire.

Only after the third or fourth commercial break and nearly an hour into the show did the first question come about one of the top three issues on the minds of American voters: Iraq. The economy was passed over quickly to move onto gun control. And unless I missed it while taking a bathroom break, the issue of health care never came up.

I logged onto the ABC News website after the debate and wrote a quick note in their feedback form. I politely informed them that I will never, ever watch ABC News again. Shameful.

Who's Behind Obama Passport Info Leak?

The Dirt Diggers Digest blog by former reporter Phil Mattera has some interesting speculation. Hint: the owner of the outside contractor that does substantial security work for the State Department has made significant campaign contributions to Sen. Joe Lieberman (D-CN), who is recent days has been traveling with Republican presidential candidate John McCain.

McCain's Religion Problem

Rev. Rod Parsley of the World Harvest (mega-)Church in Columbus preaches before 5,200 Pentecostal parishioners and a large weekly television audience. A week before the hotly contested Ohio primary, he endorsed John McCain over Mike Huckabee, the favorite with most of his parishioners. Parsley called McCain the "true conservative" in the race.

According to a new article by David Corn of Mother Jones magazine, Parsley has called 9/11 a wake-up call to all Christians to wage "war" against the "false religion" of Islam with the aim of destroying it.

McCain appeared at a campaign rally in Cincinnati with Parsley a week before the primary. Corn doesn't report what was said at the rally, but here is an excerpt from Parsley's 2005 book, "Silent No More":

"I cannot tell you how important it is that we understand the true nature of Islam, that we see it for what it really is. In fact, I will tell you this: I do not believe our country can truly fulfill its divine purpose until we understand our historical conflict with Islam. I know that this statement sounds extreme, but I do not shrink from its implications. The fact is that America was founded, in part, with the intention of seeing this false religion destroyed, and I believe September 11, 2001, was a generational call to arms that we can no longer ignore.

Will McCain denounce Parsley and what he stands for? I use as my text this morning a column by Charles Krauthammer, headlined in the Washington Post: "The Speech: A Brilliant Fraud." Referring to Sen. Barack Obama's comparison of his grandmother's private fears about black men while walking the streets to Rev. Jeremiah Wright's angry denunciations of white America from the pulpit, Krauthammer asks, "Does he not see the moral difference between the occasional private expression of the prejudices of one's time and the use of a public stage to spread racial lies and race hatred?" He called Obama's speech and his failure to leave his church "an elegantly crafted, brilliantly sophistic justification of that scandalous dereliction."

When will McCain, who asks us to endlessly stay the course in Iraq and threatens to "bomb, bomb, bomb, bombomba Iran," offer America a detailed explication of his views on Islam so that we can watch them on YouTube (I'll certainly reproduce it here). And, if he doesn't, or asks Americans to understand the anger about 9/11 that informs the wild ravings of a so-called man of God like Parsley, how long will it take before Krauthammer and his ilk call it a scandalous dereliction of duty?

Obama' speech

I spent the day in a Food and Drug Administration advisory committee meeting, and thought when I got home tonight that I would use my late night blogging time to comment on one of the issues discussed there today. But a friend sent me the YouTube video of Barack Obama's speech delivered in Pennsylvania earlier today. I found his call to the American people to "move beyond some of our old racial wounds" to work together solve our pressing problems truly inspiring. I think you will too.

Big Pharma's Health Care Reform Playbook

The drug industry gets a disproportionate share of attention when it comes to the high cost of medicine. Drugs and biologics, whether prescribed by physicians or administered in clinics and hospitals, account for just 10 to 12 percent of health care expenditures, significantly less than, say, the 15 to 20 percent administrative overhead associated with allowing private firms to sell health insurance (as compared to the 3 to 5 percent overhead associated with the nation's largest single-payer organization, Medicare).

Still, Congress' ability to curb the explosive rise in drug costs is a bellwether of the political prospects for health care reform. Along with eliminating unnecessary payments to insurance firms (like the 12 percent bump they get for selling Medicare Advantage plans), curbing Big Pharma's voracious appetite for selling overpriced and often unnecessary drugs is the low-hanging fruit of cost control.

An article in today's Washington Post reveals just how hard that is going to be. According to the Center for Responsive Politics, Big Pharma lobbying expenditures have tilted sharply in the two years since the Democrats took control of Congress. Democrats, who only received a third of industry lobbying money in 2006, now get fully half, more than at any time since at least 1988.

And it appears to be working. The prospects for legislation allowing Medicare to negotiate with drug companies for lower prices now that we have a prescription drug benefit for seniors? Dead in the water. The Canadian import bill (another major Democratic Party initiative)? Stopped.

And who are the lobbyists newly hired by Big Pharma? Former top aides for House Speaker Nancy Pelosi (D-CA), Senate Finance Committee chair Max Baucus (D-MT), House Ways and Means Committee chairman Charles Rangel (D-NY), and Senate Health Education Labor and Pension Committee chair Ted Kennedy (D-MA).

The Pharmaceutical Research and Manufacturers Association, the industry's main lobbying group, is leaving nothing to chance. It's signed on to lobby in support of issues not germane to the drug industry in the hope that it will curb their new allies' appetites for going after Big Pharma. So PhRMA, headed by former Congressman Billy Tauzin, is now working with AARP on universal health care, the American Lung Association on clean air and the Partnership for a Drug-Free America to curb the use of illegal drugs.

Don't think that the insurance industry, organized medicine, the hospitals, the device manufacturers and all other providers to the health care system aren't paying close attention to the Big Pharma playbook. Universal health care that costs the taxpayers a bundle (or increases everyone else's fees) is one thing. But tying effective cost control to health care reform is quite another.

If the drug industry succeeds in deep-sixing drug pricing reform issues in this Congress, it bodes ill for other, more far-reaching cost control measure in the next -- measures that are crucial to successful health care reform.

The Muslim Smear

Last week, Nation columnist Naomi Klein wrote a convincing column calling on Barack Obama to go on the offensive against the internet-spread hate campaign accusing him of being a Muslim. "Use the attacks to begin the very process of global repair that is the most seductive promise of his campaign," she recommended. "He can state clearly that while a liaison with a pharmaceutical lobbyist may be worthy of scandalized exposure, being a Muslim is not."

While she posted her column last Friday, I didn't read it until I got my copy of the magazine in the mail this evening. I had to laugh. Last night, I watched 60 Minutes. It was like he'd read it, too. Here's what Obama told correspondent Steve Croft after he showed a clip of a focus group that included a distressed, laid off paper mill worker who was leaning toward Obama but expressed fears about the "fact" that Obama was a Muslim and didn't know the national anthem (to his credit, Croft immediately told the fellow it was a lie).

These emails are not just offensive to me, somebody who is a devout Christian and has been going to the same church for the last 20 years, but it's also offensive to Muslims because it plays in, obviously, to a certain fear-mongering."

When Clinton was asked about the Muslim lie and the photo of Obama in Somali dress that her campaign had to deny distributing, she at first said she had "no reason to believe it's true." She then expressed empathy for her opponent, having been the target of so many smear campaigns herself.

If Obama wins the two big primaries tomorrow and he and McCain become the presumptive nominees, it will be interesting to see how the Republicans handle the Muslim issue. Will they denounce the rumor-mongerers? Or will they cave in to the Rovian dark side with non-denial denials like having no reason to believe it's true?

Last night, Obama showed that he has nothing to fear from the Muslim card. To the extent it gets played, he showed that he can turn it to his own -- and the nation's -- advantage.

Super Tuesday

The stark message from yesterday's vote is how little has changed among the U.S. electorate despite seven years of feckless Bush rule that brought us an endless war, a looming recession, and managerial incompetence. A few observations:

Arizona Republican John McCain has become the frontrunner for the Republican nomination by winning primaries in states that almost always go Democratic. But how different is his emerging triumph from the outset of George W. Bush's own ascent to the presidency in 2000? He, too, posed as a moderate -- remember compassionate conservatism? -- to gain mainstream voters' support.

On the Democratic side, the Clinton-Obama split reflects the divisions in the party that have been there since 1972. The young, the antiwar, and the university-town ghettoes support the insurgent candidate, while the traditional base of the party -- the blue, pink and gray collar workers that haven't defected to the Republicans over cultural issues, the baby boomer soccer moms (now morphed by the miracle of time into empty-nesters and grandmoms), and minorities -- go for the consensus candidate of the party machine. The vote is only close because one element of the traditional coalition, African-Americans, is voting along ethnic lines. They, like the insurgent wing of the party, will like Hillary well enough if and when she wins the nomination.

Clinton did well in traditional Democratic bastions -- Massachusetts, New York, New Jersey, California. Obama won Illinois, but that was a favorite son vote. Meanwhile, Obama did well in states that in recent years have leaned Republican, many of which held caucuses yesterday, not voting primaries. That's testimony to the organizational energy he's brought to the campaign. But I fear he would lose those states in a landslide against almost any Republican candidate.

So now that Super Tuesday has come and gone, where are we? Michael Gerson, a former Bush speechwriter turned Washington Post columnist, in this morning's paper warned McCain that he couldn't remain "uncurious" about domestic politics. If the wobbly U.S. economy nosedives and pocketbook issues take center stage, any Republican will have a hard time winning.

