McCain vs. the Addicts

Creators.com, March 10th, 2008

WASHINGTON — The congressional Republican establishment's charade, pretending to crack down on spending earmarks while actually preserving their uncontrolled addiction to pork, faces embarrassment this week when the Democratic-designed budget is brought to the Senate floor. The party's presidential nominee-presumptive, Sen. John McCain, is an uncompromising pork buster with no use for the evasions by Republican addicts on Capitol Hill. Sen. Jim DeMint, a first-term reform Republican from South Carolina, will propose a no-loopholes one-year moratorium on earmarks as a budget amendment. McCain has announced his support for the DeMint amendment and will co-sponsor it. DeMint wants to coordinate McCain's visits from the campaign trail to the Senate floor so the candidate can be there to speak for and vote for the moratorium. The irony could hardly be greater. Senate Republican Leader Mitch McConnell, an ardent earmarker, is smart enough politically to realize how unpopular the practice is with the Republican base. Consequently, McConnell combines anti-earmark rhetoric with evasive tactics to save pork. But McCain, surely not the presidential candidate that McConnell wanted, is leading his party with a pledge to veto any bill containing earmarks. McConnell is running for re-election from Kentucky bragging about the pork he has brought the state. McConnell has appointed a "task force" of five Republican senators to study earmarks, headed by the universally respected Richard Lugar of Indiana. But Lugar never has shown much interest in the subject. The dominant member is Thad Cochran of Mississippi, ranking Republican on the Appropriations Committee and the Senate's reigning king of pork. Cochran, who not long ago called McCain unfit to be president, secured $774 million in earmarks this year. Add earmarks of three other task-force members — Lugar, Johnny Isakson of Georgia and Mike Crapo of Idaho — and the task force accounts for more than $1.1 billion in pork. The fifth task-force member is Tom Coburn of Oklahoma, DeMint's partner in pork-fighting and McCain's supporter for the presidential nomination. How could Cochran and Coburn agree on earmarks? The answer is that they cannot agree. "Everyone knows," a Senate reformer told me, "Cochran will never allow his right to earmark to be diminished." Since McConnell insists on "consensus" without a majority or minority report, all that will come out of the task force is a call for "transparency." Lawyer-like, Republican leaders are demanding the definition of an earmark. They could get a good idea by looking at just a sample of current earmarks secured by task force members. Cochran: $475,000 for beaver management in Mississippi. Lugar: $240,000 to rehabilitate the Alhambra Theater in Evansville, Ind. Isakson: $300,000 for Old Fort Jackson in Savannah, Ga. Crapo: $250,000 for the Idaho sage grouse. House Republican evasions are subtler. Rep. Jack Kingston of Georgia, a staunch defender of earmarking, has proposed a statutory "earmark reform commission," with a maximum six-month life, during which Republicans would refrain from earmarking. But that will allow them to be back at the pork barrel before the year ends. House Republican Leader John Boehner, who unlike McConnell does not earmark and criticizes the practice, flinched from making a bold move as this year's session of Congress began. He could have led the House Republican Conference to endorse a yearlong moratorium and name reformer Jeff Flake of Arizona to a vacancy on the Appropriations Committee. Instead, the Republicans picked Jo Bonner of Alabama, who spent 18 years as a House staffer before his election in 2002. Bonner has voted against Flake in 49 out of 50 attempts to kill earmarks. He has promised his Mobile-area constituents they would get "fair value" for their tax dollar — the justification for bringing home the bacon from Washington. Incredibly, Boehner hailed Bonner's selection as a step toward earmark reform. The GOP may be falling behind the Democrats, with House Speaker Nancy Pelosi moving toward a moratorium. In the Senate, courageous freshman Democrat Claire McCaskill of Missouri supports the DeMint amendment. She could be joined by her choice for president, Barack Obama. These developments encouraged Flake to say: "If Democrats actually move ahead with an earmark moratorium before Republicans, the Democrats will get the credit for eliminating earmarks, and, frankly, they'll deserve it." ------------------------------------------------------------------------------------------------------------------------

