Komen Foundation, with its annual Race for the Cure, is
widely recognized as a leader in the fight against breast
cancer—except by critics who cite its ties to corporations
that profit from the cancer industry, its pro-HMO lobbying,
and its failure to address the environmental causes of disease
Mary Ann Swissler
Brady has little use for the limelight. Yet, as someone
with a lot on her mind, she has much to say about what she
terms “the marketing of breast cancer.” One of the worst
examples, she says, is the Dallas-based Susan G. Komen Foundation
and its annual fundraiser, the 5K Race for the Cure.Now
held year-round in 110 cities in the United States and abroad,
the festivities offend Brady and the group Toxic Links
Coalition. The races, they say, merely focus women on finding
a medical cure for breast cancer, and away from environmental
conditions causing it, the problems of the uninsured, and
political influence of corporations over the average patient.
To drive this point home, Brady and the coalition have,
since 1994, helped organize a vocal and visible presence
most years at Komen’s San Francisco race.
Sometimes leafleting, and sometimes holding up hand-painted
signs and banners, they always face stiff competition from
the typically uplifting and euphoric race atmosphere. Up
to 1 million participants in 2000 alone were greeted as
they crossed the finish line with live music, inspirational
speakers and acres of colorfully adorned corporate booths.
Pink, the chosen color of the international breast cancer
movement, is everywhere, on hats, T-shirts and ribbons.
A sense of community and camaraderie pervades the celebration
by hundreds, sometimes thousands, of breast cancer survivors
and friends of survivors.
missing is the truth,” wrote Brady in a Spring 2001 newsletter
article for the Women’s Cancer Resource Center, a support
services center located in Berkeley, Calif. “There’s no
talk about prevention, except, in terms of lifestyle, your
diet for instance. No talk about ways to grow food more
safely. No talk about how to curb industrial carcinogens.
No talk about contaminated water or global warming.”
really don’t think environmental causes of cancer are acknowledged
enough,” says Dr. C.W. Jameson of the U.S. National Institutes
of Health. “It warrants attention so people can make better,
more informed choices, as to where they live or what professions
they work in,” adds Jameson, the director of a biennial
report on cancer-causing agents published by the Institute
of Environmental Sciences.
Measuring these carcinogenic agents remains difficult, despite
recent gains. “Measuring levels of contaminants in the environment
is getting better,” says Dr. Michael McGeehin, director
of the CDC National Center for Environmental Health. But
proving the correlation between toxins and cancer can take
decades from the time of exposure to the time a tumor might
develop, he says.
Brady and the coalition are persistent in their message,
yet the message travels in a relatively small circle compared
with that of the Komen Foundation and its founder, Nancy
G. Brinker. Now the U.S. Ambassador to Hungary, Brinker
is the E.F. Hutton of the breast cancer world: When she
speaks, anyone who’s anyone listens.
Brinker relies on the blockbuster PR value of the 5K Race
for the Cure. The year-round calendar of cancer walks that
draw grief-stricken yet hopeful patients and their loved
ones, along with a fawning media, preserve Brinker’s and
her group’s image as being on the side of the average American
woman tragically afflicted with breast cancer. So most people
would be shocked to find that the Komen Foundation helped
block a meaningful Patients Bill of Rights for the women
it has purported to serve since the group began in 1982.
Despite Brinker’s proclaiming herself before a 2001 Congressional
panel as a “patient advocate for the past 20 years,” demanding
access to the best possible medical care for all breast
cancer patients, Federal Election Commission records show
the Komen Foundation and its allies lobbied against the
consumer-friendly version of the Patients Bill of Rights
in 1999, 2000 and 2001. Brinker then trumpeted old friend
George W. Bush in August 2001 for backing a “strong” Patients’
Bill of Rights, while most patient advocates felt betrayed.
Brinker’s support of Bush should come as no surprise, since
Bush nominated her for a U.S. ambassador post at the end
of May 2001. The president also no doubt helped toast Brinker’s
Congressional approval for the Hungary position on Aug.
3, 2001, less than 24 hours after the House version of the
Patients’ Bill of Rights, dubbed “the HMO bill of rights”
by critics, passed on Aug. 2, 2001.
health care costs during the 1980s pushed the issue of patients’
rights front and center during the 1992 presidential election.
