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President Ronald Reagan signs Executive Order 12656, assigning a wide range of emergency responsibilities to a number of executive departments. The order calls for establishing emergency procedures that go far beyond the nation’s standard disaster relief plans. It offers a rare glimpse of the government’s plans for maintaining “continuity of government” in times of extreme national emergency. The order declares the national security of the country to be “dependent upon our ability to assure continuity of government, at every level, in any national security emergency situation,” which is defined as “any occurrence, including natural disaster, military attack, technological emergency, or other emergency, that seriously degrades or seriously threatens the national security of the United States.” The order instructs department leaders to establish various protocols for crisis situations, including rules for delegating authorities to emergency officials, establishing emergency operating facilities, protecting and allocating the nation’s essential resources, and managing terrorist attacks and civil disturbances. The plans are to be coordinated and managed by the National Security Council and the Federal Emergency Management Agency (FEMA). The presidential order suggests certain laws may have to be altered or expanded to carry out the plans. Although it encourages federal agencies to base the emergency protocols on “existing authorities, organizations, resources, and systems,” it also calls on government leaders to identify “areas where additional legal authorities may be needed to assist management and, consistent with applicable executive orders, take appropriate measures toward acquiring those authorities.” According to the executive order, the plans “will be designed and developed to provide maximum flexibility to the president.” Executive Order 12656 gives specific instructions to numerous federal departments:
The Department of Justice is ordered to coordinate emergency “domestic law enforcement activities” and plan for situations “beyond the capabilities of state and local agencies.” The Justice Department is to establish plans for responding to “civil disturbances” and “terrorism incidents” within the US that “may result in a national security emergency or that occur during such an emergency.” The attorney general is to establish emergency “plans and procedures for the custody and protection of prisoners and the use of Federal penal and correctional institutions and resources.” The Department of Justice is also instructed to develop “national security emergency plans for regulation of immigration, regulation of nationals of enemy countries, and plans to implement laws for the control of persons entering or leaving the United States.” The attorney general is additionally instructed to assist the “heads of federal departments and agencies, state and local governments, and the private sector in the development of plans to physically protect essential resources and facilities.”
The Department of Defense, acting through the Army, is to develop “overall plans for the management, control, and allocation of all usable waters from all sources within the jurisdiction of the United States.” The secretary of defense is to arrange, “through agreements with the heads of other federal departments and agencies, for the transfer of certain federal resources to the jurisdiction and/or operational control of the Department of Defense in national security emergencies.” The secretary of defense is also instructed to work with industry, government, and the private sector, to ensure “reliable capabilities for the rapid increase of defense production.”
The Department of Commerce is ordered to develop “control systems for priorities, allocation, production, and distribution of materials and other resources that will be available to support both national defense and essential civilian programs.” The secretary of commerce is instructed to cooperate with the secretary of defense to “perform industry analyses to assess capabilities of the commercial industrial base to support the national defense, and develop policy alternatives to improve the international competitiveness of specific domestic industries and their abilities to meet defense program needs.” The Commerce Department is also instructed to develop plans to “regulate and control exports and imports in national security emergencies.”
The Department of Agriculture is ordered to create plans to “provide for the continuation of agricultural production, food processing, storage, and distribution through the wholesale level in national security emergencies, and to provide for the domestic distribution of seed, feed, fertilizer, and farm equipment to agricultural producers.” The secretary of agriculture is also instructed to “assist the secretary of defense in formulating and carrying out plans for stockpiling strategic and critical agricultural materials.”
The Department of Labor is ordered to develop plans to “ensure effective use of civilian workforce resources during national security emergencies.” The Labor Department is to support “planning by the secretary of defense and the private sector for the provision of human resources to critical defense industries.” The Selective Service System is ordered to develop plans to “provide by induction, as authorized by law, personnel that would be required by the armed forces during national security emergencies.” The agency is also vaguely instructed to establish plans for “implementing an alternative service program.”
The Transportation Department is to create emergency plans to manage and control “civil transportation resources and systems, including privately owned automobiles, urban mass transit, intermodal transportation systems, the National Railroad Passenger Corporation, and the St. Lawrence Seaway Development Corporation.” The Transportation Department is also to establish plans for a “smooth transition” of the Coast Guard to the Navy during a national security emergency. The Transportation Department is additionally instructed to establish plans for “emergency management and control of the National Airspace System, including provision of war risk insurance and for transfer of the Federal Aviation Administration, in the event of war, to the Department of Defense.”
The Department of the Treasury is ordered to develop plans to “maintain stable economic conditions and a market economy during national security emergencies.” The Treasury Department is to provide for the “preservation of, and facilitate emergency operations of, public and private financial institution systems, and provide for their restoration during or after national security emergencies.”
The Department of Energy is to identify “energy facilities essential to the mobilization, deployment, and sustainment of resources to support the national security and national welfare, and develop energy supply and demand strategies to ensure continued provision of minimum essential services in national security emergencies.”
