Perry and the HPV Vaccine: Selling Women’s Health (and Everything Else) to the Highest Bidder

In 2007, Governor Rick Perry shocked both public health officials and his conservative base when he signed an executive order mandating that female students in Texas be vaccinated against human papillomavirus (HPV) before entering the sixth grade. The order referred to Gardasil, a vaccine that had been approved by the FDA only a few months earlier after having been found to prevent infection with four strains of HPV, including two strains that account for 70 percent of cervical cancer and two that account for 90 percent of genital warts. The FDA approved the three-shot regimen for young women ages nine to 26 and the Centers for Disease Control and Prevention (CDC) recommended that this become part of the routine vaccinations of girls at ages 11 or 12 because “it is important for girls to get HPV vaccine before their first sexual contact – because they won’t have been exposed to human papillomavirus.”

Public health advocates argued that because HPV is so easily spread through sexual contact, universal or near-universal vaccinations would be the only the way to eradicate the disease. They pointed out that, although cervical cancer can be prevented through early detection using Pap Smears and other medical tests, approximately 10,000 women in the United State do become infected each year. As a result of these arguments, a number of states considered legislation and rules similar to Perry’s order which would make the vaccine a requirement for school attendance. (It’s worth noting that many public health advocates stopped short of supporting these types of mandates because of the fear that such requirements and the steep price of the vaccine –- about $390 for the series -– would be too much of a burden on the Vaccines for Children program, “a federally-funded program that provides vaccines at no cost to children who might not otherwise be vaccinated because of inability to pay.”)

On the flip side, social conservatives and proponents of abstinence-only-until-marriage programs argued that vaccinating young girls against a sexually transmitted disease was morally questionable and dangerous. They suggested that such a vaccine would give young women a false sense of security and lead to promiscuity. They also took issue with the young age at which vaccine was recommended and complained that at the very least this would cause parents to have to have uncomfortable and age-inappropriate conversations with their daughters. Ultimately, they said that this was a parental issue in which the state should not become involved.

When it came to issues around sexual and reproductive health, Governor Perry sided with these factions far more often that with public health experts. So, people on both sides of the debate were surprised when Governor Perry bypassed his state legislature and issued the executive order which not only required all female students to be vaccinated but also “directed state health authorities to make the vaccine available free to girls 9 to 18 who are uninsured or whose insurance does not cover vaccines,” and ordered Medicaid to offer Gardasil to women ages 19 to 21.

At the time Perry argued that “the HPV vaccine provides us with an incredible opportunity to effectively target and prevent cervical cancer,” and that it was no different than the vaccine for polio. According to one blog he had this to say to his critics:

“I understand the concern some of my great and dear friends have about requiring this vaccine, which is why parents can opt out if they so choose…I refuse to look a young woman in the eye who suffers from this form of cancer and tell her that we could have stopped it, but we didn’t. Others may focus on the cause of this cancer. I will stay focused on the cure.”

Today, as he makes his bid for the Republican Presidential nomination, it seems that Rick Perry has something different to say. When the issue of Gardasil came up in last week’s Republican debate he acknowledged that he probably didn’t handle the situation correctly but argued that he wanted to bring the issue to the attention of people in his state and said that he would always err on the side “saving lives.” He was even more contrite in an Iowa radio interview in which he said:

“I readily stand up and say I made a mistake on that.”

Exactly what Rick Perry really believes when it comes to HPV, sexually transmitted diseases, and prevention remains unclear. Unfortunately, what is very clear in looking closely at the Gardasil debate is what the governor believes about, well, campaign contributions.

The Toomey Connection

His fellow primary candidates seemed anxious to bring up the Gardasil issue as an example of Perry breaking with his anti-choice, pro-abstinence, conservative base on a social issue. What they didn’t mention (perhaps for fears of similar skeletons in their own closets), was the connection between the executive order and Perry’s relationship to the vaccine’s manufacturer. This connection, however, was a large part of the controversy and seems very indicative of how he does business.

Gardasil is manufactured by the pharmaceutical company Merck, which donated $16,000 to Perry’s campaign in the two-and-a-half years before the executive order was signed. Moreover, as part of an aggressive lobbying campaign for laws and rules just like the mandate Perry signed, Merck hired the Governor’s former chief of staff, Michael Toomey, as one of its top lobbyists in Austin. Between 2005 and 2010, “Merck paid Toomey between $260,000 and $535,000 in lobbying fees.”

Andrew Wheat, research director at Texans for Public Justice, a watchdog group in Austin explained:

At the time that he did this, it just had everybody scratching their heads. He wasn’t known as a crusader for women’s health. There’s no explanation that seems to make sense other than that Toomey’s got his ear and he got Perry to do this favor for him.”