President Clinton tried unsuccessfully to increase coverage
for the uninsured and to pass patient-protection legislation.
“Since then, managed care reform has been resuscitated time
and again on Capitol Hill without much success,” according
to the Center for Responsive Politics.
In 1999, 2000 and 2001, dramatically different versions
of the Patients’ Bill of Rights were introduced. Critics
say that both versions do little to provide universal coverage
for the tens of millions of uninsured. “They do not change
the perverse incentives that pit economic interests of managed-care
companies and employers against the health needs of patients,
and they do not reduce the huge overhead expenses, many
of which are directed toward limiting services,” wrote the
former editor of The New England Journal of Medicine,
Marcia Angell, in a New York Times op-ed piece.
Patient protections proposed in the 2001 Democrat-dominated
Senate bill (S. 1052) and the Republican-dominated House
bill (H.R. 2563) are nearly identical, but the means of
enforcing those rights are a sore spot for both parties.
Backers of the Democratic version said a patient’s right
to appeal an HMO decision was weakened under the House bill
because the HMOs control who does the review. Republicans
also insist that patients, after exhausting all appeals,
head to federal court instead of state court where damage
awards tend to be higher. The GOP-backed bill caps damages
at $1.5 million, compared to a $5 million cap on the Democratic
side. The legislation also blocks class-action lawsuits.
It’s no accident the Komen side favors the Republicans.
A July 12, 2001, agreement between the president and five
companies to run a Medicare prescription discount-card program
for Medicare patients included a company called Caremark
Rx, where Nancy Brinker was on the board of directors, according
to financial records. Another vendor, Merck-Medco, is one
of the many drug companies found in the Komen investment
portfolio. (Nancy Brinker resigned all board seats, including
Komen, when she was appointed ambassador to Hungary.) If
approved, the discount cards would provide up to a 10 percent
discount on brand-name drugs.
Meanwhile, Democrats called the whole discount card idea
“laughable, utterly superficial,” according to press reports,
since the cards are already widely available and do little
to resolve soaring prescription costs and even costlier
Komen group relies on longtime Washington lobbyist Rae F.
Evans, a self-described “corporate strategist” with little
experience or interest in grassroots advocacy, who also
doubles as lobbyist for Nancy Brinker’s husband, restaurant
magnate and polo champion Norman Brinker, of Brinker International.
Norman Brinker made his fortune from restaurants such as
Steak & Ale, Chili’s, and Bennigan’s, and has sat on
the Haggar Corporation’s board of directors—along with Rae
Also on board for Komen’s Patient Bill of Rights efforts
is Akin-Gump, the fourth largest lobbying firm in the country,
whose roster reads like a who’s who of anti-health care
reformers. Akin-Gump has direct links to the Health Benefits
Coalition, the industry’s leading PAC in the fight to stop
a Patients Bill of Rights that would boost patients’ rights
over their health plans.
This 30-member coalition of insurers, automakers, restaurants
and other powerful trade groups presented a united front
before Congress, spending millions on lobbying and advertising.
Akin & Gump clients during 1998, 1999 and 2000 included
HBC members Cigna Corporation and New York Life Insurance
along with Brinker-backed National Restaurant Association,
according to FEC records. A&G also boasts a number of
insurers, automakers and pharmaceutical firms as clients.
For his part, Norman Brinker, a longtime Komen board member,
was a bitter foe of a meaningful Patients’ Bill of Rights,
through the efforts of both Evans and the National Restaurant
Association. This “other” NRA continually topped anti-PBR
lobbying rosters, according to FEC records.
Through the years, the Brinkers helped deliver the state
of Texas to George W. Bush, for the governor’s seat and
then the presidency. Their phenomenal fund-raising skills
earned them the moniker of “Bush Pioneers” as well as committee
positions for the Bush Inaugural Ball, which requires a
minimum $25,000 donation. On her own steam, Nancy Brinker
lists nearly $256,000 in Bush and Republican Party donations,
from Bush gubernatorial races, GOP hard and soft money,
and federal PAC hard money, according to FEC records.
