Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Monday, January 24, 2005

Breaking the back of legislative meddling

Jan. 23, 2005

Breaking the back of legislative meddling

By C.B. Hanif
Palm Beach Post Editorial Writer

Sunday, January 23, 2005

The drama regarding the proposed chiropractic school on Florida State University's campus is just the sideshow. As state lawmakers have shown, the real story is whether they will continue to lord over higher education policy even though Florida voters have said politics no longer should prevail.

Thus the vote Thursday by the Board of Governors, which the voters put in charge of approving programs such as the school of manipulation of the spine, will reveal whether the board has one. For whatever the merits of the nation's first public chiropractic college, it's impossible to defend the way the proposed school was concocted.

Ideally, under the system of higher education governance that voters established by constitutional amendment in 2002, university programs will germinate among the faculty, and have thorough vetting that includes public debate. The programs next would have to be approved by the school's Board of Trustees, then by the Board of Governors. The Legislature, whose years of academic meddling had prompted the amendment, retains power to appropriate public money for the university system and require an accounting of the finances.

But lawmakers were divested of the power to enact state higher education policy. In 2000, Gov. Bush and some of the same lawmakers had abolished the Board of Regents that opposed handing out expensive political favors in the name of education, such as the school of medicine that then-House Speaker John Thrasher pushed through the Legislature that year for his alma mater, FSU. For the first time since 1905, Florida had no citizen board governing universities, and, with lawmakers running the 11-member public university system, no checks and balances. The 2002 amendment restored citizen oversight through a governor-appointed Board of Governors, to "operate, regulate, control and be fully responsible for the management of the whole university system," with local trustee boards administering each university.

Almost as if to show they were still at the head of the class, however, lawmakers established the controversial chiropractic school last spring after little public debate. They also bestowed $9 million in public money per year in the state budget toward the program's nearly $70 million estimated cost of completion.

That's a big-ticket item the state cannot defend when Gov. Bush's latest proposed budget includes yet another 7.5 percent tuition increase for university students — regardless of whether the classes they need are unavailable as the governor and Legisture continue their pattern of paying for Florida education on the cheap. Yet the program is being foisted on taxpayers with none of the discussion that should have happened in the Legislature, nor the exhaustive review that should have happened at FSU.

Worse than the fact that FSU faculty did not ask for the school, and that it was approved by neither FSU's Board of Trustees nor the Board of Governors, is that the school was devised for no demonstrated medical need. By the Board of Governors' own recent staff evaluation, The St. Petersburg Times reports, Florida already has more chiropractors per capita than the national average. An estimated 108 chiropractors are needed to keep pace with annual demand. But a new, private Volusia County college is expected to graduate up to 188 per year by 2007.

Part of the proponents' objective is institutional legitimacy for chiropractic. Chiropractic treatment is gaining ground as an alternative therapy among some patients, and being embraced by more medical doctors. Insurers commonly cover chiropractic care, whose features include promoting the body's innate healing ability without using invasive techniques or drugs. Still, chiropractic generally is considered at best untested and at worst pseudoscience by the medical profession for treating illnessess.

That includes some of the hundreds of FSU faculty members, not to mention FSU's two Nobel laureates, who are protesting the school. Many are threatening to resign if the school is approved, citing negative implications for national accrediting bodies and damage to the reputation of the school whose new medical building a week ago was named, ironically, for Mr. Thrasher, now the trustees' chairman. In turn, the faculty's parody map of a campus with an Institute for Tea-Leaf Reading has brought charges of medical bigotry from chiropractors.

But the only established basis for the FSU program's existence is as a favor to powerful state lawmakers and lobbyists with FSU connections. Those include Sen. Jim King, R-Jacksonville, who as last year's Senate president railroaded the program and its financing to his alma mater; Sen. Dennis Jones, R-Seminole, then the majority leader and himself an alumnus and chiropractor who reportedly hopes to work at the school; and FSU booster and fellow alum Guy Spearman, lobbyist for the Florida Chiropractors' Association. FSU is run by another former House speaker and alumnus, President T.K. Wetherell.

When FSU's Board of Trustees voted 11-2 last week to forward the chiropractic proposal to the Board of Governors, rather than legitimize the program that is vipering its way backward through the system, Gov. Bush slammed the trustees for dodging the issue. "They should have voted their conscience," he said. "This has gotten way out of hand." The same trustees who had advertised to hire a dean for the chiropractic school wisely concluded that this contrived political showdown is not their fight.

But asking wimpy trustees to take point in shooting down what the Legislature already had approved and financed is typical of the kind of political calculus from which the Board of Governors is supposed to insulate the universities. And if the Board of Governors won't defend the constitutional mandate voters gave it to govern the state's university system, how can school trustees?

Even as Gov. Bush criticized the trustees, he offered his own muddled signal, announcing that he was allocating just $1.9 million in his budget — nearly $7 million less than what lawmakers approved — for the school. Between the talk of conscience and his budget cut, there appeared to be cover for his appointees to the 16-member Board of Governors. He and Chairwoman Carolyn Roberts, for example, also expressed concern that the traditional faculty review and approval process had not been exercised first.

What Sen. King's threats of budgetary consequences and other political retaliation underscore, however, is that the chiropractic school is just the latest flashpoint on the question of who runs the university system. Even if the Board of Governors finally takes a stand, count on lawmakers to continue to try to finesse this and other pet programs. At stake is whether future university policy will function backward and bend to the whims of the powerful.

That explains the citizens' lawsuit by Floridians for Constitutional Integrity, which includes E.T. York, former chancellor of the state university system. The group not only is challenging the back-door chiropractic school. There's also the political overreach in 2000 that lumped higher education in Gov. Bush's "seamless" system with a "superboard" to set education policy. Voters in 1998 had approved only a switch to an appointed board and secretary of K-12 education rather than have the Cabinet continue as the board of education.

The cover is off the long-standing tension between the Legislature and university governance. If the Board of Governors ultimately has no spine for its constitutional mandate to make public policy prevail over politics in higher education, more lawsuits are likely to come. This suit serves notice that if members are more loyal to politics than to the state's citizens, they should resign from the board, and that no great universities are run by politicians, particularly with everything up for grabs each legislative session.