The Department of Health and Human Services is instructed to develop programs to “reduce or eliminate adverse health and mental health effects produced by hazardous agents (biological, chemical, or radiological), and, in coordination with appropriate federal agencies, develop programs to minimize property and environmental damage associated with national security emergencies.” The health secretary is also to assist state and local governments in the “provision of emergency human services, including lodging, feeding, clothing, registration and inquiry, social services, family reunification, and mortuary services and interment.” (US President 11/18/1988)
Elizabeth “Betsy” McCaughey (R-NY), a lawyer and future lieutenant governor of New York, writes a scathing analysis of the Clinton administration’s health care reform plan. The article, “No Exit,” is published in the New Republic, and sparks not only a detailed rebuttal from the Clinton administration, but numerous editorials and responses praising the article and joining in the attack. Echoing McCaughey’s arguments, Newsweek writes, “The plan would reduce the quantity and quality of health care and medical technologies by vastly expanding government’s coercive role.” McCaughey and Newsweek question the proposed creation of a seven-member “National Health Board” which will, she claims, “guess the nation’s health care needs and decree how much the nation may spend meeting them.” According to Newsweek: “Everyone would be locked into one system of low-budget health plans picked by the government. Fifteen presidential appointees, the National Quality Management Council, not you and your doctor, would define the ‘medically necessary’ and ‘appropriate’ care a doctor could give you. Escaping government control to choose your doctor or buy other care would be virtually impossible. Doctors could be paid only by the government-approved plans, at rates set by the government. It would be illegal for doctors to accept money directly from patients, and there would be 15-year jail terms for people driven to bribery for care they feel they need but the government does not deem ‘necessary.’ Government would define a minimum level of care and herd people in particular regions into dependence on the lowest-cost organization able to deliver that level. Doctors would be driven into organizations in which they would be punished financially for giving more treatment than the organizations’ budget targets permit. The primary care physician assigned to you would be, McCaughey notes, a gatekeeper with an incentive to limit your access to specialists and high-tech medicine. The premise of the Clintons’ plan is not just that government knows best, but that government knows everything relevant, including how many specialists there should be no more than 45 percent of all doctors [sic]. McCaughey says many medical students will be told that the specialties they prefer are closed, or closed to them because they are not the right race or ethnicity. Yes, the plan subordinates medical values to ‘diversity.’” Prescription drug prices would be controlled through the Department of Health and Human Services, and, McCaughey and Newsweek claim, would “certainly suppress research” that might benefit patients of incurable diseases and disorders. (Newsweek 2/7/1994)
Refuting McCaughey - The Clinton administration details the “numerous factual inaccuracies and misleading statements” contained in McCaughey’s article. The administration’s response says that doctors and patients, not “government bureaucrats” or a board of governors, will decide what treatments are “necessary and appropriate.” The government will not decide what treatments are, and are not, provided: “If anything, the ‘necessary and appropriate’ care provision in the bill delegates authority to the medical profession—rather than imposing further government bureaucracy between the patient and the doctor.” The plan will not block Americans from opting into private health care plans just as they do now, nor will it block doctors and hospitals from accepting payments from “non-approved” health care plans. Nor does the plan require doctors and hospitals “to report your visit to a national data bank containing the medical histories of all Americans,” as McCaughey writes. And the so-called “National Health Board” will not “decide how much the nation can spend on health care beginning in 1996,” as McCaughey claims. The plan will not seek to reduce quality of care in the interest of saving money, and it does not contain price controls. (White House 1/31/1994) A year later, author and columnist James Fallows will call the article “a triumph of misinformation,” and refutes McCaughey’s (and others’) claims point by point. (Fallows 1/1995)
Instrumental in Derailing Reform - The article will later be cited by House Speaker Newt Gingrich (R-GA) as “the first decisive breaking point” in the plan’s initial support; the plan will never be implemented. The article itself will spark tremendous controversy, winning the National Magazine Award while being attacked for being fundamentally inaccurate. (In 2006, the new editor of the New Republic, Franklin Foer, will apologize for his magazine having run the article.) In 2009 McCaughey will be a fellow at the conservative Manhattan Institute and will soon join the equally conservative Hudson Institute. Both are heavily funded by health care corporations. (Sarlin 5/15/2009)
New York City’s Office of Emergency Management (OEM) conducts a training exercise called Operation ICE, which is designed to prepare emergency response workers for the possibility of a terrorist attack and includes a simulated chemical attack near the World Trade Center. (City of New York 11/9/1997; Roane 11/9/1997; 9/11 Commission 5/19/2004) Operation ICE is the largest terrorism response exercise ever conducted by the city. Its aim, according to Mayor Rudy Giuliani, is “to see what would happen if in fact there was a chemical attack and to see how police, fire, EMS [emergency medical services], hospitals, the FBI… would all respond.” (Fan and Gershman 11/10/1997; Kennedy 11/10/1997)
Volunteers Go to Hospitals with the Symptoms of Chemical Exposure - Operation ICE incorporates a series of field and tabletop exercises. It consists of three interconnected training events, called MEDEX, FIELDEX, and INFRAEX. MEDEX, apparently the first event to take place, is held on November 8. Forty-one city hospitals are involved in it. The aim is for the emergency workers who participate to learn how to deal with and treat “walk-in, self-referred” patients who arrive at emergency rooms minutes or hours after they have been exposed to a chemical agent. Volunteers, playing the victims, visit the hospitals, complaining about various symptoms. Hospital personnel have to determine the type of chemical exposure that matches the symptoms and decide how to treat the victims. (Roane 11/9/1997; Dittmara 3/1998)
