UPDATE: Oct. 6 Amended with a correction.

A new congressional proposal to funnel federal grant money from sex-education programs that instruct in pregnancy and STI-preventive measures into abstinence-only curriculum evokes memories of a similar federally-mandated initiative that emerged during the Bush administration.

The Bush-era Community Based Abstinence Education (CBAE) program received criticism for peddling medical inaccuracies (PDF) and faded upon the advent of the Obama administration. One beneficiary of grant funding was the Palmetto Family Council, whose abstinence-only education curriculum relied heavily on some of the same points criticized throughout the duration of the CBAE program.

In 2008, a government report (PDF) cited the ineffectiveness of CBAE abstinence-only sex-ed programs. At the end of 2009, the Obama administration reduced abstinence-only spending, boosted spending for prevention-oriented programs and totally wiped out the CBAE program, the most controversial of the bunch because funding largely went to anti-abortion-rights organizations and crisis pregnancy centers. Between 2005 and 2009, the federal government expended almost a half-billion dollars in non-matching CBAE grants, according to the federal 2010 budget (PDF).

South Carolina’s Focus on the Family affiliate the Palmetto Family Council (PFC) received $1.2 million in CBAE support in 2008-09 for their abstinence-education project, which went to great lengths in linking sex outside of marriage to depression, according to grant documents recently obtained by The American Independent through the Freedom of Information Act (FOIA).

‘Sex is fire’

Hitting all points of the Bush administration’s eight-point A-H definition of abstinence-only sex education, PFC’s BTrue Youth Leadership Project was designed to dissuade teenagers from having premarital sex by teaching sexual activity within the context of a monogamous marriage is the expected American standard and sex outside of marriage will likely lead to harmful psychological and physical effects.

PFC contracted Charleston, S.C.-based Heritage Community Services to develop the curriculum, which uses a risk-elimination rather than a risk-prevention model, employing the analogy that “sex is fire.” Essentially, the message is that sex, like fire, is safe within the right place but unsafe outside a protected place. In this analogy, the safe, protected place is marriage.

Illustrating this philosophy is a student video on the still-functioning BTrue social-media network (WhyBeTrue.com), in which a boy is shown armed with a helmet and layers of protective gear before he plunges into oncoming traffic; another scene shows the same boy wearing only regular clothes but walking on the shoulder of the highway, out of harm’s way.

To carry out the BTrue program, Palmetto solicited help from church organizations statewide for access to students and meeting spaces. Alex Morales signed a letter saying that his Lino, S.C.-based organization Same Page Ministries would provide access to between 50 and 100 students. Ultimately, Morales provided access to one student, his son, Danny, who serves as the face of the lecture series.

The first lesson of the curriculum begins with Danny explaining the project’s connection to religion:

The message of abstinence of sex until marriage is not a religious message per say. A decision to wait is a decision made every day, by teens of all faiths, and by those who profess no religious faith or belief in God at all. But BTrue is also consistent with the principles of the Christian faith and other religious beliefs. In the BTrue Tube videos, we do not reference the Bible or the teachings of Christ, but we believe that the BTrue cause is a Christian cause.

Organizations such as Washington, D.C.-based Advocates for Youth*, which works for adolescent reproductive and sexual health, and the Sexuality Information Education Council of the United States (SIECUS) have condemned the CBAE program and its biggest curriculum writer, Heritage Community Services, because they claim the program is ineffective at preventing teen pregnancy and STIs, and because it often wields a faith-based component. When asked for comment on Palmetto’s project, Advocates for Life’s Emily Bridges chose to comment on CBAE projects generally.

“We find a ‘one size fits all’ approach to morality to be really problematic,” Bridges said. “Waiting until marriage is a moral goal for many young people, but not ALL young people. Delaying sex until a time when the young person is prepared for safer sex and in a committed relationship is not only a goal that fits within many people’s ideology/moral beliefs, but is also a way the young person can protect themselves from pregnancy, HIV, and STIs. And to do that, they need education about all their options, not just one option.”

