July 23, 2012
BOSTON–With Massachusetts’ recent achievement of being the second “bag-free” state, many have asked us about the details of events in 2005 and 2006 and then-Governor Mitt Romney’s role in quashing a proposed regulation from the Department of Public Health to ban marketing of infant formula by hospitals. Some of these events were described in a Time article from July 17. There are details of the story that have not made the press, including the broad support for the ban in 2006, with letters from across the public health and medical establishment sent to Governor Romney in support of the ban.
Although we are not a political organization, we would like to lay out the sequence of events, including comments by Romney and his spokesman, Eric Fehrnstrom, and the actual events that transpired.
In December 2005, the Massachusetts Department of Public Health released new perinatal regulations. These regulations, required for hospital licensure, had not been updated since 1988. Years in the making, with meetings from stakeholders across the state, they included many provisions unrelated to infant feeding. According to the Boston Globe, the Public Health Council had unanimously approved these regulations.
Then Governor Mitt Romney forced DPH to rescind this proposed regulation in February of 2006, which was announced on a Friday before a holiday weekend. Many people objected to this action. Three of the nine members of Public Health Council, the body tasked with signing off the new regulations, vocally objected to Romney’s actions and the Council agreed to revisit them 3 months later, in May.
The State House News Service reported that one of the Council members, Phyllis Cudmore said the distribution of formula gift bags “undermines the initiative to nurse” and another member, Janet Slemenda, said she agreed with that assessment. “I need to see that these (regulations) come back” to the board, said Slemenda. “It needs to stay current and on the table.” (State House News Service, Feb 21, 2006)
The Boston Globe reported the story on February 18. The Globe quoted the co-chairman of the legislature’s Joint Committee on Public Health.
“[Koutoujian said] the governor’s move demonstrates a lack of trust in the public health authorities he appointed. ”This is something where the governor should not be stepping over his own public health commission,” said Koutoujian, a Waltham Democrat. ”Certainly, marketing is something about which I’ve been concerned for many years. This is the perfect instance of marketing from literally cradle to grave.”
“At an unrelated press conference later in the day, Gov. Mitt Romney said he wasn’t sure his personal views played a role in the department’s decision-making, and elaborated on his position, according to the State House News Service (Feb. 21, 2006). “I guess I’m not enthusiastic about the heavy arm of government coming in and saying we think we know better than the mothers and we’re going to decide for you that you can’t get free formula that comes as a welcome home kit from the suppliers of formula and Q-tips and baby lotions and so forth that comes from those kits,” Romney said.”
Along with the Department of Public Health, a number of health and medical organizations had sent letters to the Governor supporting the ban. According to the Boston Globe (December 22, 2005), the Massachusetts Hospital Association also supported the regulations when they were first announced. The Massachusetts Breastfeeding Coalition had sent letters by overnight mail to the governor from the Massachusetts Public Health Association, the Centers for Disease Control and Prevention, District 1 of the American College of Obstetricians and Gynecologists, and the American Public Health Association. The ban also had the support of the Massachusetts Medical Society (publishers of the New England Journal of Medicine).
[In January of 2007, a joint letter went out to hospitals across the state, asking them to give up the marketing bags, from the Massachusetts Chapter of the American Academy of Pediatrics, the Massachusetts section of ACOG, the Massachusetts chapter of the Association of Women’s Health and Neonatal Nurses, and the Massachusetts Breastfeeding Coalition.]
As the hearing date approached in May 2006, Romney’s spokesman, Eric Fehrnstrom told the Boston Globe, “there is a very vocal minority of breast-feeding advocates who want to take a punitive approach with mothers who choose formula.” (Boston Globe, May 8, 2006). Aside from the fact that the ban was a public health action with no punitive intentions, Fehrnstrom would have known that advocates of the ban were not a “vocal minority,” but rather represented the public health and medical establishment.