Rae Evans likewise donated $500 in 1999 to the Bush presidential
campaign. The result is that lobbyists from Evans &
Black and Akin & Gump go in the doors of elected officials
as important campaign contributors, not as mere constituents.
Not surprisingly, the Komen Foundation owned as much as
$162,843 in Brinker International stock during 2000, the
only year for which records are available. The foundation
also owns stock in several pharmaceutical companies and
in General Electric, one of the largest makers of mammogram
machines in the world.
At 1998 Food and Drug Administration hearings, the Komen
Foundation was the only national breast cancer group to
endorse the cancer-treatment drug tamoxifen as a prevention
device for healthy but high-risk women, despite vehement
opposition by most other breast cancer groups. Its maker,
AstraZeneca, has long been a Komen booster, making educational
grants to Komen and having a visible presence at the Race
for the Cure. And in 2000, its parent company, Zeneca Inc.,
employed Multinational Business Services, the lobbyist for
the anti-PBR group Health Benefits Coalition.
Tamoxifen is one of the most widely used and successful
breast cancer treatments today, but groups such as the National
Women’s Health Network, Breast Cancer Action, Medical Consumers
Union and San Francisco activist Marilyn McGregor all issued
critical statements at the hearing against approving it
to prevent breast cancer. They testified about the drug’s
troubling links to uterine cancer and the FDA’s questionable
criteria used to define a woman as high-risk.
Only slightly less surprising is the half-million dollars’
worth of stock Nancy Brinker owns in U.S. Oncology, a chain
of for-profit treatment centers (on whose board she sat
at least from 1999 through 2001, according to company records).
U.S. Oncology’s lobbying firm of Rose & Hefling is a
lobbyist for the Philip Morris tobacco company, according
to FEC records.
Another lobbyist for U.S. Oncology in 2000, Alison McSlarrow
of McSlarrow Consulting, is former deputy chief of staff
to then-U.S. Senate Majority Leader Trent Lott (R-Miss.)—a
chief architect of the pro-HMO version of the Patients Bill
Komen group’s stock portfolios and cozy relationships with
Republican leadership set them apart from most breast-cancer
patient groups. Even the Beltway insiders at the National
Breast Cancer Coalition (NBCC), who played a major role
in creating the national-research and early-screening agenda
that sprung up nearly overnight beginning in the early 1990s,
are austere in comparison. So when the Patients Bill of
Rights compromise bill was announced, the NBCC, among many
others, was appalled.
at night, and behind closed doors,” read the Coalition’s
August 2001 press release, “members of Congress rewrote
what would have been a strong and enforceable Patients’
Bill of Rights, turning it into a sham for patients while
continuing to protect HMOs.”
According to the same coalition statement, “The ‘compromise’
that members of Congress agreed to is worse than current
law—it stacks the deck against patients and inappropriately
turns external review into judge and jury. Finally, this
sham of a Patients’ Bill of Rights makes a cause of action
in state court tougher for patients, but easier for HMO’s.”
corporate ties to a cancer-related industry raises huge
credibility issues for a group that is trying to influence
public policy,” says Sharon Batt, author of a seminal book
on the movement, Patient No More: The Politics of Breast
Cancer, and current chair of women’s health and the
environment at Canada’s Dalhousie University.
on corporate boards and organizations that have vested interests
in cancer policies is an even higher level of conflict than
taking funds: A board member is expected to promote the
interests of that corporation,” says Batt, who also spoke
against tamoxifen at the 1998 FDA hearing. “Even the NBCC
takes money from the pharmaceutical industry, but I doubt
(its leaders) sit on corporate boards,” a fact confirmed
by an NBCC spokeswoman in a recent interview.
San Francisco-based Breast Cancer Action goes one step further,
refusing all donations from corporations that make money
off of breast cancer, such as pharmaceutical companies,
tobacco and pesticide manufacturers, and cancer-treatment
facilities. BCA also launched a campaign to expose similar
sponsorship ties inherent in the Avon cosmetic company’s
Explains BCA executive director Barbara Brenner, “With the
growing effort by corporations to look like ‘good guys’
by supporting cancer organizations, it is difficult, if
not impossible, to know whether an advocacy organization’s
positions are based on well-thought-out policies or on who’s
paying the bills.”