Sex outside of marriage = depression

The curriculum, along federal guidelines, focused on the harmful psychological effects of sexual activity outside of marriage.

In PFC’s grant application, curriculum plans were outlined to discuss the “sex related regret & emotional pain” and the “connection between teen sex and depression.” It was encouraged to discuss the importance of beginning the wedding day “regret-free.” The curriculum design also mentioned plans to address “risky behaviors that come with teen sexual activity: alcohol, drugs and violence” and that “marriage decreases such stresses.”

A December 2004 report (PDF) commissioned for Rep. Henry Waxman (D-Calif.) on the efficacy of sex-ed programs such as Palmetto’s outlines specific problems with CBAE, among them medical inaccuracy, such as baseless claims that sex outside of marriage leads to depression and/or mental illness.

Waxman’s report, which evaluated 13 sex-ed curricula, demonstrated that 11 of them included distorted information about the effectiveness of contraceptives and the risks of abortion. The report also found these curricula often blurred religion and science and stereotyped males and females.

In October 2006, the Government Accountability Office released a report (PDF) on the federal government’s efforts to assess the accuracy and effectiveness of federally-funded programs. The report found the U.S. Department of Health and Human Service’s Administration of Children and Families, which awards CBAE grants, did not review its grantees’ education materials for scientific accuracy. Following this revelation, grantees — including PFC — were forced to sign forms declaring their curricula were “medically accurate.”

In May 2008, both PFC President Oran P. Smith and Heritage Community Services CEO Anne Badgley signed a statement declaring: “I hereby attest and certify that all medical materials proposed in this application and funded during the project period of this grant are medically accurate.”

Stan Weed, director of the Institute for Research & Evaluation (IRE), was identified in grant documents as the “3rd party independent evaluator” tasked to review PFC’s project and curriculum. As TAI reported previously, IRE had a relationship with Heritage; specifically Weed developed the “predictors of adolescent sexual initiation,” which is taught to Heritage educators during their training. In the end Weed did not work on the project; Paul Birch, now a senior research associate at Evans Evaluation, whose name is not mentioned in the grant application, was the evaluator.

Abstinence and marriage

Abstinence and marriage are promoted at seemingly equal rates throughout Palmetto’s curriculum. At the end of the second lesson, there are three videos where participating adult staffers discuss what abstinence means to them. One woman, talking about how she rediscovered abstinence after she first started having sex, emphasized how much fun marriage is.

In another the video, a student says marriage between a man and woman is beautiful, which is in direct compliance with CBAE requirements that mandate a one-man, one-woman definition of marriage.

The only way to prevent STIs and unwanted pregnancy, Palmetto’s programs materials suggested, is through marriage. But as Bridges pointed out, that does not leave a lot of room for people who do not necessarily intend to get married, or for gay men and lesbians, for whom marriage in many states is illegal.

“Any program that asks young people to wait until marriage to have sex is inappropriate for gay and lesbian young people, who can’t get married in most states and at the federal level,” Bridges said in an email. “They are being at best ignored and made to feel invisible. They’re being given a choice to either stop being gay; never have sex in their life; or become shameful, emotionally harmed, etc. … They need sex education that helps them protect themselves, not lectures about abstinence until a marriage they can’t legally enter into.”

An excerpt from PFC’s grant proposal, describing how it will promote “healthy marriage,” reads:

A-H legislation is about healthy marriages. PYN [Palmetto Youth Network] will equip youth and adults with skills/knowledge to [1] abstain from sex until marriage, [2] develop healthy relationships and marriages and [3] remain faithful when married. Since 1994, Palmetto Family Council has worked to strengthen SC’s families. Its mission is to promote a positive marriage/family culture by utilizing media and existing community, business and faith networks to promote an understanding of marriage’s central role to the fabric of society and to provide the skills/knowledge needed to form and sustain healthy marriages. … [Heritage Keepers Abstinence Education] teaches students the differences between lust, infatuation and love and the differences in cohabitation and marriage. Why Marriage Matters: 26 Conclusions from the Social Sciences is basic to all curricula.

