The view from here

An unqualified crony in charge of public health emergency preparedness

The National Response Plan (NRP), whose formulation was headed by the Department of Homeland Security, is intended to serve as the blueprint to the response to a host of possible disasters and terrorist attacks. The NRP contains several annexes which serve as situation-based response plans called Emergency Support Functions. "Function #8 ? is the Public Health and Medical Services Annex and it taks the Secretary of the Department of Health and Human Services (HHS) leadership in responding to a health crisis, such as a flu pandemic, through the Assistant Scretary for Public Health Emergency Preparedness (ASPHEP).

Our current ASPHEP is Stewart Simonson, who like Michael Brown at FEMA is a lawyer who was close to a political benefactor. Simonson graduated from the University of Wisconsin law school in 1994 and served as legal counsel to Tommy Thompson while he was governor of Wisconsin from 1995 to 1999. Simonson then followed Thompson to Washington when the governor was appointed as head of HHS. Simonson’s bio at HHS states that "from 2001-2003, he was the HHS Deputy General Counsel and provided legal advice and counsel to the Secretary on public health preparedness matters. Prior to joining HHS, Simonson served as corporate secretary and counsel for the National Railroad Passenger Corporation (AMTRAK)."

Congressman Henry Waxman has recently pointed to Simonson as an example where Bush has "repeatedly appointed inexperienced individuals with political connections to important government posts, including positions with key responsibilities for public health and safety."

In addition to being very close to Thompson, Simonson has given generously to the Bush political machine. The website, Political Money Line’s contribution database shows that he contributed $3,000 to various Bush-Cheney committees in the 2004 election cycle and gave $250 to the RNC.

The Washington Drug Letter published an article in its December 2004 issue in which Hauer was harshly critical of Simonson:

Speaking as part of a biodefense panel in Washington, D.C. Dec. 15, Jerome Hauer, formerly the Assistant Secretary for Public Health Emergency Preparedness (ASPHEP) at HHS, said the $877 million contract awarded to VaxGen to produce a new anthrax vaccine was insufficient. He also insinuated poor policymaking has left the country vulnerable to terrorist attacks using weapons of mass destruction.

Hauer faulted the current management at the ASPHEP Office, including acting secretary Stewart Simonson, for not being better prepared to handle its duties. He called for the creation of a new federal office to coordinate U.S. biodefense activities.. . ."The decisions being made do not appear to have a sound basis," said Hauer, currently senior vice president of government relations for consulting firm Fleishman-Hillard.

Last spring, Simonson came under fire from several Republican senators. The first was by Idaho Senator Larry Craig before the Homeland Security Subcommittee in April who questioned the acquisition process for influenza vaccine:

Noting that the flu can be lethal to some populations such as the elderly, Sen. Larry Craig, R-Idaho, said the country was unprepared to deal with a possible flu pandemic.

Simonson . . . stopped short of agreeing with Craig’s assessment, but said "it would pose an enormous challenge."

Sen. Ted Stevens, R-Alaska, and Gregg also questioned if the process used by Simonson’s office to award vaccine development contracts ensured open competition and delivery to prevent a vaccine shortfall. "Are we creating the same situation with anthrax?" Gregg asked, referring to the flu vaccine shortfall last winter.

Although Simonson said the different agreements show that they are "seeking not to put all our eggs in one basket," he added that he remains unsure if the contract award process is being done right. "We’re learning as we go," he said.

The bottom line is that there is a risk of a flu pandemic that could kill millions of people worldwide if it is able to jump from human to human. Hurricane Katrina amply demonstrated what happens when underqualified yet well-connected lawyers are in charge.

