Ms. Collins, in “The Love Party,” says Mark Sanford is the latest G.O.P. hopeful to do a swan dive off the adultery cliff. Perhaps the Republican Party has been too strict about the no-girlfriends-while-running-for-president rule. (Ms. Collins seems to forget the cardinal rule — IOKIYAR.) Mr. Kristof, in “The Prescription From Obama’s Own Doctor,” says President Obama should tune out the A.M.A.’s position on the public insurance option as part of health reform and reach out instead to somebody he’s often trusted for medical advice. Here’s Ms. Collins:
On behalf of the people of Illinois and New York, I’d like to thank South Carolina for giving us Mark (“I’ve been unfaithful to my wife”) Sanford. Finally, a governor who’s weirder than Rod Blagojevich and less responsible than Eliot Spitzer.
Really, we’re extremely relieved.
Sanford, as we all now know, went AWOL from his state last week, then re-emerged to admit that he had not been on the Appalachian Trail writing a book, as the chaotic explanations from his family and his staff had suggested, but in South America where he had gone to break up with his lover. “I spent the last five days crying in Argentina,” he said, completely ignoring all we have learned from Andrew Lloyd Webber.
Sanford was widely regarded as a Republican presidential contender. Many of you may have forgotten this, but for a while in 2008 he was a serious candidate to be John McCain’s running mate. (We now stop briefly to contemplate the possibility that there were even worse options than Sarah Palin.) Now, he’s become the second GOP hopeful in a week to do a swan dive off the adultery cliff. Perhaps the party has been too strict about the no-girlfriends-while-running-for-president rule. If they don’t drop it, pretty soon the youngest contender will be 75.
Until Wednesday’s unpleasantness, Sanford was chairman of the Republican Governors Association, otherwise known as the Association of Possible Presidential Contenders Plus Arnold. Over the past few years, he has tried to woo the party’s base with antics like bringing two piglets into the Capitol to protest political pork and refusing to accept $700 million in federal stimulus money aimed at preventing massive layoffs of public school teachers.
For a state with an unemployment rate above 12 percent, that ranks 39th in public school performance, that last caper might not seem all that entertaining. But it did draw the attention and affection of right-wing commentators, who nudged Sanford right up the potential-contender ladder.
However, all that is in the past. Although his wife issued a statement holding out the possibility of reconciliation, the press conference made it clear that sexual indiscretion is less the big problem here than the fact that Mark Sanford is a complete loony. “I won’t begin in any particular spot,” he said, rambling on about his “love for the Appalachian Trail” (where he didn’t go) and his fondness for “adventure trips” (clearly a personal specialty).
Then Sanford apologized to his wife, his sons, his friends, his staff, his in-laws, “anybody who lives in South Carolina” and people of faith “across the nation.” At this point, I had the terrible feeling that I was the only person in the entire country to whom Sanford was not conveying his personal regrets.
The peculiar thing about the apologies was that Sanford seemed to be under the impression that his worst dereliction of duty involved womanizing. I think I speak for us all when I say that if a governor wants to fly off for a rendezvous with his mistress, the first rule should be: leave a phone number. If you must flee to a love nest, make sure it’s one with an Internet connection.
“It was interesting how this thing has gone down,” Sanford told the assembled reporters, launching, with occasional teary asides, into an extremely boring story about how he and the unnamed Argentine had been good friends and then he tried to help her keep her marriage together, and then they started e-mailing and yadda yadda yadda. (When the governor said “I’ll tell you more detail than you’ll ever want” it was actually easy to believe him.) The whole confessional began to sound like an episode of one of those Finding Love reality shows, when the Bachelorette demands to know if her 25 suitors are all there for the right reasons.
There are some larger lessons here. I know you’re relieved to hear that, since it is highly unlikely that anybody actually gives a fig about Mark Sanford. (Including, perhaps, his beleaguered staff, which spent the last week fending off calls from the lieutenant governor and diligently filing Sanford’s daily Twitter.)
First of all, we may want to consider the possibility that the governor’s decision to reject the federal stimulus money was not a mighty stand against government spending but instead an early sign of total nuttiness.
Second, perhaps it is time to rethink the idea of constantly electing middle-aged heterosexual men to positions of high importance.