But if the slowdown is mild and the economy rights itself by mid-year, as some economists predict, then the election will become a referendum on the war, no matter who becomes the Democratic candidate. Do we want to move rapidly toward a green economy and ending the war, or do we want to be an empire that endlessly engages in low-level conflicts in the Middle East to protect our oil-based way of life?

It's rare in politics when the choices are so stark. Do we want Democracy and a focus on domestic issues? Or do we John McCain's 100 Years War? For me, the choice is easy. But don't underestimate the power of nationalism and jingoism. The whole country wanted the Vietnam War to end by election day 1968. But the "emerging Republican majority" narrowly voted for Nixon and "peace with honor." That's McCain's slogan, too, even if he doesn't use precisely those words. And in Clinton, he would face the one candidate capable of resuscitating that doddering Republican coalition for one last hurrah.

Al Franken's First TV Ad

Thank you Ezra Klein for posting this YouTube link to Al Franken's first television ad, now running in Minnesota. I liked it, and thought you might, too.

Women And Workers Shifted to Hillary

John Judis of The New Republic yesterday posted a convincing analysis that suggests my "it's the economy" stupid explanation for Sen. Hillary Clinton's come-from-behind win last Tuesday was not the most significant factor. He's one of the most astute observers of American politics because of his skill in analyzing polls, and firmly rejects the thesis that working class voters (those with less than a college education) are racist, which had been suggested in this op-ed by Andrew Kohut in Friday's New York Times.

In short, Judis shows that there was a huge shift among educated women voters in the last few days of the election. There was also a smaller but distinct shift to Clinton among well-educated male voters. And among both groups, Sen. Barack Obama's support dropped. Among college educated women, the shift was a full 12 percentage points from one to the other -- about the same as the swing in the pre-election poll to the actual results.

Among voters with only a high school education, Obama actually gained a percentage point from pre-election polls to the final results. Clinton gained five points. Obama wasn't the victim of racism. He just didn't benefit as much as Clinton from the rush away from John Edwards, who in the final hours of the race saw his support plummet. Indeed, the combined vote in every educational category for Clinton and Obama was five to nine percentage points greater in the actual polls than it was in the pre-election polls. Hillary got most of those votes. I stick with my view expressed Friday that "it's the economy, stupid" will be the watchword of this year's campaign, and that will benefit Clinton the most of all the candidates in the race.

That said, the energy and enthusiasm that Obama's legions have brought to the race will need to be translated to her campaign if the Democrats are to win in November. Given the consultants, pollsters, party insiders and centrist thinkers who dominate her camp, that's going to be one tough transplant operation if she gets the nomination.

Duh: Economy Tops Campaign Agenda

The front page of today's Washington Post confirms my New Year's Day analysis: the economy has surpassed health care as the number one domestic issue for American voters. According to exit polls in New Hampshire, it even exceeded Iraq or terrorism as a concern, and that was for Democrats and Republicans alike.

It's always nice to be ahead of the pack. And, in hindsight, I'm sorry I didn't draw the obvious conclusion from this shift in opinion. Growing fears about the economy undoubtedly contributed to Hillary Clinton's win in New Hampshire. It wasn't just women who rescued her candidacy, but voters lower down on the income scale, who turned out in droves along with every other constituency.

Why would these voters stampede to Clinton? Was it race (distaste for Barack Obama), as so many pundits have suggested? Actually, they were already there. Over the past 30 years, the only time the lower middle-class registered real (higher than inflation) gains in their take home pay was in the latter half of Bill Clinton's time in office. When it comes to economic matters, the name "Clinton" is a proven brand.

The increasing likelihood of a full blown recession this year should benefit whomever is the Democratic nominee. Their roughly comparable approaches on fiscal stimulus, tax breaks, and regulatory policy will offer voters a sharp break from the Republican mantra of tax breaks uber alles, deregulation, and "you're own your own" economics that led us into this fix.

Yet as I flipped through the op-ed pages of the nation's leading newspapers over the past few days and read the political commentary in the wake of New Hampshire's "upset," I've yet to read one pundit who has addressed the centrality of the deteriorating economy to the emerging dynamics of the race. "Populism" as a response to "middle-class anxiety" is as close as anyone gets. But that's John Edwards' 2007 formulation in the context of a still surging economy. Look where that has gotten him. And after New Hampshire, all the pundits can write about is the tear and the sneer and the woman and the black, as if the voter at the margin who considers such issues after endless television gazing is all the matters.

Frankly, I think they should take all the pundits' columns away, give them notebooks and microphones, and send them off to the boondocks to do some real reporting. They might learn something from the people.

Clinton's Win

The public pollsters got it wrong and the candidates' pollsters got it wrong, and as a result, the media got it wrong. Had reporters only reported what they saw, the story of tonight's vote in New Hampshire would have been the extraordinary surge of young and independent voters who came out for Obama and almost defeated the well-funded, Clinton juggernaut and the Democratic Party establishment.

She won by capturing the party's most consistent supporters over the past several decades: middle class women, seniors, and blue and gray collar workers who haven't defected to the Republicans and evangelicals over cultural issues. These people are voting Democratic no matter who gets the nomination.

Now we have a race. And whoever emerges the winner will be a stronger candidate for it. But Barack Obama has already defined the motif of the November election. Incrementalism is out. For the Democrats to win, they're going to have to inspire young voters. Obama's message does that. There's hope again in America. It's time for a change. Yes, we can.

Obama's Speech

If you stayed up to watch Obama's victory speech last night, you, like me, might have become an instant convert. I felt like the young Jewish kid falsely accused of murder in the movie "My Cousin Vinnie," who, after hearing Joe Pesci's Vinnie demolish a witness, dumped his legal aid lawyer and cried out: "I want him!"

Obama has clearly captured the vital "hope for the future" center, which Bill Clinton rode to victory in 1992. My choice -- John Edwards -- offered in defeat populist rhetoric that sounded all the right themes yet made him sound like a sourpuss. And Hillary Clinton? She looked and sounded like a machine pol, pushing all the rhetorical buttons but lacking passion. That's going nowhere this year. If she loses in New Hampshire, the Obama momentum may well be unstoppable.

Is Health Care Reform Fading As An Issue?

As the nation enters a new year and its quadrennial bout of temporary insanity, the latest polls show the economy has eclipsed health care as the most important domestic issue among voters. Even the health care-oriented Kaiser Family Foundation's latest poll shows the number of Americans who name health care as their primary concern fell to 30 percent in early December from 38 percent just two months earlier. When offered a list of possible issues the candidates ought to address, the economy had pulled even with health care.

The escalating fear that the nation may be heading into a recession because of the sub-prime mortgage meltdown and sky-high gas prices has certainly played a role in the turnabout. In that sense, 2008 is beginning to look a lot like 1992. The year before that election, health care dominated the national discussion after Harrison Wofford used the issue to win a surprise victory in a special Senate election in Pennsylvania. But by the time Arkansas Gov. Bill Clinton stormed to victory in the primaries, "it's the economy, stupid" had become the Democratic standard bearer's watchword.

That appears to be the way things are shaping up in Iowa and New Hampshire, which will hold caucuses and cast the first ballots over the next week. On health, the Democrats have coalesced around a common strategy to pursue safe, incremental reforms that rely in the insurance industry to get everyone insured. Meanwhile, the Republicans have become the radicals in the debate by calling for subsidies and tax breaks for individuals so they can "go it alone" as consumers in the dysfunctional individual insurance market.

These policies will mark a clear differentiation between the parties that should favor the Democrats come the general election. But the fine distinctions between the various Democratic plans, which are worthy of debate, are lost on the general public, and as things stand now, won't play much of a role in the primaries.

This, of course, is bad news for wonks like me who would like nothing better than to debate the fine points of the competing Democratic plans. Are individual mandates really the best way to go or is it a political trap? Should employers who don't provide their workers with health insurance be required to pay a payroll tax into a common fund to cover the uninsured? Should the government expand Medicare to people under 65 who lose their health coverage? Should the government set up another "Part" to Medicare to cover the uninsured and compete directly with the insurance industry plans?

A debate over these fine points would set the stage for political battles to come. Given the entrenched special interests that earn their living from the status quo, reform ain't going to be easy. If nothing else, the debate would educate the public about the complexities of the issue. Wouldn't it be nice if single-payer advocate Dennis Kucinich got a chance to explain to the public that having the government run a single, common insurance pool (sort of like Medicare) is not the same thing as socialized medicine?

Alas, it hasn't happened in Iowa and New Hampshire and probably won't elsewhere. One reason is that covering the uninsured and outsized health care costs simply aren't big issues in those early voting states. In the Commonwealth Fund's latest ranking of states' performance in covering the uninsured and delivering affordable health care, the two states ranked second and third in the nation, trailing only Hawaii.

In Iowa, fully 88 percent of the adult population has health insurance compared to a national average of 82 percent. In New Hampshire, the number was 86 percent. Moreover, both states did extremely well in quality measures such as delivering preventive care and treating adult diabetics. And both states had below average costs for Medicare enrollees, fully 20 percent below the national average in Iowa's case where the first blood in the presidential race will be drawn on Thursday.