Amidst this week's three-ring circus imvolving the Fitzgerald indictment rumors, the Miers fiasco, and Tom DeLay's court appearance, you may have missed an important GOP sideshow: the collapse of a House Republican effort to patch together an amended federal budget resolution to pay for a small portion of the Katrina recovery effort. Read all about it on the DLC site, and be sure to follow the link to Gov. Tom Vilsack's op-ed on how to help pay for the Gulf Coast recovery. Vilsack wouldn't mess with Medicaid or food stamps; does not rely on the brain-dead approach of across-the-board cuts; and while he identifies far more spending savings than the House GOP green eyeshades, he also doesn't ignore the immorality of implementing new tax cuts for the wealthiest Americans, either

Time Magazine on The Broken Promise Congress’s role has been pivotal. Lawmakers wrote bankruptcy regulations to allow corporations to scrap the health insurance they promised employees who retired early—sometimes voluntarily, quite often not. They wrote pension rules that encouraged corporations to underfund their retirement plans or switch to plans less favorable to employees. They denied workers the right to sue to enforce retirement promises. They have refused to overhaul America’s health-care system, which has created the world’s most expensive medical care without any comparable benefit. One by one, lawmakers have undermined or destroyed policies that once afforded at least the possibility of a livable existence to many seniors, while at the same time encouraging corporations to repudiate lifetime-benefit agreements. All this under the guise of ensuring workers that they are in charge of their own destiny—such as it is.

The Club for Growth blog tracked the debate over the Coburn amendment that would cancel the Bridge to Nowhere and Don Young Way and use that $454 million for New Orleans reconstruction. It was a heated debate. Sen. Ted Stevens threatened to resign if the amendment passed (too bad it failed).

What bothers me most is that there is no reason for any Democrat to vote against this amendment, yet our Senator Russ Feingold (D-WI) was the only Democrat to vote for it!

Another, earlier, Coburn amendment to revoke pork projects in Rhode Island, Washington State, and Nebraska, for a total of $1.5 million in savings, was rejected. Of the 13 "yes" votes, Sen Feingold's was the only one from a Democrat.

It's wonderful for Wisconsin that Feingold voted for it, but ugly and embarrassing for the Democratic Party. (And, back to Wisconsin: Where was our other senator?)

Why would anyone vote against a bill that is overwhelmingly both fiscally and morally correct? Because if it pases, it puts every single slab of pork in every single state in danger. What Coburn did is allow a challenge to every single pork line item. As well as it should be. Let each project stand on its own.

The amendment failed 15-82. This is becoming a gross failure by both parties and the institution of government. This time, Sen. Feingold was joined by three other Democrats and 11 Republicans in voting "yes." (Once again, where was Wisconsin's other senator?)

We have to wonder aloud: How the heck is a $223 million bridge serving 50 people more important to 82 senators than rebuilding storm-battered New Orleans (or fending off the proposed cuts to Medicare and Medicaid)?

Simply unconscionable. Those who voted against these amendments have zero credibility on issues of fiscal responsibility (much less moral accountability). Zero. Did I mention, lately, the culture of corruption?

And by the way, Feingold is starting to look really good for '08.

Ed Garvey had this to say on his blog today:

Jim Doyle is a smart man. A good lawyer and, I believe, an honest man. But he is in a system that rewards corruption.

He has been in public office for most of his adult life and yet he cannot seem to understand the old truism that that the perception of corruption is almost as bad as actual corruption. S

o you must scratch your head and wonder how he permitted Craig Adelman to donate $10,000 to his campaign while his administration was consideing Adelman's bid to handle all state travel. About $250,000 per year. And why did Adelman think it necessary to make the contribution? Was it mere coincidence?

Yah, sure, Ole.

So Doyle looks awful. Why? Figure it out. He is now under crminal investigation because he has failed to do one thing: All he had to do was to ban political contributions from those who do business with the state or those trying to do business with the state. You know, road builders, law firms, utilities, insurance companies, travel agents.

One stroke of the pen and he would never face this embarassment again. Why won't he? And who are his advisors who should be protecting him?

Ah, they are the ones telling him to raise money day in and day out. They are the ones telling him that publicly financed campaigns is a foolish idea because it would level the playing field.

Join us on Thursday. Bring your broom. Let's sweep out the Capitol and demand real reform.

Read here to grasp the reality of waiting lists for healthcare in America. Long waiting lists. For someone with good coverage and access to lots of doctors. Best healthcare in the world, baby, best in the world. Just keep telling yourself that.

The editor of the Wisconsin State Journal's editorial page couldn't resist gloating that former state Senator Chuck Chvala's (D) trial begins on Halloween. He writes that Chuck's "sharp elbows...his ferocious appetite for competition to get his way...clutching so tightly to power meant Chvala needed money--lots of it..." As fun as it may be to watch others getting their just reward, the editorial actually distracts from the larger, far mor important, issue of Madison's culture of corruption.

