Eastman Kodak
no merri
trump supply chain kushner fail COVID
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AM PROS
FOur and a half years ago, Department of Government Efficiency co-czar Brad Smith stumbled on a counterintuitive revelation: The most effective way to slash federal health care spending involved drastically raising Medicare and Medicaid reimbursement rates for hospital care.
:{At the time, Smith was running something called the Center for Medicare and Medicaid Innovation, an obscure off-the-books laboratory created by the Affordable Care Act for experimenting with “alternative payment models”—neoliberal for “larger sums with less accountability.” In its ten years of operation, CMMI had spent more than $10 billion testing various methods of tweaking reimbursement standards in (theoretical) hopes of improving health care outcomes for lower costs:{. They had worked with UnitedHealth, Aetna, Molina,}: and other insurers in 13 states to reward primary care physicians who administered more preventative care and collected more specific data on their patients.
They’d worked with more than 100 hospitals and mega-practices to bundle payments for complex patients, in hopes of lowering the ultimate cost of treating chronic illnesses. CMMI had spent some $10 billion testing out dozens more schemes, nearly all of which subscribed to an ideology called “value-based care,” in which the central flaw of American health care is “volume-based” fee-for-service compensation schemes that incentivize “overutilization” of the health care system, and so the natural “solution” involves the government paying health care providers and various intermediaries to take steps designed to decrease said “utilization.”}:
Value-based care grew especially important during the Obama years, because the ACA mandated that insurance companies spend a minimum of 85 percent of patients’ premium dollars on “care,” wiping out profit drivers like the mandatory insurance policies UnitedHealth sold to college students that often boasted medical loss ratios as low as 10 percent. Insurers in turn began to focus their energies around their highest-revenue patients: seniors with a lot of complex health issues who were enrolled in the private Medicare offerings known as Medicare Advantage. They would soon buy up the medical practices, home health agencies, and surgery centers that treated these patients, in a move that enabled them to at once “align incentives” (i.e., control more of the medical decisions they were paying for), park the excess profit margins they weren’t allowed to report on their insurance sides, and find more Medicare patients to convert to MA plans.
Brad Smith was a value-based guy. He’d gotten in on the ground floor of the craze during the first term of the Obama administration, while helming the education reform foundation of former Senate Majority Leader Bill Frist (R-TN), whose billionaire brother Tom Frist founded the hospital behemoth HCA, whose long history of unnecessary overtreatment of Medicare patients perhaps ironically gave birth to the value-based revolution. Together, the two had built a home health care business with more than 650 employees that they had just sold for $440 million to health insurer Anthem.
Smith had been working as the chief operating officer of Anthem’s value-based business when he’d been tapped for the CMMI gig by one Adam Boehler, another value-based evangelist who often talked about how he wanted to “blow up” the “volume-based” ancien régime. Still, doctors, especially the types of doctors who complained about Obamacare and voted for Trump, hated value-based care, because it required spending way too much money on software and far more hours doing paperwork than the incentive payments could justify. Smith’s boss, Centers for Medicare & Medicaid Services (CMS) head Seema Verma, was value-based skeptical, and wanted to know whether CMMI’s programs were actually working as “intended.” So Smith ordered his staff to conduct a financial analysis of all 54 programs CMMI had bankrolled to test out the new approach to health care.
Smith and a 24-year-old deputy from his Nashville VC firm are said to be building the vision of what will replace everything that DOGE has eradicated.
The verdict was unambiguous: Value-based care was a bust. For two of its biggest programs, CMMI had spent $7 billion more than it had saved, just from compensating all the various intermediaries that had administered the trials. The reasons for this were twofold, say two individuals who worked on value-based care policy for the Obama administration: One, CMMI and CMS invariably outsourced the management of the trials to “venture capital or private equity firms or nonprofits where the CEO is making millions of dollars” that typically alienated and underpaid the clinicians they were ostensibly seeking to incentivize; and two, most of the policymakers involved were too preoccupied with “how they were going to monetize their expertise” to design programs that might actually save CMS money.
Lending credibility to that analysis, the shining star of the small agency’s roster of reform measures was the “Maryland All-Payer Model,” a state-operated system originally devised in the early 1970s by which an independent commission fixed flat hospital prices for the state that every payer—from Blue Cross to Medicaid—is expected to pay. The Maryland Model, which was modified in 2014 and discarded in favor of a more complex, almost European-style “global budgeting” system in 2018, is a rabbit hole with its own unique advantages and disadvantages, but it is decisively notvalue-based care, and sources familiar with CMMI said its affiliation with the initiative was something of a fluke, especially given that Medicare conclusively pays far higher rates for medical care in Maryland than anywhere else (though yearly per capita expenditures are higher in Florida). And yet the Maryland system saved CMS $1 billion over just five years tracked by CMMI, likely in large part by lacking the administrative middlemen and arbitrageurs in the system and the waste and fraud that tend to accompany them.