Bush says faith helped him beat drinking

AP News, January 30th, 2008

President Bush is talking more openly lately about his old drinking habit, and on Tuesday he offered perhaps his most pointed assessment yet by saying plainly that the term "addiction" had applied to him. "Addiction is hard to overcome. As you might remember, I drank too much at one time in my life," Bush said during a visit to the Jericho Program, a project of Episcopal Community Services of Maryland that helps former prisoners deal with problems such as drug addiction so they can find jobs and reintegrate productively into society. Bush spoke to reporters after meeting privately with two men who have graduated from Jericho's program and dealt with drug problems. During that session, which the White House allowed one reporter to attend, Bush spoke frankly about himself. "I understand addiction, and I understand how a changed heart can help you deal with addiction," he told the two men. "There's some kind of commonality." He asked Adolphus Mosely and Tom Boyd how they stopped using drugs — and then answered his own question. "First is to recognize that there is a higher power," Bush said. "It helped me in my life. It helped me quit drinking." "That's right, there is a higher power," Mosely said. "Step One, right?" Bush said, apparently referring to the Alcoholics Anonymous twelve-steps program. Actually, it is the second step. When the president spoke publicly, flanked by both men, it was plain that it was a powerful subject for him personally. Bush grew unusually somber and fixed an unbroken gaze on the cameras as he related the similarities between himself and the men in this sketchy East Baltimore neighborhood who are struggling to put their lives back together. "These are men who were, in some ways, lost, and lonely, and found love and redemption at Jericho," Bush said. "Proud to be with you." He hailed them for now being "reunited with their daughters." "Girls love their dad, especially a redeemed dad," said Bush, father of 26-year-old twins Jenna and Barbara. The 61-year-old president decided to quit drinking the day after a particularly boozy 40th-birthday celebration — July 6, 1986. He has often credited both his Christian faith and vigorous exercise with giving him the discipline he needed to execute that decision and to keep to it since, with nonalcoholic beers the only indulgence he says he allows. But when he was first running for president in 2000 and during his earlier years in office, Bush stuck to almost quaint code words when on the topic. He has never said publicly whether he was an alcoholic. As was typical, Bush said during a November 2000 news conference in which he admitted pleading guilty in 1976 to drunken driving that he merely "occasionally drank too much" as a younger man. He told an interviewer that same year that alcohol "was beginning to compete for my affections" before he quit. In September 2003, Bush was talking at a Houston community center on the same topic he was on Tuesday — the value of federal support for religious charities that address societal ills. "I know firsthand what it takes to quit drinking, and it takes something other than a textbook or a manual," he said. His checkered relationship with booze comes up frequently in his conversations, but often as a joke or an aside. Bush is known to have said that the subject is never too far from his mind. Last year, for instance, while traveling the country promoting ethanol created from biowaste as an alternative energy source, he'd often find himself in laboratories with beakers full of the alcohol-based substance. At a North Carolina plant, Bush held a container up to his nose for a mock sniff and then shook his head at the bemused reaction from his press corps. "I quit drinking in 1986," he said, laughing. Recently, though, his talk has grown more revealing. Whether it's because he has no more elections to worry about, or has become convinced of the positive impact he could have, or some other reason, they are likely to be welcome words for those facing similar problems, coming from the most powerful man in the world. In December, Bush cited his experience with alcohol as he encouraged young recovering addicts visiting the White House to stick with their fight. "Your president made the same kind of choice and I had to quit drinking, and addiction competes for your affection ... you fall in love with alcohol," Bush said during the meeting, according to a behind-the-scenes account from ABC News. His statements at Jericho seemed to go a little further. White House aides would not discuss the evolution. Nora Volkow, director of the National Institute on Drug Abuse, said research shows that frank talk about addiction from prominent people helps enormously. Any kind of substance abuse still is so stigmatized — even though it is largely the result of genetic and environmental factors that are outside a person's control — that 85 percent of addicts don't seek treatment, she said. An admission from someone like Bush shows the disease does not discriminate and can encourage more to get help. "Very few people have the courage to say, 'I am an addict, or 'I was an addict,'" she said. John Schwarzlose, head of the Betty Ford Center, a substance abuse treatment hospital in Rancho Mirage, Calif., said Bush's new openness might well be inspirational. But he said that is far overshadowed by his disappointment that Bush has missed opportunities as a leader and policymaker to aggressively tackle substance abuse in America. Schwarzlose said he found the same fault with Bill Clinton, who also said he was familiar with the pain of addiction because of the drug problems of his half brother, Roger. "I love that he (Bush) said that today," Schwarzlose said. "But where's the action? ... It's really too late." ------------------------------------------------------------------------------------------------------------------------

