Author: denialism_bv2x6a

Former Surgeon General Richard Carmona alleged yesterday in testimony before the House Government Reform Committee that the White House censored his speeches and activities. Laura Mackler of the Wall Street Journal reports:

The most recent U.S. surgeon general told Congress the Bush administration routinely blocked him from speaking out on controversial issues, including stem-cell research, emergency contraception and sexual abstinence, and pressured him to support an “ideological, theological” agenda.

Dr. Richard Carmona, surgeon general from 2002 until 2006, said that his speeches were edited to remove material about controversial issues and that he was encouraged to attend internal “political pep rallies.” He said he was prevented from releasing a report on global health because he wouldn’t make it a “political document” touting actions by the U.S. The report has yet to be released.

[…]

Dr. Carmona told the committee that, as surgeon general, he hadn’t been permitted to talk about the importance of comprehensive sex education or emergency contraception. He said he wasn’t permitted to discuss the science of embryonic-stem-cell research. Under the Bush administration, there are strict limits on federal funding for such research. “I was blocked at every turn,” he said. “I was told the decision had already been made — stand down, don’t talk about it,” he said.

He also said he was prevented from attending a Special Olympics event to talk about health and disabilities. “I was told I would be helping a politically prominent family, [and] why would I want to help those people?” Dr. Carmona said. The Special Olympics were founded by Eunice Kennedy Shriver, sister of Sen. Edward Kennedy (D., Mass.).

He said his speeches were regularly vetted to ensure they weren’t controversial. Speeches were edited to add references to Mr. Bush — he was told there should be at least three per page. “The vetting was done by political appointees who were specifically there to spin my words to ideologically preconceived notions,” he said.

Another interesting article in the Times discusses shining the light on pharmaceutical industry gifts to doctors. What’s interesting about it is that shows another example of how industry self-regulatory principles often have holes (here, a lack of “detail”) that leave the problem to be addressed unaddressed.

In the privacy field, the most notable example of this was the IRSG Principles, which allowed databrokers to sell personal information to anyone they deemed “qualified,” and surprise, surprise, even criminals were “qualified” to buy Social Security Numbers. But back to doctors:

In the midst of a Senate hearing about the money and gifts that drug makers routinely provide to doctors, Senator Claire McCaskill mentioned that she had a brother who runs a restaurant.

“And he said that the most lucrative part of his business was the private room that is used mostly by drug companies” to entertain doctors, said Ms. McCaskill, Democrat of Missouri. “He said that you wouldn’t believe how much expensive wine these guys buy.” The tab often totals thousands of dollars, she said later.

Marjorie Powell, senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America, assured Ms. McCaskill that major drug makers no longer offer doctors expensive dinners. The industry’s code of ethics mandates that free meals be modest — pizza, for instance, Ms. Powell said.

“I would, with all due respect, suggest that there has been a change in your brother’s restaurant in recent years,” she said.

Ms. McCaskill pressed, “Are they allowed to buy alcohol?”

Ms. Powell responded, “Our code does not go into that level of detail.”

The senator said, “So they can.”

[…]

After the hearing, Ms. Powell’s trade association released a statement criticizing the state registries, saying they “disarm doctors by inhibiting access to critical scientific information about the benefits and risks of treatment options that help patients win their battle against disease.”

The laws have led to some embarrassing disclosures: that some doctors earn hundreds of thousands of dollars from drug makers, that doctors who are paid by drug makers tend to prescribe more of their drugs, and that some doctors who have been hired to perform clinical trials have serious medical disciplinary records.

So, Apple releases Itunes 7.2, complete with the ability to download DRM-free, high-quality MP3s. However, these MP3s contain all sorts of personal information in the metadata, thus allowing tracking of who possesses the files. The solution? Privatunes, a program provided by a French company that erases the personal information from the metadata.

The best part? How the French justify the protection of privacy. I love it:

5 reasons to erase private information from my legally acquired iTunes Plus library:

1. Am I still a child who needs his pencilcase and schoolbag tagged with my name?

2. I bought the damn tune, but someday I may want to sell it (hey, how is it more stupid that selling old CDs ?).

3. I just have a thing for privacy. Is it dirty?

4. How the heck do I know it’s not gonna be shared on P2P networks by my 6 year old step sister???

5. I thought good customer-seller relationship ment something like… how do they say, “trust’ ?

An article in today’s New York Times shines some light on drug industry gifts to doctors. Pretty interesting stuff:

Vermont officials disclosed Tuesday that drug company payments to psychiatrists in the state more than doubled last year, to an average of $45,692 each from $20,835 in 2005. Antipsychotic medicines are among the largest expenses for the state’s Medicaid program.