This analysis might have made for an embarrassing news cycle for CMMI and all the affiliated grifters who had cashed in on the value-based boom, like Smith’s predecessor Boehler, a college roommate of Jared Kushner’s who would soon sell his home health agency for $3.5 billion to UnitedHealth, or CMMI founding director Patrick Conway, who’d left the agency a few years earlier to become the richly remunerated CEO of Blue Cross in North Carolina, where he had rolled out a mandatory value-based care regime in conjunction with the CMMI-friendly healthtech Aledade, and recently been charged with driving under the influence after crashing his car with his two elementary school–aged daughters inside.
Instead, they were all saved by the pandemic, during which Smith was detailed to the Trump inner circle for assistance with various pandemic response efforts, and ended up becoming close to Kushner himself, according to The New York Times. By the time he returned to CMMI to write up the results of his staff’s analysis in The New England Journal of Medicine, CMS had rained down hundreds of billions of bailout dollars on the health care system, and no one even bothered making hay of the news that the agency had wasted $10 billion testing out cost-cutting ideas that didn’t pan out.
In one of his last acts at the agency, Smith introduced a new program called the Geographic Direct Contracting Model, or “Geo,” by which all remaining traditional Medicare beneficiaries were slated to be automatically assigned on the basis of their residence to a value-based care organization to which CMS would pay a flat annual fee to assume their health care “risk.” Geo contractors would be virtually unregulated, though they would be held to a medical loss ratio minimum requiring them to spend at least 60 percent of their revenues on care. The Biden administration scrapped Geo in early 2021, but kept a slightly less radical Smith plan with a similar goal of stealth total privatization after renaming it ACO REACH, for “Accountable Care Organization Realizing Equity, Access, and Community Health.”
Smith moved back to Nashville and took the helm at two new value-based care upstarts, a Medicaid home health intermediary called CareBridge and a rural Medicare Advantage play called Main Street Health. In late October, he sold the former to Elevance, the new name of the insurer to whom he’d sold his first home health company, Aspire. This time, the head count was lower—fewer than 500 employees—but the price tag was much, much bigger, at $2.7 billion.
A putative class action lawsuit filed last month in Florida by a “clinical assessor” for CareBridge alleges that she and other low-level employees were required to work 45 hours a week for only 40 hours’ pay, and dozens of negative reviews on job sites suggest assessors work as many as 20 extra hours without pay. Worse, employees say the job mostly consists of “managers … demanding that you drastically cut caregiver hours for people who desperately need someone in their home.”
“This is a greed-driven company that is preying on our nation’s most vulnerable and poorest people. If you can sleep at night and live with yourself while harming the poor and disabled during the day, this job is for you,” reads one review on Glassdoor. “If CareBridge is the future of healthcare then we heading to a sad state of affairs,” reads another.
Just months after the CareBridge deal, Smith was reported to be hanging around Mar-a-Lago with Steve Davis, the longtime Elon Musk loyalist who ran the hostile takeover of Twitter. Underneath Musk and Vivek Ramaswamy, who would soon depart, Smith and Davis are said to be the real operating leaders of DOGE, with the latter playing the bad cop masterminding the scorched-earth shutdowns and cuts, while Smith and a 24-year-old deputy from his Nashville VC firm are said to be building the vision of what will replace everything that DOGE has eradicated, according to a source familiar with his recruiting efforts. CMMI, a highly unusual agency with a ten-year, self-renewing budget outside the appropriations process and an extraordinary ability to grant waivers from the statutes governing CMS, including fraud and kickback statutes, is said to be a model for how Musk wants DOGE to reimagine the federal government.
As further evidence of that, Smith’s predecessor as CMMI director, Boehler, whose brand-new venture capital firm Rubicon Founders last spring raised more than a billion dollars for its latest fund and also groomed Trump’s newest CMMI director, 33 year-old Abe Sutton, is currently working as Trump’s special presidential envoy for hostage affairs. Boehler got his start in the health care business as a medical debt collector, first at a firm called MedeFinance and then with a shadowy empire called Accretive, which was banned from the state of Minnesota in 2012 after an employee left a laptop in a taxi that revealed the company had essentially seized the operations of a Minneapolis nonprofit hospital system and was using confidential health records, collected under the guise of value-based care modeling, to manipulate patients into coughing up large cash payments for hospital services to “embedded” collection agents, sometimes while under the influence of powerful anesthesia.