Field Exercise Is Held near the WTC - FIELDEX, which is the centerpiece of Operation ICE, takes place a day later, on November 9. This is an elaborate field training exercise involving a simulated chemical attack at a large public gathering. It is directed by Jerome Hauer, head of the OEM, and more than 600 emergency response workers take part. They belong to agencies including the New York Police Department, the New York Fire Department, the FBI, the Office of the Chief Medical Examiner, and the Departments of Defense, Environmental Protection, Health, and Transportation. (City of New York 11/9/1997; Kennedy 11/10/1997) The exercise is held less than a mile away from the WTC, on Greenwich Street, between Hubert and North Moore Streets. (Fan and Gershman 11/10/1997) It takes place “eerily in the shadow of the Twin Towers,” Giuliani will later comment. (Giuliani 2002, pp. 63)
Islamic Terrorists Release a Lethal Gas in the Simulation - The scenario for the exercise involves a rally held by a controversial political group. This is “a greed-is-good kind of group,” Giuliani will say. A speaker at the rally explains the group’s philosophy, which gets his listeners angry, and two or three of them consequently attack the group. They release VX, a deadly nerve gas, killing 21 people and injuring at least 27. The mock attackers are Islamic terrorists, according to Giuliani. Red Cross volunteers and police cadets pretend to be victims of the attack, while several mannequins represent people who have been killed. FIELDEX lasts for four hours. (Fan and Gershman 11/10/1997; Kennedy 11/10/1997; 9/11 Commission 5/19/2004)
Real Bomb Goes Off before the Exercise Starts - Participating emergency response workers are unaware of the details of the scenario before the exercise begins. “[W]e know to be prepared, that it is going to happen, but haven’t been given any particulars,” one law enforcement official comments. (Roane 11/9/1997) Local residents reportedly approve of the exercise, despite the disruption it causes. One woman remarks that she feels it “needs to be done” because, she says, “Living downtown, we are a direct target for this kind of threat, with the World Trade Center and everything.” (Fan and Gershman 11/10/1997) Ironically, two hours before the exercise commences, a real but crude bomb explodes in front of an office building a few blocks away from where the exercise is held. No advance warning is given but, fortunately, no one is injured. No one will take responsibility for the bombing. (Kennedy 11/10/1997)
Exercise Is Mostly Funded by the Defense Department - The INFRAEX segment of Operation ICE consists of a workshop that considers how the simulated attack would affect the city’s infrastructure, and how any adverse effects could be minimized and corrected. The date when this part of the exercise is held is unstated. (Dittmara 3/1998) Operation ICE is the culmination of a yearlong disaster preparedness project. (City of New York 11/9/1997) Most of the funding for it has come from a grant from the Department of Defense. (Fan and Gershman 11/10/1997; Kennedy 11/10/1997) The exercise is intended to be a model for cities throughout the US. (Dittmara 3/1998)
New York City’s Office of Emergency Management (OEM) activates its Emergency Operations Center (EOC) on the 23rd floor of World Trade Center Building 7. The OEM is responsible for managing the city’s response to major incidents, including terrorist attacks. (9/11 Commission 7/24/2004, pp. 283-284, 293) Its personnel arrived at WTC 7, where it has offices, early this morning to prepare for Tripod, a major biological terrorism training exercise scheduled for September 12 (see September 12, 2001). (Jenkins and Edwards-Winslow 9/2003, pp. 15 )
Staffer Is Told to Open the Operations Center - OEM Commissioner John Odermatt and Richard Bylicki, a police sergeant assigned to the OEM, heard the explosion when Flight 11 crashed into the WTC, at 8:46 a.m. (see 8:46 a.m. September 11, 2001). As they look out of the window at the burning North Tower, Odermatt debriefs Bylicki and instructs him to open the EOC for a fully staffed operation. Bylicki therefore sets about activating the operations center. (Bylicki 6/19/2003)
Staffers Call Agencies and Tell Them to Send Their Representatives - EOC personnel start contacting agencies, including the New York Fire and Police Departments and the Department of Health, and instruct them to send their designated representatives to the center. They also call the State Emergency Management Office (SEMO) and the Federal Emergency Management Agency (FEMA), which they ask to send at least five federal urban search and rescue teams. (9/11 Commission 5/18/2004 ; 9/11 Commission 7/24/2004, pp. 293) Meanwhile, Bylicki helps the OEM’s Watch Command handle an “enormous influx” of phone calls, many of which are from senior city officials. (Bylicki 6/19/2003)
Activation Proceeds without Any Problems - EOC personnel initially struggle to make sense of what has happened at the Twin Towers. (Wachtendorf 2004, pp. 77) However, the activation apparently proceeds without any problems. Firefighter Timothy Brown, a supervisor at the OEM, is instructed by Calvin Drayton, a deputy director with the OEM, to go up to the 23rd floor of WTC 7 and make sure that personnel are getting the EOC up and running, and the Watch Command is being properly supervised. He goes up to the 23rd floor and first checks the Watch Command. He sees that its supervisor, Mike Lee, has things under control. Then, in the EOC, he sees Michael Berkowitz, a supervisor with the OEM, powering up all the computers and television screens necessary to handle the emergency, and beginning to notify the dozens of agencies that need to send representatives to the center. Berkowitz tells Brown he has the manpower he needs to get the center up and running. “I was very comfortable that OEM was beginning to do what we do in a major emergency,” Brown will later recall. Activating the EOC is something OEM personnel have “drilled for and drilled for and drilled for… and so we were very good at it,” he will comment. (Brown 1/15/2002; Brown 6/30/2002 ; Brown 1/31/2003)
Center Is Designed for Managing a Crisis - The EOC, which opened in 1999 (see June 8, 1999), is a state-of-the-art facility designed to operate as a stand-alone center from which the city government can operate during a crisis. (City of New York 2/18/2001) It is one of the most sophisticated facilities of its type in the world. It includes a communications suite, a conference room, a press briefing room, and a large number of staff offices, and has numerous computer-equipped workstations. (Kendra and Wachtendorf 3/2003 ) It has enough seating for 68 agencies to operate during an emergency. (City of New York 2/18/2001) However, it will be evacuated at 9:30 a.m. due to reports of further unaccounted-for planes, according to the 9/11 Commission Report (see (9:30 a.m.) September 11, 2001). (9/11 Commission 7/24/2004, pp. 305) Other accounts will indicate that it may be evacuated at an earlier time, possibly even before the second crash at the WTC occurs (see (Soon After 8:46 a.m.-9:35 a.m.) September 11, 2001 and (Shortly Before 9:03 a.m.) September 11, 2001).
