From Evidence To Policy---From The Perspective Of An Experienced
Legislator
Researchers at Johns Hopkins have had a longstanding interest in how
to translate research into policy or practice. This was evidenced over
15 years ago by a workshop on the topic reported in this newsletter (EM
August/September 1998, see
https://tinyurl.com/pr8jxgq
) and
in the American Journal of Epidemiology. In keeping with that
interest, the fall issue of Johns Hopkins Public Health magazine
includes an interview with former Congressman Henry Waxman who
was instrumental in passing legislation which reduced smoking,
expanded Medicaid coverage, and increased access to generic drugs.
Below
are excerpts from the interview conducted by Clarence Lam, MD,
MPH, and himself recently elected as a Maryland state delegate.
CL: Is
the politicization of science—whether that’s climate change,
environmental issues or vaccination policy—a growing trend?
HW: Until
five to 10 years ago, most people would pay a lot of deference to
scientists because their decisions are based on evidence. Now I see a
lot of people in power dismiss science as just another point of view,
and probably one that’s biased.
Ideology seems to be much more prevalent in approaching a number of
issues that otherwise should be looked at as scientific issues.
CL: What
motivates politicians and special interest groups to discredit
scientists today?
HW: There
are a lot of groups that oppose what the scientists think we ought to
do, for ideological reasons—but more often than not, it’s for profits.
CL: What’s
your advice to scientists, researchers and others reaching out to
legislators to effect policy change?
HW: I
think it’s important that people who have expertise and knowledge
share that with the policymakers. They ought not to feel any
reluctance in that kind of a role. They’re the ones who have a special
knowledge and whose views carry a lot of weight. So my recommendation
is that they try to get those views across.
Because of the nature of what they do, scientists and researchers
often don’t want to say things in a conclusive kind of way—because
their scientific method is to always keep looking to revise the
hypothesis based on new evidence. And so they say, “It appears to be,”
or “The overwhelming evidence would indicate…” They need to be honest
about how they express it, but not in any way be cowed by the
difficulties.
CL: When
you first arrived on Capitol Hill, I think there was a greater sense
of collegiality and working amongst colleagues, particularly those
across the aisle. Do you believe that today’s
bickering and grandstanding is the new norm? Or is
there hope that the pendulum will once again swing back to that spirit
of bipartisanship?
HW: I
think the idea of the spirit of bipartisanship is overrated, because
we [always] had people who were partisans. But the parties had a more
diversity of opinion than each party now has. …But we’ve seen a
transition to the two political parties going to polar points on a lot
of issues.
CL: So
you attribute a lot of what we’re seeing today to further entrenchment
within the parties themselves. And that’s led to fewer areas where
they could work across the aisle?
HW: The
idea of working across the aisle is still there. It’s a question of
being patient enough. I look at my career in Congress as a good
example. I authored many bills that became law that people now would
say, “Well, of course we should be able to get nutritional information
when we buy a food item.” Or, “Of course we shouldn’t have to breathe
in someone else’s tobacco smoke in a public place.” Or, “It’s obvious
that we ought to do everything we can to clean up the air we breathe.”
But
there’s no inevitability to anything. Even the simple labeling law
took years to pass, to develop the consensus behind it. The Clean Air
Act took us 10 years of battling. On a lot of the laws, it sometimes
took a decade or more to pass them as we tried to educate people, so
that when they heard a quick sound bite from somebody on the other
side—who usually had an economic interest in the outcome—to step away
and evaluate the evidence and to see what’s really at stake. And
eventually, people did come around.
To
read the full interview, visit:
https://tinyurl.com/ozsjhon ■
|