The obscure agency Boehler launched after leaving CMMI, the U.S. International Development Finance Corporation—best known for its failures to do much of anything with its nine-figure budget for bolstering supply chains during the pandemic after an ill-fated $765 million loan it made to Eastman Kodak was shelved after revelations of insider trading—was reported on Wednesday to be DOGE’s designated “replacement” for the U.S. Agency for International Development, under the leadership of venture capitalist Joe Lonsdale and Ben Black. The latter is the son of disgraced billionaire Leon Black, an accused sexual predator who was forced to leave the private equity juggernaut after revelations that he had wired nearly $200 million to Jeffrey Epstein, whom he considered his best friend, in the years before Epstein’s death. A January Substack post by Lonsdale and Black on their plans for “disrupting” the $43 billion USAID budget is light on specifics but advocates defunding nongovernmental organizations to pursue an “investment-driven model focused on strategic project finance initiatives.”
Foreign aid, of course, is a rounding error compared to the multitrillion-dollar health care budget, in which the *Prospect estimates a team of forensic accountants might easily find as much as a half-trillion dollars in waste annually, roughly $100 billion of that in Medicare Advantage overpayments alone. (Obama had the chance to clamp down on the obvious MA grift, but abruptly reversed course in 2014.) In a 2021 Zoom
on the tenth anniversary of the agency and the future of “value-based care” moderated by ubiquitous value-based care venture capitalist Ann Lamont, Smith, Boehler, and CMMI founder Conway, now the CEO of UnitedHealth’s OptumRx division, held forth almost giddily on the rosy “future of value-based care,” with Boehler jokingly describing Conway as the agency’s “Adam Neumann,” the self-aggrandizing WeWork founder who burned some $20 billion in venture capital funding. At one point, Smith brought up his analysis, commending the agency for making “value-based care” such an inescapable industry buzzword but acknowledging that only five of the group’s 54 experiments had delivered any cost savings whatsoever. Lamont quickly changed the subject. “Imagine in a few years, we receive 90 percent of payments in value-based commitments. How do we get there?”
This probably wasn’t how any of them imagined it going down, but with Smith running the rogue operation that is apparently running the country, it seems likely we’ll get there.
Tags
Health & Social Policy CMS Medicare health insurance Affordable Care Act Obama Administration privatization federal government DOGE Elon Musk Donald Trump Trump transition
Maureen Tkacik is investigations editor at the Prospect and a senior fellow at the American Economic Liberties Project.
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https://www.alternet.org/2020/09/team-trumps-response-is-now-a-worldwide-embarrassment
hunter kos
stats --> They’re laughing at us, Donald. Well, they’re laughing at you. Well, actually nobody’s laughing, there’s 200,000 Americans dead and in the ground right now and, still, the only pandemic “plans” coming out all members of Republican leadership combined ended up abandoned because they left it to Jared Kushner, and Jared Kushner got bored.
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920 an
https://www.alternet.org/2020/09/we-were-flabbergasted-new-report-says-jared-kushners-conduct-stunned-attendees-at-a-19-meeting/
when Jared Kushner was grilled by CNN’s Wolf Blitzer earlier this week, the White House senior adviser vigorously defended President Donald Trump on a range of issues — including the president’s widely criticized response to the coronavirus pandemic. Kushner has played a key role in that response: he was put in a charge of a private sector-oriented coronavirus task force that was separate from the White House task force with Dr. Anthony Fauci and Dr. Deborah Birx.
And in a lengthy, in-depth article for Vanity Fair, Katherine Eban revealed some explosive details of Kushner’s coronavirus response, focusing heavily on a meeting on Friday, March 20.
Kushner was present at that meeting, which was attended by “a large group of officials at the Federal Emergency Management Agency — people one attendee described as ‘the doers’ — to strategize how best to replenish the nation’s depleted reserves of PPE.”
Kushner, Eban reports, had a “confrontational tone” when he told attendees, “The federal government is not going to lead this response,” he announced. “It’s up to the states to figure out what they want to do." When one of the attendees expressed concerns about PPE shortages, Kushner said, “Free markets will solve this. That is not the role of government.”
New York Gov. Andrew Cuomo, Eban notes, was desperate for supplies — and Kushner’s response was, “Cuomo didn’t pound the phones hard enough to get PPE for his state…. His people are going to suffer, and that’s their problem.” And one of the attendees told Vanity Fair, “That’s when I was like, ‘We’re screwed.’”
According to Eban, “What actually transpired in the room stunned a number of those in attendance. Vanity Fair has reconstructed the details of the meeting for the first time, based on recollections, notes, and calendar entries from three people who attended the meeting. All quotations are based on the recollections of one or more individual attendees.”
Kushner, according to one of the attendees Vanity Fair interviewed, became “very aggressive” and told the group they “only understood how entrepreneurship works, but didn’t understand how government worked.”
Another attendee told Vanity Fair it was “very clear” that Kushner wasn’t interested in finding a solution to the shortages because in March, COVID-19 was primarily hurting blue states. According to that attendee, “We were flabbergasted. I basically had an out-of-body experience: where am I, and what happened to America?”
Eban goes on to describe some of the subsequent problems with Kushner’s coronavirus response, including plans for Eastman Kodak to manufacture drugs needed during the pandemic.
