Time for a Surgeon General-ectomy?
President-elect Obama has reportedly chosen Sanjay Gupta, CNN’s chief medical correspondent and one of People
magazine’s “sexiest men alive,” for the post of surgeon general. Those
aren’t the only reasons that the surgeon general’s position ought to be
abolished.
The original version of
the surgeon general position was created in 1870 to administer what was
then known as the Marine Hospital System (MHS), which cared for sick
and injured merchant seaman. The MHS, including a uniformed “Commission
Corps” of physicians, was converted in 1902 into the Public Health and
Marine Hospital Service, and its mission was expanded to medical
inspection and quarantine of arriving immigrants, such as those landing
at Ellis Island in New York.
In 1912, the
Service was renamed the U.S. Public Health Service (PHS) as its mission
was further expanded to conduct investigations into infectious diseases
(such as tuberculosis, hookworm, malaria, and leprosy), sanitation,
water supplies, and sewage disposal. Between 1930 and 1944, the
Commission Corps officers were expanded to include engineers, dentists,
research scientists, nurses, and other health care specialists.
But
in 1968, the surgeon general position fell victim to President Lyndon
Johnson’s reorganization of the then-Department of Health Education and
Welfare (HEW, or what is known today as the Department of Health and
Human Services). The Office of Surgeon General that administered the
PHS was scrapped, and responsibility for the PHS was assigned to the
assistant secretary for health, who reported directly to the secretary
of HEW. A position of “surgeon general” was then created to merely
“advise” the assistant secretary on professional medical matters.
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After
almost two decades of more bureaucratic reshuffling — during which time
the surgeon general was made a direct adviser of the secretary of HEW
followed by the combining of the positions of surgeon general and
assistant secretary for health in 1977 and their separation again in
1981 — the Office of the Surgeon General was re-established in 1987
with largely nominal responsibility for managing the PHS Commissioned
Corps personnel.
The surgeon general doesn’t
actually command all of the Commission Corps officers. Most of them
work in other federal agencies — like the EPA, Coast Guard and Bureau
of Prisons — and report directly to the various line managers in those
agencies who may or may not be in the PHS.
Although
C. Everett Koop attempted to revitalize the Corps in the late 1980s,
the superfluous nature of the surgeon general position became glaringly
obvious during the tenure of Jocelyn Elders, President Bill Clinton’s
first surgeon general. Besides taking controversial positions on drug
legalization and the distribution of contraceptives in schools, in
early December 1994, Elders spoke in support of the teaching of
masturbation. She was promptly fired by Clinton. The position of
surgeon general remained vacant for three years, until Clinton
nominated David Satcher.
At the time of Satcher’s nomination, the Cato Institute’s Dr. Michael Gough and I observed in a Wall Street Journal column, “We have not had a surgeon general for three years. Has anyone noticed? Is anyone’s health at risk?”
The
answer, of course, was that no one’s health was at risk and, in fact,
the U.S. public health had never been better. Life expectancy was at an
all-time high. Death rates from cancer, heart disease and AIDS were
falling. This trend continues today, no thanks to whatever it is that
the surgeon general does. And, by the way, what exactly has the current
surgeon general been doing?
Judging by 23 of the 32 press releases issued from his office during
2008, Acting Surgeon General Steven Galson has spent a great deal of
time traveling coast-to-coast promoting the “Healthy Youth for a
Healthy Future” project, which “focuses on recognizing and showcasing
those communities throughout the nation that are addressing childhood
overweight and obesity prevention by helping kids stay active,
encouraging healthy eating habits, and promoting healthy choices.”
So let’s look at a few examples of Surgeon General Galson in action:
In
Harrisonburg, Pa., Galson presented, “… the Healthy Youth for a Healthy
Future Champion Award to the Girls Golf Program, a partnership between
the Ladies Professional Golf Association, the United States Golf
Association, James Madison University, and Mulligan’s Golf Center." The
media release continued: “This program is helping local girls and women
stay physically active, gain self-confidence, and develop lasting
friendships, while fostering an enjoyment for the game of golf.”
At Disney World, Galson honored the Walt Disney Company for removing trans fats
from the foods on its menu and for making sure that the use of the
Disney name and its characters is limited to kid-focused products that
meet specific guidelines that limit calories, fat, saturated fat and
sugar.”
In New Mexico, Galson honored a
wellness center that “will help students stay fit and healthy using new
tools such as exer-gaming and interactive stationary bicycles.”
So
over the last 96 years, the Surgeon General has gone from working on
genuine public health problems (infectious disease, clean water and
sanitation) to advocating golf, Mickey Mouse-less food and beverage
containers and video exercise games as public health measures.
It
may very well be that Gupta’s celebrity — apparently his unique
qualification to hold office — makes him the ideal nominee to continue
the Office of Surgeon General’s downward trajectory into obscurity and
oblivion. On the other hand, if Gupta were really serious about
advising Americans on health matters, he would stay at CNN where he
could reach more people on any given day than he could by traveling the
country handing out dubious prizes that amount to little more than
corporate public relations.
Steven Milloy publishes JunkScience.com and manages the Free Enterprise Action Fund. He is a junk science expert, and an adjunct scholar at the Competitive Enterprise Institute.
Originially published here: http://www.foxnews.com/story/0,2933,477891,00.html