Addicted doctors are allowed to practice

AP News, December 19th, 2007

Troubling cases in which doctors were accused of botching operations while undergoing treatment for drugs or alcohol have led to criticism of rehab programs that allow thousands of U.S. physicians to keep their addictions hidden from their patients. Nearly all states have confidential rehab programs that let doctors continue practicing as long as they stick with the treatment regimen. Nationwide, as many as 8,000 doctors may be in such programs, by one estimate. These arrangements largely escaped public scrutiny until last summer, when California's medical board outraged physicians across the country by abolishing its 27-year-old program. A review concluded that the system failed to protect patients or help addicted doctors get better. Opponents of such programs say the medical establishment uses confidential treatment to protect dangerous physicians. "Patients have no way to protect themselves from these doctors," said Julie Fellmeth, who heads the University of San Diego's Center for Public Interest Law and led the opposition to California's so-called diversion program. Most addiction specialists favor allowing doctors to continue practicing while in confidential treatment, as does the American Medical Association. Supporters of such programs say that cases in which patients are harmed by doctors in treatment are extremely rare, and would pale next to the havoc that could result if physicians had no such option. "If you don't have confidential participation, you don't get people into the program," said Sandra Bressler, the California Medical Association's senior director for medical board affairs. California's program ends June 30. If no alternative program is adopted, the rules could revert back to the zero-tolerance policy in place before 1980, when doctors who were found by the medical board to have drug or alcohol problems were immediately stripped of their licenses. No other state has followed California's lead. But the president of California's medical board, Dr. Richard Fantozzi, said that behind the scenes, regulators nationwide share his ambivalence toward such programs. "To hide something from consumers, something so blatant ... it's unconscionable today," Fantozzi said. Between 10 percent and 15 percent of physicians nationwide will have a substance abuse problem at some point in their lives, a rate similar to that of the general population, according to widespread estimates. An estimated 7,500 to 8,000 practicing doctors are probably in confidential treatment, or about 1 percent of all physicians practicing in the U.S., said Dr. Greg Skipper, head of Alabama's program and a leader of an upcoming study on the issue. Opponents of such programs are unable to cite any documented cases in which doctors who were confidentially undergoing treatment botched operations while drunk or high. But they say the very secrecy of the programs makes it hard to assess the risks. Nevertheless, some doctors have been accused of harming patients while they were in treatment. In Montana, a patient accused a doctor enrolled in the state's treatment program of not following up on her abnormal test results, delaying her cancer diagnosis by more than a year. Montana revoked Dr. Robert Schure's license last year after he flunked out of treatment six times since 1994, according to board documents. The patient's suit was settled for an undisclosed sum. A North Carolina surgeon enrolled in the state's program for alcoholism charged patients for one type of gastric bypass and then performed a shortcut procedure that led to serious complications, including stomach ulcers and vomiting, according to patients and a medical board investigation. It wasn't until Dr. Steven Olchowski lost his license in 2005, years after many of the incidents occurred, that his participation in North Carolina's program became publicly known. Opponents of California's program have focused on the case of Dr. Brian West, a Long Beach plastic surgeon who has been accused of negligence by the state medical board and is fighting to keep his license. In 1999, West performed a double mastectomy and breast reconstruction surgery on Becky Anderson. The procedure left her with gaping, infected wounds that wouldn't close and, ultimately, a grotesque lump the size of a melon caused by organs spilling through an unhealed hole in her abdomen. Weeks before performing his final, futile procedure on her, West was arrested for a drunken-driving accident. After his conviction, West entered the diversion program for alcoholism. A year later he performed a tummy tuck on a 37-year-old woman that also healed poorly. West ultimately flunked out of the treatment program after investigators uncovered a pattern of relapses, binge drinking and doctored urine tests that "demonstrate that he is a physician who has been long and chronically impaired by alcohol," according to a 2005 medical board complaint. West's supporters say he has been made a scapegoat, asserting that he is not to blame for his patients' complications and that the severity of his drinking problem has been exaggerated by investigators. "I have no information from any of my investigations that Dr. West has ever cared for patients while under the influence of alcohol," said his attorney, Dominique Pollara. West admitted no fault in settling Anderson's malpractice lawsuit for $250,000, Pollara said. The tummy-tuck patient lost her malpractice case. Without the assurance of confidentiality, some say, addicted doctors will go underground and continue to practice without getting any treatment at all. Jim Conway, a Venice, Calif., drug and alcohol counselor, said that before confidential treatment programs, doctors would do whatever they could to hide their addiction for fear they would lose their licenses. At a Pomona hospital where Conway worked, an alcoholic obstetrician came to work and delivered a baby while "dead drunk," he said. In the process, the doctor severed the newborn's spine. "And that's how it will be if they just do a punitive approach," Conway said. Dr. Jason Giles, a Malibu physician, completed California's program in 2004 after five years in treatment for alcoholism and addiction to prescription drugs. "I was never intoxicated taking care of patients. It didn't get to that — but would have if I didn't avail myself of that rope dropped from the helicopter," he said. His experience in rehab was so transformative, he said, that he quit practicing anesthesiology and opened the drug treatment center he now runs. Giles said allowing physicians to continue to practice while in rehabilitation is crucial to the success of the treatment. "Working actually helps them get better," he said.