Over all last year, drug makers spent $2.25 million on marketing payments, fees and travel expenses to Vermont doctors, hospitals and universities, a 2.3 percent increase over the prior year, the state said.

The number most likely represents a small fraction of drug makers’ total marketing expenditures to doctors since it does not include the costs of free drug samples or the salaries of sales representatives and their staff members. According to their income statements, drug makers generally spend twice as much to market drugs as they do to research them.

[…]

Still, a similar pattern was evident in a Minnesota database that was the subject of a series of articles in The New York Times this year. As in Vermont, psychiatrists earned on aggregate the most in Minnesota, with payments ranging from $51 to $689,000. The Times found that psychiatrists who took the most money from makers of antipsychotic drugs tended to prescribe the drugs to children the most often.

I just received my July issue of Harper’s Magazine, complete with an article about lobbying and public relations in Washington. Unfortunately, the article is behind a paywall, but it’s too good for me not to share some highlights.

It seems to me that this article screams for a legislative intervention and for an ethical rule at newspapers: the strengthening of the Foreign Agents Registration Act of 1938 (You can search registrations under FARA here), and a requirement for oped writers to disclose their financial conflicts of interests. After all, what makes this all possible is newspapers like the Washington Post that routinely publish opeds by these think tanks.

I explained the background in an earlier post. Basically, Harper’s Ken Silverstein posed as a business interest from Turkmenistan, and approached four major Washington lobbying firms to see what they’d do for a foreign government with serious human rights issues.

APCO Associates, winner of PR Week’s PR agency of the year award in 2006, offered Silverstein a four part plan. First, “policy maker outreach,” which is simply setting up meetings with Congressmen. The others were more interesting:

…APCO promised to “create news items and news outflow,” organize media events, and identify and work with “key reporters.”

[…]

In addition to influencing news reports, Downen added, the firm could drum up positive op-eds in newspapers. “We can utilize some of the think-tank experts who would say, ‘On the one hand this and the other hand that,’ and we place it as a guest editorial.” Indeed, Schumacher said, APCO had someone on staff who “does nothing but that” and had succeeded in placing thousands of opinion pieces.

Discussion about the strategy’s third item–building “coalition support,” which meant developing seemingly independent and therefore more credible allies to offer favorable views about Turkmenistan–was brief.

[…]

How could we use think tanks and academics?…[the fourth element] …One possibility, Downen said, would be to hold a forum on U.S.-Turkmen relations, preferably built around a visit to the United States by a Turkmen official. Possible hosts would include The Heritage Foundation, the Center for Strategic & International Studies, and the Council on Foreign Relations. “Last week I contacted a number of colleagues at think tanks,” Downen went on. “Some real experts could easily be engaged to sponsor or host a public forum or panel that would bring in congressional staff and journalists.” The only cost would be refreshments and room rental–Schumacher joked that

[…]

Another option, he explained, would be to pay Roll Call and The Economist to host a Turkmenistan event. It would be costlier than the think-tank route, perhaps around $25,000, but in compensation we would have tighter control over the proceedings, plus gain “the imprimatur of a respected third party.”

This is all typical Washington PR, but the frankness with which groups like Heritage can be hired to do the dirty work is troubling.

The courts, prodded on by libertarians, civil libertarians, and corporate-funded think tanks, have afforded more and more protection for “commercial speech,” expression in the business interest of the speaker. Commercial speech has a lower level of protection than religious and political expression, but still, in order for the government to regulate it, it has to have a good reason to do so, and the regulation has to be effective.

Expanding protections for commercial speech makes it more difficult to regulate advertising for consumer protection purposes. It makes it harder to enforce privacy laws, to limit the spread of billboards, and to control DTC drug ads.

Sometimes, one wants the government to be limited in its control of advertising, because censorship can masquerade as consumer protection. For instance, the state of Virginia once banned advertising of abortion, but the law was invalidated as unconstitutional.

Supporters of expansive protections for commercial speech often argue that advertising is often more important than political speech. They argue that advertising brings more information into the market, and thus makes the market more efficient. Consumer protections aren’t needed because the market will out bad speakers and bad messages in favor of good ones.

I’m not so sure about this. It seems to me that speakers with strong commercial interests will flood the market with their messages, and overwhelm the truth. They’ll even intimidate people who call attention to dangerous products.

The consequences of this can be severe. You probably remember Vioxx. Well, the newest potentially dangerous (and in this case pointless) heavily-advertised product appears to be Bengay. The Washington Post reports:

…Now, muscle creams have drawn attention because toxicology tests revealed last week that the April death of a 17-year-old in New York was caused by overusing such rubs.

“Anyone educated [in athletic training] in the last 25 years doesn’t advise kids to use that stuff,” said Jon Almquist, athletic training specialist for Fairfax County Public Schools. “The demand is due to marketing. That’s the only reason why [athletic] trainers even have it.”