The “Why Marriage Matters” report (PDF) Palmetto referred to as being “basic to all curricula” in the project was produced by the Institute for American Values, and infused with research and editorial assistance by Maggie Gallagher, who recently stepped down as president of the nation’s leading group working against marriage for gay men and lesbians, the National Organization for Marriage. In 2007, PFC was involved in a campaign to amend South Carolina’s constitution to ban same-sex marriage. The amendment passed in 2007; it was listed as Palmetto Family’s “top priority” the year before.

*Correction: TAI previously mis-identified the organization Advocates for Youth as Advocates for Life. We regret the error.

At the center of the controversy is the recent revelation that the Iowa Family Policy Center (IFPC) might have used taxpayer dollars to wage a campaign against same-sex marriage in the state.

Shorty after The American Independent’s sister site The Iowa Independent began reporting on IFPC’s Marriage Matters program, IFPC announced they had agreed in September 2009 to stop accepting money from the U.S. Department of Health & Human Services (HHS) for the counseling operation. Marriage Matters was funded by federal government dollars while the organization carried out a campaign to oust three state Supreme Court judges whose 2009 ruling legalized same-sex marriage in Iowa.

But IFPC did not officially relinquish the grant funding until nearly a year later, The Iowa Independent reported.

In a letter dated Aug. 3, 2010, HHS’s Administration for Children and Families (ACF) asked IFPC President Chuck Hurley to submit a formal relinquishment letter explaining the group’s reasoning for rejecting the funds. That was the first step in the process. The next step in the process, as ACF Grants Management Specialist Abangolee J. Caulcrick explained in that initial letter, would be for IFPC to submit a final financial status report and a final progress report.

As to the reason for rejecting additional government money, on Aug. 10, 2010, Hurley wrote:

“While the process has been invigorating, we believe the federal constraints are impeding our progress to help a broader range of couples. We believe organizationally we are in a position to become privately funded.”

After filing a records request with ACF, The American Independent discovered that IFPC never filed the required documentation. On Dec. 30, 2010, Caulcrick sent Hurley a letter stating:

“I am contacting you for the last time to submit your final financial status report and program progress report along with your property inventory and disposition statement. If I do not receive these reports on or before January 7, 2011, I will be left with no alternative but to administratively closeout your grant.”

However, according to the ACF FOIA office, IFPC’s grant file is still open, because that documentation was never received.

The ACF communications department was not forthcoming with further information about the closeout process and would not answer questions as to whether IFPC violated federal policy by not submitting the requested reports.

Even less forthcoming was The Family Leader, who declined to explain why it has not submitted financial documents for the final year that it received funding.

“We have made a decision as an organization not to grant any more interviews on that subject,” Family Leader spokesperson Julie Summa told The American Independent (TAI), referring to the Healthy Marriage grant. “The public records are [available].”

Unanswered questions

While neither ACF nor The Family Leader will answer questions about process, larger ethical questions remain concerning the funding of the grant itself.

In her explanation as to why IFPC will not comment on the Healthy Marriage grant, Summa referenced the Associated Press article that sparked outrage among LGBT-rights groups in Iowa because it showed a funding overlap for the taxpayer-funded program and the political anti-same-sex-marriage campaign. Adding to the ire was the revelation gay and lesbian couples were shut out of the marriage-counseling program. Early this month, LGBT-advocacy group One Iowa launched a petition asking The Family Leader to return the $2.2 million dollars it received in grant funding back to America’s taxpayers.

In a phone interview, University of Iowa Professor Brad Richardson, who was paid to evaluate IFPC’s grant, told TAI he had never heard of an organization turning down a full year’s worth of federal funding for a successful program.

“I’ve never seen anybody turn back money, so they must have had a good reason,” Richardson said.

As a third-party evaluator, Richardson — who also evaluated IFPC’s federally-funded Compassion Capital Fund demonstration grant projects in 2004 and 2005 – reviewed the organization’s proposal and achievements. Richardson’s semiannual evaluation report from October 2010, obtained by TAI, reflects progress: IFPC met each of its goals by about 25 percent, and data from the Iowa health department shows that as of 2005, the state’s divorce rate has been on a steady decline.