Does the editor think for an instant that Chvala created the cesspool we call electoral politics? Go here: Caucus Scandal Archive (Links to articles covering the ongoing scandal.) Does the editor not know -- or not want his readers to know -- that there are nearly a thousand well paid lobbyists who stand ready to provide "honest graft" in the form of campaign contributions for favors? Go here: Graft Tax Scorecard 2005 [Keep track of "legal" graft in state government with this handy scorecard (pdf document).]

Why do some interests nearly always get what they want, while others almost never do? Why is there an apparent relationship between those who contribute and those who "win" in legislation, regulation and policy? Could it be they are being rewarded for enormous campaign contributions? As just one example: Let's visit the PSC to find out about ex parte communications. Let's wonder aloud why utilities can push a bill through the "lobbyist's Legislature" to gain the right, under eminent domain, to take public lands.

Now, I'm no fan of Chvala. When I used to talk to him about the plight of home care providers trying to serve the needs of Wisconsin's frail elderly and low-income disabled residents, all he wanted to talk about was campaign contributions. It wasn't a direct "pay to play" demand, but his indirect message was clear. I always felt the need to scrub thoroughly afterward. But the State Journal would serve its readers more if it gave us fewer partisan-based sanctimonious editorials and more genuine reporting to expose Madison's culture of corrpution. Go here: Three already violate annual contribution limit.

What do you think Tommy Thompson was doing for 14 years while the State Journal slept? Did the editor miss the series the Milwaukee newspaper ran on the relationship between the nursing home industry and Thompson? Or were the apparent links between those campaign contributions and Thompson's policies merely the world's most consistent and long-running coincidence?

The editor asks -- rhetorically, I assmue -- whether Chvala is a good guy or "the power-hungry, felony-facing political boss he became." He wants us to think Chvala is the problem, and that's a problem in itself. I can't know what's behind his reasoning -- Does he want to deflect attention from the causes of our corruption or is he just ignorant? -- but until he figures out the system, investigates those who give the money and gets back to us, he's doing more harm than good. Go here: Money in Politics 101 (Learn the basics of campaign finance.)

In the meantime, I'm stocking up on lye soap.

As the Hill reports, Republicans in Congress are getting ready to reduce the deficit by making "tough choices" and hacking at programs for the politically powerless. (This despite the fact that discretionary spending cuts won't make a dent in the deficit; repealing the Bush tax cuts is, needless to say, off the table.) On the other hand, as Sam Rosenfeld notes, the outcry over Katrina may shame them into restraint; already the Senate has dropped a plan to slash food stamps—which would, again, shave off a mere $500 million from an annual deficit that's exceeding $400 billion. It's like trimming a few blades of grass near the porch by hand when the yard is overrun by weeds, but no one seems to mind.

In all likelihood, the bulk of the cuts will come from Medicaid; a terrible idea considering that the health care program for the poor has been taking care of the ever-growing number of Americans losing their health insurance and sinking into poverty. The GOP is envisioning some $35 billion in cuts over the next five years, but the rather disgusting irony here, as a new study from the Center on Budget and Policy Priorities shows, is that it's very, very easy to achieve these savings from the government health care programs merely by trimming some of the excess payments made to the managed care companies that run Medicare. Most of this excess is the famous "waste" we hear so much about. Of course, since PPOs and HMOs have their own set of lobbyists, and tend to make large campaign contributions, while Medicaid recipients have... desultory popular outrage... on their side, the choice here isn't going to come as much of a surprise.

After Katrina, Cutting Programs For The Needy Is An Outrage!

Virtually every mainstream national labor, peace, justice, health, poverty, Christian, Jewish, housing etc, groups have endorsed this campaign from the Coalition on Human Needs. Please take two minutes out of your day today to call Congress and let them know that we will not tolerate further cuts in services to the poor.