Batt finds Brinker “eerily reminiscent” of an earlier so-called
cancer activist, Mary Lasker. “Her husband, the advertising
executive Albert Lasker, created the famous cigarette ad,
‘Reach for a Lucky Instead of a Sweet.’ In the 1940s through
the 1960s, Lasker used her business and social connections
to transform the American Cancer Society from a small, local
charity into the world’s richest, most powerful health charity.
The ACS became a voice for policies that have made cancer
research and early detection into lucrative business ventures
with little connection to the welfare of patients or to
breast cancer prevention. The Komen Foundation is a reincarnation
of the ACS, but specific to breast cancer.”
Batt says that one of the dangers of Komen’s success is
that the only messages that get through to the media and
Congress are those that don’t threaten or embarrass corporations
or the Republican Party.
For example, she says, during the 1990s, the NBCC and smaller
organizations may have convinced the National Cancer Institute
and other government policymakers to begin addressing the
health concerns of a more diverse group of women: ethnic
minorities, lesbians and the poor. But the power brokers
in government and the corporate world still listen most
readily to the messages publicized by the high-profile Race
for the Cure or, another corporate and Komen darling, the
National Breast Cancer Awareness Month each October.
problem with those (awareness) programs,” says Batt, “is
that unless you also fund treatment for those same women,
you don’t help them by detecting their cancers earlier;
and you perpetuate the emphasis on mammography screening,
rather than prevention, better treatment and equitable care.”
But it’s an uphill battle, she says. “For one thing, the
Komen Foundation has had more money. For another, they carry
friendly, reassuring messages through the media and their
own programs, a phenomenon I like to term the ‘rosy filter,’
meaning the public is spoon-fed through a rose- colored
lens stories of women waging a heroic battle against the
disease, or the newest ‘magic bullet.’ Yet little light
is shed on insurance costs, the environment or conflicts
Brinker has reached large audiences by billing herself as
an objective patient advocate, and signing as a “medical
speaker” for Barber & Associates, a booking agency that
handles broadcasters and television experts such as ABC’s
Dr. Nancy Snyderman, Dr. Bernie Siegel, Dr. Joyce Brothers,
and Jane Brody of The New York Times.
One topic you’ll never catch either of the Brinkers mentioning
is the need for a cleaner environment. That might be because
the international petrochemical giant Occidental Corp.,
a big Komen booster and the same corporation that brought
us Love Canal, donates 4,000 square feet of “glass and marble
offices” to Komen on the premises of Occidental’s Dallas
The petrochemical industry, including Occidental, successfully
lobbied in 2000 and 2001 for looser EPA air, water and chemical
regulations at the same time government researchers reported
that auto and industrial emissions caused cancer. In March
2002 alone, the EPA approved a two-year delay of the Clean
Air Act rules that would cut toxic emissions from 80,000
Officially, the Komen group is pro-environment, and joined
with a national coalition of cancer and women’s groups in
late 1999 to demand research on the links between breast
cancer and environmental toxins. However, a subsequent Congressional
bill, the Breast Cancer and Environmental Research Act,
went nowhere fast when it was introduced in May 2001. Komen’s
lobbyists made little or no effort to fight for the bill
or the concepts behind it, according to midyear 2001 lobbying
records filed by Evans & Black and Akin & Gump.
Black, along with many Occidental officals, sat in with
Brinker on the Bush Inaugural Committee.
Coincidentally, Occidental lobbyists also spent time in
2001 on the House version of the Patients Bill of Rights.
Charles Black, one of Occidental’s lobbyists, spouse of
Evans & Black’s Judy Black, and a leading Republican
strategist, is also a consistent lobbyist for Brinker International.
Charles Black is a board member of the American Conservative
Union, a group that defines pharmaceutical price controls
as “a bitter pill for American consumers,” and “beating
up on the pharmaceutical industry.” And Black, along with
many Occidental officials, sat in with Nancy Brinker on
the Bush inaugural committee.
political biases and conflicts of interest evade public
scrutiny primarily because lobbyists and nonprofits like
Komen are required to tell us only a few details of their
work. As a Washington consumer group official quips, “Politicians
don’t even want to admit talking to lobbyists much less
saying which ones they spoke with, or why.”