Arielle Newman, who ran for Notre Dame Academy in Staten Island, was found dead at her home on April 3. Toxicology tests showed that her blood contained lethal amounts of methyl salicylate, an active ingredient commonly found in products such as Bengay and Icy Hot. The New York medical examiner’s office reported Newman had used “topical medication to an excess,” causing salicylate poisoning over time.

[…]

The marketing appeal of muscle creams is one of the few reasons the products still are popular today, Almquist said. He said they provide little more than a placebo effect for their users.

“The chemical [in the rubs] is just an irritant to get the skin warm,” Almquist said. “It doesn’t do a whole lot physiologically. Physical rubbing [a muscle] is going to cause the most change.”

There will come a time where the marketers will get together and broadly challenge the FDA’s role in limiting advertising around drugs. When that challenge happens, it’s going to be critical for scientists to point out all the examples where advertising drove the use of dangerous products. Let’s try to build the record, and I’ll start–

-Listerine used to be advertised as effective in preventing deadly diseases, such as the flu and TB.
-Lysol used to be advertised as a douche!

Watch your newsstand for the July issue of Harper’s Magazine. Today’s Wall Street Journal reports today that Harper’s Ken Silverstein has written an article describing his experience posing as a businessman with interests in improving the image of Turkmenistan. He approaches lobbying firms, and hints that he represents a front company that can direct oil revenues to officials in Turkmenistan.

The results are very revealing. They show how lobbying and public relations strategies work–attack opponents as “biased,” hold bogus conferences to lure journalists hosted by others (the so called “third party method”), etc. These are activities that take place every day in DC, and they work.

Both APCO Associates and Cassidy & Associates gave Mr. Silverstein a sales pitch outlining their strategy and successes in similar cases. They recommended an aggressive campaign against “biased” news stories, organizing conferences at which sympathetic views could be aired, finding ways to get members of Congress to take paid trips to Turkmenistan and emphasizing how much the U.S. would benefit if Turkmenistan further opened its economy to outside investment.

APCO recommended holding forums for journalists, academics and politicians, hosted by a third party, where a Turkmen politician could give a speech. To avoid the feel of a paid advertisement, the lobby firm suggested possible names for the forum such as “Energy Security” or “Caspian Basin Pipelines.”

Cassidy took credit for helping to clean up the image of President Teodoro Obiang of Equatorial Guinea. Three years ago, he had been ranked the world’s sixth-worst dictator by Parade Magazine. The firm pointed out he was no longer in the top 10.

And get this–APCO won PR Agency of the Year in 2006 from PR Magazine!

Of course, these tactics are used outside Washington, and PR firms even use academics in their efforts. Earlier this year, the Boston Globe reported that “eSapience,” a consulting company, had engaged a number of top academics to remedy the image of a common (but rich) alleged fraudster:

Business ethicists are questioning why the academics, affiliated with some of the top business and law schools, joined a campaign to repair the image of Maurice R. “Hank” Greenberg , who was forced to resign in February 2005 as chairman of American Insurance Group Inc., billing him at rates of $400 to $1,000 an hour.

[…]

The academics, working with eSapience, a little-known Cambridge company calling itself a new media and research firm, included Richard Schmalensee , dean of MIT’s Sloan School of Management; David S. Evans , adjunct professor at University College London; and Richard Epstein , a University of Chicago law professor.

Their mission was “to change the public conversation about Maurice Greenberg ,” according to a confidential plan summary. This was to be accomplished, in part, by organizing invitation-only events where “influencers” would hear Greenberg weigh in on insurance issues and by penning papers, editorials, books, and other content aimed at putting the executive in a favorable light, the summary said.

[…]

The eSapience plan, though it doesn’t name him, seems aimed at discrediting Eliot Spitzer , the crusading former New York attorney general who is now the state’s governor. As attorney general, Spitzer filed a half dozen civil charges against Greenberg, accusing him of using accounting tricks to mask AIG’s underwriting losses and faltering reserves. Some of the charges were later dropped, and Greenberg continues to contest the remaining charges.

[…]

While they aren’t mentioned in the suit, the eSapience plan summary presented to C.V. Starr lists several other academics as members of what it calls its “core academic team and network,” suggesting “they are ready to begin the development of the papers, articles, opeds, books, monographs, and other content related to our key themes,” such as the onerous insurance regulatory environment.

Three of those listed, Harvard Business School professors Josh Lerner and Andrei Hagui and Boston University law professor Keith Hylton , last week said they played no role in the Greenberg campaign. Another, Robert Hahn , executive director of AEI-Brookings Center for Regulation, didn’t respond to a request for comment.