It seems this isn’t the only time that Toomey “got his ear.” Last week, Mother Jones reported on a plan that Rick Perry had floated to privatize the state’s prison health care system. Toomey (who the article says is referred to in Austin as “Mike the Knife”) now lobbies for the Corrections Corporation of America (CCA) which “provides health care services to male and female inmates and youthful offenders who are housed in local jails, detention facilities, and correctional institutions around the country.” Toomey is not only Perry’s former chief of staff but also a campaign contributor having given $20,000 to the 2010 gubernatorial campaign. And, Toomey is not the only donor who cares about this issue: Thomas Beasley, the founder of CCA, has given $17,000 to Perry’s campaigns over the last decade; Luis Gonzales, a lobbyist for another private prison firm, the GEO Group, gave $50,000 to the campaign; and Geo Group itself gave another $15,000.

Mother Jones points out that Perry has been a fan of privatizing everything from “public lands to highways” but had been largely quiet on the issue of prisons until the influx of funds from these interested parties. The article goes on to say:

Perry’s rush to privatize prison health care is consistent with the approach he’s taken throughout most of his 10 years as governor: slashing public services under the guise of austerity, and then contracting those services out to the well-connected businesses that have made his rise possible.

Toomey is still a close friend of the governor and is running the newly formed super-PAC, Make Us Great Again, which was created to support Perry’s presidential campaign. (For those of us who aren’t in full-on election mode yet, a super-PAC, technically known as an “independent-expenditure only committee,” is a new kind of political action committee made possible by the recent Supreme Court decision which lifted some campaign finance restrictions. These committees can raise unlimited amounts of funds from corporations, unions, and individuals.)

Toomey, is not, however, the only friend, colleague, or donor who has been rewarded for his contributions to Perry’s political career.

Political Appointees

There are over 600 boards, commissions, authorities, and departments in Texas to which Perry has made almost 4,000 appointments in his 11 years as governor. And, his campaigns seem to have profited from many of these. Governor Perry’s Patronage, a report released in September 2010 by Texans for Public Justice found that between 2001 and June of 2010 “Perry’s campaign received $17,115,865 from 921 of these appointees or their spouses.”

For example, in August of this year, Perry “named James Lee, president of JHL Capital Holdings, to the Texas Higher Education Coordinating Board. Lee, who served on Perry’s 2011 inaugural committee, has donated more than $190,000 to Perry’s campaigns during the last decade.” Similarly, he appointed, Dan Friedkin, chief executive officer of The Friedkin Group, as chairman of the Texas Parks and Wildlife Commission. Friedkin contributed more than $750,000 during the last decade. In fact, the report concluded that “gubernatorial appointees accounted for an impressive 21 percent of the $83.2 million that Perry’s campaign has raised since 2001.”

Apparently, the State Parks and Wildlife Commission is one of the most lucrative for Perry as is the board of regents of Texas A & M University, Governor Perry’s alma mater. Over the years, the individuals he has appointed to these posts, including Friedkin, have collectively donated more than $4 million to his campaign.

But while a campaign contribution may be enough to get you onto one of these boards, donor beware: it takes absolute loyalty to keep you there. The New York Times reports:

In 2009, two members of the Board of Regents of Texas Tech University said the Perry administration pressured them to resign because they supported Mr. Perry’s challenger in the gubernatorial race, Senator Kay Bailey Hutchison. One regent, Windy Sitton, told The Austin American-Statesman that she was given a choice to disavow Senator Hutchison or resign; when she refused, she was replaced. Mark Griffin, the other regent, said he was told by Mr. Perry’s chief of staff that the governor “expects loyalty out of his appointees and if you can’t be loyal, it’s probably not best to be on the team.”

If Not an Appointment, Perhaps a Grant

If you donated to the Perry campaign but were not among the lucky 4,000 who could call themselves an appointee, there is no need to despair. You see the governor has a number of pots of money at his disposal that frequently seem to make it into the hands of his contributors.

The Texas Emerging Technology Fund, for example, is an economic development effort designed to create jobs in the state. Since 2005, the fund has distributed nearly $200 million to companies. Not surprisingly, a New York Times analysis found that:

[M]ore than a quarter of the companies that have received grants from the enterprise fund in the most recent fiscal year, or their chief executives, made contributions to either Mr. Perry’s campaign dating back to 2001 or to the Republican Governors Association since 2008, when Mr. Perry became its chairman.

The Times points to the case of G-Con, a pharmaceutical start-up that received a three million dollar grant from the technology fund. Not only did the head of G-Con, John McHale, contribute $100,000 to Perry’s campaign, a number of other individuals affiliated with the company are also donors. Michael Shanahan, whose biotech company Gratalis owns 10 percent of G-Con and received a separate $1.75 million grant from the technology fund, gave Perry $10,000 just a month before G-Con submitted its applications. In addition, San-Antonio business man James Leininger, who has a minority stake in Gratalis, has given Perry more than $230,000.

Of course, there are also less direct ways in which state funds are funneled to contributors. One example involves the Teacher Retirement System, a $110 billion pension fund that is among the nation’s largest. The New York Times reports that Perry has appointed at least four top donors or fund-raisers to that board, and that some of the appointees have “leaned on the fund to invest more money with hedge funds and private equity firms” and “in some cases, the appointees appear to have pushed for firms whose investors, officers, or partners were Perry donors.” When an investment manager at the fund complained about this he was told simply: “This is the way business is done.”

