Brett Giroir: It is Time to Protect the Protectors of America’s Health

Brett Giroir, Independent Director at OncoNano Medicine, Inc., shared on LinkedIn:

“The US Public Health Service Commissioned Corps: It is Time to Protect the Protectors of America’s Health

I debated whether it would be worthwhile responding to baseless, biased opinions from a private practice surgeon who previously professed that concern about the nation’s opioid crisis was largely unfounded, and who is a fellow at an institute with little contemporary relevance.

But after internalizing the illogical, outdated, and uninformed analysis that disparaged thousands of uniformed personnel of the US Public Health Service Commissioned Corps (Corps), and the millions of lives they have saved, I counted to ten – multiple times – and decided to respond.

President Obama awarded the Corps the Presidential Unit Citation – a recognition for gallantry, determination, and esprit de corps above what is normally expected – for its risky and selfless deployment to Africa during the Ebola outbreak in 2014 to care directly for infected health care providers. No Armed Forces personnel were assigned to this duty. Without the Corps, there might have been thousands of Ebola cases in the US, with indelible consequences for our future generations and the nation’s economic trajectory. Think back to what might have been.

President Trump also awarded this prestigious citation in recognition of the Corps’ lifesaving and nation-preserving mission during COVID-19. From repatriation, to testing, to hospital ships, to leading the nation from the Situation Room and the White House Press Room, the Corps was front and center protecting America’s health. But I guess Cato either did not know, or purposely chose to ignore, these distinguished recognitions and life-saving contributions.

I had the privilege of being nominated by President Trump and confirmed by the Senate as the 16th Assistant Secretary for Health in 2018 and served as Admiral in the Corps until 2021. I served alongside my close colleague Vice Admiral Jerome Adams, the 20th US Surgeon General – one of the most influential public health advocates of our time.

It is hard to understand the motivation for such a hit piece from Cato and how four co-authors could be so lazy in their research and illogical in their conclusions. To summarize their main arguments, they assert that the Commissioned Corps is too expensive and bureaucratic, and that the Surgeon General is focused on non-public health issues (like nutrition, opioid overdoses, smoking, and marijuana use by pregnant women – I guess!).

As the Assistant Secretary in 2018, I commissioned a new, properly conducted and independent study to understand – and reform if necessary – the cost effectiveness and capabilities of the Corps. Contrary to previous findings from decades before based on flawed analysis, the Commissioned Corps was proven definitively to save tens of millions of dollars each year compared to a privatized service.

Corps physicians and nurses in the Indian Health Service and Bureau of Prisons, for example, are one-third of the cost of contractors, and provide continuity of care for years (not weeks). How would you like to change your doctor or nurse or pharmacist every month with a temporary, profit-motivated contractor who does not have your interest in mind as their primary motivation?

Moreover, Corps officers deploy for the nation and for their agencies, are on-call 24/7 doing overtime without pay, work during government shutdowns, and accomplish missions that no one else would agree to. Corps officers are duty bound – by oath – not profit-motivated by revocable choice.

I surveyed every single agency where Corps officers are assigned, and the response was unanimous. Every agency wanted Corps officers, not because of what they saved monetarily, but because of who they are as uniformed officers, and what they bring in terms of capability to achieve diverse missions to protect American lives.

The ‘policy analysis’ in which Cato assaults the Corps and the Surgeon General would be laughable, if it weren’t so offensive and incorrect. They argue that alcohol and cancer risks are not public health issues, and that service as health care providers in the Coast Guard, or leading the agency that repatriates Americans during pandemics, or assuring sanitation in our National Parks, are not legitimate public health issues. This is an insane position informed by delusional ideology.

Cato asserts many objectively false statements, such as the Corps being an ‘Agency.’ It is not. They assert that deployments are voluntary. They are not. However, they are correct that the funding structure needs to be reformed so that the Surgeon General has more direct control over budgets and deployments. Such a change would improve the Corp’s ability to achieve the missions assigned to it by the President and the Secretary of HHS.

I can only speak definitively about my time in office, working closely and directly with President Trump, often daily, making a lasting and indelible impact on our nation’s health through the Corps. No mistake – we saved lives and also saved the Administration’s political future numerous times.

During Trump 45, the Corps was called to stop the outbreak of influenza, measles, and meningitis in Customs and Border Protection facilities. I personally deployed four times to the Southern border to assure this mission was accomplished. In addition, the Corps deployed to review the records and account for separated children at the border, in weeks, as opposed to months or years that it would have taken by routine civilian review.

This was a humanitarian cause, most heartfelt by our officers and me; but it was also one in support of President Trump’s directives to remedy the flawed policy of his cabinet.

The Corps provided lifesaving and community-preserving service for the hurricane and earthquake victims in Puerto Rico, the Campfire Wildfires in California, and the multiple opioid pill-mill take downs in the southeast of the United States. We also provided expertise, behind the scenes, to distribute billions of dollars in opioid settlements to heal the millions left ravaged by the opioid epidemic.

Now let’s turn to COVID.

The Corps manned the stations at airports and points of entry to slow the spread of the disease into America in response to President Trump’s orders. After the Centers for Disease Control and Prevention and the Food and Drug Administration created the perfect storm to stall COVID testing in February 2020, the Corps solved the testing problem in a weekend, establishing nationwide drive-through testing sites in days. This accomplishment was highlighted in a national briefing with the President and Vice President from the White House in March 2020.

Corp officers risked their lives on the front lines of COVID. They deployed to Washington state to relieve the front-line workers at nursing homes ravaged by the initial assault of COVID-19. They ran to the fire and led joint forces at military bases and makeshift hospitals. Without SG Adams, few minorities would have been enrolled in vaccine trials, which would have led to widespread distrust in COVID-19 vaccination by minorities and thousands of avoidable deaths.

SG Adams is an example of what a Surgeon General should be; he was the opposite of a political puppet – in contrast to those who do not have his scientific foundation and moral backbone. Political Surgeons General are a result of partisan, idealogue Presidents, not the office of the Surgeon General itself.

During the next hurricane, or wildfire, or flood, or Chinese bioweapons attack, or Iranian nuclear assault, ask yourself if you want to call a Cato policy wonk to protect your family; or would you want an oath-bound service of uniformed health professionals who deploy anywhere at any time without regard to their own well-being. If you have any sense of risk or right, please support a future of biosecurity for your families and our nation.”