An American Editor

November 1, 2010

How Much Is That Job Worth?

I read the other day that Meg Whitman has spent $143 million of her own money in her quest to become governor of California. Today I read that midterm campaign spending will set a new record — nearly $4 billion, approximately 50% more than the last midterm election spending, and the article didn’t make it clear whether this was spending on just federal races or on all races (my bet is just federal races). These numbers started me thinking, primarily about how far down the wrong path we seem to be going.

How much is the job of governor of California really worth? Or United States senator or representative? To the office seekers, apparently a lot, but I don’t understand the return, unless it is sheer naked power or being able to say “I am 1 of 50!” Does Meg Whitman really need to be governor to influence policy? As the various pressure groups demonstrate daily, one can buy a lot of lobby power and influence for a lot less than $143 million.

But consider the other ramifications. A lot of Americans go to bed hungry, and with no health insurance. If it costs $12,000 a year to buy a family health insurance plan in the private marketplace, Whitman’s $143 million could insure nearly 12 million families for a year. Or it could give more than 12 million families $200 a week for a year to buy groceries.

And after the election has been bought, what will we citizens get in return? If the past few years are any guide, not much.

Contrast the value placed on elective office to the value placed on editing. I’m not sure we are even talking same dimension, let alone same planet. Isn’t it interesting that corporate America keeps pressuring editors to lower their fees yet corporate America keeps raising the expense of obtaining elected office. One would think if it were good enough for editors, it would be good enough for politicians, too. (I wonder when the day will arrive when we outsource/offshore our political offices because the candidates cost less?)

Okay, I’ll concede that any politician has a greater influence on most people’s daily lives than does any editor, but that may well be because we value editorial skills so lowly. Grammar skills don’t seem to matter; spelling skills don’t seem to matter; only cost seems to matter. Yet the future of corporations lies in the communication skills of the generations of leaders yet to come, which would make, to my way of thinking, editorial skills more important than they currently are viewed. Imagine the chaos that will ensue when the corporate CEO gives instruction (or the politician drafts a bill) and those whose job it is to follow those instructions do it incorrectly for the lack of clarity. (Think of simple things like: “Johnny Depp’s wife, Brad Pitt and Matt Damon.”)

Of course, the other sad thing about the cost of buying political office is that voters’ choice is generally among those who were failures but pocketed a large fortune while failing. Carly Fiorina wants to bring jobs back to America yet fired a third of her American workforce in order to make her company more profitable and thus pocket more in bonuses. Is there a disconnect? Yet she can afford to dig into her own money to run a political campaign, whereas the successful small business owner who has created American jobs in each of the last 10 years cannot afford to run for political office against a Fiorina or Whitman.

This is much like the argument against health insurance mandates. I admit that I do not like being told what I have to spend my hard-earned money on, but I also realize that sometimes you need to spend some to make some, and these mandates are like that. Consider the person who has no health insurance and becomes ill. Where do they go for treatment? To the hospital. If they cannot afford to pay the hospital bill, what happens? The cost gets spread to those of us who either have insurance or are able to pay the bill, as well as to the government (or the taxpayer). Strikes me that opposing a mandate to carry insurance is like insisting that the government raise my taxes or that my insurance carrier raise my premium rates. Someone has to pay, and it generally falls on the taxpayer to do so, which is what gets lost in the argument.

All of which brings me full circle to the original matter: Is spending $143 million to become governor of California what we citizens want to see? Wouldn’t it be better to take that same sum of money and provide health insurance or food to 12 million American families? How did we, as a society, come to be so disconnected from what is right and good? I don’t know, but I sure don’t think spending billions of dollars on politicians is such a great idea.

September 28, 2010

Rationing: An American Conundrum

The election season is now in full swing with the primaries over and only a few weeks to a shorter-than-usual campaign season. I guess there are still some things one can be thankful for.

But this campaign season differs from past seasons in one major respect — not since the Civil Rights legislation of the 1960s can I recall a campaign in which so many candidates are running on the vote-for-me-to-repeal issue, which, in today’s case, means repeal of the recently enacted healthcare legislation.