What concerned Richardson in the initial proposal, however, was the fact that gay and lesbian couples were explicitly written out of the project.

“Early on in the project, as I was looking at the materials, [I noticed] the materials were implying couples [they would] be serving were male and female,” Richardson said. “I mentioned, ‘What about if they are not male and female?’ They told me that it wasn’t a target population they were focusing on.”

“I don’t know what would happen today,” Richardson continued, referring to fact that in 2009, same-sex marriage was legalized. “Because you’d be excluding people that were legally married. It would be a bigger issue today.”

The question of funding overlap comes from the fact that, according to the AP, IFPC spent $192,000 of the $550,000 it received in 2009 on salaries and employee benefits for five employees, including Hurley. The AP revealed that in April, when the news organization asked Marriage Matters operations manager Chris Nitzschke which IFPC employees were paid through the grant, Nitzschke only mentioned IFPC Vice President Mike Hartwig was paid; he did not mention more than half of his own salary came from the grant.

Additionally, the Healthy Marriage grant money was spent on telephone, Internet and rent for the same building out of which IFPC was operating its campaign to overturn the gay-marriage Supreme Court ruling.

Political connections

One of the paid employees, Matt Reisetter — who was running the Northeast Iowa Marriage Alliance (NIMA) for the Marriage Matters program and is now the Family Leader’s director of development — was running for state political office and working for a presidential candidate at the same time.

In 2006, Reisetter, a Republican, ran a failed bid for Iowa House District 19 seat against the Democratic incumbent Bob Kressig. And in late 2007, he was hired by then-GOP presidential candidate and former Arkansas Gov. Mike Huckabee. Reiseitter’s job as director of coalitions was essentially to help pastors figure out how much political activity they could engage in without violating the law.

Huckabee was publicly endorsed by IFPC President Chuck Hurley.

In IFPC’s grant project abstract, obtained by TAI, IFPC proposed to pay Reisetter for 1,140 hours of work at a rate of $22 an hour, or $25,080. As part of the proposal, $19,100 of Reisetter’s salary would be paid by federal money; the rest would be matched by NIMA funds.

As part of the Healthy Marriage grant conditions, IFPC was required to sign a form “Assurances – Non-Construction Programs” (PDF) drafted by the Office of Management and Budget, which stipulates grant recipients “will comply, as applicable, with provisions of the federal Hatch Act (5 U.S.C. § 1501 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds.”

Richardson told TAI it was not his job to evaluate whether or not there was any improper usage of the federal grant money received by IFPC. He said that would likely be the job of the operations manager, who is not talking.

Randall Wilson, legal director for the American Civil Liberties Union (ACLU) of Iowa, which is investigating how the IFPC spent the Healthy Marriage federal funds, told TAI the ACLU is trying to determine whether taxpayer funding for this project was diverted as a subsidy for political activity.

“One does not want federal money to be funding religious organizations to be engaging in political activity,” Wilson said.

The investigation, however, is stalled because the ACF has not fulfilled the ACLU’s FOIA request filed months ago.

Senate Majority Leader Harry Reid, Speaker of the House Nancy Pelosi (WDCpix)

The Democrats downplaying the gravity of new recommendations for breast cancer screening have left out an inconvenient fact: their health care bills would automatically adopt them.

Both the House and Senate health reform proposals would force insurance plans to follow the new mammogram guidelines for women ages 50 to 74 as part of a minimum swath of services deemed by the legislation to be medically essential. The recommendations were an unexpected wildcard in the middle of an already contentious health reform debate, and they’ve caused Democrats to de-emphasize their significance at the same time that some in the party are calling for a legislative fix to nullify them.

