Every year, the incoming Academy president is given one page here to ruminate on his or her view of the ophthalmologic galaxy. It’s a wonderful bully pulpit to speak about our organizational mission and professional challenges. However, this is an election year, and while I’d prefer to focus on fly-fishing and Labrador retrievers, we must talk politics. Whatever party leases the White House and control of Congress for the next four years statistically will hold it for the next eight years. That same president will likely have the opportunity to name at least three Supreme Court justices over the next four years. This will define more than our next decade of professional life.
My purpose in bringing this up is not to harangue you about a particular candidate or party, or to make predictions as to what will happen. Winston Churchill said, “It is always wise to look ahead, but difficult to look farther than you can see.” But we don’t have to be prescient to see some things.
Health care is on the front burner, and it will be difficult for the new president and Congress to ignore substantive action. Every candidate must have a crafted policy on “rising health care costs” and “the underinsured.” Barack Obama’s official campaign Web site states as a core principle “Quality Affordable Health Care for All by the End of Barack Obama’s First Term in Office.” The John McCain Web site says, “While we reform the system and maintain quality, we can and must provide access to health care for all our citizens—whether temporarily or chronically uninsured, whether living in rural areas with limited services, or whether residing in inner cities where access to physicians is often limited.” What’s the detail behind the two seemingly similar principles?
Whether the outcome is incremental or tsunami-esque, we will have change. It’s difficult to believe that in four years we’ll still be looking at the same SGR (sustainable growth rate) debate. We each have a vote in that outcome.
Despite this, research shows the average American spends only five minutes a month learning about the presidential campaign. How much does the average ophthalmologist spend? Hopefully a lot more since the education (and hopefully the community commitment) of ophthalmologists is way above the national average. Yet, how many of us can accurately describe the position of Barack Obama on a single-payer system? Or of Hillary Clinton on managed Medicare? Or of Rudy Guiliani on NIH funding? Or of Mitt Romney on the SGR? While “bigger” issues of foreign policy and domestic spending dominate the campaign, we should be particularly knowledgeable about health care issues. And we can’t say we are underexposed to the candidates.
Certainly we ophthalmologists should not be single-issue citizens. It’s not in our national interest to select a president based predominately on the health care platform. Yet, as physicians, with a special responsibility to speak for our profession and the patients we serve, we must understand the positions of the major candidates on health care. Our Academy Washington staff are superbly effective advocates but depend upon the American people to elect intelligent, dedicated public servants.
Even if you don’t financially contribute to the candidate(s) of your choice, at least be knowledgeable. We demand it of ourselves in the operating room. We should demand it of ourselves in the voting booth. Given our unique professional position and the trust placed in us by society, our friends and patients will listen when we speak.