Medical alert 


Dr. Bob Brooks, whose political views on social issues often place him to the right of even Gov. Jeb Bush, easily dismisses the bridges he's burned.

It's tempting to say he doesn't care. Elected twice to the Florida Legislature, the Winter Park physician plays directly to a solidly conservative constituency. He's won support from the Senior Resource Alliance, an elder lobbying group; the Christian Coalition; and the Florida Family Association.

Against such an alignment, critics from the left and middle are hardly a surprise. And the anti-abortion, anti-gay Brooks has served stints as a lightning rod for his causes while the GOP controlled the Legislature and marshaled a conservative majority in support of its social agenda. In matters of abortion in particular, only Democratic former Gov. Lawton Chiles served as its foil.

But now Chiles is gone. And Brooks is Bush's pick to be the state's Secretary of Health. Last month he quit his post in the Florida House to oversee the 13,500 employees who operate the state's 67 county health departments. At age 46, he is currently the highest-ranking physician in the state.

Rather than elevate Brooks above the political rhetoric, the appointment he aggressively lobbied to secure has set off a new round of alarms. Indeed, his predecessor in that job, the respected Dr. James Howell, says that with Jeb Bush and Bob Brooks at the helm, "I fear for the future of Florida medicine."

He's not alone.

He's not alone.

Worry focuses on Brooks' outspoken belief that some people deserve to receive state-funded care while others clearly do not.

Last year, for example, Brooks co-sponsored House Bill 3715, which, among other things, called for HIV-prevention programs and refinement of the treatment process. The bill proposed a greater standard of care in HIV testing for pregnant women, health-care professionals and even embalmers. It did not mention homosexuals.

Moreover, his "Vision for a Healthy Florida" -- a 28-page color resume that he compiled with the help of a public-relations agency in order to sell himself to the Bush transition team -- suggests several sweeping policy changes, some with chilling overtones.

He proposes using tobacco money to pay for low-income families' access to medical care. He would let patients choose which doctors they want to see, whether or not those doctors work within the patient's managed care system. And he advocates medical savings accounts, a sort of medical IRA in which Floridians could save money for medical emergencies as a way to curb reliance on employer-backed health insurance.

But he also says the state should set health-care priorities, suggesting, for example, that rather than fund a liver transplant for an alcoholic, state money should be spent on prenatal care for pregnant women. And he wants to cut the number of terminal patients kept alive by artificial means.

Unbowed by attacks on his agenda, Brooks believes that his entire legislative record is a testament to his commitment to Floridians. "I vote my conscience," he says, "and I just want what's best for the patients across the state. I believe that I was a strong voice in Tallahassee for my constituents, and I hope to be a strong voice for every patient in the state."

His critics are just as strong.

"I could go on for days about my ideological differences with Bob Brooks," wrote Barry Silver, a former state lawmaker and Boca Raton attorney who is so resolute in his opposition that, when asked for comment, he replied with a 26-page fax challenging many of Brooks' policies. "I have come down squarely against him on numerous House bills. It's not just a question of politics; it's a question of intention. I have a problem with someone who forces his religious beliefs on others."

Silver added: "I have no doubt that Bob Brooks feels he is doing the right thing. His heart is in the right place, but the implementation of his policies are faulty. He's a sincere man, but sometimes he's sincerely wrong."

Not all of Brooks' battles have been uphill. As chairman of the Panel for the Study of End-of-Life Care, he drew praise from both Republicans and Democrats as a result of his progressive elder-care measures. During his last term, Brooks established criminal background checks for nursing-home personnel, an action that won strong support from across the state. He also established memory-disorder clinics to research Alzheimer's disease.

And he scored a bipartisan success in the repeal of the intangibles tax, a burden on the wealthy because it taxed investments; also eliminated were taxes on accounts receivable, which earned the measure solid support from some unions, corporate lobbying groups and chambers of commerce. In Brooks' view, that change will bring more business to Florida, which means more jobs.

"I'm proud of this bill, because it puts more money back in the small businessman's pocket," says Brooks. "It's a very pro-family bill."

Other bills in his "pro-family" push have been much more contentious.

Brooks launched the Traditional Family Forum in the Legislature and pushed through such measures as a ban on same-sex marriages. His bill requiring females under 18 to alert their parents before seeking an abortion would be law if not for the veto of Gov. Chiles. His Woman's Right to Know Act -- requiring the state to first give an informational brochure to those who would end their pregnancy, a proposed sample of which was decidedly anti-choice -- has been voided by a court injunction.

And in 1995, Brooks initiated a letter sent by several lawmakers to Michael Eisner on state stationery condemning Disney's decision to extend health benefits to partners of its gay and lesbian workers. The letter -- thrust into the national spotlight, and employing buzz words used by the religious right to back anti-gay initiatives -- insisted the action was "a big mistake both morally and financially" that would alienate Disney's audience.