If the candidates emerge from Iowa and New Hampshire in a dead heat as some polls now indicate, it's still possible that we will have a debate in the Democratic primaries about what is the best approach to health care reform. But if, as some pundits are predicting, Sen. Hillary Clinton's strategy of going for the early knockout proves successful and Super Tuesday in early February seals the nomination, then it looks like health care reformers come November are going to have to rely on the pol and not the plan.

Economy Tops Health Care at Top Domestic Concern

The latest Gallup Poll shows that the economy has pulled ahead of health care as the chief domestic issue for the American people when it comes to how they'll vote next year.

Iraq is still number one, of course, with 36 percent citing it as their main worry. But the sub-prime mortgage meltdown and the slowing economy are having an impact. Fully 16 percent of those polled now say the economy will determine how they will vote, just ahead of health care at 15 percent. A month ago, health care outpolled the economy by three percentage points as a driver of votes (18 percent versus 15 percent). Immigration, the other high profile domestic issue, gets noted by just 10 percent of respondents.

Main Cats Fully Engaged

Remember the cat fight over the role of racial politics in the rise of the GOP that I predicted a week ago after a column by David Brooks? The main cats are now fully engaged. Lou Cannon, Ronald Reagan's sympathetic biographer, offered an apologetic op-ed in yesterday's New York Times. The great communicator was a nice guy, and even quit the country club that discriminated against blacks! Reagan’s defenders protest furiously that he wasn’t personally bigoted. "So what?" rejoins Paul Krugman in this morning's paper. "We’re talking about his political strategy. His personal beliefs are irrelevant."

Meow.

The Lives of Others -- a must-see this holiday season

The Washington Post reported details yesterday about the Bush administration's massive domestic telephone/internet/email monitoring project. The surveillance is being carried out by the National Security Administration (NSA).

The report was based on the Congressional testimony of a phone company whistleblower, recently retired, who had seen a diagram showing how data was being routed to a "secret room" in an AT&T building in San Francisco:

"That was my 'aha!' moment," he said. "They're sending the entire Internet to the secret room." The diagram showed splitters, glass prisms that split signals from each network into two identical copies. One fed into the secret room, the other proceeded to its destination, he said.

"This splitter was sweeping up everything, vacuum-cleaner-style," he said. "The NSA is getting everything. These are major pipes that carry not just AT&T's customers but everybody's."

After reading that story, you might consider renting this movie over the holiday season. It should help get you in the mood for next year's election campaigns:

Cat Fight

This could be fun. David Brooks, the New York Times' in-house conservative columnist, this morning launched a frontal attack on the paper's in-house liberal columnist Paul Krugman. Brooks accuses anyone who points out that Saint Ronald Reagan kicked off his 1980 presidential campaign with an overtly racial appeal to southern voters of propagating a calumny.

The essence of Brooks' argument is that the man who made his first mark in politics by attacking welfare queens and Berkeley demonstrators should be excused for highlighting "states rights" in that opening speech outside Philadelphia, Mississippi, a few miles from where three civil rights workers had been slain. Why? Because a weekly earlier he showed up at Vernon Jordan's bedside and offered the inner city tax breaks for breakfast.

I recently read Krugman's "The Conscience of a Liberal." A major theme of his book is that the politics of race, and the South's wholesale defection to the Republican Party in the wake of the Civil Rights era, is the real cause of the nation's rightward drift in recent decades. It provided the plutocrats who control the Republican party with the political cover needed to impose their unfair economic agenda.

Krugman repeatedly says that in writing the book, he was forced to confront his own bias as a professional economist that economic events and evolution drive political change. In that standard view, rapid technological change and the evolution of a high tech society raised the rewards to education and skill, thus creating a more unequal society in terms of income and wealth. In Krugman's new view, the growing inequality that has characterized American life over the past three decades is the product of political decisions to change tax law, regulations and to eviscerate social programs, changes that were enabled by the southern strategy political realignment initiated by Nixon and achieved under Reagan.

Brooks never mentions Krugman in his column. It will be interesting to see if Krugman rises to the bait and answers his critic -- without naming names, of course.

Open Access Bill Advances despite Publisher Protests

Free public access to all published articles produced from National Institutes of Health-funded research moved one step closer to reality last week. The bill, pushed by a coalition of more than 200 academic libraries, the U.S. Chamber of Commerce, and many academic societies, was included in the Labor-Health and Human Services appropriations bill that overwhelmingly passed the Senate. The House has already passed a similar measure. President Bush has threatened to veto the bill for other reasons.

Heather Joseph, executive director of the Scholarly Publishing and Academic Resources Coalition of the Association of Research Libraries, hailed the Senate vote, which would vastly expand the content in NIH’s free library at PubMedCentral. "This policy sets the stage for researchers, patients, and the general public to benefit in new and important ways from our collective investment in critical biomedical research," she said. The provision was opposed by the Association of American Publishers, which includes leading scientific publishers like Elsevier, Wiley, and the American Chemical Society, which claim their ability to support independent peer review of new studies depends on exclusive copyrights.

The publishers' campaign triggered an anonymous email campaign by an ACS insider that accused the chemical society's leaders of opposing the provision because their high salaries and bonuses are tied to publishing profits, The Scientist reported. Several top officials at ACS, which generates about a half a billion dollars a year in revenues from its 36 journals, earn over $750,000 a year, according to its latest Internal Revenue Service filings. The anonymous emailer's allegations drew an angry open letter from ACS chairwoman Judith L. Benham, who wrote that "the ACS's position on open access has been developed carefully over many years, in consultation with scientists and publishing experts from a wide range of scientific disciplines and interests."

ACS belongs to the Association of American Publishers, which earlier this year hired Dezenhall Resources, best known for defending Enron executives and opposing public interest groups, to launch a campaign opposing the open access legislation. In August, AAP launched a new website called Prism (Partnership for Research Integrity in Science and Medicine) that echoed the claim that open access would undermine peer review. That sparked James D. Jordan, president of Columbia University Press, to resign from AAP. Stephen Bourne, chief executive officer of Cambridge University Press told The Chronicle of Higher Education that "Prism's message is oversimplistic and ill-judged, with the unwelcome consequence of creating tension between the publishing community and the proponents of open access."

The preceding appeared first in Integrity in Science Watch, a publication of the Center for Science in the Public Interest.

Von Eschenbach Issues Veiled Threat of Layoffs

Food and Drug Administration commissioner Andrew von Eschenbach late this afternoon updated employees on the status of negotiations on the FDA reform bill, which contains reauthorization of the drug and device user fees that fund a substantial portion of the agency. Though failure to pass user fee reauthorization bills before the fiscal year runs out (October 1) has never resulted in layoffs in the past, the commissioner raised that specter in his email:

No one underestimates or fails to appreciate the disruption and demoralizing impact that even the threat of a RIF is having on you and your families. We all have our responsibilities and roles in seeing that this does not occur, and we at FDA will be fully responsive to Congress at every moment to help facilitate prompt passage of this essential legislation.

Von Eschenbach said next Friday represented the deadline for passing for bill.

The Contrived Search for a Middle Way

I must be getting lazy. It's Monday morning, and I'm still thinking about the Sunday papers. Or maybe it is the contrived nature of what my hometown paper (I live in Washington, DC, the new Rome, according to all the book reviews) considers news.

Yesterday's Washington Post all but endorses a third party "independent" bid for the presidency. Between a less than insightful polling story on the many faces of self-identified independent voters and a David Broder column outlining the political space a potential independent candidate could occupy, the paper clearly identifies with what is rapidly emerging as the inside the Beltway consensus: all the announced candidates are pygmies.

What's needed now, these grand poobahs of conventional wisdom assure us, is a candidate who can occupy political real estate that is more precious than a vacant lot on Massachusetts Avenue's embassy row -- the above-it-all center. Too bad Michael Bloomberg and Arnold Schwarzenegger, who recently graced the cover of Time Magazine, are, respectively, a short, Jewish media mogul from ultra-liberal New York and a naturalized citizen from the Left Coast.

They are the archetypes for what is likely to be a major distraction in next year's presidential campaign: the problem-solving man of the middle whose primary appeal is to self-satisfied middle class voters for whom a pox on both your houses is always the preferred non-ideological stance. Never mind that such a candidate stands no chance of getting elected, or, if a freak accident happened and they actually got into the White House, of solving any of the serious problems facing this country (number one in foreign affairs: disengaging from Iraq; number one in domestic affairs: universal health care).

The real purpose of such a candidacy is to deny the winning Democratic candidate a mandate, which is as of this writing the most likely denouement of the gross failures of the Bush administration, the worst in modern American history.

In that regard, my best reading over the weekend was former American Prospect editor Michael Tomasky's review of two new books on Hillary Clinton: Carl Bernstein's "A Woman in Charge" and Jeff Gerth and Don Van Natta Jr.'s "Her Way." He's no fan of Clinton. Tomasky has written his own critique of her campaign for the Senate.

