The progression of getting to today's decision to make Plan B available from pharmacists without a prescription is somewhat circular – in many ways ending up where it began. It goes something like this:

• April 2003 – Evidence and data about the safety and effectiveness of Plan B for women of all ages presented to a government scientific panel.
• December 2003 – FDA panel of experts finds the evidence and data to be solid and recommends approval by a large majority.
• Soon after – FDA Commissioner Mark McClellan starts getting heat.
• Soon after – Anti-contraception activists get worked into a lather, go on misinformation campaign and beat their chests about how the Administration must limit access to this contraceptive.
• March 2004 – Mark McClellan leaves the FDA and Lester Crawford named to replace him.
• Soon after – For the first time, politics completely overtakes a supposedly independent, scientifically-based, evidence-driven process preventing a decision on Plan B for months and months and months and months and months.
• August 2005 – Politics at the FDA gets so bad that qualified staff feel driven to resign because they do not want to be complicit in the corruption of a federal process that is supposed to be protecting the health and well-being of US citizens.
• September 2005 – After months of making up reasons why Plan B can't be approved Lester Crawford resigns from the FDA.
• Soon after – Public outrage grows that the Administration and its cronies have spent so much time and energy preventing access to emergency contraception – with no scientific basis for this decision.
• August 2006 – The newest Bush appointee to the FDA to be put before the firing squad is challenged during his confirmation hearing about when FDA will make a decision – and why he thinks that the age of 18 should be the threshold for obtaining Plan B when there is no scientific evidence to support it.
• Soon after – Anti-contraception activists rhetoric is in overdrive – begin attacking Bush's FDA nominee and coming up with new approaches to attack Plan B.
• August 2006 – FDA Acting Commissioner von Eschenbach tries to thread a political needle by enabling pharmacists to provide Plan B without a prescription to those who can prove they are at least 18 years old.

After three years this all feels like discovery of the obvious – ending with a decision that is close to where we started. But it raises oh so many questions. Why does it take three years of time and energy to basically get back to the answer we knew at the beginning? Why does it take three years to have the government agency that is supposed to make sure that food and drugs are safe for the American public to affirm the evidence? Why is it OK to completely undermine the structure of the government process designed to protect the health and lives of Americans?

Politics. Pure, bloody, ugly politics.

For some reason the Administration thought that they could undermine the public health process by guiding what an independent agency should do. Then the American public caught on – and the Administration had to do a little backpedaling to regain some of the confidence of the public. But their backpedaling has caught them in their own political muck and mire with their base – they're pissed.

But in the end one has to question if the final tweak to the approval – different than what the evidence stated is in there for public health (doubtful) or political reasons. Did the Administration provide their political base the window to walk through to undermine access to safe and effective emergency contraception? Is that why they arbitrarily – without any evidence supporting why this should happen – made 18 the age for access to Plan B? We'll have to wait and see.

But politics or no, this whole process has been a failure of this Administration to work in the best interest of the health of its citizens. What a shame – but perhaps that's why the first entry seen in a Google search of the word "failure" is what it is.