“Of all the aborted efforts to secure America’s supply chain of essential lifesaving supplies,” Eban writes, “no deal has blown up more spectacularly than the one to turn an aging camera film company, Eastman Kodak, into an American manufacturer of ingredients for low-cost generic drugs.”
According to Eban, “Vanity Fair has learned, Eastman Kodak was so untested when it came to making drug ingredients that the company’s head of government relations, Kristin Calabrese Williams, wrote to a government health official in March saying that the company would need a ‘waiver from the FDA’s requirements’ to ensure drug safety.”
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lobbyist
Williams, Kristin Calabrese BKSH
| 2008- | Eastman Kodak Revolving Door Personnel: (6) |  Client lobbying profile Major Donor profile | |
|---|---|---|---|
| 2006-2006 | Center for International Education Revolving Door Personnel: (4) | Client lobbying profileMajor Donor profile | |
| 2004-2005 | Public Broadcasting Service Revolving Door Personnel: (19) | Client lobbying profileMajor Donor profile | |
Walsh, James T Revolving Door Personnel: (5) | Legislative Aide | Legislative Aide |
Eastman Part of Coalition that Quashed Stricter Bill on Chemicals
by Emily Kopp on February 12, 2014 8:00 AM
In the months before the Jan. 9 spill of a coal-washing agent into West Virginia's Elk River, an effort to ensure more oversight of commercial chemicals was supplanted by a heavily lobbied, industry-friendly measure that in many ways would have defanged existing Environmental Protection Agency regulations.
The spill has brought new attention to a yellowing statute that is supposed to keep chemical dangers in check.
When the Toxic Substances Control Act (TSCA) went on the books in 1976, most of its requirements applied only to new chemicals; those that existed at the time were effectively accepted as safe. The licorice-scented fluid that turned up in the faucets of thousands of West Virginia homes last month, 4-MCHM, was one of those 62,000 chemicals grandfathered in.
In Congress last year, advocates for a tougher law watched as theAmerican Chemistry Council -- a powerhouse trade association that lists **Eastman Chemical** (which made the substance that leaked in January), **Exxon Mobil** and **Dow Chemical** among its members -- worked to support the bipartisan Chemical Safety Improvement Act, an overhaul of TSCA. The Council spent almost $12.3 million on lobbying in 2013, the group's highest tab on record and the most of any chemical industry organization that year. It even sponsored a sharp-looking interactive website, complete with cheerful stock photos and colorful tabs, dedicated to promoting the proposed legislation.
The group's support seemed to signal an abrupt turnaround, given its legacy of opposing regulation. For instance, just the year before, the Council weighed in to oppose greater oversight of flame retardants in couches after a study by researchers with three prominent universities found them hazardous. As this blog has noted, the Council maintained in a press release that retardants provided valuable escape time in the case of a fire. Existing EPA regulations, according to the group, provided the public with sufficient safety. The Council logged nearly $9.1 million in lobbying expenses in 2012.
'It's important to remember that flame retardants currently in use, like all chemicals, are subject to review by the U.S. Environmental Protection Agency (EPA) and national regulators around the globe," the press release reads.
So why would the premier advocate for the chemical industry's interests suddenly embrace stiffer rules? One reason: The TSCA update -- sold to the public as an improvement -- was mostly hollow, and the bill also weakened state authority to regulate chemicals, according to Daniel Rosenberg of the Natural Resources Defense Council. To pass the Chemical Safety Improvement Act "would be compounding one environmental disaster with another," Rosenberg wrote in a blog post on Jan. 15. The bill would grandfather in even more chemicals, assess chemicals using industry-preferred standards over National Academy of Sciences-approved methods and prevent the EPA from requiring testing of existing chemicals unless it has evidence they're dangerous, according to Rosenberg. Sen. Barbara Boxer (D-Calif.) cited the post in a Senate hearing on the spill on Feb. 4.
The bill, which was sponsored by Sens. David Vitter (R-La.) and the late Frank Lautenberg(D-N.J.), replaced an earlier measure that Lautenberg had proposed, the Safe Chemicals Act of 2013. That bill, which did not have bipartisan support and would have imposed stricter oversight, attracted hundreds of lobbying reports by 51 discrete organizations during the month between its introduction in April and the Chemical Safety Improvement Act's appearance in May.
Safer Chemicals, Healthy Families, a coalition of public health and parent organizations, praised the Safe Chemicals Act for broadening and strengthening the EPA's authority to regulate dangerous chemicals. By contrast, in testimony to the House Energy and Commerce Committee, the group was critical of the Chemical Safety Improvement Act.
"Neither bill would have prevented the [West Virginia] spill but the key difference is that with SCA there would be health and safety information available to better respond and protect people," wrote spokesman Tony Iallonardo in an email interview with OpenSecrets Blog. "The CSIA continues the status quo on that score." The coalition spent $100,230 lobbying on the two bills in 2013.