In addition, the Massachusetts Breastfeeding Coalition circulated a petition that was signed by approximately 4,000 people, which we presented to the Governor’s office in person on May 12, 2006, the day we held a demonstration in front of the State House. (See photos). In our public campaign about the ban, we highlighted the connection between the formula makers and their parent companies, which are mostly pharmaceutical companies. At the time, there was growing public attention in the state to conflicts of interest between health care professionals and pharmaceutical companies.
Then Romney surprisingly dismissed the three members of the Public Health Council who had publicly objected to his actions. The Boston Globe reported on Saturday, May 20, 2006 that Romney had fired two of the members on May 18, and the third on the month before. The hearing was scheduled for Wednesday, May 24. According to the Globe:
“At the council’s February meeting, Cudmore had declared: ”I don’t think there is any place in the hospitals for corporate America to be trying to influence a population that is vulnerable at this time in your child’s life and a mother’s life.”
“She was replaced in April.
“Yesterday, Romney completed his transformation of the nine-member council, replacing members Janet M. Slemenda and Manthala George Jr. In February, Slemenda had described the gift bag ban as ”really critical.”
“In an interview yesterday — the same day he was told he was being replaced — George said distribution of the freebies at hospital maternity wards ”commercializes the entire process.”"
Public Health Council members are appointed by the Governor and serve at the Governor’s discretion. When asked about the firings, Fehrnstrom told the Globe, “As their terms expire, it is common practice for the governor to replace them and give new people a chance to perform public service.” (Boston Globe, May 20, 2006)
According to the Globe, Cudmore’s term had ended a year before and Slemenda’s term had expired in 1999. Only George’s term had expired in May 2006. Per the Globe, “It is not uncommon for members of appointed boards to continue serving at a governor’s pleasure, even after the official end of their terms. No one else on the board [was] serving in an expired term.” (Boston Globe, May 20, 2006)
The same article noted the response from the Massachusetts Breastfeeding Coalition:
”I find the timing of all three replacements disturbing,” said Dr. Melissa Bartick, chairwoman of the Massachusetts Breastfeeding Coalition. ”I think the governor is clearly illustrating that he is more interested in protecting the pharmaceutical industry than in standing up for the children and mothers of Massachusetts.”
When the hearing finally did take place on May 23, the discussion of the ban was taken off the agenda. The nine Public Health Council members took their seats at the front of the room. Six of them sat behind had placards engraved with their names. Romney’s three new replacements had apparently been replaced so hastily that their placards had their names handwritten in green magic marker. Two of the three replacements were business executives, and the third was a lawyer who was very active in the Republican party.
In its coverage of the hearing published May 24, the Globe quotes said state Senator Richard T. Moore, an Uxbridge Democrat, as saying: “This whole flap over the formula is a case where they’ve been directed basically to follow a particular philosophy, and three members are no longer members because they weren’t marching in step with the administration.”
On June 2, 2006, a front-page story ran in the Boston Globe detailing a deal the state made with Bristol Myers Squibb to build a new $660 million pharmaceutical plant at Devens, a defunct army base in Central Massachusetts, which could bring in as many as 550 jobs. Bristol Myers Squibb, “a $50 billion company” is the parent company of Enfamil, the nation’s largest formula maker. According to the Globe:
“To land Bristol-Myers Squibb, the state offered the company more than $60 million in spending and incentives, including $34 million to build new waste treatment and sewage facilities on the Devens site, and a change to the state’s investment tax credit rules to let the company claim a refund for 5 percent of its investment in the facility. According to the company’s current building plan, that could cost the state as much as $33 million.”
The Globe went on to describe the negotiations behind the deal:
“Yesterday’s announcement marked the culmination of an eight- month competition between Massachusetts, Rhode Island, New York, and North Carolina, which has made a strong push to become a biotechnology manufacturing center by touting its low housing and labor costs.
“The state first received word in October that a major drug company was scouting for a new site. For two months officials assembled a proposal without knowing the name of the company, referring to the deal only as “project Hummingbird.” They finally met Bristol-Myers Squibb officials at Devens in December.”
December was the same month the formula ban was announced in the new perinatal regulations.