Weekly Shredder 17:
Ask the White House: Tommy Thompson
by James Norton

Disease brings us together.

No other phenomenon unites private concerns and public welfare so dramatically. A single death can devastate an entire family; an epidemic of deaths can devastate an entire society. A government acting with foresight and care can save thousands of lives; a government acting recklessly or carelessly can compound a natural disaster.

The lies, omissions and distortions of the Bush administration have been so frequent, so pervasive and so clearly documentable that entire cottage industries have sprung up to publicize and analyze them. Books of debunkery have appeared like toadstools springing up after a hard April rain.

Even so — when it comes to public health, you've got to be straight with people. Panic and misunderstanding spreads quickly. So, as fear about the flu season percolates through the populace, it's time for straight talk from Tommy Thompson, the cheesehead secretary of Health and Human Services.

Jennifer, from Cincinnati, Ohio writes:
As I see all our elderly standing in lines outside groceries hoping for a flu shot, I wonder if there's anything that the government could do to round up the remaining shots and see that the most elderly, the most ill could receive a shot without waiting for hours in various weather conditions. Certainly people in nursing homes have little hope of getting their shot since they can't get out to wait in the lines. Thank you for any help that you could give these people.

There are three reasonable ways to handle this question, all of which involve telling the story of how the unsafe vaccine was discovered.

You could come completely clean, an approach we're not likely to see taken by either political party any time soon. Here's what that would sound like, in this case:

For archives, audio, and background about the column, click here.

On Oct. 5, the British government shut down Chiron Corp.'s entire production of influenza vaccine due to contamination. The FDA, warned about possible shortages in an August 2003 report by the Institute of Medicine, had failed to act diligently enough to guarantee the safety and stability of the flu vaccine supply. HHS and the president — by failing to heed warnings dating back to 2001 that called for centralizing government oversight of the national flu vaccine supply, failed to strengthen a naturally fragile system for supplying the country's supply of medicine. This has resulted in a shortfall in the supply, and a national minipanic reminscent of the Cabbage Patch Kid craze of the mid-1980s. Sorry about that, everybody. We made a mistake! We had a lot on our minds!

That's asking a lot. Approach No. 2: Stick to the facts, but spin things a bit. Spin and polish. Go ahead, you're a politician — be political!

On Oct. 5, my agency was notified by the British government that the Chiron Corp.'s entire production of influenza vaccine might be contaminated. The Food and Drug Administration immediately inspected the plant, and agreed with the British authorities, who had done due diligence, that it would not be safe for consumers to use this vaccine. It was important that the Brits caught this problem and worked with our government to prevent contaminated vaccine from being used in the United States, but the manufacturing problems reduced our expected supply.

Sadly, Thompson took approach No. 3: Make it up.

On Oct. 5, my agency was notified by Chiron Corp. that its entire production of influenza vaccine might be contaminated. The Food and Drug Administration immediately inspected the plant, and concluded that it would not be safe for consumers to use this vaccine. It was important that we caught this problem and prevented contaminated vaccine from being used in the US, but the manufacturing problems reduced our expected supply.

We caught this problem? In what possible sense could he mean this? This directly echoes Bush's lie from the Oct. 13 debate in St. Louis:

Bob, we relied upon a company out of England to provide about half of the flu vaccines for the United States citizen, and it turned out that the vaccine they were producing was contaminated. And so we took the right action and didn't allow contaminated medicine into our country.

The "company out of England" was an Emeryville, Calif., company outsourcing work to the United Kingdom. The "we" who took the right action was the British government. 0 for 2.

But why recount history accurately? It's not a reality that's flattering. It's a reality that implies fault in a faultless administration — and therefore, it can't stand.

Thompson moves on:

I am working with the attorneys general of each state

I guess it's not too much to expect that the US government would get the pluralization of Attorney General right, but... still. You've got to give them credit for this.

More relevantly: By this point in the Q&A, Thompson is getting into the feel-good "we're taking action" part of his answer.

And today I announced a new interagency Flu Response Task Force that includes high-ranking officials from my department and the Departments of Justice, Homeland Security, Veterans' Affairs and the Federal Trade Commission. Our task force will make sure that we have a comprehensive coordinated federal response.

Why, that task force sounds terrific, Secretary Thompson! But you — and President Bush — have been warned multiple times since 2001 that this problem was looming. In fact, the Government Accountability Office issued a harsh report at the end of September 2004. To quote the Christian Science Monitor from Wednesday:

In a prescient report issued Sept. 28, just before the vaccine shortage was announced, the US Government Accountability Office criticized US flu vaccine preparedness and warned of possible shortages if a manufacturer's production were to be interrupted. The GAO report concluded, "there is no system in place to ensure that seniors and others at high risk for complications receive flu vaccinations first when vaccine is in short supply."