But he puts these latest journalistic rehashes, now flying off bookshelves across the country, in their proper context, which also applies to the misconceived search for an independent candidate who could only subtract from the emerging national consensus that a Bush repudiation is in order for 2008. He writes:

(These authors) want to relive the controversies of the Clinton White House. After an unprovoked war built on lies, the deaths of tens and possibly hundreds of thousands of Iraqi civilians, illegal domestic spying, government-sanctioned torture, the indefinite incarceration of suspects, a scandal surrounding efforts by the nation's highest-ranking law enforcement officer to install prosecutors willing to undertake blatantly political prosecutions, and astonishing tales of congressional corruption, is it not at least demeaning and superfluous to be presented with one-thousand-plus pages revisiting such questions as how many hours of billable work Hillary Clinton actually performed for Madison Guaranty? It might not be, if we learned useful new information, about both the Clinton presidency and Hillary's more recent record in the Senate. But "Woman in Charge" and "Her Way" — the former sometimes by intent, the latter almost always inadvertently — tell us less about Mrs. Clinton than they do about the political and journalistic cultures that allowed hysteria about the Clintons to thrive.

Or drumbeats for independent candidates to sound.

High Court Unleashs Political Issue Ads

The Supreme Court this morning opened the floodgates for groups that run issue ads on the eve of elections. The 5-4 ruling stems from a 2004 case in Wisconsin where the local right-to-life group wanted to runs ads encouraging their senators (Democrat Russ Feingold was up for reelection) not to filibuster President Bush's judicial nominees. The McCain-Feingold campaign finance law prohibits ads in the two months before an election that surreptitiously attack candidates by highlighting their stands on issues, usually in a negative way.

This is very bad news for those of us who were hoping for an intelligent debate next year on health care reform. Candidates will be much less willing to go out on a limb with specific plans when they know every special interest group (can you say Big Pharma, Big Insurance, Big Doctors and Big Hospitals) can run unlimited attack ads in the months leading up to the election.

Obama Wins Crucial Early Test

This is what I love about political reporting. . . from today's Los Angeles Times:

Clooney Steps Cautiously into Obama's Camp

You can find the story on the Times' website under "Most Viewed Stories."

Polling the Netroots

The Daily Kos has an interesting set of surveys on its website this morning, asking its readers to weigh in on how well the Democratic Party leadership is doing as it positions itself to assume control of Congress. It has individual polls for Howard Dean, Nancy Pelosi, Charles Schumer, Harry Reid and Rahn Emanuel. Dean is the overwhelming favorite with the online crowd while only one person gets negative results. Can you guess who?

Answer: Rahm Emanuel.

"There Is A Strong Populist Tinge To This Class"

Today's New York Times captures the spirit that animated many swing voters who went to the polls on Tuesday. Economic populism is back in fashion.

On Thursday, I attended a forum where I was able to watch a series of campaign commercials ran by candidates who ousted Republican incumbents in closely contested districts. Over and over, the newly elected Democrats pledged to do something about health care by curbing the power of the drug and insurance companies.

In stressing the centrist credentials of many winners, the media has ignored this aspect of the electoral earthquake. Just 44 percent of the electorate heard about health care during the election, according to Democratic pollster Celinda Lake. But that shouldn't be surprising. In most of the country, House races were not contested, no ads ran, and the press, both national and local, ignored health care as an issue.

But in swing districts, 62 percent of voters heard about health care because the Democratic candidates made it a major point in all of their ads. "It was a powerful issue," Lake said.

These incoming freshmen may have a major say in how the health care debate shapes up over the coming years.

State House Politics

Don't overlook the importance of the gubernatorial races. The Democrats won 20 of 36 races and now hold the executive branch in a majority of statehouses.

The television pundits are talking about gridlock. But over the next few years, I think we will begin to see a lot of state experimentation on issues like energy independence, health care and campaign finance reform. States are our laboratories of democracy. The next round of change won't be coming out of Washington, but in states with strong governors and progressive-minded legislatures.

I was especially pleased to see Republican Ken Blackwell go down in flames in Ohio. I've followed the evolution of his opportunistic career (he began as a liberal) closely for three decades (I lived in Cincinnati during the 1970s), and it is fitting that it ends ignominiously. Conversely, Baltimore mayor Martin O'Malley's narrow win in Maryland (my current home state) over Republican incumbent Robert Ehrlich signals a repudiation of the desperate racist tactics employed by Republican admen. Voters didn't buy the pictures that showed rundown buildings with a voiceover saying this was what O'Malley had planned for the rest of the state. What garbage.

Arnold Scharzenegger won big in California. But he tacked left throughout the campaign after hitting rock bottom in the polls last year. The left coast, don't forget, passed a single payer health insurance bill a few months ago, which the Governator vetoed. Our biggest state isn't afraid of experimentation. It's a perfect testing ground for a national solution to our health care mess.

Arnold, you can't become president (sorry, weren't born here). Make a legacy for yourself. If not single-payer (like your native Austria), what?

Speaker Pelosi Speaks

"The campaign is over. The Democrats are ready to lead."

We'll see. If I were writing President George W. Bush's lines for his morning press conference, I'd invite Speaker-designee Nancy Pelosi to the White House to listen to her "new directions" for Iraq.

This is not a Democratic problem. It's an American problem. As Barack Obama just said, "most of all, this is about a change in Iraq." But nothing was articulated during the campaign. We're going to learn fairly soon if somebody has a good idea about what to do next about this horrible conundrum the Bushites got us into.

Today's Election Day

Vote!

Our Weird Political Culture

Are these really, as Frank Rich claims in today's New York Times, "the most perilous times in our history"? Let's review the weekend headlines on the eve of the election.

Discounting all the horserace stories (take your pick: Democrats to win anywhere from 15 to 40 seats in the House, 3 to 5 in the Senate), what do we have? Republican Congressman Bob Ney resigns in Ohio; Saddam Hussein faces death by hanging in Baghdad; and Ted Haggard, the former head of the National Association of Evangelicals, tells his 12,000-member flock that yes, it's true, he's guilty of buying drugs and consorting with male prostitutes. Hardly the stuff of momentous times.

Meanwhile, the Times felt the need to apologize for endorsing all Democrats. "It is frightening to contemplate the new excesses he (Bush) could concoct if he woke up next Wednesday and found his party had maintained its hold on the House and Senate." Yet I didn't read a word in the paper of record about the joint editorial running in a series of military papers this weekend that demanded that Secretary of Defense Rumsfeld resign. The military establishment is deserting the president. His freedom to wreak havoc is over, no matter who is declared "winner" of the mid-terms by the sycophantic press.

The only front page stories that mattered continued the steady drumbeat of bad news out of Iraq, with a heavy focus on what it is doing to the troops. A Times story focused on how the military lied to a family whose son was killed by a fellow soldier, and the Washington Post reported that the National Guard can expect more call-ups and extended stays abroad in the months ahead.

Meanwhile, the leftwing blogosphere is proving it's a not ready-for-prime-time player by preparing the "they cheated, they lied" defense in case the Democrats don't win a major victory. Robo-calling with aggravating messages, ostensibly from Democratic candidates; handing out phony leaflets for judicial candidates, claiming they're Democats when they're in fact Republicans; we'll be hearing about all manner of Republican perfidies after the polls close on Tuesday, especially if things go badly for the Ds.

I care deeply that Karl Rove has dragged the practice of American politics into the gutter. Yet somehow I don't feel compelled to add my voice to the cacophony.

The latest polls show a late Republican surge (completely expected, given their financial advantages and monopolization of the airwaves). The most likely outcome of this election is that not much will change, even if one or both Houses change hands. The war in Iraq is the source of most of our woes. The overreaching of the Bush administration in pursuing that disastrous policy may make these feel like the most perilous of times. But this campaign has basically proven that there is no longer public support for those policies.

No matter what happens on Tuesday, we're going to see a distinct if minor shift in the key of government that will put the realists once again in command of U.S. foreign policy. The centrists will also be in charge of domestic politics. Imagine a Senate that owes its Democratic majority, should it occur, to Joe Lieberman, Harold Ford and Jim Webb.

The domestic issues that this blog cares about -- health care, retirement security, social inequality, the relative deprivation of the bottom half of the workforce -- will go nowhere in the next Congress, no matter which party is in charge. I hope the right wing is repudiated. But the task that moves front and center for me the minute the votes are counted is making those issues, and not electing Democrats, the centerpiece of our politics. It's time for America to come home.

Chamber of Horrors

All eyes are on Congressional races, but voters next week will also be casting ballots in hundreds of judges' races that they know almost nothing about. I voted absentee the other day (I'll be in Boston on election day at the annual American Public Health Association meeting), and my eyes glazed over as I stared at a ballot whose last page was filled with judgeship races that I had not seen, much less read, a single story about in the runup to the election.

If we did pay attention to judges' races, we'd quickly discover that the news isn't good. As Public Citizen pointed out in a press release today, the nation's business community has poured millions of dollars into these races to get a judiciary that is friendly to their anti-consumer and anti-worker agenda. But by going over the U.S. Chamber of Commerce's tax returns, Public Citizen discovered that the Chamber failed to report those taxable expenditures to the Internal Revenue Service.

The corporate gambit paid off in the short run. The nation's rightward drift over the past three decades has been fueled in part by a sympathetic judiciary willing to trample on our basic rights, ignore executive overreach, and undermine our economic security.

Abramoff, Ney, Cunningham ad nauseum are history. It's time to put corruption of the judiciary on the political agenda.

Harold Ford's "Back Atcha" Ad

My Bartlett's informs me that it was Shakespeare in his play Henry IV who first wrote "I want there to be no peasant in my realm so poor that he will not have a chicken in his pot every Sunday." To win the white male vote, I suggest Democrat Harold Ford of Tennessee run a version of this ad to counter the desperate racist drivel emanating from the Republican National Committee.

