Just days prior to the confirmation hearing of Dr. James Holsinger, Bush’s controversial nominee for Surgeon General, the current and two former Surgeon Generals testified about political interference of that office.  

At a hearing before the House Committee on Oversight and Government Reform, Surgeon General Dr. Richard Carmona testified that the Bush administration would not allow him to speak or issue reports about stem cells, emergency contraception, sex education, or prison mental and global health issues, that he was discouraged from testifying against the tobacco industry and that top officials toned down statements that he made in a report about the harmful effects on secondhand smoke and delayed the release of the report for years.   He also testified that even though he pointed to studies showing that sex education is most effective when it contains a discussion of contraceptives, the Bush administration refused to allow such a discussion because it conflicted with their abstinence only program.  

But the Bush administration didn’t just try to stifle Carmona’s speech, it also dictated it.     For example, Carmona testified that he was never able to get approval for a report on global health because it did not contain enough positive reference to the Bush administration and that he was ordered to mention President Bush’s name three times on every page of his speeches.

Finally, in a chilling reminder of the administration’s do-nothing approach to climate change, Carmona also testified that the White House dismissed global warming as "a liberal cause."

Dr. Carmona’s testimony about political interference into the fields of medicine and health should echo loudly into the confirmation hearing of Dr. James Holsinger, Kentucky’s former top health official, who once compared human genitalia to pipe fittings and said that homosexual practices can cause injury or death.

Former Surgeon Generals Dr. C. Everett Koop and Dr. David Satcher also testified about the political pressures that Surgeon Generals face.   Below are some highlights from their testimony:

Testimony of C. Everett Koop:

Former Surgeon General Everett Koop served for two terms (1981 through 1989) under President Ronald Reagan and President George Bush Senior.

One of the main points of Koop’s testimony was that he did not experience the same level of pressure to change his scientific positions the way his successors have.  

For example :

-Koop stated that President Reagan never suppressed his findings although "Mr. Reagan was pressed to fire me every day by members of his cabinet" because some of his findings about the transmission of HIV went against the belief that "those who had AIDS deserved what they got."

On who is responsible for pressuring scientists:

"Who was responsible? I don’t know. I assume it was "they and them." My Chief of Staff frequently had calls from the White House– you all know what that means– "This is the White House calling. My boss didn’t like what your boss said yesterday in Des Moines."


On the treatment of the two subsequent Surgeon Generals:

-Koop stated that the Secretary of Health and Human Services can play a large role in helping or hindering the Surgeon General.   Koop testified that one of the subsequent Surgeon Generals, Dr. Satcher, was hindered by the Secretary of HHS who resisted cooperating with him for political reasons."

-"Dr. Carmona was treated with even less respect than Dr. Satcher."

On what would make the position of Surgeon General less political and more about science :

– "I believe that the Surgeon General should not be a political appointment. The

President has 800 other such appointments to make. Why does he want the contentious political fall out which usually follows such a presidential appointment?"

– "Lack of financial independence means that the Surgeon General must seek the permission and support of others to prepare a report, hold a press conference or attend an out of town meeting."

Testimony of Surgeon General David Satcher:

Dr. Satcher was sworn in as Surgeon General of the United States in February 13, 1988.

On the firing of a previous Surgeon General and the chilling effect that this had on Stacher’s own research :            

-"… Surgeon General Joycelyn Elders was fired as Surgeon General because of comments she made having to do with sexuality."

-"Later on, as Surgeon General, I would issue a report on overweight and obesity, building on many of the points we made about the inactivity of the American people. But it was a difficult time–the nature of Dr. Elders’ firing created a difficult situation, and one that underminded [sic] the Office of the Surgeon General, and certainly led me to say no when first approached about serving as Surgeon General."

On the politicization of funding for the needle exchange program:

-"…while waiting and preparing for the press conference about the results of needle exchange program we learned that the White House had decided not to support Federal funding for needle exchange programs, despite the science, because of a political environment in Washington that would not support it. And so, serving as Surgeon General and Assistant Secretary for Health, I found myself in a very difficult position. As Assistant Secretary for Health, I was expected to support the administration’s position, but as Surgeon General, I had the responsibility to communicate directly with the American people."

On the Clinton administration’s refusal to publish Call to Action to Promote Sexual Health and Responsible Sexual Behavior , a study dealing with sexual health :

– "The White House was very sensitive to the public’s concern and interest about the Lewinsky case and asked that the Surgeon General not release a report dealing with sexual health."

More on the reaction to Call to Action to Promote Sexual Health and Responsible Sexual Behavior :

– After Secretary Thompson read the report, he remarked that it was a "very sensitive issue [and] made it very clear to me that he would not necessarily support my release of this report and that I would be on my own after I released it."

-After the report was released, the White House’s only response was: "the President believes in abstinence only, and there were no other comments on the report."

Testimony of Surgeon General Richard Carmona :

Dr. Carmona was sworn in as Surgeon General on August 5, 2002 as Surgeon General.

In general:

-"My fellow U.S. Surgeons General warned me that partisan political agendas often undermine the public health and well-being of our nation. During my first year as Surgeon General, I was still quite politically naïve in the ways of the Beltway. As I witnessed partisanship and political manipulation, I was astounded but also unsure of what I was witnessing — for I had no reference point. I asked myself whether this was just happening to me as the new Surgeon General, or whether this was the norm for all Surgeons General"

On the increasing politicization of the Surgeon General’s position:

-Previous Surgeon Generals agreed that: "never had they seen Washington, D.C. so partisan or a new Surgeon General so politically challenged and marginalized as during my tenure."

-"[T]he reality is that the nation’s doctor [i.e.- the Surgeon General] has been marginalized and relegated to a position with no independent budget, and with supervisors who are political appointees with partisan agendas.   Anything that doesn’t fit into the political appointees’ ideological, theological, or political agenda is ignored, marginalized, or simply buried."

On the structural changes to the position of Surgeon General that have made it more susceptible to political manipulation:

– "Politicians in the late 1960s decided that the Office of the Surgeon General should be disempowered and its authorities placed within offices of Department of Health and Human Services political appointees."