Judging by another press release from the American Chemistry Council, it appears that industry reps were working with Vitter to craft an industry-friendly alternative as soon as Lautenberg's first bill was introduced.
Vitter has been a strong ally of the chemical and energy industries. He consistently bucked evidence showing that formaldehyde is a carcinogen. From his seat on the Environment and Public Works Committee, he held up the confirmation of an EPA nominee to push for more research and delay tighter regulation of the chemical. Though thousands of Hurricane Katrina victims in his district developed respiratory problems after staying in emergency trailers that contained formaldehyde, Vitter didn't change his position. The EPA is expected to release a new assessment of formaldehyde's potential public health risks this year.
Charles Grizzle, a lobbyist for the chemical industry who worked briefly for EPA, contributed sizably to Vitter after the release of new evidence that formaldehyde is a carcinogen, according to a ProPublica investigation. In the spring of 2010 Grizzle hosted a fundraiser for the lawmaker at the Capitol Hill Club with a $1,000 per plate suggested donation. According to OpenSecrets.org data, he and his family have contributed $18,000 to Vitter since the 2011 ProPublica story.
The super PAC supporting Vitter's bid to be his state's next governor, Fund for Louisiana's Future, has pulled in $1,509,574 so far, much of it connected to oil and energy interests.
Meanwhile the oil and gas industry has given Vitter $1.2 million over the course of his congressional career, putting it in a virtual tie with health professionals as his most generous industry donor. So far in the 2014 cycle, it has given him $46,000.
Vitter's personal finances also are tethered to the chemical and energy industries. Investments in energy accounted for at least 48 percent of his minimum net worth in 2012 (it is impossible to tell what some assets, such as mutual funds, are invested in).
It appears Eastman was also very invested in the Chemical Safety Improvement Act in the months before 4-MCHM trickled into the West Virginia water supply.
Of the 17 lobbying reports Eastman filed in 2013, 11 expressly mentioned TSCA. Eastman spent more than $1.9 million on lobbying last year.
"Eastman [Chemical] strongly supports the Chemical Safety Improvement Act," wrote company spokesperson Maranda Demuth in an email interview with OpenSecrets Blog. "The bill would address some of the issues raised by the West Virginia situation," though she didn't specify what those were.
Eastman has operated a PAC since at least since 1993, according to FEC records; the PAC reported spending $208,000 in 2013. Most of Eastman's favored candidates for 2014are Republicans, and many are from Tennessee, including Rep. Marsha Blackburn, vice chairman of the Energy and Commerce Committee; she received a $3,000 contribution. In the 2012 cycle, Eastman's PAC gave $378,495 to congressional candidates.
Overall, chemical manufacturers have spent more than $456 million lobbying in the last decade, in part to avoid stricter regulation of their products. Though lobbying overall fell in the years following the 2007 financial downturn, chemical industry lobbying ticked rapidly upwards, hitting an all-time high of $61 million in 2013. Campaign contributions by PACs and individuals connected to the chemical industry increased five fold from 2010 to 2012, from $9 million to $48 million.
A pending class action lawsuit alleges Eastman Chemical should have provided more information about the chemical's potential harms, especially any carcinogenic dangers, to plant workers and the public. Whether current law requires Eastman to provide that information, or for that matter, to have done any such research on 4-MCHM, remains ambiguous at best.
Currently, the Chemical Safety Improvement Act is stalled, with no votes or hearings scheduled, according to a staffer in Boxer's office. The bill is being held up in negotiations over strengthening its provisions and ensuring they don't preclude state action, the staffer said.