[Congress1]The animated reaction to the recommendations follows several weeks in which women’s reproductive health had been at the forefront of the health reform debate, after the House passed a provision limiting coverage of abortion under private plans. The saga has been a distraction to Democrats as they aim to enact the most sweeping health care reform in generations, and it’s complicated their defense against GOP-fueled charges that their proposals would lead to a rationing of care. House leaders have already passed their version of the bill, but the debate in the Senate is just beginning, with upper-chamber leaders scheduled to vote Saturday on a procedural measure to bring their bill to the floor.

The mammogram episode has also revealed the influence of a previously obscure preventive-medicine panel, raised questions about the effectiveness of the Democrats’ reform proposals to weed out unnecessary medical procedures, and highlighted the potential complications when the entrenched habits of patients and providers are called into question by medical science.

“These new recommendations,” breast cancer specialist David Gorski wrote this week, “are a classic example of what happens when the shades of gray that characterize the messy, difficult world of clinical research meet public health policy, where simple messages are needed in order to motivate public acceptance of a screening test.”

The controversy ignited on Monday, when the U.S. Preventive Services Task Force, a federally appointed panel of independent medical experts, released guidelines suggesting that women should not seek routine mammograms before the age of 50 — 10 years later than current protocols dictate. The task force also concluded that annual mammograms are unnecessary for any age group, suggesting biennial screenings instead.

Critics in Congress and the medical community were quick to pounce, arguing that the recommendations would jeopardize the lives of women, particularly those aged 40 to 49. Democrats moved swiftly to divorce their health reform proposals from the new guidelines, maintaining that they merely represent a non-binding data-bank for lawmakers to consider as they craft coverage policies, both public and private.

“I don’t think there’s any general acceptance of what was proposed,” House Speaker Nancy Pelosi (D-Calif.) told NPR Thursday.

“These individuals do not determine federal policy,” Rep. Rosa DeLauro (D-Conn.) added in a statement. “They have simply made recommendations.”

Yet the health reform language moving through Congress tells a different tale. Both the House and Senate bills create an “essential benefits package” which all insurance plans would have to offer. Neither chamber’s proposal specifies what those services would be, instead, empowering the Department of Health and Human Services to make those decisions at a later date. But the bills do outline broad categories of minimum services, including a mandate to cover those recommendations of the task force rated “A” or “B.” The new biennial-screening guidelines for 50- to 74-year olds are rated “B.”**

The 16 members currently on the panel were all appointed by the Bush administration. None specializes in oncology.

A number of Democrats have blasted the findings. Rep. Debbie Wasserman Schultz (D-Fla.), a breast cancer survivor, said the guidelines are “causing mass confusion” among women accustomed to screening more frequently and earlier in life. Rep. Frank Pallone (D-N.J.), chairman of the Energy and Commerce health subcommittee, has already indicated that he’ll hold a hearing early next month to examine the recommendations. And Rep. Jerrold Nadler (D-N.Y.) is pushing legislation to require insurance companies that cover diagnostic mammograms also to cover routine, annual mammograms to women beginning at age 40.

“Cancers can progress very far in two years,” Nadler said Friday, criticizing the panel’s recommendation for biennial screenings.

The White House has also been wary, quickly indicating that the new recommendations would have no bearing on public policy. In a statement issued Wednesday, HHS Secretary Kathleen Sebelius played down the task force as “an outside independent panel of doctors and scientists who make recommendations.”

“They do not set federal policy,” she added, “and they don’t determine what services are covered by the federal government.”

Yet they certainly can have influence. Indeed, in May, when HHS announced the controversial decision not to pay for virtual colonoscopies under Medicare, the agency leaned heavily on the judgments of the Preventive Services Task Force, which had concluded earlier that the radiation risks outweighed the benefits of the less intrusive cancer-detection procedure.

The HHS declined to comment this week on why the agency was so quick to dismiss the panel’s new mammogram recommendations.

By issuing their report in the middle of a contentious debate over health care reform, the task force didn’t do the Democrats any favors. Republicans are already blasting the reform bills for their funding of comparative effectiveness research, which compares different treatments of the same ailment to discover which work best. The critics fear that the effectiveness data could tempt insurers — both public and private — to deny coverage of certain drugs, devices and other treatments. In the eyes of the GOP, the new mammogram recommendations are just another threat to patients’ access to care.