---

Blunt's Bluster

Wall Street Journal: "House Majority Whip Roy Blunt, a Missouri Republican, yesterday sent an email to the media suggesting House Democrats would "plot to establish a Department of Peace, raise your taxes and minimize penalties for crack dealers."

I like the Peace Department idea.

The Political High Season

The consensus is hardening that the Democrats will sweep the November election, winning at least the House and possibly the Senate. I still have my doubts, driven in part by a front page story in today's New York Times that pointed out that the Democrats Have Intensity, But G.O.P. Has Machine. I vividly recall how shocked many liberals were in November 2004 when President Bush posted a two million vote margin of victory, largely because of the overwhelmingly Republican ex-urban vote. Are we in for another rude surprise?

Turnout is the key to every election. Recall that the U.S. has one of the lowest voter participation rates among industrialized nations, and non-presidential election year turnouts are lower than years divisible by four. Moreover, it is largely poor and lower-middle class people who don't vote.

Those who do tend to be brought to the polls by issues or political machines. As today's article points out, the Republicans still have more resources to pour into turnout operations. The pro-Democrat Moveon.org operation is targeting the already convinced. The AFL-CIO and other unions can only target their own members, who already turn out at a higher rate and more reliably Democrat than their non-union colleagues. During the Democratic primary here in Maryland, I got hit up three times on election day to make sure I voted. I have zero confidence that the Democratic Party under Howard Dean's leadership has built a solid turnout operation, or that it is aimed at the precincts that really need it.

But there's still the issues, right? So what issues might motivate traditionally Democratic lower-middle class voters to come to the polls this year? The failure of Congress to enact a higher minimum wage, there's one. How about the 46 million people without health insurance. Or the growing insecurity of aging working class boomers who are staring at a retirement without savings or pensions. Heard anything about any of these issues lately? I saw more issues in one movie trailer for the remake of "All the King's Men" that I've seen in the endless stream of political ads on my television this fall.

Sure, lower middle class folks are like the rest of America in their concern that the war in Iraq is going badly and realize they've been lied to by Bush and his coterie. (The best article on that subject today was in the Washington Post by Rep. John Murtha, the Pennsylvania Democrat and 37-year Marine veteran who has become the conscience of the nation on this war.) But is disaffection from a failed foreign policy enough to bring people who don't usually vote to the polls?

Let's hope so.

Reform FDA's Advisory Committees, Too

The Institute of Medicine report calling for reform of the Food and Drug Administration got a strong boost today from the New England Journal of Medicine. The journal's editors called on Congress to take prompt action to enact the more far-reaching elements of the report.

There is "a crisis of confidence" at the agency," they wrote, and the growing problems with drug safety are "a mounting public health crisis. . . The critical issues of financing, transparency, and independence must be addressed."

Unfortunately, the editorial makes no mention of the issue that the Center for Science in the Public Interest (where I work) helped bring to the fore: the FDA's overreliance on outside advisers with financial ties to the drug industry. The IOM report called for a "substantial majority" of those advisers to have no ties to firms the agency regulates.

Could it be that the NEJM editors disagree? If so, they would find strong support from the American Enterprise Institute, whose leading drug scholar, John Calfee, today published a ringing defense of the FDA's current practices.

Feel free to read it for yourself. But before you do, allow me to point out the arguments that Dr. Calfee ignores.

First, he argues that the "best and brightest" among the nation's academic physicians work for the drug industry. If the FDA cut them out of the advisory process, it would deny the public the best help. Hogwash. The nation's 125 medical schools, the National Institutes of Health and leading health delivery systems like Kaiser Permanente and the Mayo Clinic are filled with experts who are equally qualified as those academicians and scientists who advise industry. Given the chance, these scientists would gladly serve the public by evaluating the safety and efficacy of new drugs that come before the FDA.

Indeed, many committees have few advisers with conflicts of interest. Is the FDA and defenders of the status quo arguing that these people are somehow unqualified or less qualified? If not, surely there are more where they came from.

Calfee also argues that few if any votes are swayed by the ballots cast by conflicted advisory committee members. He points to the Public Citizen study in the Journal of the American Medical Association that turned up that unremarkable statistic. An FDA re-analysis of those numbers showed that most conflicted scientists actually work for competitors of the firm with a drug application before the agency. Since most advisers with conflicts of interest vote to approve new drugs, they are, in fact, voting against their supposed self-interest.

Alas, Calfee fails to address the central point, which I'm sure he is aware of because he heard me present it at a conference last week at Hofstra University. The core problem with larding advisory committees with conflicted members is not that there is some crude quid-pro-quo behind their votes.

Their presence creates an ideological imbalance. Scientists and clinicians who serve industry are biased toward approving drugs, whether it is their sponsor's drug or a competitor's drug. They do not cast a cold eye on the underlying data. They do not hunt for signals in the data that hint at a safety problem down the road when millions of people -- not the few hundred or thousand in a clinical trial -- are taking the drug. By continually drawing from the same crowd of scientists with long-standing ties to industry, the FDA fails to balance its committees with scientists who have these critical skills and perspectives.

No one argues that ending conflicts of interest on FDA advisory committees is a panacea for what ails the agency. But the presence of so many scientists with financial ties to the firms the agency is supposed to regulate casts a pall over the entire process. When it comes to the agency charged with overseeing the health and safety of the American people's food and drug supply, appearances matter.

If the new Congress takes FDA reform seriously, ending conflicts of interests on the FDA's advisory committees will rank high on its agenda. The other reforms in the IOM report are, quite frankly, more important. They will give the FDA the tools it needs to do a better job. But ending conflicts of interest will send a clear signal to the public that a new day has dawned at the agency. That's a signal worth sending.

The Republicans' Penis Woes

This Foley thing prompted some thoughts this morning, after a week of non-stop coverage in the press:

A month ago, this election was shaping up as a referendum on the Bush administration's war in Iraq and a Congress beholden to special interests that ignores every pressing domestic concern. Now? The press is obsessed with a meaningless sex scandal, and is suggesting Republican losses will be due to a decline in evangelical turnout (see today's New York Times and yesterday's Washington Post).

Unless the public and the press return to the real issues in this election, the Bush administration will have a perfect foil for browbeating the newly elected Democratic Congress (should that occur) into continuing its unpopular war policies. And the so-called "values" of the religious right will once again have been given far more political credence than they deserve.

Hearing Slated for von Eschenbach

The Senate Health, Education, Labor and Pensions Committee will hold a hearing next Tuesday on whether Dr. Andrew von Eschenbach's appointment to head the Food and Drug Administration should be made permanent. The headlines will be dominated by his stance on Plan B, the over-the-counter morning-after pill. Senators Hillary Clinton and Patty Murray are threatening to hold up his approval unless he lets the FDA scientists call the shots on this one -- not the religious right.

I hope the Senators also look into the question of conflicts of interest stemming frmo his tenure as head of the National Cancer Institute. NCI, as I've pointed out numerous times in this space, has a structural conflict with FDA since one of its jobs is to bring new therapies to market, which the FDA must approve. The public has been repeatedly told that von Eschenbach has severed his ties with NCI and now that he is at FDA, he will recuse himself in any matters that he worked on during his years at the cancer research shop.

Yet how do you explain this listing on the Health and Human Services Department website? It says he is still an employee of NCI. And if you go here, you'll see he's also listed as an employee of FDA. The Senators might want to ask him about that.

Campaign '08

Here's some campaign slogans for Massachusetts Governor Mitt Romney if he seeks the GOP presidential nomination:

"If elected President, I won't appoint some Chicken Little to run the Army Corps of Engineers!"

"You can trust me to rebuild New Orleans!"

"I'll find Jimmy Hoffa's body if it takes all four years!"

Wisdom from the Fathers of Our Country

As we all pause for this July 4th holiday, ponder these thoughts from some great patriots:

"When people speak to you about a preventive war, you tell them to go and fight it. After my experience, I have come to hate war. War settles nothing." --Dwight D. Eisenhower

"Guard against the impostures of pretended patriotism."
--George Washington

"The spirit of this country is totally adverse to a large military force."
--Thomas Jefferson

"Wars are not paid for in wartime, the bill comes later."
--Benjamin Franklin

"No nation could preserve its freedom in the midst of continual warfare."
--James Madison

"I'm fed up to the ears with old men dreaming up wars for young men to die in."
--George McGovern

"The statesman who yields to war fever...is no longer the master of policy but the slave of unforeseeable and uncontrollable events."
--Sir Winston Churchill

"To announce that there must be no criticism of the president...is morally treasonable to the American public."
--Theodore Roosevelt

"Our country is now geared to an arms economy bred in an artificially induced psychosis of war hysteria and an incessant propaganda of fear."
--General Douglas MacArthur

And my favorite comees from the FDR Memorial along the Potomac River. FDR served as assistant secretary of the Navy during WWI, and visited the frontlines in France. In 1936, as president, he gave a speech at Chatauqua, NY that included these memorable lines:

"I have seen war. I have seen war on land and sea. I have seen blood running from the wounded. I have seen men coughing out their gassed lungs. I have seen the dead in the mud. I have seen cities destroyed. I have seen 200 limping, exhausted men come out of line—the survivors of a regiment of 1,000 that went forward 48 hours before. I have seen children starving. I have seen the agony of mothers and wives. I hate war." --Franklin Delano Roosevelt

AND THIS PRESIDENT?