On October 18th Tell Congress: Responding to Katrina by cutting programs for the needy is an outrage

Some in Congress want to use the hurricane as an excuse to make even deeper cuts in services for people in need and to pass even more tax cuts for the well-off. Many members are saying that we cannot afford the clean-up and rebuilding efforts unless we cut programs that serve the needy -- even as they support tax cuts for the wealthy that cost at least seven times as much as Katrina expenditures. If they can get away with cutting human needs NOW... well, we don't even want to think about it.

1-800-426-8073
Call the Capitol toll-free October 18 and tell Congress to get its priorities straight. Tell your friends and networks that they can call the Capitol using this toll-free number (thanks to the American Friends Service Committee) on the 18th.

Step 1: On October 18, call 1-800-426-8073 to be connected toll-free to the Capitol Switchboard. Ask to speak to one of the senators from your state.

Step 2: When the senator's phone is answered, say:"My name is _____ and I live in [your town/city]. I would like Senator [name] to oppose $35 billion in cuts to Medicaid, Food Stamps and other vital services, and to oppose $70 billion in more tax cuts. The right priorities are protecting people from sickness and hardship, investing in housing, jobs, and other services that families need - not squandering billions on tax cuts for the well-connected."

Step 3: Use the toll-free number in step 1 and call your other senator and your representative. If the lines are busy, please be patient and try again. Or, dial their direct lines (not toll-free) - find the numbers at www.senate.gov and www.house.gov.

Polls show Americans choose aiding Katrina victims over new tax cuts by a margin of 2 to 1.
So what's Congress's reponse? Congress will return to Washington Monday, and many committees will take up legislation to cut spending, targeting at least Medicaid, Medicare and Food Stamps, and quite possibly other vital forms of assistance like the Earned Income Tax Credit, TANF, or child welfare services. Not only that, but Congress is starting to talk about across-the-board cuts in most other programs.

Both your Senators and your Representative need to hear it from you.

Other actions:
Email Congress: Don't Cut Medicaid! Right now, Congressional committees are working out how to make billions of dollars in cuts to low-income services, even while victims of Hurricane Katrina need the most basic housing, health care, and food assistance. Congress will cut Medicaid if they do not hear from constituents.

Email Congress: Protect Services - Vote NO on More Tax Cuts Contact your members of Congress and tell them to oppose permanent repeal of the estate tax or other tax cuts for the wealthy that will imperil services for the most needy Americans.

Join The Online March Organized By The Emergency Campaign For America's Priorities
This is an innovative way to join with thousands of Americans who are telling the President and Congress to put America's families as the first priority.

Go to it.

I realize this is an era for more creative forms of political propaganda. But when the pharmaceutical industry gets involved in commissioning a novel to scare Americans, you know things have gotten out of hand.

In a tale worthy of a zany Washington satire — except for the lamentable fact that it's true — the rich and powerful pharmaceutical lobby secretly commissioned a thriller novel whose aim was to scare the living daylights out of folks who might want to buy cheap drugs from Canada.
When the project fell through in July, I'm told the drug lobby offered $100,000 to the co-authors and publisher in a vain effort to sweep it under the rug.

"This is the most outrageous example of deception and duplicity on the part of a Washington lobby in the history of the country," said Capitol Hill denizen Jeff Weaver, chief of staff to Rep. Bernie Sanders (I-Vt.), a diehard foe of the pharmaceutical industry.

A multibillion industry, which already gets subsidies from the government, is so worried about reimportation that it would secretly commission pop fiction? Sad. Very sad.

Lloyd Grove explained that a DC divorce lawyer came up with the idea and approach Phoenix Books about the project. The publisher struck a six-figure deal and the Pharmaceutical Research and Manufacturers of America, which is trying to distance itself from the whole thing, made at least one payment to Phoenix Books.

Think that's bad? Wait until you hear the plot — and PhRMA's role in shaping it.

Work began in April, after Viner hired veteran ghostwriter Julie Chrystyn. Her story concerned a Croatian terrorist cell that uses Canadian Web sites to murder millions of unwitting Americans looking for cut-rate pharmaceuticals.

PhRMA has vigorously fought all efforts to legalize the purchase of cheap drugs from Canada. Even though the lobby has found some success, the underground business still takes an estimated $1 billion in annual profits from American drug behemoths.

