Published December 2, 2016
It's that time of the year again when drug companies, doctors, government officials and media conduct a national advertising campaign...
— William Wilberforce
How is it that supremely educated and well-informed individuals in positions of high authority within government so often make colossal errors in judgment that were so predictably wrong-headed from the start? They just must have known what they were doing, right? The tendency is to assume that the decisions were based on some hidden concern or motivation that the average person cannot begin to fathom.
Perhaps it was a calculated move to draw publicity and create a sense of urgency for the purpose of growing a budget or expanding influence? Or was the person blinded by fear or ideology?
Otherwise, how could intelligent, powerful people with extensive access to the best information available fail to perceive obvious mistakes in making major public policy decisions? Can it be that sometimes intelligent people just do stupid things? Maybe.
I had a long conversation a few weeks ago with a friend who has extensive experience in managing security for the U.S. government. He suggested that one reason poor decisions get made at the highest levels of government is that many heads of departments and agencies go about their jobs in fear of making mistakes that could have major consequences for national security. This situation has become more pronounced since the terrorist attacks of Sept. 11, 2001.
The implication is that some of our government leaders have become so concerned about getting things wrong that this has made them overly tentative and unable to fully trust their own knowledge, judgment, and instincts.
This tentativeness can be exacerbated whenever an official’s competence is publicly called into question, which often happens when governments are summoned to testify before a Congressional committee about a policy initiative gone wrong or an inadequate response to a threat or an emergency. Take, for example, Tom Frieden, MD, the director of the Centers for Disease Control and Prevention (CDC), in Oct. 16, 2014 when he was grilled by members of the House Energy and Commerce Subcommittee on Oversight and Investigations about his agency’s handling of the spread of Ebola virus infections in Texas earlier that year.1 2 3
You get a sense of the tone of that hearing from Representative Fred Upton’s (R-Michigan) prepared statement:
People are scared. We need all hands on deck. We need a strategy and we need to protect the American people, first and foremost. It’s not a drill. People’s lives are at stake and the response so far has been unacceptable. As Chairman of this committee, I want to assure the witnesses that we stand ready to support you in any way to keep Americans safe, but we’re going to hold your feet to the fire on getting the job done, and getting it done right. Both the U.S. and the global health community have so far failed to put in place an effective strategy fast enough to combat the current outbreak.1
Rep. Upton continued:
The CDC admitted more could’ve been done in Texas. Two health care workers have become infected with Ebola even as nurses and other medical personnel suggest that protocols are being developed on the fly. And none of us can understand how a nurse who treated an Ebola infected patient and who herself had developed a fever was permitted to board a commercial airline and fly across the country. It’s no wonder that the public’s confidence is shaken. Over a month ago, before Ebola reached our shores, we wrote HHS Secretary Burwell seeking details for the preparedness and response plans here at home and abroad. And it’s clear whatever plan was in place was insufficient.1
The statement is peppered with suggestions that Dr. Frieden didn’t do his job the way he should have done it. Comments like “the response so far has been unacceptable” and “we’re going to hold your feet to the fire on getting the job done, and getting it done right.” There’s “Both the U.S. and global health community have so far failed to put in place an effective strategy fast enough to combat the current outbreak,” and “The CDC admitted more could’ve been done in Texas,” and “It’s no wonder that the public’s confidence is shaken.” Finally… “And it’s clear whatever plan was in place was insufficient.”
That was one heck of a damning indictment of Dr. Frieden and the CDC. Later, there were also a few tense and awkward exchanges, notably with Rep. Steve Scalise (R-Louisiana). It went like this:
Scalise: One of the biggest concerns I get from the hospitals in my district that I’ve talked to, and I’ve talked to a number of hospital officials, medical officials, professionals in my district. They’re concerned that they haven’t had consistent protocols. There have been at least four just in the last few weeks where the protocols keep changing. Now, with the nurse, the first nurse that was infected, I believe you personally said that the protocols were breached originally. Have you backed away from that?
Frieden: We’re looking at what might have resulted…
Scalise: You said the protocols were breached. Were the protocols breached with the first nurse that was infected?
Scalise: Yes or no.
Frieden: Our review of the records suggest that in the first few days…
Scalise: If you didn’t know for a fact you shouldn’t have said it. Do you withdraw that statement or do you still stand by the statement that protocols were breached by the first nurse?
Frieden: There was a definite exposure that resulted…
Scalise: Were protocols breached, yes or no?1
Rep. Scalise was clearly starting to get under Dr. Frieden’s skin. It must have been difficult for Dr. Frieden to be so closely cross-examined by a congressman. It’s almost never pleasant for a government official to testify at a congressional hearing investigating potential errors of judgment made by government agencies.
You have to wonder how that sort of experience might affect a person in Dr. Frieden’s position—how it might influence his decision-making going forward. Does he grow more conscious of covering his back to ensure he never leaves himself exposed to criticism again?
And if so, to what degree does that desire for securing an insurance policy manifest itself in the public policies he and the CDC promote? For instance, with regard to the Zika virus,4 5 6 or the more recent proposed rulemaking to allow the CDC to “authorize the quarantine, isolation, or conditional release of an individual traveling interstate” if the agency “reasonably believes” that that “individual is infected with a communicable disease in a qualifying stage”?7
Whether errors in judgment in public policy and lawmaking are made by government officials because of ignorance, ideology, fear or simply a desire to secure more money or power for an agency, there are serious consequences for the people impacted by those errors in judgment. That is why it is so important for all of us to actively participate in the public policy and law making process whenever we can to hold the executive and legislative branches of government responsible for their actions.
1 Congress Hammers CDC on Ebola: Demands Answers / Flight Bans Now. YouTube.com Oct. 16, 2014 (published by Scott Anthony).
2 Diamond J, Walsh D. U.S. health officials grilled on Ebola at congressional hearing. CNN Oct. 16, 2014.
3 Tavernise S. Congress Scrutinizes Handling of Ebola Cases in Texas. The New York Times Oct. 16, 2014.
4 Cáceres M. Dr. Frieden’s Zika Letter: A False Alarm? The Vaccine Reaction Apr. 6, 2016.
5 Centers for Disease Control and Prevention. CDC Concludes Zika Causes Microcephaly and Other Birth Defects. CDC.gov Apr. 13, 2016.
6 Frieden T. CDC Chief: Zika is coming. To fully protect Americans we must have the funds we need. Fox News Apr. 1, 2016.
7 Control of Communicable Diseases—A Proposed Rule by the Health and Human Services Department on 08/15/2016. Federal Register Aug. 15, 2016.