In 2001, for example, Evans & Black listed both Democratic
and Republican versions of the Patients Bill of Rights in
its disclosure reports; its 1999 and 2000 reports were right
out front by listing the Republican version. Likewise, Akin
& Gump’s 2001 reports show it lobbied “pertaining to”
the Senate’s more liberal version. As a result, it’s impossible
to prove which version it was lobbying for. But it’s also
a foregone conclusion, given the Komen’s characterization
of the GOP-ruled version as “strong,” the close and longstanding
ties with President Bush and the Republican party, and its
vested interests with industry.
Komen lobbyist Rae F. Evans says that she refused to talk
about which legislators were approached about the Patients’
Bill of Rights and their position on it because it would
be “unethical.” Moreover, she says, “It’s only a problem
Komen’s freewheeling lobbying is possible because of a little-known
exemption written into the U.S. tax code a quarter century
ago. In 1976, the nation’s nonprofit organizations were
granted the right to hire, or go toe-to-toe with, professional
lobbyists on Capitol Hill, while maintaining tax-exempt
Nonprofits can spend 20 percent of the first $500,000 of
annual expenditures on lobbying, 15 percent of the next
half-million, and so forth, up to $1 million per year, according
to an IRS fact sheet. Spent this way, the entire amount
is deductible, allowing the Komen Foundation to emphatically
state—as it has whenever asked—that it spends “zero dollars”
Can stock ownership, directors’ seats, campaign contributions
and longstanding business relationships result in any tangible
effects on a nonprofit’s mission? At best, it’s tricky to
prove any material conflict of interest, and even a cancer-patient-advocacy
organization is allowed by law to be right-wing, well-connected
and pro-industry. According to Bennett Weiner, chief operating
officer of the Better Business Bureau Wise Giving Alliance,
a national charity-rating organization, “As long as they
fulfill what’s described in their mission statement.”
In Komen’s case, that mission would be to “stop cancer as
a life-threatening disease through research, detection and
education,” according to Komen’s statements.
But, Weiner continued, it’s wrong for Komen’s literature,
Web site, and public statements to feature a central figure
like Nancy Brinker—or Norman Brinker for that matter—while
omitting relevant parts of their lives such as seats on
boards of private cancer-treatment corporations, stock interests,
lobbying ties or their political activism as GOP darlings.
Weiner says, “If a charity is making recommendations to
the public regarding health care among other things, and
if they have ties to the industry, then the public needs
to be able to objectively use that information.”
As it stands now, even the watered-down Patients’ Bill of
Rights is on life support, after President Bush refused
to sign it over lingering liability limitations, according
to a spokesman for U.S. Sen. Edward Kennedy (D-Mass), co-sponsor
of the Senate’s Bipartisan Patient Protection Act. Quiet
negotiations with the president still continue. In late
June 2002, U.S. Sen. John Edwards (D-N.C.) released a statement
saying, “[I] remain optimistic that negotiations with the
White House will produce agreement on meaningful patient
protection that Congress could pass this year.”
The foundation denies that it spends money to lobby, and
denies that it is solely aligned with the Republican health-care
and environmental agendas. In a September 2001 letter in
response to questions for this article, a Komen spokeswoman
defends Norman Brinker as a devoted “volunteer.” The Foundation
even seems to distance itself from Nancy Brinker by citing
her new post overseas.
Full disclosure could be slow in coming, given the vast
tangle of political, business and personal alliances involved.
Even a spokesman in Sen. Edwards office, a staunch defender
of a liberal Patients’ Bill of Rights, recalls the Komen
Foundation as one of his biggest clients at Fleishman-Hillard,
the sixth largest PR firm in the world.
As Judy Brady points out, the Komen Foundation, and the
Brinkers in particular, represent the systemic corruption
of business-as-usual in a corporate- dominated society.
“It would be a mistake to demonize the Komen Foundation,”
Brady says. “They have the best of intentions and I truly
believe that they think they are doing good—with a capital
they don’t see is that ‘business as usual’ is why we have
Ann Swissler is a writer based in New Jersey. She can be
reached at maplemas@
yahoo.com. This article was made possible through
financial support of the Fund for Investigative Journalism
in Washington, D.C.