Chrystyn titled her thriller-in-progress "The Spivak Conspiracy," an homage to her friend Kenin Spivak, an L.A. telecomm entrepreneur and onetime Hollywood exec. Spivak said he became Chrystyn's co-writer after she delivered the first 50 pages, and PhRMA made several editorial suggestions. "They said they wanted it somewhat dumbed down for women, with a lot more fluff in it, and more about the wife of the head Croatian terrorist, who is a former Miss Mexico," Spivak said. Apparently, women are among the most loyal buyers of Canadian drugs. He added, "They wanted lots of people to die."

I had no idea the Pharmaceutical Research and Manufacturers of America was so desperate that it would stoop this low. (I'm not even going to elaborate on the self-evident bigotry of "dumbed down for women.")

Visit the National Priorities or Cost of War web site. ( http://costofwar.com/index.html ) The cost of the adventure in Iraq cannot be calculated in human terms but the financial cost is incredible. Last count--$200,651,019,999. How much home care would that pay for? How many students could get a full scholarship to nursing school? This misplaced priorities leave me gasping.

Politics is always a matter of priorities, and the folks who are running the federal government right now are putting the health care of Wisconsin's residents rather low on the priority list. Let's look at some of the trade-offs we have been, we are, and we will be making:

Taxpayers in Wisconsin will pay $3.3 billion for the cost of war in Iraq -- so far. For the same amount of money, the following could have been provided: health care for 406,993 people in Wisconsin alone.

The $89 billion in tax cuts for the wealthiest 5% this year could be spent on the people of Wisconsin instead. If that money were used to support state and local programs, the residents of Wisconsin could have $1.6 billion, which could provide: 981,557 Wisconsin residents with health care.

The $55 billion in tax cuts for the wealthiest 1% this year could be spent on the people of Wisconsin instead. If that money were used to support state and local programs, the residents of Wisconsin could have $971.9 million, which could provide: 119,602 Badger state citizens with health care.

The $225 billion in tax cuts this year could be spent on the people of Wisconsin instead. If that money were used to support state and local programs, Wisconsin would receive $4.0 billion, which could provide: 486,185 of our neighbors with health care.

Sometimes, all you can do is shake your head and sigh.

Please visit the Flu Wiki and use their resources to blog about bird flu. The more accurate information people have, the better off we'll be.

So, you're probably wondering what the U.S. government has in the way of a plan for dealing with a possible flu pandemic. Here's some quick history:

August 2004: The Department of Health and Human Services released a "Pandemic Influenza Response and Preparedness Plan". It was actually a draft plan.

May 2005: The DHHS draft plan was still in draft form when it was assessed by the GAO (pdf).
The GAO report commented that the plan did not define the role of the federal goverment in vaccine and antiviral drug purchase, distribution, and administration, among other things.

Other noteable dates: Click here for a timeline through May 2005, of steps taken by the U.S. government to prepare for a possible pandemic. Note that these steps are important, but obviously, an actual plan is still missing (source, pdf).

Until now... well, not really. The draft plan is a little more detailed, but it's still a draft. It was leaked to the New York Times:

A plan developed by the Bush administration to deal with any possible outbreak of pandemic flu shows that the United States is woefully unprepared for what could become the worst disaster in the nation's history. A draft of the final plan, which has been years in the making and is expected to be released later this month, says a large outbreak that began in Asia would be likely, because of modern travel patterns, to reach the United States within "a few months or even weeks." If such an outbreak occurred, hospitals would become overwhelmed, riots would engulf vaccination clinics, and even power and food would be in short supply, according to the plan, which was obtained by The New York Times. The 381-page plan calls for quarantine and travel restrictions but concedes that such measures "are unlikely to delay introduction of pandemic disease into the U.S. by more than a month or two." The plan's 10 supplements suggest specific ways that local and state governments should prepare now for an eventual pandemic by, for instance, drafting legal documents that would justify quarantines. Written by health officials, the plan does [not] yet address responses by the military or other governmental departments.

So this plan has been "years in the making," yet it still doesn't define the role of the federal government in the response to a flu pandemic? At least the roles of local and state governments have been defined, but what the heck is the problem with saying "this is our advice to Executive Branch, and various federal agencies..."?