US Health and Human Services (HHS) Secretary Tommy G. Thompson announces his agency’s emergency response: “CDC has a team on the ground taking air, dust and water samples. This is of utmost concern to health officials. Also, Disaster Mortuary Operational Response Teams will ensure that the process of removing bodies is conducted as safely as possible, and identifications occur as efficiently as possible. The heavy dust that has coated Lower Manhattan following the attack also poses respiratory risks, particularly to our children and elderly citizens. We are well aware that New York has one of the highest childhood asthma rates in the nation, and CDC officials are working with New York authorities to conduct tests and protect our vulnerable residents from high levels of dust in the air.” (US Health and Human Services 9/12/2001)
US Health and Human Services (HHS) Secretary Tommy G. Thompson announces after meetings in New York with NY State Governor George Pataki and NYC Mayor Rudolph Giuliani that the CDC Epidemic Intelligence Service (EIS) will send 35 EIS officers to New York hospitals to assist “health officials and physicians monitor diseases, conduct a medical and health needs assessment, identify existing health problems, such as dust or allergic reactions, determine if there are new medical needs, and if already deployed resources are better used elsewhere.” (US Department of Health and Human Services 9/14/2001)
The Department of Health and Human Services (HHS) publishes a “fact sheet” on the dust and debris that blanketed surrounding streets and penetrated numerous buildings during the collapse of the World Trade Center. The first section, titled, “What is in the dust,” states only: “Dust is a mixture of very fine particles that originally made-up the materials of the WTC and the aircraft that struck it. These particles differ depending on what material the dust came from, how the dust was created, and what happened to the dust after it was released. Analysis of dust samples will provide information on components of the dust. We expect that materials that would be present would be at concentrations lower than those normally associated with health effects.” The flyer makes no effort to name the toxic chemicals and other harmful substances that were known to have been in the two towers. (US Department of Health and Human Services 9/16/2001; Kupferman 2003 )
ATC Associates of New York analyzes bulk dust samples taken from Vesey and Liberty Streets near the WTC site by Monona Rossol, an industrial hygienist with the Arts, Crafts, and Theater Safety organization, and Attorney Joel R Kupferman of the New York Environmental Law and Justice Project. The first four samples tested are found to contain 10-15 percent fiberglass, an extremely high concentration. A quarter of the samples have an asbestos level of 2.1 percent. (Environmental & Toxicology International 9/19/2001; NY Environmental Law and Justice Project 9/22/2001; Baard 9/26/2001; Ramirez 10/12/2001) Shortly after these results are made public, the New York State Department of Health warns local labs that they will lose their licenses if they process any more “independent sampling.” (Kupferman 2003 )
The US Department of Health and Human Services announces that it has released $126 million for disaster related expenses. The figure includes $10.4 million for environmental hazard control to pay for worker safety measures, technical assistance for responding to hazardous environmental exposures, and potential needs related to exposure to contaminants. (US Department of Health and Human Services 9/21/2001)
The US Department of Health and Human Services implements a new policy requiring that all enforcement letters to drug companies potentially engaged in false advertising be pre-screened by FDA Chief Counsel Daniel E. Troy. Prior to the policy change, the FDA’s drug-marketing division and district offices were free to determine when an enforcement letter was warranted. After the policy change, the number of enforcement letters sent annually drops by two-thirds. (Dembner 10/19/2002; Kranish 12/22/2002; Mulkern 5/23/2004) In October 2002, the General Accounting Office (GAO) finds that the FDA is taking so long to review the letters that “misleading advertisements may have completed their broadcast life cycle before FDA issued the letters.” (Kranish 12/22/2002) Fifteen months later, another report by the GAO finds that the review process is still slow, with the average approval time being six months. (Rowland 1/30/2004)
On October 2, 2001, Robert Stevens, a photo editor at the tabloid The Sun, arrived at a Florida hospital with a 102-degree fever and vomiting. He quickly got worse. The next day, doctors determine he has been infected with anthrax. He is put on a respirator. On October 4, Florida doctors and officials hold a press conference to confirm that a patient has anthrax, but that they believe it is an isolated case. On October 5, Stevens is pronounced dead, becoming the first person in the US to die from anthrax since 1976. One of Stevens’s coworkers, Ernesto Blanco, has been hospitalized with pneumonia since October 1, but it will not be discovered that Blanco also has anthrax until shortly after Stevens’s death. (South Florida Sun-Sentinel 12/8/2001) Health and Human Services Director Tommy Thompson tells reporters that the Stevens infection is “an isolated case” that is “not contagious.” Thompson reassures the public, “There is no terrorism” involved in Stevens’s infection. He also asserts that Stevens was infected from an environmental source, saying, “We do know that he drank water out of a stream when he was traveling to North Carolina last week.” It is unclear whether Thompson is misinformed or being deliberately deceptive. (Harnden and Fenton 10/5/2001; Rich 2006, pp. 34)
A federal advisory committee at the Centers for Disease Control and Prevention (CDC) is preparing to vote on whether to lower the amount of lead exposure considered dangerous to children. The level was last set in 1991, and since then new research has proven that even smaller amounts of lead than previously thought are harmful to children’s cognitive development. The panel is preparing to adjust the level downward, a move that could cost paint and gasoline companies in potential lawsuits. But Tommy Thompson, the secretary of health and human services, intervenes. He abruptly replaces five experts with five new panel members known to be supporters of corporate interests that would be affected by the new regulation—one had testified on behalf of a paint company to his belief that children could withstand exposure to lead far in excess of federal regulations (and established science), and others handpicked by the lead industry. Two have financial ties to the industry. Unsurprisingly, the new panel votes to leave the recommended lead level exposure at its given levels. Until Thompson’s move, panel members had not been chosen for ideological or political reasons, but by career staff. (Savage 2007, pp. 302)
The Office of Policy at the US Department of Health and Human Services (DHHS) releases a report concluding that the US government should not impose price caps on prescription drugs. According to the report, doing so “could put the future of medical innovation at risk and may retard advances in treatment.” (US Department of Health and Human Services 7/2002, pp. 2 ) The deputy assistant secretary of the division, Ann-Marie Lynch, had used the same argument when she was a drug industry lobbyist (see June 2001) fighting against congressional efforts to cap drug prices. (Mulkern 5/23/2004) Critics of the report say its conclusions are contradicted by the experiences of other countries that have remained innovative despite price controls. DHHS officials “haven’t taken as seriously their job of making medicines affordable to all Americans,” says Gail Shearer, director of health policy analysis for Consumers Union. According to critics, the report plays a role in the passing of Bush’s Medicare drug plan that prohibits the government from using its buying power to negotiate lower prices from the drug companies.
New York Times reporter Robert Pear discovers that the Bush administration has employed two fake “reporters,” Karen Ryan and Alberto Garcia, who have appeared in administration-produced television “news” segments—“video news releases,” or VNRs—designed to promote the administration’s new Medicare prescription-drug policies. (Garcia primarily appeared in Spanish-language Medicare VNRs.) HHS had budgeted $124 million for the fake news segments, more than most real news organizations can provide. The segments are under investigation by the General Accounting Office (GAO) for possible violation of government statutes prohibiting the use of federal money to produce propaganda or partisan presentations. The Secretary for Health and Human Services (HHS), Tommy Thompson, appears in one of the segments, saying, “This is going to be the same Medicare system only with new benefits, more choices, more opportunities for enhanced benefits.” Several others show a crowd giving President Bush a standing ovation as he signs the new Medicare bill into law. Another segment shows a pharmacist talking to an elderly customer. The pharmacist says the new law “helps you better afford your medications,” and the customer says, “It sounds like a good idea.” The pharmacist agrees, “A very good idea.” The segments, professionally produced and ending with tag lines such as “In Washington, I’m Karen Ryan reporting,” were regularly aired by at least 50 local television news broadcasts in 40 cities around the country. The government also provides scripts that can be used by local news anchors to introduce, or “walk up,” the VNRs. One script suggested that anchors read the following: “In December, President Bush signed into law the first-ever prescription drug benefit for people with Medicare. Since then, there have been a lot of questions about how the law will help older Americans and people with disabilities. Reporter Karen Ryan helps sort through the details.” A VNR is then broadcast explaining how the new law benefits Medicare recipients.
