Political Pollyana 10/96

Practical Politics consists in ignoring the fact.

                                                                                            Henry Brooks Adams, 1907

The political season is upon us. The political rallies in San Diego and Chicago had more to do with theater than with illuminating the issues. We may have enjoyed these circuses more if the issues werenít so large. David Rosenbaum of the New York Times states that on important issues, Dole and Clinton are taking positions that are out of character. He states that barely two years ago President Clinton was still envisioning the greatest expansion of government social policy in a generation and now he has set his sights so low that his greatest ambition seems to be helping teach children how to read. Rosenbaum states that Bob Dole, who always called tax cuts "bunkum," is now proposing deep across-the-board tax cuts. Not to be outdone, Clinton is proposing capital gains tax reductions.

Being a politician, according to The Economist, a weekly newsmagazine, would not be nearly as exciting if one did not have so much of other peopleís money to throw around. While most of the media is telling us how the 104th Congress has taken us backwards, the Wall Street Journal tells us that the same Congress accomplished budgetary goals that only Ronald Reagan could have dreamed about. This Congress eliminated 270 federal programs, agencies, offices and projects and did major surgery (over 10% reduction) on numerous other federal commissions and agencies creating the lowest budget deficit in 15 years forcing staff reductions in 29 of 39 major government offices. The Democrats decried that far too much was cut and stalwart Republicans believed not enough was done.

I have always felt as a physician that it was unprofessional to join a political party. How could I affiliate myself with a group with no discernible moral code? Although Iíve been registered in both major parties at different times, I prefer the situation which existed when I was a medical resident in Michigan, where I could register as an Independent and cast my primary election ballot in whichever party had the most relevance to the issues of the day. Rumor has it that California is now considering a similar process.

In California there is such distrust for the legislative process that we have citizens writing initiatives for our ballot which have the same force as any law. Frequently poorly written, they may be in the courts for years to make sure they make legal sense. The editorial office has received many requests for our endorsement of propositions. The hospitals are trying to get us to vote NO on issues that will involve their staffing of nurses. Others are trying to get us to vote YES on a petition to allow the smoking of marijuana by cancer and AIDS patients without the necessary scientific research to justify the recommendation.

As we prepare to choose a President and Members of Congress, and to vote on initiatives, there are crucial issues to be considered concerning ourselves and our patients. Patients look to us__depend on us__to know and do what is best for them. Unfortunately, we cannot agree on how to help them or ourselves. Medical ills are not necessarily responsive to political prescriptions. But if we, who live and breathe our medical profession 10_14 hours a day, canít agree on what must be done, how can we take a unified political position? How can anyone else even come close? Somehow we must sort through the issues, look at the medical aspects of each, and support what is "correct" for medicine rather than what may be "politically correct."

No political process is without flaw, and as the election draws ever nearer, we will hear constant reminders of shortcomings and defects of our system. The media will no doubt see that we are entertained with all the grizzly details. But we must remember that there are still billions of people without free election to allow the legislative process to occur. We are fortunate in this respect, for afterall, that is the best way for us to improve our society. And it is also the best avenue for our involvement in a process, to assure our patients the freedom to choose a kind, competent, sensitive, and compassionate physician for all that ails them. As physicians, let us get involved individually to preserve our heritage of service to humankind.

Politics is not an exact science.
Politics is the art of the possible.

                                                                                            Bismarck, c 1884