http://www.opensecrets.org/orgs/summary.php?id=D000000744
Top Candidate Recipients, 2013-2014
| Candidate | Amount |
|---|---|
| Alexander, Lamar (R-TN) |  $10,000 |
| Pryor, Mark (D-AR) |  $10,000 |
| Toomey, Pat (R-PA) |  $7,250 |
| Murphy, Tim (R-PA) |  $5,750 |
| Black, Diane (R-TN) |  $5,000 |
2014
| Senate | Alexander, Lamar (R-TN) | $10,000 |
|---|---|---|
| Senate | Pryor, Mark (D-AR) | $10,000 |
| Senate | Toomey, Pat (R-PA) | $7,250 |
| House | Murphy, Tim (R-PA) | $5,750 |
| House | Black, Diane (R-TN) | $5,000 |
| House | Boehner, John (R-OH) | $5,000 |
| Senate | Crapo, Mike (R-ID) | $5,000 |
| House | Griffith, Morgan (R-VA) | $5,000 |
| House | Rogers, Mike D (R-AL) | $5,000 |
| House | Blackburn, Marsha (R-TN) | $3,000 |
| Senate | Cornyn, John (R-TX) | $3,000 |
| Senate | Ayotte, Kelly (R-NH) | $2,500 |
| Senate | Baucus, Max (D-MT) | $2,500 |
| Senate | Cruz, Ted (R-TX) | $2,500 |
| House | Duncan, John J Jr (R-TN) | $2,500 |
| Senate | Landrieu, Mary L (D-LA) | $2,500 |
| Senate | Tester, Jon (D-MT) | $2,500 |
| House | Byrne, Bradley (R-AL) | $2,000 |
| House | Fincher, Steve (R-TN) | $2,000 |
| House | Fleischmann, Chuck (R-TN) | Fleischmann, Chuck (R-TN) |
But before long Bittner began butting heads with Welshons and vom Saal. Bittner wanted the researchers to sign over the rights to the test Welshons had developed, while they insisted it belonged to the University of Missouri. Eventually, they had a bitter falling out. Welshons and vom Saal filed a complaint with the NIH, alleging that Bittner had misrepresented data from Welshons' lab in a brochure. (Bittner maintains that he merely excluded data from contaminated samples; the institute found no evidence of wrongdoing.) Bittner, meanwhile, enlisted V. Craig Jordan, a pharmacology professor at Georgetown University with an expertise in hormones—he discovered a now-common hormone therapy that blocks the spread of breast cancer—to refine the testing protocol. By 2005, Bittner had opened a commercial lab in a leafy office park in Austin. He managed to attract some big-name clients, including Whole Foods, which hired CertiChem to advise it on endocrine-disrupting chemicals and test some of its products.
At this point, BPA was among the most studied chemicals on the planet. In November 2006, vom Saal and a top official at the National Institute of Environmental Health Sciences convened a group of 38 leading researchers from various disciplines to evaluate the 700-plus existing studies on the subject. The group later issued a "consensus statement" that laid out some chilling conclusions: More than 95 percent of people in developed countries were exposed to levels of BPA that are "within the range" associated with health problems in animals, from cancer and insulin-resistant diabetes to early puberty. The scientists also found that there was "great cause for concern with regard to the potential for similar adverse effects in humans," especially given the steep uptick in these same disorders.
At the same time, a new body of research was finding that BPA altered animals' genes in ways that caused disease. For instance, it could switch off a gene that suppresses tumor growth, allowing cancer to spread. These genetic changes were passed down across generations. "A poison kills you," vom Saal explains. "A chemical like BPA reprograms your cells and ends up causing a disease in your grandchild that kills him."....
Even as the industry crafted defensive talking points, some companies began offering BPA-free alternatives. But they often didn't bother testing them for other potentially toxic compounds or synthetic hormones. Nor did they have to: Under US law, chemicals are presumed safe until proven otherwise, and companies are rarely required to collect or disclose chemical-safety data. Michael Green, the Center for Environmental Health director who worried about his daughter's sippy cup, says this results in a "toxic shell game": Corporations that come under pressure to root out toxins often replace them with untested chemicals, which sometimes turn out to be just as hazardous. "It's an unplanned science experiment we're doing on our families," Green told me when I visited him at his Bay Area home, where Juliette, now 5, was padding around in a pink princess costume.
One of the most popular BPA-free options, especially among companies catering to families and health-conscious consumers, was Tritan, a clear, sturdy, heat-resistant plastic that Eastman rolled out in 2007. (Eastman also produces the chemical that sullied the drinking water of 300,000 West Virginians in January [32].) A company founded by alternative medicine guru Dr. Andrew Weil launched a line of Weil Baby bottles made from Tritan, which it touted as "revolutionary" and "ultra-safe" material. Thermos began churning out Tritan sippy cups, decorated with Barbie and Batman. With more and more consumers demanding BPA-free products, Nalgene, CamelBack, Evenflo, Cuisinart, Tupperware, Rubbermaid, and many other companies also worked Tritan into their production lines.
Eastman, a $7 billion company that was spun off from Eastman Kodak in the 1990s, assured its corporate customers that it had done extensive safety testing on Tritan. But its methods were questionable. According to internal Eastman documents, in 2008 Eastman signed a two-year contract with Sciences International, another product defense firm that had played a key role [33] in the tobacco industry's scientific misinformation campaign. On Sciences' advice, Eastman then commissioned a study that used computer modeling to predict whether a substance contains synthetic estrogens, based on its chemical structure. The model suggested that one of Tritan's ingredients—triphenyl phosphate, or TPP—was more estrogenic than BPA.
Eastman, which never disclosed these findings to its customers, later commissioned another study, this one involving breast cancer cells. Again, the initial results appeared positive for estrogenic activity. In an email to colleagues, Eastman's senior toxicologist, James Deyo, called this an "oh shit moment [34]."
...