When Donors Impact Policy

Sure, that is the way it is done. “You scratch my back, I’ll scratch yours,” is not a new concept in business or politics though Perry’s brand of it does seem a bit more conspicuous than many. What is more disturbing, however, than the direct tit-for-tat exchange of appointments, grants, or state contracts for donations, is the more indirect ways in which this system of favors impacts how the state of Texas does business. Perry’s contributors have certainly left their mark on the state.

Take the case of Waste Control Specialist LLC which applied for permits to build a radioactive waste dump in Andrews County. Waste Control is owned by the holding company Contran Corp., whose chairman, Texas billionaire Harold Simmons, is the governor’s second largest donor having given over $1.2 million. In 2003, Perry laid the ground work for Simmons’ company to open such a dump by signing “legislation allowing a private company to build and run a low-level disposal site that would be owned by the state.”

In 2004, Waste Control applied for permits to build three facilities that would take waste from labs, military bases, nuclear plants, and hospitals as well as other radioactive “by-products.” The permits had to be approved by the Texas Commission on Environmental Quality (TCEQ). Not surprisingly, all three commissioners on the TECQ were appointed by Perry. TCEQ’s review of the application raised concerns because initial maps from the Texas Water Board showed the site to be on top of an aquifer that fed drinking and agricultural water to five states. Interestingly enough, in 2006, the water board (five of the six members of which were also appointed by Perry) released new maps that moved the boundaries of the aquifer.

To make a long story short (or at least not as long), TCEQ eventually voted 2-1 to grant the permits despite the fact that its own review committee recommended against doing so. That wasn’t the end of the controversy, however:

At least three commission employees resigned in protest At least three commission employees resigned in protest and [one commissioner] voted against the permit. Meanwhile, a state employee who advanced the permit became a lobbyist for the company a month after it was approved.

In a similar example, the TXU Corporation, a utility based in Dallas, sought permits in 2005 to build coal-fired power plants. Perry used an executive order to “fast-track” the application. According to the New York Times:

In the months that followed, current and retired TXU executives, as well as the company’s political action committee, sent Mr. Perry more than $100,000 in donations, including one check dated the same day as Mr. Perry’s order.

In this case, a state judge blocked the fast-track order saying that the governor had overstepped his authority.

In what seems to me like another gubernatorial over-reach, the Governor created a brand new state board in, the Texas Residential Construction Commission, because apparently the 600 or so he already had weren’t enough to hold all of his contributors. The Commission was, in part, created to deal with a series of mold-related lawsuits against construction companies: “the legislation creating the board also sharply limited the rights of homeowners to sue contractors for faulty construction, shunting most disputes to the commission.” According to the New York Times, this commission was a priority of Bob Perry (no relation) a home builder who has contributed more than $2 million to Perry over the years. After the legislation creating the commission was passed, Bob Perry and his wife sent two $50,000 checks to the governor’s campaign and:

Three weeks later, the governor appointed an executive of Perry Homes, Bob Perry’s company, to the commission.

This one gets to me, maybe because in the wake of Irene I’m growing mold in my basement or maybe because it just seems like such a flagrant disregard for even the appearance of impartiality.

Selling Out

I remember being surprised when I learned that Texas was one of the few states that followed through with efforts to mandate the HPV vaccine (though other states proposed legislation, only Virginia and the District of Columbia actually passed mandates). After all, having followed abstinence-only-until-marriage programs there since then-Governor George W. Bush founded his Lone Star Leaders, I considered it one of the birth places of the chastity movement.

Sure, I was as cynical as everyone else when the news of Merck’s relationship with Toomey as well as the pharmaceutical company’s own contribution to Perry’s campaign came to light. But, I was willing to give the man the benefit of the doubt as he fought his legislature’s attempts to overturn his order. He (almost) sounded genuine when he discussed the issue. After state lawmakers were successful, Perry held a news conference during which “he was flanked by several women who had contracted the virus, including one who had been raped,” and gave this impassioned plea:

“I challenge legislators to look these women in the eyes and tell them, ‘We could have prevented this disease for your daughters and granddaughters, but we just didn’t have the gumption to address all the misguided and misleading political rhetoric.’ ”

Maybe he really was thinking outside the strict parameters set by social conservatives. Maybe even though he supported abstinence before marriage, he rejected the idea that a vaccine could promote promiscuity. Maybe he realized that no matter how badly you want to control woman’s behavior, you can’t deprive them of a vaccine that prevents cancer. And maybe he really was just trying to “save lives.”

But since declaring his intention to be our next president he has put that passion aside, apologized, and backtracked. He told reporters: “The fact of the matter is that I didn’t do my research well enough to understand that we needed to have a substantial conversation with our citizenry.”

Maybe he was just willing to sell women’s health out to the highest bidder after all.