Wisconsin Gov. Tommy Thompson, Bush's nominee for secretary of Health and Human Services (HHS), faces Senate confirmation hearings this week. And the long-standing governor of Wisconsin, who is popular and renowned for his pioneering welfare reforms, is likely to be confirmed. But on the road to confirmation, he will face questions on some of key health issues, including tobacco control.
"Thompson is about as good as it gets for the cigarette companies," says Stanton Glantz, PhD, a medical school professor at the University of California at San Francisco. Glantz, who has studied Thompson's tobacco record, tells WebMD, "It's very troubling to have somebody with his intimate ties to the tobacco industry in charge of the FDA, CDC, and NIH."
Thompson is scheduled for hearings on Jan. 18-19 before two committees that share jurisdiction over health issues. The sessions will afford lawmakers the opportunity to question -- and potentially grill -- the Wisconsin governor about his stances and his plans for a cabinet department with a total annual budget of more than $400 billion.
Considering Thompson's allegedly weak tobacco control efforts in Wisconsin and his cozy relationship with cigarette makers, the most intriguing controversy over Thompson's health record may be tobacco.
According to Sen. Tom Harkin (D-Iowa), "The governor's views and record on ... tobacco control will come out into the open during the hearing process. Tobacco is the number one preventable healthcare problem in the United States, and I intend to raise this question."
Paul Billings, a lobbyist for the American Lung Association, tells WebMD that Thompson has a well-documented relationship with Philip Morris, maker of Marlboro and Virginia Slims. "That causes us some concern," says Billings. "He needs to articulate clearly what measures he supports: Will he support FDA authority [to regulate cigarettes]? Will he fully fund the CDC to do tobacco prevention programs? And does he think that tobacco is addictive?"
Since 1993, Thompson has received well over $60,000 in campaign contributions from tobacco companies, and he's close to some of the industry's top brass. After a 1995 international trip that was largely paid for by tobacco giant Philip Morris, Thompson wrote to an executive there: "I value your loyalty and friendship and look forward to sharing many more great meals. ... I eagerly anticipate our next adventure together." Thompson again traveled overseas on Philip Morris' dime the next year.
But several large health groups that have been prominent in pushing for tighter tobacco controls aren't taking a stand against Thompson.
A spokeswoman for the American Heart Association tells WebMD, "We're not taking a position. We'll certainly be working very closely, hopefully, with the new administration."
Rachel Tyree, a spokeswoman for the American Cancer Society, tells WebMD, "While the governor has not been a champion of tobacco control, his record is improving, and we have a good relationship. He's worked with our division office on a lot of other cancer issues."
These positions don't please Glantz. "I have been disappointed by the muted response of the national tobacco control organization," he tells WebMD. "They figure he's likely to be confirmed, and they don't want to [anger him]."
Tyree says, "We look at it a little bit more broadly than some of the other groups that are only tobacco focused and may have a more poignant viewpoint on him."
But tobacco isn't the only aspect of Thompson's health record that is likely to come up in the confirmation hearings.
Tim Leshan, director of public policy for the American Society for Cell Biology, tells WebMD that scientists, medical schools, and disease research groups are concerned over a possible threat to federal funding for research with embryonic stem cells. The cells hold great promise in fighting a host of dreaded diseases because the 'immature' cells have the potential to develop into almost any type of body tissue, including bone, heart, or brain tissue. But foes of abortion believe that the research involves destroying life. Under President Clinton, the National Institutes of Health OK'd federal funding for stem cell research, though no research funds have been distributed.
"We worry that the Bush administration could just come in and block this research with an executive order," Leshan tells WebMD. "On the one hand, Tommy Thompson has been supportive of embryonic stem cell research because the discovery was made at the University of Wisconsin at Madison, but the Bush campaign team expressed opposition to federal funding for stem cell research."
Thompson also opposes abortion, which has provoked strong opposition to his nomination from the National Association for Women, the Planned Parenthood Federation of America, and the National Abortion and Reproductive Rights Action League.
Another possible Thompson hearing flashpoint: Those in the organ transplantation community remind that Thompson sued Clinton's HHS over its plans to redistribute available organs based on medical need, not geography. Thompson had argued that the HHS plan favored other states at the expense of Wisconsin, which has a robust donation program.
The suit was dismissed, and the government has recently begun implementing a revised version of its distribution plan.
Lisa Rossi, spokeswoman for the University of Pittsburgh Medical Center, which endorsed the national plan that Thompson opposed, tells WebMD, "If he were to try to undo the regulation, that would raise a lot of protests and challenges and get the transplant community all riled up again. I don't think the Bush administration wants there to be that kind of controversy, at least not at the beginning."
The United Network for Organ Sharing (UNOS), which runs the nation's organ donation organization, clashed with HHS over the rules and supports Thompson's nomination. According to Walter Graham, UNOS executive director, Thompson "has devoted significant personal interest and commitment to the issues of organ donation and transplantation. We look forward to working with him upon his confirmation."