An underpinning argument made by opponents to healthcare is that it will result in Xyz-style (substitute country of your choice for Xyz) rationing of medical resources. I guess I must live on a different planet because of all the possible arguments against the healthcare legislation and of all the possible reasons to support its repeal or modification, this is the weakest argument. But, then, we need to consider the circumstances of those who are making the argument of rationing — it is hard to see millionaires like Mitch McConnell who also happen to have gold-plated medical insurance at someone else’s expense (yes, I know he pays a monthly contribution, but that is all it is — a contribution; the bulk of the cost is borne by those of us who do not have access to that gold-plated plan, and often have no access to any plan, gold-plated or lead-plated) even knowing what medical rationing really means.

What brings this to mind is a story in yesterday’s newspaper titled “$93,000 cancer drug: How much is a life worth?” This article demonstrates the conundrum of medical rationing in America.

Provenge is a new, unique cancer drug. A patient receives it once and that one-time treatment costs $93,000. In return, a patient, on average, gains 4 months of life. The patient interviewed in the article who received the treatment put the issue out front: “Bob Svenson is honest about why he got it: Insurance paid. ‘I would not spend that money’ because the benefit doesn’t seem worth it, [said] Svenson, 80,….” The insurance that is paying for it is his supplemental Medicare plan — until Medicare itself decides whether the drug will be paid for and for whom.

Provenge has several problems as regards rationing: (1) the drug is in short supply because it has to be made uniquely for each patient; it can’t be mass produced, and (2) it is an all-or-nothing $93,000 gamble because it can only be given once and there is no assurance it will work in a particular patient. As regards the short supply, doctors at the University of Texas’ M.D. Anderson Cancer Center plan a lottery to see who of the otherwise eligible patients will receive the treatment (there are approximately 150 eligible patients at the Center but only 2 can receive treatment).

None of this rationing is brought about by the new health legislation; in fact, if anything, the new health legislation has broadened the pool of people who will be eligible for such treatment because it will broaden the number of insured. So exactly how does the healthcare legislation cause rationing?

The usual focus once one gets past drugs is on access to doctors. You might have to wait to see your doctor. Hmmm — I believe we already see that. Try getting in to see a specialist, or even your primary care doctor immediately. Except in an emergency (and then they usually tell you to go to the emergency room at the hospital), appointments are made 2 to 4 weeks or even longer down the road. I suffer this wait, my neighbors suffer this wait, my friends suffer this wait. Maybe the problem is that I don’t have Republican branded on my forehead because if I listen to the Republicans, I don’t have to wait unlike in Britain or Canada. Again, I think the problem is that they have immediate access to Walter Reed Hospital as VIPs, something I can’t get.

I’m also told that part of the rationing will be a loss of choice of doctors. Huh? The only way such a statement makes any sense whatsoever is this: Either the government-sponsored and taxpayer-funded health plans they have will pay for treatment given by any doctor or hospital on the planet or they are paying the full cost out of pocket. I know in my case, my plan limits me to doctors who participate in the plan. Doesn’t matter if another doctor is better or less expensive, if the doctor isn’t in the plan, my insurance doesn’t cover any visits. As for paying out of pocket, well I’m already paying out of pocket $1500 a month between insurance premiums, doctor copays, and drug copays, which stretches my budget; I just don’t have the resources our elected representatives seem to have.

The rationing is being done by the “private” marketplace — the insurance company who tells me who I can see based on whether or not the insurance company was able to cut a financial agreement with a doctor and by how much money I can earn and devote towards medical treatment and bills. And before the new healthcare legislation, if I found that my financial circumstances had changed and I could no longer afford insurance premiums, I could have been excluded from ever getting insurance again because of preexisting conditions. Seems to me that that is much more egregious form of rationing than what is done in the more level playing fields of Britain and Canada and what is feared by healthcare opponents in the United States.

When really analyzed, the rationing argument boils down to this: The people trying to convince us of the evils of government legislation on healthcare are the people who will always walk outside the restrictions of any such legislation because of wealth and connections. They are the people who stand to gain personally from the failure to provide the majority of citizens with decent healthcare. Why is it alright for the private marketplace to ration Provenge but not for the government?

I don’t mind their being opposed to healthcare legislation; I just want them to be honest about why. Treat us more like equals than like sheep; give up their perks and privileges so that they have to deal with the situation as ordinary folk do. Take us back to our founding roots — “All men are created equal” except those that have and those that have not.

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