'Infoganda' - Ryan is a freelance journalist, the administration claims, and using her for such fake news segments is perfectly acceptable. But cursory investigation reveals that she was once a freelance reporter, but has for years worked as a public relations consultant. Her most recent assignments include appearing in marketing videos and “infomercials” promoting a variety of pharmaceutical products, including the popular drugs FloMist and Excedrin. Perhaps the most telling reaction is from Comedy Central’s comedy-news program The Daily Show, where host Jon Stewart can’t seem to decide whether to be outraged or flattered by what Rich calls “government propaganda imitating his satiric art.” (Daily Show member Rob Corddry calls the HHS videos “infoganda.”) Administration officials also insist that the VNRs are real, objective news releases, but the company that produced the segments, Home Front Communications, confirms that it had hired Ryan to read a script prepared by government officials. The VNRs give a toll-free phone number for beneficiaries to call. To obtain recorded information about prescription drug benefits, the caller must speak the words, “Medicare improvement.” The Columbia Journalism Review writes, “The ‘reports’ were nothing more than a free advertisement for the legislation, posing as news.”
Legal? - GAO lawyers say that their initial investigations found that other fliers and advertisements disseminated by HHS to promote the new Medicare policies are legal, though they display “notable omissions and other weaknesses.” Administration officials claim the VNRs are also a legal, effective way to educate Medicare beneficiaries. The GAO is still investigating the VNRs. GAO investigators believe that they might violate the law in at least one aspect: misleading viewers by concealing their government origins. Federal law expressly forbids the use of federal money for “publicity or propaganda purposes” not authorized by Congress. Earlier investigations have found government-disseminated editorials and newspaper articles illegal if they did not identify themselves as coming from government officials. The GAO will find that the VNRs break two federal laws forbidding the use of federal money to produce propaganda (see May 19, 2004).
'Common Practice' - HHS spokesman Kevin Keane says the VNRs are well within legal guidelines; their only purpose, he says, is to inform citizens about changes in Medicare. “The use of video news releases is a common, routine practice in government and the private sector,” he says. “Anyone who has questions about this practice needs to do some research on modern public information tools.” Congressional Democrats disagree with Keane. “These materials are even more disturbing than the Medicare flier and advertisements,” says Senator Frank Lautenberg (D-NJ). “The distribution of these videos is a covert attempt to manipulate the press.” Lautenberg, fellow Senator Edward Kennedy (D-MA), and seven other members of Congress requested the GAO investigation. Keane is correct in one aspect: businesses have distributed VNRs to news stations as well as internally for years, and the pharmaceutical industry has been particularly successful in getting marketing videos that appear as “medical news” or “medical features” aired on local and even national news broadcasts. And government agencies have for years released informational films and videos on subjects such as teenage smoking and the dangers of using steroids. Bill Kovach, chairman of the Committee of Concerned Journalists, says HHS’s VNRs have gone far beyond what the government has previously provided. “Those to me are just the next thing to fraud,” he says. “It’s running a paid advertisement in the heart of a news program.” (Pear 3/15/2004; McDermott 3/15/2004; Rich 2006, pp. 164)
Media Responsibility - The Columbia Journalism Review’s Bill McDermott writes: “[F]or our money, the villains here aren’t the clever flacks at HHS—they’re supposed to be masters of deception. Nope, the dunce hats go to the local TV station editors willing to slap onto the air any video that drops in over the transom.” (McDermott 3/15/2004) Ryan is relatively insouciant about the controversy. “Stations are lazy,” she says. “If these things didn’t work, then the companies would stop putting them out.” (Pittsburgh Post-Gazette 3/20/2004)
The General Accounting Office (GAO) finds that the Bush administration broke two federal laws as part of its publicity campaign to promote its new Medicare prescription drug policies. The Department of Health and Human Services (HHS) illegally spent federal monies on what amounts to covert propaganda in producing and distributing “video news releases,” or VNRs, to local television news broadcasters around the country that were designed to look like objective news reports (see March 15, 2004). The GAO findings do not carry legal weight, because the GAO acts as an adviser to Congress. The viewers in the more than 40 cities who saw the reports did not know they were watching government-produced videos anchored by public relations “flacks” paid by HHS who were not real reporters. The VNRs have only fueled criticism of the Medicare prescription drug coverage program, which gives private health care firms and prescription drug companies a much larger role in providing and setting prices for Medicare recipients’ prescriptions. Democrats have long insisted that the law cripples Medicare beneficiaries’ ability to receive low-cost prescriptions in favor of funneling Medicare dollars into the pharmaceutical companies’ coffers; with the GAO findings, Democrats now say that the government used illegal propaganda tactics to “sell” the citizenry on the new program. The administration has already admitted that the program will cost hundreds of billions of dollars more than originally claimed. Democratic presidential candidate John Kerry (D-MA) calls the videos “another example of how this White House has misrepresented its Medicare plan.” Kerry’s Senate colleague, Edward Kennedy (D-MA), says: “The new GAO opinion is yet another indictment of the deception and dishonesty that has become business as usual for the Bush administration. It was bad enough to conceal the cost of the Medicare drug bill from the Congress and the American people. It is worse to use Medicare funds for illegal propaganda to try to turn this lemon of a bill into lemonade for the Bush campaign.” The Bush administration continues to insist that the VNR program is legal. “GAO opinions are not binding on the executive branch. That’s an opinion of the GAO. We don’t agree,” says HHS spokesman Bill Pierce, who justifies the VNR usage by pointing to their ubiquitous usage in corporate settings. Asked if he understands that a viewer might be angry at being led to believe that the VNRs were real news stories, Pierce replies, “If I’m a viewer, I’d be angry at my television station.” (Goldstein 5/20/2004; Kemper 5/20/2004)
An investigation by the New York Times reveals that the government’s use of “video news releases,” or so-called “fake news” reports provided by the government and presented to television news viewers as real news (see March 15, 2004), has been used by far more government agencies than previously reported. The Times report finds that VNRs from the State Department, the Transportation Security Administration (TSA), and the Agriculture Department are among the agencies providing VNRs to local television news broadcasters. Previous media reports focused largely on the VNRs provided by the Department of Health and Human Services to tout the Bush administration’s Medicare proposals. The Times finds that “at least 20 federal agencies, including the Defense Department and the Census Bureau, have made and distributed hundreds of television news segments in the past four years.… Many were subsequently broadcast on local stations across the country without any acknowledgement of the government’s role in their production.… [T]he [Bush] administration’s efforts to generate positive news coverage have been considerably more pervasive than previously known. At the same time, records and interviews suggest widespread complicity or negligence by television stations, given industry ethics standards that discourage the broadcast of prepackaged news segments from any outside group without revealing the source.”
