Blog | Wednesday, May 30, 2012

Health policy catfight


The New York Times featured a front page story about squabbles between the Obama Administration and the Food and Drug Administration (FDA).

It's a well-written piece which contains solid inside reporting. I also think the article is especially powerful because it takes the esoterica of a dispute between policy makers and politicians and brings it to life via brief personality sketches of the main players:

"There's Nancy-Ann Min DeParle, White House policy adviser and point person on the health reform law. She used to run the behemoth federal agency that is Medicare and Medicaid (now known as CMS). The writer describes her as " ... whip-smart and sometimes caustic ..., deeply loyal to the President."

Whip-smart. I like that.

Dr. Margaret Hamburg, who runs the FDA, is presented as "... polished, cerebral ... and a well-known public health advocate."

Dr. Hamburg, like FDA commissioners before her, wants her agency to be left alone from political calculus and meddling in what are considered to be purely scientific/public health decisions."

Battle lines drawn.

Supporting cast in this ongoing battle include Health and Human Services Secretary Kathleen Sebelius, with a cameo by Cass "Nudge" Sunstein, who directs the Office of Information and Regulatory Affairs.

An example of the questions wrestled with: "Should the FDA have the power to mandate movie theaters to list nutrition information about the popcorn they sell?"

On the one hand, information is power. If you at least know the caloric information of the junk you choose to eat, you might conceivably make a better choice.

On the other hand, no White House wants to come off looking as a buzz-killing, namby-pamby nutrition nag. People generally know that movie treats are junk; why take the paternalistic position and scare them out of enjoying it?

What do you think? Hands off the FDA, or should the President and his staff get final say on these issues, depending on how they play in Peoria?

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.