Don’t let politics guide U.S. health, safety decisions

When Theodore Roosevelt served on the U.S. Civil Service Commission, he authored an article lauding the reforms that prevented the U.S. Postal Service from serving “as a vast bribery chest with which to debauch the voters of the country.”

A few years later, when as president he signed the Food and Drug Act of 1906 into law, Roosevelt put a scientist in charge of the new regulatory agency, which in those days focused mostly on food. TR frequently had to step in to prevent his politically powerful agriculture secretary, who had close ties to the meatpacking industry, from undermining the new agency’s scientists.

TR’s Progressive Era reforms built on the prior commitment of both political parties to put expertise ahead of politics when it came to public service and public health. Republican Ulysses S. Grant created the nation’s first Civil Service Commission in 1871. In 1889, Democrat Grover Cleveland signed a law that required officers in the uniformed Public Health Service to pass an exam before they could be appointed to their posts.

Even the location of the Centers for Disease Control and Prevention in Atlanta has been called a boon to the primacy of science over politics. It allowed the agency to escape the political pressures that sprang from Washington. 
Science has become a contested terrain in the past half century, even before the fossil fuel industry ginned up controversy over global warming. Industries facing regulation by science-based agencies like the EPA and OSHA commissioned studies to contest the findings that government and academic scientists used to justify controlling emissions and health risks.

But those conflicts always take place in the context of administrative rulemaking and judicial review. Politicians and lobbyists often seek to influence the outcomes. But their letters and phone calls are not dispositive. At the end of any proceeding, agencies base decisions on a careful review of the scientific evidence.

Recent actions by President Donald Trump threaten to destroy more than 150 years of progress in putting science at the center of the nation’s efforts to promote health and safety. In recent months his appointees at the U.S. Postal Service and the Food and Drug Administration have violated the core principles of the agencies they run. 

Louis DeJoy, a major Trump campaign donor with no prior experience at the Postal Service, disrupted deliveries without review and without considering the impact that might have on the millions of people who depend on the mail for their prescription drugs and medical supplies. That includes most of the nation’s veterans. The Disabled American Veterans reports significant delays in the delivery of critical medicines, “by an average of almost 25% over the past year.”

FDA Commissioner Dr. Stephen Hahn, who had just gone through the hydroxychloroquine fiasco, joined the president in the Rose Garden to announce a second emergency use authorization, this time for convalescent plasma. There’s minimal evidence of its efficacy in treating COVID-19. 

He then misrepresented that limited data. While he walked back those comments a day later (when few were listening), it came only after an uproar among scientists who closely follow the agency.

Progressive Era reforms came about because they reflected the interests of a new class: educated professionals. This rising group had a stake in putting their property—their degrees and government certifications that reflected their commitment to science-based professional standards—over the short-term interests of venal politicians and greedy corporations.

That entire edifice is now under sustained assault by the incumbent president. Staying silent is not an option.

No group has more to lose from Trump’s depredations than organized medicine and the healthcare industry. Their enterprise is wholly dependent on the public trust that comes from putting science and service ahead of politics. 

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