VNRs Presented as Actual News - While government VNRs are generally labeled as being government productions on the film canister or video label, the VNRs themselves are designed, the Times writes, “to fit seamlessly into the typical local news broadcast. In most cases, the ‘reporters’ are careful not to state in the segment that they work for the government. Their reports generally avoid overt ideological appeals. Instead, the government’s news-making apparatus has produced a quiet drumbeat of broadcasts describing a vigilant and compassionate administration.” The VNRs often feature highly choreographed “interviews” with senior administration officials, “in which questions are scripted and answers rehearsed. Critics, though, are excluded, as are any hints of mismanagement, waste or controversy.”
Benefits to All except News Consumers - The Times explains how VNRs benefit the Bush administration, private public relations firms, networks, and local broadcasters: “Local affiliates are spared the expense of digging up original material. Public relations firms secure government contracts worth millions of dollars. The major networks, which help distribute the releases, collect fees from the government agencies that produce segments and the affiliates that show them. The administration, meanwhile, gets out an unfiltered message, delivered in the guise of traditional reporting.” News viewers, however, receive propaganda messages masquerading as real, supposedly impartial news reports.
Ducking Responsibility - Administration officials deny any responsibility for the use of VNRs as “real” news. “Talk to the television stations that ran it without attribution,” says William Pierce, a spokesman for the Department of Health and Human Services. “This is not our problem. We can’t be held responsible for their actions.” But the Government Accountability Office (GAO) has disagreed, calling the use of government-produced VNRs “covert propaganda” because news viewers do not know that the segments they are watching are government productions (see May 19, 2004). However, the Office of Management and Budget (OMB) and the Justice Department (see March 2005) have called the practice legal, and instructed executive branch agencies to merely ignore the GAO findings.
Creative Editing - The Times gives an example of how seamlessly government-produced propaganda can be transformed into seemingly real news segments. In one segment recently provided by the Agriculture Department, the agency’s narrator ends the segment by saying, “In Princess Anne, Maryland, I’m Pat O’Leary reporting for the US Department of Agriculture.” The segment is distributed by AgDay, a syndicated farm news program shown on some 160 stations; the segment is introduced as being by “AgDay’s Pat O’Leary.” The final sentence was edited to state: “In Princess Anne, Maryland, I’m Pat O’Leary reporting.” Final result: viewers are unaware that the AgDay segment is actually an Agriculture Department production. AgDay executive producer Brian Conrady defends the practice: “We can clip ‘Department of Agriculture’ at our choosing. The material we get from the [agency], if we choose to air it and how we choose to air it is our choice.” The public relations industry agrees with Conrady; many large PR firms produce VNRs both for government and corporate use, and the Public Relations Society of America gives an annual award, the Bronze Anvil, for the year’s best VNR.
Complicity by News Broadcasters - Several major television networks help distribute VNRs. Fox News has a contract with PR firm Medialink to distribute VNRs to 130 affiliates through its video feed service, Fox News Edge. CNN distributes VNRs to 750 stations in the US and Canada through its feed service, CNN Newsource. The Associated Press’s television news distributor does the same with its Global Video Wire. Fox News Edge director David Winstrom says: “We look at them and determine whether we want them to be on the feed. If I got one that said tobacco cures cancer or something like that, I would kill it.” TVA Productions, a VNR producer and distributor, says in a sales pitch to potential clients, “No TV news organization has the resources in labor, time or funds to cover every worthy story.” Almost “90 percent of TV newsrooms now rely on video news releases,” it claims. The reach can be enormous. Government-produced VNRs from the Office of National Drug Control Policy reached some 22 million households over 300 news stations. And news stations often re-record the voiceover of VNRs by their own reporters, adding to the illusion that their own reporters, and not government or PR employees, are doing the actual reporting.
Office of Broadcasting Services - The State Department’s Office of Broadcasting Services (OBS) employs around 30 editors and technicians, who before 2002 primarily distributed video from news conferences. But in early 2002, the OBS began working with close White House supervision to produce narrated feature reports promoting American policies and achievements in Afghanistan and Iraq, and supporting the Bush administration’s rationale for invading those countries. Between 2002 and now, the State Department has produced 59 such segments, which were distributed to hundreds of domestic and international television broadcasters. The State Department says that US laws prohibiting the domestic dissemination of propaganda don’t apply to the OBS. Besides, says State Department spokesman Richard Boucher: “Our goal is to put out facts and the truth. We’re not a propaganda agency.” State Department official Patricia Harrison told Congress last year that such “good news” segments are “powerful strategic tools” for influencing public opinion. The Times reports that “a review of the department’s segments reveals a body of work in sync with the political objectives set forth by the White House communications team after 9/11.” One June 2003 VNR produced by the OBS depicts US efforts to distribute food and water to the people of southern Iraq. The unidentified narrator condluded, “After living for decades in fear, they are now receiving assistance—and building trust—with their coalition liberators.” OBS produced several segments about the liberation of Afghan women; a January 2003 memo called the segments “prime example[s]” of how “White House-led efforts could facilitate strategic, proactive communications in the war on terror.” OBS typically distributes VNRs through international news organizations such as Reuters and the Associated Press, which then distribute them to major US networks, which in turn transmit them to local affiliates.