Bloomberg news service piled it on:

Janet Heinrich, the GAO's director for health-care and public health issues, said Sept. 28 that the government's plan doesn't set up a "definitive federal role" for purchasing and distributing flu vaccine, she said.

And now... a "citizen" who sounds suspiciously like White House advisor Karen Hughes fires off her question:

Marie, from Milwaukee writes:
Please remind people more that the shortage of flu vaccines is largely due to the fact that many of the companies who made them, did not want to be sued and stopped producing vaccines.

Marie, this is false. This is patently false. The fragile commercial/industrial system that provides flu vaccine suffers from two major problems: a depressed price point for the medicine that makes it a risky investment for manufacturers and a scarcity of manufacturers that means if one batch is contaminated, the entire supply is jeopardized. Are lawsuits a factor in the lack of manufacturers? Minor at most, say experts, including the GAO and National Institutes of Health. Blaming tort reform for a system that the government has failed to take care of is a buck passing of epic proportions.

In fact, the HHS website, documenting the link between liability concerns and vaccine shortages, says: "Current vaccine shortages do not appear to be liability related." So. Thompson, must, of course, refute the basis of the question, or at least inject a healthy sense of perspective into the debate.

But he doesn't.

Thompson: Thanks for raising that point, Marie. Vaccines are a very important tool in protecting the public health, and since this president took office, we have been working to address problems facing the vaccine industry.

He then launches into budget statistics that indicate an increase in government support for vaccine development, without explaining why the criticism of vaccine watchdogs has mounted even as the reliability of the supply has wavered over the past four years. And then — he confirms the faulty premise of Karen "Marie" Hughes's question.

And, of course, the President has urged Congress to take the critical step of providing vaccine manufacturers with liability protection.

But when the Institute of Medicine delivered its verdict on the vaccine supply in August 2003, it wasn't liability fears that it cited as the threat to the health of Americans. Instead, it cited:

The ability of the US government, which purchases half of all vaccines administered in the country, to command low prices means "companies face declining financial incentives to develop and produce vaccines.

Could a government solution have addressed this problem? Yes. Would a single centralized vaccine authority been in a good position to identify and correct the problem? Yes. Was such an authority created? Absolutely not.

Time for another question.

Leo, from Acadia writes:
Youve said numerous times that you oppose against the importation of Canadian drugs because of safety issues. Yet you said the other night that you were working on obtaining flu vaccines from Canada. Why do you trust the Canadians for this medicine but not others?

Thompson sets it up: It'd be great to import foreign drugs, but the government has to act as an advocate for the people and ensure that they're safe. Does he present a statistical case against Canadian and European drugs?

No. He presents a mish-mash of information.

During one investigation, my agency found that 88 percent of imported drugs were unapproved.

During only one investigation? Is this the most damning, or the least damning? Who was conducting this investigation? How wide was the sample? Where were these drugs imported from...? Canada? Zaire? Andorra?

And then:

We found animal drugs shipped for human use, drug labels written in Chinese and pills shipped from a Canadian website that were packaged in a tupperware container and turned out to be from India.

Well, that sounds pretty bad. And the Tupperware thing seems to implicate Canadian drugs as a whole.

But the AARP — a group so nonpartisan or even right-leaning that it went to bat for Bush's flawed Medicare bill — looked into the question of importing drugs. It talked to Illinois Gov. Rod Blagojevich about his findings on foreign drugs:

Blagojevich investigated foreign drug safety and no longer believes the United States holds the gold on this issue. Unlike the FDA, he has sent state officials to investigate drug safety procedures in Canada and six European nations. There, the officials reported, regulations and practices are sometimes more stringent than US ones, and counterfeit medicines are rare. "Frankly," he says, "I don't think our safeguards are as good as other countries'."

Thompson's presentation is, in closing, a garbage barge. He takes credit for the actions of the British. He misleads Americans as to why we have a vaccine shortage in order to make hay on the question of tort reform. He covers up longstanding government dereliction on the question of creating a central vaccine authority, at a time when accountability would be both crucial and welcome. And he badmouths drug importation — a bugbear of the incredibly well hooked-up US drug industry — with a pile of sloppy facts and impressions.

Voters worried about health care — or about our government's willingness to side with citizens instead of drug companies — would do well to carefully read Secretary Thompson's answers.

Who knew flu season and election season could have such crossover?

E-mail James Norton at jim@flakmag.com.

— graphic by Derek Evernden (derek@ocellus.net)