"We are surprised at your belittlement of the sanctity of marriage," it said. "By implying that vows no longer need to be made in order to gain marital privileges, you are alienating the millions of people in this country who take the marriage covenant seriously and believe that it is ordained by God. We strongly disapprove of your inclusion and endorsement of a lifestyle that is unhealthy, unnatural and unworthy of special recognition."

Immediately afterward Brooks, a specialist in infectious diseases who treats HIV/AIDS patients in his own practice, elaborated in an interview with editor Tom Dyer in the gay newspaper Watermark. He linked his concern to the rising numbers of infected homosexual and bisexual men whose medical care, Brooks estimated, "is in the range of $150,000 per person."

He added: "I know this is going to be a point of disagreement between us, and I hope you understand that I just come from a different world view probably than you do. But the reality is that if our society further legitimizes the lifestyle, and that helps promote any more people to go into it who otherwise wouldn't have chosen that lifestyle, that's going to result in more cases of AIDS."

In the four years since, Brooks has defended his letter in nearly every public appearance. He won't discuss that stand now. "That's old news," he says, "and it's not relevant anymore."

But it is.

But it is.

"As a leader in our public health system, I'm worried that your world view will spill over" into health-care policy, state Sen. Mandy Dawson-White told Brooks last week before a Senate committee voted to back his nomination to join Bush's administration.

Added Sen. Howard Foreman: "Would you be tolerant of having gay and lesbian people working for the Department of Health?"

Brooks said that he would. But many continue to doubt his ability to understand and accept human differences and human needs.

"This is a dangerous road we're going down," says Dr. Sandra Elliott-Branch, founder of the American Alliance of AIDS Researchers. "When the government starts deciding who is worthy of treatment, we start seeing discrimination against certain groups. Where does it stop? Blaming a heart-attack victim because he ate too much? Blaming an AIDS patient because of a broken condom? It sounds outlandish, but it could happen."

"Calling AIDS a 100-percent-preventable disease `as Brooks has done` is basically blaming the patient for his plight," says Ruth Bennett, executive director of Miami-based AIDSupport. "AIDS is not preventable; it's an epidemic that has spread through various means." She adds: "Why do we give ... protection to embalmers, which represent an infinitesimal percentage of AIDS patients, but not to homosexuals, which have historically represented the largest number of HIV-positive citizens? I thank God that he's not my doctor."

Says Chris Alexander, director of Orlando's Gay Lesbian Bisexual Community Center: "I wish we could focus on answers rather than creating more problems."

Brooks also raised eyebrows with a successful push to restrict tobacco products in state prisons. The bill was intended to "protect the health, comfort, and environment" of workers and inmates by banning tobacco inside all Department of Corrections facilities; because many inmates are permitted only one hour a day outside, the bill would effectively keep them from smoking.

"Smoking can be banned entirely," says Andy Kayton, legal director of the Florida chapter of the American Civil Liberties Union. "However, to add cigarettes to contraband in a prison is going to be burdensome. It's going to increase the value of cigarettes."

Silver's most vociferous opposition to Brooks came in 1997, with the Brooks-sponsored measure that came to be known as the Woman's Right to Know Act. The bill, co-sponsored by 36 other members of the House, required physicians to inform women seeking abortions of their medical alternatives and directed the Department of Health to create a brochure for that purpose.

"The brochure that was provided had a decidedly pro-life slant. Come to find out, it was prepared by a Catholic agency in Pennsylvania," wrote Silver, who filed an appeal in court. "The pro-choice side has no problem with information," he continued, "but it does have a problem with misinformation."

West Palm Beach Circuit Judge Kathleen Kroll agreed and entered an order halting implementation of the Legislature-approved measure. That injunction will remain indefinitely unless the court decides to do something else. The law has been in limbo for the past 20 months.

Brooks believes it eventually will be enforced. "Everyone has a right to have their doctor explain things to them," he says. "We simply want to give the women every shred of information they will need in the decision to terminate a pregnancy."

The question of who makes that decision fueled debate on a Brooks bill that would have required minors seeking abortions to first notify their parents or guardians. Many argued that the bill gave "veto power" to the parents. Yet Brooks advocated the right of minors to defy their parents if the minor wanted to carry the baby to term. That left critics confounded.

"Either the minor child has the rights over her own body, or the parents have the control. It has to be one or the other," contends Silver. "You can't have it both ways." Chiles agreed, and vetoed the bill.

But his fans remain.

"He is a true friend to Florida's families," says Michael McCarron, executive director of the Florida Catholic Conference, who nonetheless adds, "We don't agree on all social issues, because the Florida Catholic Conference is not a conservative group."

Those differences did not prevent McCarron from writing an endorsement letter to Bush on Brooks' behalf. "He is a natural bridge-builder and has demonstrated the ability to achieve consensus among disparate groups," he wrote.

The question now is whether -- and how quickly -- any of those bridges will be withdrawn.


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