The role of the DHHS has actually been laid out in the plan. But who's going to be in charge?
While the administration's flu plan, officially called the Pandemic Influenza Strategic Plan, closely outlines how the Health and Human Services Department may react during a pandemic, it skirts many essential decisions, like how the military may be deployed.
"The real shortcoming of the plan is that it doesn't say who's in charge," said a top health official who provided the plan to The Times. "We don't want to have a FEMA-like response, where it's not clear who's running what." The same official says that the plan is "a major milestone." Well, yes, it is, compared to the one that came out two years ago.

Other issues in the leaked document:
Who gets vaccines and essential medicines first? This is a major point of contention in the plan. The military wasn't included in the discussion, but pharmaceutical plant workers are at the top of the list, as well as medical workers. These are followed by the elderly and severely ill, pregnant women, immunocompromised individuals, parents of infants, and police, firefighters, and government leaders.

A stockpile of 133 million courses of antiviral medication (the Bush administration has bought 4.3 million).

The responsibility of health officials is laid out (planning and surveillance, as well as coordination with the DoD).

Finally, the NYT article says that the plan includes some elements of drama. It has a fictional scenario: "In April of the current year, an outbreak of severe respiratory illness is identified in a small village. Twenty patients have required hospitalization at the local provincial hospital, five of whom have died from pneumonia and respiratory failure," the plan states.
The flu spreads and begins to make headlines around the world. Top health officials swing into action and isolate the new viral strain in laboratories. The scientists discover that "the vaccine developed previously for the avian strain will only provide partial protection," the plan states.
In June, federal health officials find airline passengers infected with the virus "arriving in four major U.S. cities," the plan states. By July, small outbreaks are being reported around the nation. It spreads. As the outbreak peaks, about a quarter of workers stay home because they are sick or afraid of becoming sick. Hospitals are overwhelmed. "Social unrest occurs," the plan states. "Public anxiety heightens mistrust of government, diminishing compliance with public health advisories." Mortuaries and funeral homes are overwhelmed.

Heightened mistrust of government because...? Just go back to the first paragraph of the article. Would you trust a government that was "woefully unprepared"? After Katrina, it's hard to trust the government in the event of any disaster.

A proposal by Senate Finance Committee Chair Chuck Grassley (R-Iowa) would reduce Medicare payments to private insurance plans and home health agencies, CQ Today reports. Grassley's proposal would reduce mandatory spending by $12 billion over five years -- $2 billion more in cuts than the committee was required to make as part of the fiscal year 2006 budget resolution. You can Click here to take action on home care issues! or get there from the home page of the Wisconsin Homecare Organization's web site at www.wishomecare.org Either way you choose, you can use our prepared text (or create your own) to speak up with just a couple of clicks of the mouse.

High costs of oil it hard this summer...but what's going to happen this winter? Democrats tried unsuccessfully last week to get an increase in funding for a program that helps poor people pay for heating in the winter. The Bush administration doesn't seem to have a plan according to AP: Energy Secretary Samuel Bodman said last week that additional money was "not on the agenda." Department spokesman Craig Stevens, however, said Monday, "I think it's an option on the table."

Then, I saw this quote in that article from a social service program director in Northeast PA and think he is dead on: "This is a life-and-death situation," [Stephen] Nocilla said. "People are going to have to make some very difficult choices."

Once winter starts rolling in, people in Wisconsin -- think "home health patients" who are homebound -- are going to be faced with outrageous home heating bills from oil and natural gas. People could literally die because of this. Is this yet another crisis developing right in front of us while we do nothing...?

"I'm trying to go around the country and help, as others are, to restore the prospects of the Democratic Party." -- Democratic Sen. Russ Feingold testing the presidential waters in New Hampshire, home of the nation's first presidential primary. "If I ultimately get to the point of thinking about this seriously, I would probably make a decision sometime after the 2006 election." He'd be the first occupant of the White House to understand and appreciate home care.

An article by James Cramer in New York magazine predicting what has been obvious since 2002: that President Bush's fiscal profligacy is pushing the nation toward a harrowing economic crisis. We'd better start preparing for what this will do to our poor (and Medicaid), our elderly (Medicare) and our ability to serve those who need us most.