"I just want you to know that, when we talk about war, we're really talking about peace." --George W. Bush

Dems Win FDA Reform Measures in House

House Democrats led by Rosa DeLauro (D-Conn.) inched forward on another measure yesterday that would curb the power of the drug industry. Her amendment to the Food and Drug Administration appropriations bill would force drug companies to conduct post-marketing safety clinical trials ordered by the FDA or risk having the drug withdrawn from the market. Annual reports produced at the FDA show that about two-thirds of post-approval trials promised at the time of approval never get done.

This newfound power among House Democrats (yesterday, I reported that the same Appropriations committee passed Rep. Maurice Hinchey's amendment banning scientists with conflicts of interest from serving on FDA advisory panels) suggests that Big Pharma's rock-bottom public approval ratings, coupled with the sinking Republican poll numbers, adds up to declining clout on Capitol Hill -- a long overdue event.

Bill To Ban Conflicts of Interest on FDA Panels Moves Forward

Rep. Maurice Hinchey (D-NY) won passage late yesterday of legislation that would prohibit the Food and Drug Administration from placing scientist-physicians with ties to drug and device manufacturers on its advisory committees. Similar language passed last year, but got watered down in the Senate to an advanced notice reporting provision (which has been useful, but isn't as good as an outright ban which would open up these advisory process to the hundreds of medical thought leaders who conduct their research with government or foundation funds). You can read the Hinchey press release here.

Former FDA Official Blames Congress for Short-Changing Agency

A former associate commissioner of the Food and Drug Administration documents the decline of that once-great agency in an important op-ed in today's Washington Post. Critics have rightfully blasted the agency for becoming too close to the drug industry in recent years. But few point out a major cause of the problem: the FDA now relies on drug industry user fees for fully 25 percent of its overall revenue and nearly half of its budget for regulating new drugs and medical devices. How tough can you be when saying no might put funding for your job in jeopardy?

William Hubbard, who retired from the FDA last year, puts the blame squarely where it belongs: on Congress, which has consistently underfunded the agency, especially its regional inspection divisions.

For most of the FDA's 100-year history, presidents and congresses have recognized its importance to public health by giving it the resources and authority to respond to the rapid evolution in risks from the thousands of products it regulates. But for some years now, the agency's budget has remained essentially flat while major new responsibilities have been piled on. The results of this weakening of the agency are easy to document: Food inspections have dropped from a robust 50,000 in 1972 to about 5,000 today, meaning that U.S. food processors are inspected on average about every 10 years. The chance of a food product from overseas being inspected is infinitesimal. Most raw materials for our drugs come from foreign producers that are rarely inspected. The rate of quality-control failures found in manufacturing facilities by FDA inspectors has soared. Think your pacemaker, heart valve, microwave oven or morning vitamin was inspected? Dream on.

The Prescription Drug User Fee Act is up for renewal next year. The time is ripe for questioning the government's reliance on industry user fees to fund just the FDA functions industry wants, and not the ones the public needs.

Rep. Hinchey Is on the Case

Last year, I had the pleasure of working closely with Rep. Maurice Hinchey (D-NY), who managed to pass an amendment to the Food and Drug Administration appropriations bill that would ban scientists with ties to drug companies from serving on FDA advisory committee evaluating new drugs. It passed the House in a shocking upset, but was watered down in the Senate (see this GoozNews). Tonight, the Nation's on-line blogger John Nichols quotes Hinchey on the significance of the possibility that the President engaged in high crimes and misdemeanors:

"If what Scooter Libby said to the grand jury is true, then this latest development clearly reveals yet again that the CIA leak case goes much deeper than the disclosure of a CIA agent's identity to the press. The heart and motive of this case is about the deliberate attempt at the highest levels of this administration to discredit those who were publicly revealing that the White House lied about its uranium claims leading up to the war. The Bush Administration knew that Iraq had not sought uranium from Africa for a nuclear weapon, yet they went around telling the Congress, the country, and the world just the opposite" -- Rep. Maurice Hinchey

V.P. on the Hot Seat?

I'm starting to do my homework, and I will let you follow along if you're interested.

Joshua Micah Marshall of Talking Points Memo reports that:

"Scooter Libby has sworn under oath that Vice President Cheney told him that President Bush had authorized him to disclose classified information. Let's set aside the whole question of whether the president can do that or whether there's a specific procedure he has to follow. Just set that issue aside. If it isn't true that Vice President Cheney told him that, then Vice President Cheney must know that Libby has again perjured himself. I would think the Vice President has an affirmative duty to come forward and say that Libby's testimony is false.

So my initial understanding may be wrong. The Vice President stands between the President and allegations of criminality. If the press and/or Congress sweeps this under the rug, then we're doomed. This is Watergate redux. We'll be talking about nothing else for the next six months . . . and with the quagmire in Iraq showing no signs of ending, it's a good thing, too.

An Impeachable Offense?

This afternoon, while driving my daughter to her orthodontist appointment, the radio told me that Vice President Cheney's former chief aide says President Bush authorized the deliberate leaking of classified national intelligence (erroneous as it turned out) to a New York Times reporter to build a public justification for the war in Iraq.

I have been busy preparing for a week trip to another part of the country. I have not read a single commentary anywhere else on the web, in a newspaper or, this evening, watched a single show on television or listened to follow-up on the radio. So this is my unvarnished reaction as a simple citizen of this country.

Isn't this a high crime, not to mention a misdemeanor? How does leaking classified information to justify an unjustifiable war compare to a blow job? If Congress doesn't deal with this issue, or the American people this fall don't elect a Congress that will deal with this issue, then we are no longer living in a democracy.

Some Good News for a Change: The Rule of Law Is Still Operative

In a victory over the Bush administration's routine flouting of freedom of information act requests, a federal court has ordered the Internal Revenue Service to turn over audit statistics to the Transactional Records Access Clearinghouse. For over 30 years, the Syracuse University-based TRAC had published detailed analyses of IRS audits, documenting the agency's turn from going after the big guys.

TRAC is run by Susan Long and David Burnham, a former New York Times reporter. They use publicly available data to show how government regulatory agencies have retreated from performing their legislatively-mandated functions. In 2004, the Bush administration began denying their FOIA requests for data that had been routinely provided for decades. Their lawyers at Public Citizen sued to uphold the law.

Yesterday's decision in the western district of Washington by Judge Marsha Pechman is a welcome sign that the judiciary branch is starting to do its job. Someone has to rein in an administration that routinely breaks the law.

What's the Bush Administration's Plan B?

President Bush this afternoon officially nominated Dr. Andrew von Eschenbach to run the Food and Drug Administration, setting off an immediate firestorm of criticism. Senators Hillary Clinton (D-NY) and Patty Murray (D-WA) pledged to block his appointment until the FDA comes up with a decision on over-the-counter Plan B, the morning-after contraceptive. All the science points to allowing its use; only the Bush administration's fealty to its religious base has held up approval.

What's the administration's strategy? Three possibilities. First, and most likely, is that Bush merely wanted to get Republicans like Sen. Charles Grassley (R-IA), who had been pushing for a permanent appointment, off his back. Von Eschenbach can continue running FDA as interim head while blaming the lack of hearings on the Democrats.

This fits in well with a Karl Rovian polarization strategy for the fall elections. It mobilizes the conservative religious base by demonizing Hillary, pro-choicers and blue-staters generally as libertines who promote promiscuity.

Anther possibility is that von Eschenbach will finally come up with a decision. Just say no to Plan B. That mobilizes the base while giving Clinton, Murray and others middle-of-the-road Democrats an out from blocking his confirmation. They will still vote again him, of course. But he would win a party-line vote.

Of course, this runs the risk of antagonizing anyone who believes in science, freedom of choice and separation of church and state. But in the Bush-Rove imagination, that is a shrinking share of Americans anyway.

The third and most remote possibility is that von Eschenbach will approve Plan B. which is what he probably wants to do (I'm basing this on Connecticut Democratic Rep. Rosa DeLauro's kind words for von Eschenbach during a House appropriations hearing a few weeks back; she said she looked forward to his permanent appointment as head of FDA). If anyone other than ideologues were running the Republican Party, he'd be allowed to.

In an election year where the president's approval rating is hovering around 35 percent, the vice president's approval rating is among the lowest on record, and the lobbying scandals show no sign of abating, tacking to the middle to win centrist voters would seem to be the wise and prudent choice.

But as we long ago learned about this administration, prudence, wisdom and centrism are not qualities it has in abundance.

A Conflicted FDA?

The Wall Street Journal and Bloomberg News confirm reports from earlier this week that Dr. Andrew von Eschenbach will get the Bush administration's nod to run the Food and Drug Administration. He's been interim commissioner since Lester Crawford resigned last September amid financial conflicts of interest allegations.

While the news accounts suggested Plan B, condoms and other culture war issues would dominate Senate hearings on a von Eschenbach appointment, the central issue from where I stand is his simultaneously holding the highest post at the National Cancer Institute. There were no indications in today's news reports that he plans to resign from that job.