Despite its "oh shit" findings, by 2010 Eastman began to produce marketing materials claiming that Tritan was free of all synthetic estrogens. One section of its website [36] featured the tagline "Safety is our key ingredient" along with photos of smiling children eating and drinking out of plastic containers. The site claimed "third-party research" had shown Tritan to be free of estrogenic activity, but when corporate customers tried to verify this information, Eastman grew cagey. In early 2010, Philips Avent, a top producer of baby bottles and sippy cups, inquired about having an outside lab run testing on Tritan. Eastman's senior chemist Emmett O'Brien fired off an email [37] to colleagues, saying, "We need to [do] everything possible to convince the customer NOT to do EA [estrogenic activity] testing." Philips was persuaded. But, according to testimony from Eastman executives, that same year Nestlé vetted Tritan, and found it leached synthetic estrogen. (Frédérique Henry, a spokeswoman for Nestlé, acknowledges the company tested Tritan but denies the results were positive.) Nestlé has nevertheless continued using Tritan in some of its water bottles.
Bittner and Usey, meanwhile, decided to go public. "As long as the consumer demand wasn't there, product manufacturers felt we were selling them a problem rather than a solution," Usey explains. "We saw this as the only way forward." Bittner's companies, which have received more than $8 million in NIH funding, began working with Jordan, the Georgetown professor, on a paper for publication. In the fall of 2010, Usey attended the ABC Kids Expo, a children's product extravaganza in Las Vegas, and handed out flyers with a graph showing how various products that were marketed as nonestrogenic stacked up in CertiChem's tests. The most estrogenic among them, Weil Baby bottles, were made from Tritan. (The company referred Mother Jones to a press release on its website stating that it "remains confident that Tritan is safe.")
Soon Eastman's customers began inquiring about CertiChem's findings. For the most part, Eastman convinced them to disregard Bittner's claims. At one point, O'Brien met with Whole Foods executives. They were considering replacing their polycarbonate bulk food bins with ones made from Tritan, even though Bittner had previously informed them [38] that the product was estrogenic. According to a memo O'Brien later wrote [39], when the subject came up, he responded by attacking Bittner, whom he called "shady," and his test results, which he alleged were "very questionable." The Whole Foods executives later pressed O'Brien about the other tests carried out on Tritan....
The month after Bittner's study appeared, the American Chemistry Council contacted Chris Borgert, the former tobacco industry scientist who stymied the EPA's Endocrine Disruptor Screening Program. According to internal emails [41], the council and the Society of the Plastics Industry offered to pay him $15,000 to write a brief letter to the journal's editor refuting CertiChem's study, and to enlist another scientist to sign on. Their letter argued that CertiChem's findings were "unconvincing"; just because a substance behaved like estrogen in a culture dish didn't mean it would do so in animals or humans.
At the same time, Eastman laid plans to sue CertiChem and PlastiPure for false advertising. Expecting that Bittner would lash out after being served papers, the company launched a preemptive PR blitz. "By proactively promoting Tritan safety," an internal memo [42] noted, "it will put PlastiPure in a position to have to prove Eastman wrong." The company also paid a scientist named Thomas Osimitz $10,000 to author a research paper on Tritan. While Osimitz was ostensibly working independently, Deyo, the Eastman toxicologist, micromanaged the process, from designing the study to writing the introduction. Deyo's study design virtually guaranteed estrogenic activity wouldn't be found. For example, he opted to use the hormone-insensitive Charles River Sprague Dawley lab rat. Rather than testing Tritan itself, he instructed Osimitz to test only some Tritan ingredients—TPP, the one that had raised red flags in the computer-modeling study, was not included. (The European Union has since classified the compound as a suspected endocrine disruptor.)
In June 2012, Osimitz's paper—finding that Tritan was not estrogenic—appeared in Food and Chemical Toxicology, an industry-friendly journal. Its editor, A. Wallace Hayes, was previously vice president of biochemical and biobehavioral research at R.J. Reynolds, which led the attack against science linking secondhand smoke to human health problems.
Scientific journals generally require authors to disclose any conflicts of interest. But the Food and Chemical Toxicology article made no mention of Eastman's role in the study. According to internal Eastman emails [43], the company was also aiming to hire Osimitz to author a second paper, again with "no…mention of Eastman." As Deyo noted, "credibility is somewhat enhanced if it is not 'Eastman' authors."
...
Once its own data had been published, Eastman set out to bury Bittner's findings. In August 2012, the company sued CertiChem and PlastiPure [44], which it claimed were spreading false information about Tritan to generate demand for their own services. Eastman's lawyers asked the judge to bar both firms from ever claiming Tritan was estrogenic—or saying that cell-based tests could detect estrogenic activity, even though scientists routinely use them for this purpose. For decades, scientists have relied on the same breast cancer cell line Bittner's lab uses, MCF-7, to screen for estrogenic activity. According to UMass' Vandenberg, these cells have proven "remarkably good at telling us if compounds found in plastics and personal care products mimic estrogen" and their "failure rates are minuscule."