The Pentagon Channel and 'Hometown News' - In 2004, the Defense Department began providing The Pentagon Channel, formerly an in-house service, to cable and satellite operators in the US. The content is provided by Pentagon public relations specialists who produce “news reports” identical to those produced by local and national news broadcasters. And the content is free. The Pentagon Channel’s content is supplemented by the Army and Air Force Hometown News Service (HNS), a 40-man unit that produces VNRs for local broadcasters focusing on the accomplishments of “hometown” soldiers. Deputy director Larry Gilliam says of the service, “We’re the ‘good news’ people.” Their reports, tailored for specific local stations, reached 41 million households in 2004. But the service’s VNRs sometimes go beyond celebrating a hometown hero. Weeks after the Abu Ghraib scandal broke, HNS released a VNR that lauded the training of military policemen at Missouri’s Fort Leonard Wood, where many of the MPs involved in the scandal were trained. “One of the most important lessons they learn is to treat prisoners strictly but fairly,” the “reporter” in the segment says. A trainer tells the narrator that MPs are taught to “treat others as they would want to be treated.” Gilliam says the MP report had nothing to do with the Pentagon’s desire to defend itself from accusations of mistreatment and prisoner abuse. “Are you saying that the Pentagon called down and said, ‘We need some good publicity?’” Gilliam asks the Times reporter. He answers his own question, “No, not at all.” (Barstow and Stein 3/13/2005)
Congress Bans Use of Government VNRs - Two months after the Times article is published, Congress will ban the use of government VNRs for propaganda purposes (see May 2005).
The Family Research Council, an organization of religious and social conservatives, sends a letter to the Department of Health and Human Services (HHS) protesting a department Web site that for six years has provided the public with information about gay-related health issues. Two weeks later, the entire Web site disappears. (Savage 2007, pp. 106)
Conservatives and Congressional Republicans attack President Obama’s economic stimulus plan with a variety of claims centering on “earmarks” or “Democratic pork.” One claim is that the stimulus package wastes hundreds of millions of dollars on funding for contraceptives. “You know, I’m concerned about the size of the package.” says House Minority Leader John Boehner (R-OH). “And I’m concerned about some of the spending that’s in there, [about]… how you can spend hundreds of millions on contraceptives. How does that stimulate the economy?” (New York Post 1/26/2009)
Reduces Costs to State, Federal Budgets - House Speaker Nancy Pelosi (D-CA) explains the rationale behind the funding: “Well, the family planning services reduce cost. They reduce cost. The states are in terrible fiscal budget crises now and part of what we do for children’s health, education, and some of those elements are to help the states meet their financial needs. One of those—one of the initiatives you mentioned, the contraception, will reduce costs to the states and to the federal government.” (Terkel 1/26/2009)
Limbaugh's Suggestion - Conservative talk show host Rush Limbaugh retorts that if Pelosi “wants fewer births, I have the way to do this and it won’t require any contraception: You simply put pictures of Nancy Pelosi… in every cheap motel room.… That will keep birthrates down because that picture will keep a lot of things down.” (Media Matters 1/26/2009)
Savings of $700 Million - The language of the stimulus bill reads: “Under current law, the secretary [of health and human services] has the authority under section 1115 of the Social Security Act to grant waivers to states to allow them to cover family planning services and supplies to low-income women who are not otherwise eligible for Medicaid. The bill would give states the option to provide such coverage without obtaining a waiver. States could continue to use the existing waiver authority if they preferred.” The Center for American Progress (CAP), a progressive think tank, explains that this portion of the stimulus bill “would not only aid states, but also provide preventative, cost-saving health care to help low-income women support their families and keep working.” According to the Congressional Budget Office (CBO), the measure would save the nation $200 million over five years and $700 million over 10 years. States that choose not to participate in the program are not required to do so. Representative James Clyburn (D-SC) notes, “I think that Mr. Boehner is looking for one little sound bite rather than looking at the total package here and seeing what it will do for the American people.” (Terkel 1/26/2009)
Betsy McCaughey (R-NY), the former lieutenant governor of New York and a fellow at the conservative Hudson Institute, writes that health care provisions in the Obama administration’s economic stimulus plan will affect “every individual in the United States.” McCaughey writes: “Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors. But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and ‘guide’ your doctor’s decisions.” McCaughey says the provisions are similar to suggestions in the book Critical: What We Can Do About the Health Care Crisis, by former Senate Majority Leader Tom Daschle (D-SD), until recently Obama’s pick to head the Department of Health and Human Services. McCaughey writes that hospitals and doctors who do not use the system will be punished, by a federal oversight board to be called the Federal Coordinating Council for Comparative Effectiveness Research. Perhaps most worrisome is McCaughey’s claim that elderly Americans will be given reduced health care based on their age and expected productivity. “Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost-effectiveness standard set by the Federal Council,” she writes. “The Federal Council is modeled after a UK board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis. In 2006, a UK health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.… If the Obama administration’s economic stimulus bill passes the Senate in its current form, seniors in the US will face similar rationing. Defenders of the system say that individuals benefit in younger years and sacrifice later. The stimulus bill will affect every part of health care, from medical and nursing education, to how patients are treated and how much hospitals get paid. The bill allocates more funding for this bureaucracy than for the Army, Navy, Marines, and Air Force combined.” (McCaughey 2/9/2009) McCaughey’s claims are very similar to the ones she made against the Clinton administration’s attempt to reform health care in 1994 (see Mid-January - February 4, 1994). They will be proven false (see July 23, 2009).