This is a structural conflict of interest, not to mention a conflict of commitment (how can one person devote full attention to both of these complicated jobs?). As I've said in this space many times before, NCI's job is to investigate the causes of and, more importantly, develop cures for cancer. The agency's scientists file applications to the FDA to start human clinical trials, those trials are overseen by the agency, and, in some cases, it even submits new drug applications to the FDA.

In his role as head of NCI, von Eschenbach has repeatedly said that it is his personal goal to end the pain and suffering of cancer by 2015. The unrealistic assumptions behind that statement aside, it is a statement that one would expect from an advocate.

As head of FDA, he has said that streamlining the process by which drugs get brought to market will be his highest priority. The FDA does need to reevaluate the way it monitors and approves drugs. But no one on either side of the aisle on Capitol Hill, not to mention the American public, would want that streamlining and modernizing to jeopardize the agency's core mission of protecting the safety of the U.S. food and drug supply.

If the White House pursues his nomination, Congress should demand a full accounting of his actions at NCI that might present future conflicts of interest in matters that come before the FDA. What clinical trials has he had a personal hand in organizing? How many cooperative research and development agreements has the agency signed under his tenure? How many grants has he approved for companies whose products will eventually come before the FDA? Will he recuse himself from all of these matters?

There's a role in the world for advocates like von Eschenbach. It's just not as the head of the agency whose job it is to serve as policeman over companies that account for one-quarter of the U.S. economy. Someone on the Hill should inform the White House that the former cancer surgeon is not the right man for this job.

Von Eschenbach Throws Hat in Ring to Run FDA; Pledges Faster Drug Approvals

The Baltimore Sun reports today that Dr. Andrew von Eschenbach, the acting head of the Food and Drug Administration, is actively seeking a full-time appointment.

In an appearance before the Personalized Medicine Coalition, an industry-sponsored group, the cancer surgeon (who right now also runs the National Cancer Institute) said he wanted to "improve" the drug approval process. He vowed to make faster drug approvals "one of my highest priorities."

Two weeks ago, von Eschenbach told a Congressional appropriations committee considering the FDA's 2007 budget that "we are making a tremendous commitment to the whole area of safety."

It is, of course, possible to both hasten drug approvals and still ensure that they are safe. But one can't help but think that he's talking out of both sides of his mouth depending on the audience.

Word among lobbyists is that von Eschenbach's wish for a permanent appointment at FDA has already been greeted cooly by Sen. Michael Enzi (R-Wyoming), who chairs the Senate Health Education Labor and Pensions Committee. He's probably not anxious to hold hearings about the embattled agency in an election year.

All Hail the Prosecutor . . .

. . . seems to be the motif of the day and a well-earned kudos it is. But I've read very little today about the train of events he has set in motion with this limited indictment. Much of the next year's politics will hinge on Scooter Libby's character, which will be sorely tested from this point forward. The man faces 30 years in prison for lying to the grand jury. The best evidence Fitzgerald could have that other high officials -- here I'm thinking the Vice President and Karl Rove -- were involved in the cover-up would be Libby's own testimony. What better way to compel it than a plea bargain that allows Libby to walk in exchange for the truth, a sadly lacking commodity in this administration.

Only A Step in the Right Direction on Conflicts of Interest on FDA Advisory Panels

Senate and House conferees considering the FDA appropriations bill last night approved language that will open up the secretive nature of the FDA a bit. I have been busy this year trying to get Congress to bar scientists who do work for industry from serving on FDA advisory committees. We didn't get that (although it passed the House last June). The Senate version, accepted by the conference committee, requires the FDA to give advance notice (two weeks) when they're appointing conflicted scientists to advisory panels and list their conflicts on the FDA website. Maybe sunshine will help curb the practice.

I issued the following statement today in my role as director of the Integrity in Science Project at the Center for Science in the Public Interest:

The compromise provision to the FY2006 Agriculture/FDA appropriations bill that provides advance notice when scientists with conflicts of interest serve on FDA advisory committees is a step in the right direction. We congratulate the Senate and House conferees, especially Sen. Richard Durbin and Rep. Maurice Hinchey, who helped make this possible.

Consumers concerned that drug, device and food manufacturers have corrupted the FDA’s advisory committee process will soon have 15 days notice when the FDA wants to put scientists with conflicts of interest on one of its 30 advisory panels. Simultaneous publication of the waivers granted to scientists, along with their conflicts, gives the public additional information for evaluating whether their participation may taint the proceedings. Under the current system, where the waivers are kept under wraps pending a Freedom of Information Act request that can take years, the public is effectively kept in the dark about the ties between some scientists on FDA panels and the companies whose products are up for approval.

Moreover, we're glad to see that the FDA will have to document to Congressional appropriators and the HHS inspector general what steps it has taken to avoid appointing scientists with conflicts to its panels. This will encourage the agency to seek out more of the nation’s highly qualified scientists who do not have financial ties to industry.

However, past experiences suggests this bill does not go far enough. CSPI believes the FDA can find qualified scientists without conflicts of interest to serve on all of its advisory panels. That’s why the waivers should be disallowed entirely. At the least, the present disclosure bill could have been made stronger by forbidding scientists with waived conflicts of interest from voting at the conclusion of a committee’s deliberations.

Von Eschenbach Still at NCI?

The National Cancer Institute put out a press release yesterday announcing grants to cutting edge nanotechnologies for diagnosing and treating cancer. The release prominently quoted Dr. Andrew von Eschenbach, the Bush family friend who indicated two weeks ago he was temporarily giving up his duties at NCI to take over the Food and Drug Administration. The discrepancy was first reported by The Hill, which covers Congress.

These grants -- worth $35 million to 12 university-based research teams -- graphically demonstrate why holding both jobs represents an inherent conflict of interest and can't be allowed to stand. A quick check on several of the awardees reveals many have patented their technologies and several are collaborating with private sector firms.

Take James Baker Jr., M.D., of the University of Michigan, who is working on a nanotech system to deliver drugs directly to cancer cells. So far, it's worked fairly well in mice. In a June report on the NCI website, Baker indicated he was preparing to license this technology to Avidimer Therapeutics, an Ann Arbor start-up in which Baker holds a significant financial interest.

Baker also indicated he hopes to be in clinical trials within a year. When that happens, he'll have to go to the FDA to approve his protocols. At that point, the guy who was in charge of the agency that gave Baker his grants will be in charge of the agency responsible for reviewing the animal data (often from tests in dogs) that claims this brand new technology is safe enough to try in humans.

Recall that the first words out of von Eschenbach's mouth after getting the FDA interim appointment were that he wanted to "streamline" the approval process at the agency. If I were a dying or very ill cancer patient, I would be very interested in participating in early trials of this promising new technology. But von Eschenbach's conflict of interest might give me pause. After all, no one -- not even the dying -- wants to be treated like a dog.

Pollsters on Drugs

I never much liked political operatives and seeing James Carville on TV usually sends me lurching for the clicker. But with President Bush's approval ratings slipping below 40 percent in the latest Gallup Poll, all the signs are pointing toward a classic correction. The midterm elections in the second term of a two-term presidency almost always result in a major turning out of incumbents. So I was curious about Carville's data in his latest poll, which landed in my in-box today.

The former Clinton braintrust (Carville works with Stanley Greenberg and Robert Shrum in an outfit called Democracy Corps) reports the country is "ready for a political upheaval in 2006." But the Democrats, they warn, are "underperforming."

That's putting it mildly. Over the past year, support among the electorate for Republicans slipped from 53 to 48 percent, according to their poll. But support for Democrats fell by the same five points landing at 49 percent. "Both national parties are at a half-century low point in public esteem," they noted.

Okay, so what will it take for the public to turn out enough Republicans to create a Democratic Congress next year? Carville and company ran a number of "attack" lines by their sample voters. Ranking right up near the top of the list of things that angered voters was Republicans giving drug companies the right to raise prices for seniors and barring Medicare from negotiating a better deal.

Sound familiar? This line of attack was typical of their other ideas that polled well. Attack oil companies, score points. Attack Bush's effort to privatize Social Security, score more points. Indeed, virtually all the talking points on their list could have been lifted from political ads run in 2004, 2002 or even 2000.

Well, one doesn't have to be a political specialist to know that the Social Security debate went nowhere this year and no one will be talking about it next year. Likewise, oil prices may be an issue -- or not. If I were running for office next year as a Democrat, I don't know that I'd want to pin my hopes on high oil prices and a recession.

And as someone who has followed the drug issue pretty closely the past few years, I can say with some certainty that this is not going to be an issue next year. Why? The Medicare drug benefit is going to have its intended effect of making drug prices a non-issue for most seniors. In the long run it is nothing more than a massive giveaway to the drug industry. Indeed, within a decade, most seniors will be paying as much or more for drugs as they're paying now and that's on top of the $100 billion a year the feds will be chipping in.

But in the short run, most seniors are going to be paying less because Medicare will be picking up some of the tab. Every senior with income at 150 percent of the poverty level or less -- and that's about one-third of the elderly population -- will have their drug bills reduced to a minor monthly co-pay. Anyone with annual drug bills less than $2,500 will see their out-of-pocket payments reduced to well under $1,000. And people with catastrophic drug bills will get substantial relief.