“This is how rationing starts,” Sen. Jon Kyl (R-Ariz.) said Friday. “Delay of care … then denial of care. At first, it’s guidelines, then the insurance companies … adopt those guidelines with respect to coverage decisions.”

Private insurers, for their part, say they often use the task force recommendations to make coverage determinations. But they deny that the mammogram findings will have any effects — at least not immediately. “Whatever we do today, we’ll continue to do — as far as we can tell,” said Gloria Barone, spokeswoman for Cigna.

Susan Pisano, spokeswoman for America’s Health Insurance Plans, the industry lobby group, pointed out that the task force recommendation against routine screenings for 40-somethings is hardly an outright moratorium, instead leaving the decision to women and their doctors. “I don’t see this as limiting coverage,” Pisano said.

Under Medicaid, states have leeway to set their own coverage rules. Ann Kohler, director of the National Association of State Medicaid Directors, said state officials use the task force guidelines “often.” “However in this case,” she added, “I think they will not change their historical policy.”

Julius Hobson, former lobbyist for the American Medical Association and now a senior policy analyst at the Washington law firm Bryan Cave, suggested that the members of the task force had crunched their numbers without consideration of the broader effects of their recommendations. “They missed the psychological and social impact of what they were saying,” Hobson said.

Their timing, he added, was also a bit suspect. “You’d have to be deaf, dumb, blind and crazy not to know that Congress has spent the whole year working on health reform.”

**Clarification: An early version of this story implied that the recommendations for 40- to 49-year olds would also be adopted by the Democrats bill. That would not be the case. That recommendation is rated “C.”

Benjamin was unanimously approved by the Health, Education, Labor and Pensions Committee on Oct. 7, but Senate Republicans are holding up all [Department of Health and Human Services] nominees over a so-called gag order on insurance companies that have been critical of Democratic efforts to reform health care.

“We’ve not received any recent calls from the administration about their nominee,” a senior Republican aide said. “There won’t be any time agreements for confirmation of HHS nominees until their actions have been fully reviewed.”

At issue is an investigation of insurance companies by the Centers for Medicare and Medicaid Services, a division of the HHS, which announced the probe last month after a letter surfaced from Humana to seniors critical of the Senate Finance Committee’s health care bill.

CMS officials charged that the letter contained misleading information, a claim Republicans have disputed.

That’s it. Because of that, HHS is working without a surgeon general during the H1N1 outbreak. Local newspapers in the deep South have noticed, and called for Benjamin to get an up-or-down vote, but this issue really hasn’t gotten anywhere in the beltway.

While Benjamin has waited in limbo, Democrats — who ostensibly run the Senate — have held two hearings on whether the president is appointing too many czars.

In a letter to the White House, Republican leaders have threatened to block confirmation of 10 White House nominees to various posts in the Health and Human Services Department unless the “gag-order” is rescinded. Senate Minority Leader Mitch McConnell (R-Ky.) reiterated that threat today on Fox News.

“None of those people will get through the Senate easily until they lift the gag order,” McConnell said.

None of these people make it through the Senate without extensive debate until they lift the gag order and allow the First Amendment to function for everyone in this country, including people who just happen to be doing business with the federal government.

The ruckus began last week when the federal Medicare agency announced an investigation into Humana for letters the insurance giant had mailed to seniors warning that the Democrats’ health reform plans were threatening their private insurance coverage, called Medicare Advantage. The letters urged the seniors to contact their lawmakers opposing the legislation.

The Centers for Medicare and Medicaid Services claim those letters represent a breach of contract, because CMS requires MA sponsors to screen such mailings through the agency. CMS has barred all MA sponsors from sending similar messages to their customers. Republicans, though, say the First Amendment trumps the CMS guidelines.

This might have been just a minor footnote in the debate over health reform. But the GOP holds on the HHS nominees mean it could grow into something much bigger.