The Department of Health and Human Services rescinds the controversial “conscience rule” that allows health care workers to refuse to provide abortion counseling or other family-planning services if doing so would violate their moral or religious beliefs. The rule was announced on December 19, 2008 as one of the Bush administration’s final policy initiatives. Seven states have already challenged the rule in court, arguing that it sacrifices the health of patients to religious beliefs of medical providers. The American College of Obstetrics and Gynecology has reported numerous cases regarding the rule, including a Virginia mother of two who became pregnant after being denied emergency contraception, and a rape victim whose prescription for emergency contraception was rejected by a pharmacist. Obama officials say the administration will consider drafting a new rule to clarify what health care workers can reasonably refuse for patients. The public has 30 days to respond to the move before it becomes viable. Sister Carol Keehan, president of the Catholic Health Association, said in December that her organization supported the rule because in recent years “we have seen a variety of efforts to force Catholic and other health care providers to perform or refer for abortions and sterilizations.” However, opponents of the rule, including the American Medical Association, the National Association of Chain Drug Stores, and Planned Parenthood, said it could have voided state laws requiring insurance plans to cover contraceptives and requiring hospitals to offer emergency contraception to rape victims. It could also allow drugstore employees to refuse to fill prescriptions for contraceptives. And the Civil Rights Act of 1964 already offers broad protection against discrimination based on religion, mandating that an employer must make reasonable accommodations for an employee’s practices and beliefs. Cecile Richards of Planned Parenthood says, “Today’s action by the Obama administration demonstrates that this president is not going to stand by and let women’s health be placed in jeopardy.” (Levey 2/27/2009; Stout 2/27/2009)
According to media reports, the Obama administration intends to reverse the “right of conscience rule,” formally called the Provider Refusal Rule, for health care workers enacted by President Bush in the last weeks of his term. In December 2008, Bush issued an executive order allowing health care workers to deny care based on their personal beliefs. The order was issued to target doctors and nurses who do not want to provide abortions, even if they work in a facility that offers abortions to clients. Specifically, the rule denies Department of Health and Human Services (HHS) funding to institutions that do not allow workers to refuse care that goes against their beliefs. Now the Obama administration says President Obama will override that order. Seven states have already challenged the rule, claiming it sacrifices the health of patients in order to satisfy the religious or moral beliefs of medical personnel. The American College of Obstetrics and Gynecology has reported cases such as that of a Virginia mother of two who became pregnant because she was denied emergency contraception; in Texas, the group said, a rape victim had her prescription for emergency contraception rejected by a pharmacist. Obama has already overturned a ban on US funding for international aid groups that provide abortion services. However, administration officials say the administration may consider a rule that would clarify what health care workers can reasonably refuse. An HHS spokesman says: “We recognize and understand that some providers have objections to providing abortions. But we do not want to impose new limitations on services that would allow providers to refuse to provide to women and their families services like family planning and contraception that would actually help prevent the need for an abortion in the first place.” Dr. Suzanne Poppema of Physicians for Reproductive Choice and Health praises Obama “for placing good health care above ideological demands,” and says: “Physicians across the country were outraged when the Bush administration, in its final days, limited women’s access to reproductive health care. Hundreds of doctors protested these midnight regulations and urged President Obama to repeal them quickly. We are thrilled that President Obama took the first steps today to ensure that our patients’ health is once again protected.” Tony Perkins of the anti-abortion Family Research Council (FRC) counters: “Protecting the right of all health care providers to make professional judgments based on moral convictions and ethical standards is foundational to federal law and is necessary to ensure that access to health care is not diminished, which will occur if health care workers are forced out of their jobs because of their ethical stances. President Obama’s intention to change the language of these protections would result in the government becoming the conscience and not the individual. It is a person’s right to exercise their moral judgment, not the government’s to decide it for them.” (Levey 2/27/2009; Young 2/27/2009; Stout 2/27/2009) The liberal Center for American Progress (CAP) writes in April 2009: “Conservatives have criticized the Obama administration for infringing upon the conscience of health care professionals and ‘forcing’ them to provide abortion services.… Yet this assertion could not be further from the truth. President Obama’s proposal to rescind Bush’s last-minute rule restores the pre-existing compromise established through decades of debate.” CAP notes that Title VII of the Civil Rights Act disallows employers from firing or harassing workers who decline to fulfill assigned tasks due to moral or religious objections. “Obama’s proposal to rescind the Bush ‘conscience’ rule simply restores the prior balance that existed on matters of conscience,” CAP concludes. “It once again guides the health care system to value the consciences of health care providers and patients.” (Jessica Arons and Sarah Dreier 4/28/2009) However, for reasons never made publicly clear, the Obama administration will never actually rescind the order. It is possible that Obama or HHS officials bow to pressure from a number of organizations such as the FRC and the Christian Medical Association, which have continually pressured the administration not to rescind the order. (Bream 4/8/2009; Sullivan 2/4/2010; Megan Sullivan 7/13/2010)
Health and Human Services Secretary Kathleen Sebelius and Senator Arlen Specter (D-PA) hold a meeting at the National Constitution Center in Philadelphia to discuss the White House’s health care reform proposals. A large and vocal crowd of anti-reform protesters attempts to shout over, or shout down, both Sebelius and Specter during the event. Over 400 people attend the meeting, and many “cheered, jeered, and booed” the two, according to the Philadelphia Inquirer. Sebelius’s response to the crowd: “I’m happy to see democracy is at work.” The Inquirer reports, “Sebelius and Specter managed, barely, to impose a tenuous civility on the hour-long meeting titled ‘Health Insurance Reform—What’s in it for You.’” At one point, the booing and screaming become so pervasive that Sebelius informs the crowd, “We can shout at one another, or we can leave the stage.” Audience members verbally engage with each other as well: one, a self-identified Republican “political junkie,” says the nation cannot afford to insure 47 million uninsured Americans, and is countered by a rheumatologist who works with underinsured and uninsured patients, and who describes the horrific situations many of them face. One anti-reform participant tells the pair, “The American people don’t want rationed health care,” winning cheers from many in the audience. When Sebelius retorts that health care is already rationed for the 12,000 people a day whose insurance disappears when they lose their jobs, she wins applause from other audience members. About a dozen members of the Service Employees International Union (SEIU) are there to support Sebelius and Specter, and some members of the pro-reform group Physicians for Obama are also in attendance. Countering them are numerous audience members with “Tell Washington No” bumper stickers plastered to their chests. One anti-reform organization, the Philadelphia Tea Party Patriots, will later claim to have around 40 members in attendance. Outside the hall, dozens of anti-reform protesters picket with signs saying, among other slogans, “Government Health Care: Dangerous to Your Health,” “Welcome to the United States Socialist Republic,” and various anti-abortion signs. After the meeting, Sebelius says: “Health care touches everybody personally.… I find it difficult, because so much misinformation gets repeated in questions at town hall meetings. We have a challenge to get the message out.” (Bergen 8/3/2009) After the meeting, FreedomWorks (see April 14, 2009), a lobbying organization that actively promotes the town hall disruptions by conservative protesters, calls the event “a must emulate at town halls across the country over the next month.” (FreedomWorks 8/3/2009)
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