There will be tons of confusion as seniors are forced to choose among drug plans and the media will have a field day this winter as the program stumbles in its efforts to get off the ground. But by next spring, the issue will be gone -- as it was last year after the Republican Congress stayed up late one night twisting arms to get it passed so it wouldn't be an issue in the presidential race.

Carville and company are so wrapped up in their old way of thinking about issues (poll on it; if it taps a nerve, make a commercial about it) that they can't see the coming catastrophe. The drug bill is symptomatic of a much larger problem: we have an out-of-control health care system that is threatening to bankrupt the entire economy.

Democrats need to start talking about that. Their problem, though, is that the solution -- some variation of national health insurance with either price controls or caps on expenditure growth -- is considered a political non-starter by the high-paid consultants peddling the usual Democratic nostrums.

So the conversation about meaningful reform can never begin. A political constituency is never built. And change never comes.

Dems Attack Von Eschenbach Appointment at FDA

Reps. Henry Waxman (D-CA) and John Dingell (D-MI) today called on the Bush administration to remove Dr. Andrew von Eschenbach as interim leader at the Food and Drug Administration and move rapidly to appoint a permanent director. In a letter to HHS Secretary Michael Leavitt, the two senior Democrats on the House Government Reform and Commerce Committees, respectively, said von Eschenbach had irreconciliable conflicts of interest from his previous job as head of the National Cancer Institute.

Ted Kennedy had sounded the same theme on the Senate side immediately after the von Eschenbach appointment. And this website and Paul Goldberg's Cancer Letter have been pounding on this issue since the late Friday afternoon announcement on September 23rd.

Here's most of the House Democrats' letter:

"This dual responsibility - which exists despite Dr. von Eschenbach's pledge to give up his 'day to day' duties at NCI - opens the door to unacceptable conflicts of interest. FDA and NCI each have critical and independent roles in the drug safety system. In order to conduct a study on an experimental drug in human subjects, NCI must demonstrate to FDA that the drug is reasonably safe for initial testing in humans. Later in the drug development process, FDA is responsible for approving the same drugs that were tested at NCI.

"Having the same person at the helm of the NCI and the FDA violates the independent safeguards built into this system. There is no justification for merging these distinct roles.

"Unfortunately, Dr. von Eschenbach's responses to this conflict have been inadequate. For instance, he stated that, at FDA, he will refrain from participating in 'approval applications affecting drugs, devices, and biologics submitted by NCI or where an NCI employee was a Principal Investigator.' There may be occasions in which NCI employees invented or were involved in the early development of a particular drug compound that was then transferred to a commercial enterprise for additional development. Although that commercial enterprise would ultimately be responsible for seeking FDA drug approval, in this instance, NCI clearly would have played a significant role in the drug's development.

"Dr. von Eschenbach's prior involvement with this drug at NCI would still represent a conflict of interest.

"We are also concerned that the administration has explicitly reserved the ability to involve Dr. von Eschenbach in FDA matters in which NCI is a party on a 'case-by-case basis.' This provision negates Dr. von Eschenbach's promise to abstain from such matters. There is also no process by which the public can access information on the administration's handling of Dr. von Eschenbach's conflicts of interest as they arise.

"At a time when public confidence in the FDA has been severely undermined by a series of controversies, appointing a commissioner who faces a variety of potential conflicts of interest is a misguided choice that will seriously weaken both agencies. We urge you to insist on the appointment of an acting commissioner who is free from conflicts of interest and unencumbered by the demands of a second, equally vital role in protecting our nation's public health. Further, we urge you to nominate a permanent full-time FDA commissioner at the earliest possible moment."

The Colin Powell Memo

Michael Tomasky, editor of the American Prospect, posted a must-read column on the noose tightening around the highest officials of the Bush administration, including possibly the President himself. Published reports and commentary over the weekend suggest the President may have seen a memo given former Secretary of State Colin Powell that mentioned CIA agent Valerie Plame, whose name ended up in a Robert Novak column a week later. That memo is now a key piece of evidence in the hands of special prosecutor Peter Fitzgerald, who is investigating the administration's leaks of Plame's name.

Tomasky likens the chain of events to the scenario in The Constant Gardner, the new film of the John LeCarre novel where drug company officials don't actually order an assassination, but by the time their displeasure gets translated down the line, the nosey inquisitors into the firm's unethical practices are dead on a rural road. All I can add is, see the movie, read his column.

Von Eschenbach's Two Hats

Let's see if I have this right:

The Bush administration, under fire for appointing incompetent cronies to key positions, learns late last week that the Food and Drug Administration commissioner owns stock in a drug distributor. A high administration official calls Lester Crawford and asks him to resign. He does.

This same official or group of officials gets on the phone to Dr. Andrew von Eschenbach, who runs the National Cancer Institute after a long career at the Houston-based M.D. Anderson Cancer Center. He has no particular experience in evaluating the safety of food, drugs, medical devices, or dietary supplements, the primary job of FDA. However, he does serve with George (Sr.) and Barbara Bush on the board of C-Change, a partially industry-funded advocacy group for speeding the pace of cancer drug approvals. He gets the interim job at FDA.

However, von Eschenbach insists on keeping his NCI post, where his mission is to run an agency charged with developing new drugs to treat cancer. Moreover, while in that position he has developed deep ties with the drug industry. He advocates for relying on new and untested markers for measuring drug effectiveness. He sets a goal of turning cancer into a manageable disease by 2015, which causes many oncologists to cringe.

There was immediate and bipartisan outrage at the administration's inability to perceive that this appointment, even on an interim basis, was a blatant conflict of interest. Senators Ted Kennedy (D-Mass.) and Dick Grassley (R-Ia.) immediately condemned the von Eschenbach choice.

A prediction: The Bushies, reeling in the polls, will move quickly to find a permanent replacement for Crawford. The von Eschenbach appointment, made in haste, is a liability they just don't need at this point.

The Crawford Resignation Mystery

True to form, the administration picked late Friday afternoon to announce that Food and Drug Administration commissioner Lester Crawford resigned. The veterinarian in charge of the world's premier food and drug safety agency, who was confirmed for the job just two-and-a-half months ago, cited his age. He is 67.

The Saturday morning papers (the least read of the week; that's why troubling announcements get released late Friday) gave no clues as to what drove the decision, although both the New York Times and the Washington Post hinted broadly that he was forced out. But why? It couldn't have been the postponement -- again -- of approving Plan B, the morning after contraceptive pill. Crawford was doing the administration's bidding on that issue.

One possible clue to the administration's thinking comes from the appointment of Andrew von Eschenbach, head of the National Cancer Institute, as acting commissioner. Von Eschenbach, who previously ran the M.D. Anderson Cancer Center at the University of Texas, has been touting the new generation of targeted cancer drugs and in recent speeches has been confidently predicting that cancer would become a manageable disease -- like AIDS -- by 2015.

The Post story mentions that many oncologists have criticized von Eschenbach for overpromising, but ignores the back story. His prediction and embrace of the latest drugs has been prominently featured by the conservative Manhattan Institute, whose work on FDA and medical issues is conducted at its Center for Medical Progress. The Center is funded by the drug industry.

In the world of journalism, the Wall Street Journal's editorial page has been touting the new cancer therapies even when the clinical trial evidence shows they don't work or help as few as 10 percent of patients (and even then only for a few months). The Journal has been on the warpath against Richard Pazdur, who runs the FDA's oncology bureau, claiming he has slowed the pace of drug approvals.

Paul Goldberg's influential "Cancer Letter" pointed out in its August issue how a right wing "insurgency" is pushing for early approvals of cancer drugs. The insurgency includes Michael Milken (who has been treated for prostate cancer) and an all-star cast of conservative think tanks like the Manhattan Institute, the American Enterprise Institute, the Cato Institute, the Competitive Enterprise Institute, the Washington Legal Foundation and a cancer patient advocacy group known as the Abigail Alliance.

Grabbing a page from the AIDS activists of the early 1990s, their slogan is early access to experimental cancer drugs for the dying. If they can get the FDA to approve early access based on experimental data that suggests a new, experimental drug may affect the disease (usually based on some surrogate marker like tumor shrinkage, which can have no relationship to survival), they can then force insurance companies, Medicare and Medicaid to pay for the treatments.

That would be a godsend to the drug industry, which has invested billions in searching out cancer cures with marginal success. The new targeted therapies can cost anywhere from $4,000 to $10,000 a month. No wonder it has financially supported many of the conservative groups in the coalition.

Pazdur, who also came to the FDA from the M.D. Anderson Cancer Center, has fought to hold the line for the agency's traditional standard that a drug be shown to be effective before getting approved. His staff has also done a good job assessing whether a new drug's usually marginal benefits outweigh the substantial side effects and risks that are often associated with cancer therapies, including the newer targeted therapies. Just yesterday Genentech announced it had to stop a trial of its new drug Avastin for ovarian cancer after 11 percent of patients began developing holes in their stomachs and intestines.

There is a serious discussion that needs to take place at the FDA about how companies with new therapies can be encouraged to collaborate to see if in combination these drugs can have a major impact on cancer. But sophisticated scientific discussions and breaking the entrenched habits of competitive drug firms is not what the ideologues behind the anti-Pazdur campaign have in mind.

If von Eschenbach forces his former colleague out and appoint someone more malleable to run the agency's oncology division, we'll know the real reason why Crawford resigned.