On July 15, 2013, Bittner squared off against Eastman at a federal courthouse in Austin. The company's attorneys went in hard. Specifically, they claimed running a company that tested products for estrogenic activity, as well as one that helped companies find nonestrogenic alternatives, created a conflict of interest. (Bittner counters that he's no more conflicted than a doctor who both diagnoses and treats patients.) But they didn't directly challenge the validity of Bittner's findings. Instead, they leaned on the questionable industry claim that tests based on human cells aren't sufficient to establish estrogenic activity.
Eastman's star witness, Chris Borgert, made the case that animal studies—which the industry had also fought to undermine—were a more telling indicator. But even they were not "in and of themselves" definitive. For the result to be relevant, the effects had to be demonstrated "in an animal, at least, and then on to humans." There was no mention of the ethical and legal barriers to testing on humans. And the judge barred Bittner's lawyers from mentioning Borgert's tobacco industry ties, which Eastman argued were "prejudicial." This left the jury ill-equipped to gauge his credibility.
Borgert's testimony may have done less damage than other factors. Bittner's lawyers struggled to explain the science to jurors, and Bittner grew testy on the stand. Welshons, who'd designed CertiChem's tests, testified in a deposition—just as he'd told the NIH—that Bittner had misrepresented some data in a brochure. Bittner's attorneys managed to block his testimony from being introduced. But, Bittner says, his attorneys balked at presenting key evidence, such as figures on CertiChem's NIH funding, because it might have made Welshons' testimony admissible. Bittner also maintains that his rift with vom Saal and Welshons made it difficult to recruit witnesses.
Still, several prominent scientists testified for CertiChem, including UC-Davis' Michael Denison, who coinvented a widely used test for estrogenic activity using human ovarian cells. Denison testified that he'd tested 27 samples of Tritan for estrogenic activity using this method and registered positives across the board.
But the most remarkable data might have come from none other than Wade Welshons. In the run-up to the trial, the University of Missouri scientist, who expected to prove Bittner wrong, began testing Tritan products in his lab. To his surprise, he wound up confirming CertiChem's findings. "It doesn't matter what I think of them personally," Welshons told me. "If they're right, they're right, and many of my objections no longer matter."
Welshons' findings never made it into court, however, and when the jurors returned their verdict in late July, they found against Bittner's companies [45] on counts of false advertising and unfair competition. They also concluded Tritan was not estrogenic. Their rationale, according to postverdict interviews, echoed Eastman's claims that estrogenic activity could not be established solely through cell-based tests. In his final ruling, the judge also noted that the "jury was likely unimpressed with Dr. Bittner's combative demeanor." And he upbraided both sides for failing to explain the science in terms jurors could understand. In the end, he barred Bittner's companies from ever talking about their Tritan findings, at least in a commercial setting. But he refused to stop the companies from asserting that their tests could detect synthetic estrogens.
The long legal battle has depleted CertiChem and PlastiPure's coffers—"We've laid off half of our staff," Usey told me. "It has pretty much crushed us"—and emboldened Eastman. After I began raising questions about Tritan, Rick W. Harrison, an attorney for the chemical giant, inadvertently copied me on an email [46] about Eastman's damage control strategy. "If this somehow gets picked up by mainstream media—Oprah or NY media—Eastman sends Lucian [Boldea, the vice president of Eastman's specialty plastics division] or whoever on the show prepped with the verdict, order and judgment and express surprise and indignation that these issues are still being raised after three years of litigation," he wrote. "The court/jury has spoken and spoken loudly."
The industry, meanwhile, has revived its campaign to downplay the dangers of BPA. A month after the Eastman case concluded, the American Chemistry Council relaunched its pro-BPA website, FactsAboutBPA.org [47]. The section on infant health suggests that BPA isn't harmful, even to premature babies. "They're reverting back to exactly the arguments they were making in 1998," says vom Saal. "It's as if the last 15 years didn't happen."
US regulators also have continued to ignore the mounting evidence linking BPA and similar chemicals to human disease, even as bans have cropped up around the world. Although more than 90 studies examining people with various levels of exposure suggest BPA affects humans much as it does animals, the FDA recently announced that its research "supports the safety of BPA [48]" in food containers and packaging. And the EPA program that was supposed to screen some 80,000 chemicals for endocrine disruption hasn't fully vetted a single substance. In 2010, the agency sought White House approval to add some endocrine-disrupting chemicals that are commonly found in plastic—among them BPA, phthalates, and a class of compounds known as PBDEs—to its "chemicals of concern" list because it found they "may present an unreasonable risk to human health."This would have required chemical makers to share safety-testing data with federal regulators. The proposal languished until last September, when the EPA quietly withdrew it [49], along with a proposed rule requiring manufacturers to disclose safety data on chemicals in their products.