Yesterday, President Obama stood before the nation’s largest doctors’ group and made his strongest case yet for the creation of a government-backed insurance plan to compete with private companies. Such an option is necessary, Obama told members of the American Medical Association, “[to] force waste out of the system and keep the insurance companies honest.”

Today, Kathleen Sebelius, head of the Department of Health and Human Services, tempered the president’s remarks, telling The Associated Press that passing a health reform bill is more important than including a public plan.

“It’s way too early to say ‘This is absolutely in, this is absolutely out,’” she said when asked about [the public option]. “I mean, what he’s trying to do is get a bill passed.”

At what point does political savvy become waffling?

Sebelius, who will step down from her current job as the governor of Kansas, had come under fire from the right because of her support for abortion rights. On Twitter, Sen. John McCain (R-Ariz.) announced he had another reason for opposing her nomination:

SenJohnMcCainvoted against Sebelius – already moving towards socialized auto companies, we don’t need socialized medicine!

“Some people think that declaring a state of emergency about the flu was a political thing to push the Sebelius nomination through,” said Wright. She pointed to news stories that ask whether the slow-walking of the Sebelius choice will hurt the response to the flu. “If there’s even a hint that [Department of Homeland Security] is manipulating the health situation to push a political appointee through, well, it almost defies imagination that they’d be willing to that.”

Wright said that she’d heard the speculation “on talk radio,” and wanted to be skeptical, but “there’s too much of a basis in that argument to easily dismiss it.”

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From the statement from Collins office, via Politico’s Glenn Thrush:

As Ranking Member of the Senate Homeland Security Committee, Senator Collins has led hearings on pandemic flu preparedness, worked on “bioshield” legislation and funding, and helped strengthen our nation’s preparedness for a pandemic flu.

Claims that she is opposed to increased funding for pandemic flu research are blatantly false and politically motivated. In fact, in December 2008, Senator Collins joined in a letter to Senate leaders requesting a $905 million increase for the Public Health and Social Services Emergency Fund at the Department of Health and Human Services.

There is no evidence that federal efforts to address the swine flu outbreak have been hampered by a lack of funds. Senator Collins does, however, believe that it is a problem that the Centers for Disease Control and the Department of Health and Human Services still do not have top positions filled. She hopes the Senate will move promptly to confirm Governor Sebelius for HHS Secretary.

Two bills introduced in Congress recently stake out rival positions on a key issue related to health care reform. Which approach ultimately prevails will help determine whether the pharmaceutical industry maintains the support that Pfizer CEO Jeffrey Kindler voiced Wednesday for President Obama’s plan’s to overhaul the nation’s health care system.

Reps. Anna Eshoo (D-Calif.), Jay Inslee (D-Wash.) and Joe Barton (R-Texas) introduced a bill Tuesday that would give manufacturers of new drugs up to 14 years of market exclusivity before generic versions could come onto the market. Earlier this month, Rep. Henry Waxman (D-Calif.) introduced legislation providing five years market exclusivity. Big Pharma hailed the Eshoo bill while the Obama administration has indicated it prefers the Waxman approach.

Can the drug companies live with shorter exclusivity, which cuts into the big profits margins of popular drugs?

Maybe, says Kindler, who heads the world’s largest pharmaceutical manufacturer. He told CNN, “My guess is that, assuming there is comprehensive health care reform and it’s passed, there will be elements of any bill that any number of participants won’t like, because everybody will undoubtedly have to make compromises and contributions. And I’m sure we will be no exception, nor should we be, by the way.”

In an op-ed that appeared today in The Washington Post, former House Speaker Tom Daschle (D-S.D.) — who withdrew his nomination to be President Obama’s secretary of health and human services earlier this month amid a tax scandal –  said the prospect for comprehensive health care reform has never been better, in part, because “reformers have some new and unlikely allies,” including the insurance and pharmaceutical industries.

Since his bid to become HHS secretary failed, Daschle has become more of a cheerleader, not a czar. But that doesn’t mean he’s wrong.

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