Third, although the governor-run-amok thing is worrisome, South Carolinians can take comfort in the fact their state gives its chief executive slightly less power than a game warden.
Fourth, before this search for a presidential nominee goes any further, I’m thinking it’s time for the Republicans to apologize for putting us through the Clinton impeachment. We seem to have pretty well established that sexual stone-throwing is a dangerous sport.
Here’s Mr. Kristof:
As a society, we trust doctors to be more concerned with the pulse of their patients than the pulse of commerce. Yet the American Medical Association is using that trust to try to block a robust public insurance option as part of health reform.
In fact the A.M.A. now represents only 19 percent of practicing physicians (that’s my calculation, which the A.M.A. neither confirms nor contests). Its membership has declined in part because of its embarrassing historical record: the A.M.A. supported segregation, opposed President Harry Truman’s plans for national health insurance, backed tobacco, denounced Medicare and opposed President Bill Clinton’s health reform plan.
So I hope President Obama tunes out the A.M.A. and reaches out instead to somebody to whom he’s turned often for medical advice. That’s Dr. David Scheiner, a Chicago internist who was Mr. Obama’s doctor for more than two decades, until he moved into the White House this year.
“They’ve always been on the wrong side of things,” Dr. Scheiner told me, speaking of the A.M.A. “They may be protecting their interests, but they’re not protecting the interests of the American public.
“In the past, physicians have risked their lives to take care of patients. The patient’s health was the bottom line, not the checkbook. Today, it’s just immoral what’s going on. It’s abominable, all these people without health care.”
Dr. Scheiner, 70, favors the public insurance option and would love to go further and see Medicare for all. He greatly admires Mr. Obama but worries that his health reforms won’t go far enough.
Dr. J. James Rohack, the president of the A.M.A., insisted to me that his group is committed to making health insurance accessible for all Americans, and that its paramount concern is patient health.
“When you don’t have health insurance, you live sicker and you die younger,” he said. “And that’s not something we’re proud of as Americans.”
He added that the A.M.A. is not necessarily opposed to a public option, and I have the impression that it might accept a pallid one built on co-ops. Dr. Rohack wouldn’t repudiate his association’s letter to the Senate Finance Committee warning against a new public plan. That letter declared: “The introduction of a new public plan threatens to restrict patient choice by driving out private insurers.”
I don’t mind the A.M.A. lobbying on behalf of doctors in the many areas where physicians and patients have common interests. The association is dead right, for example, in calling for curbs on lawsuits, which raise medical costs for everyone.
An excellent study published in 2006 in The New England Journal of Medicine found that for every dollar paid in compensation as a result of lawsuits against doctors, 54 cents goes to legal and administrative costs.
That’s an absurd waste of money. Moreover, aggressive law leads to defensive medicine, in the form of extra medical tests that waste everybody’s money. Tort reform should be a part of health reform.
Yet when the A.M.A. uses its lobbying muscle to oppose major health reform — yet again! — that feels like a betrayal. Doctors work hard to keep us healthy when we’re in their offices, and that’s why they win our trust and admiration — yet the A.M.A.’s lobbying has sometimes undermined the health of the very patients whom the doctors have sworn to uphold.
I might expect the American Association of Used Car Dealers to focus exclusively on wallet-fattening, but we expect better of physicians.
In fairness, most physicians expect better as well, which is why the A.M.A. is on the decline.
“It’s what has led to the decline of the A.M.A. over the last half century,” said Dr. David Himmelstein, a Massachusetts physician who also teaches at Harvard Medical School. “At this point only one in five practicing doctors are in the A.M.A., and even among its members about half disagree with its policies.” To back that last point, Dr. Himmelstein pointed to surveys showing a surprising number of A.M.A. members who support a single-payer system.
For his part, Dr. Himmelstein co-founded Physicians for a National Health Program, which now has more than 16,000 members. The far larger American College of Physicians, which is composed of internists and is the second-largest organization of doctors, is also open to a single-payer system and a public insurance option. It also quite rightly calls for emphasizing primary care.
The American Medical Student Association has issued a sharp statement disagreeing with the A.M.A.
The student association declared that it “not only supports but insists upon a public health insurance option.”
Look, a public option is no panacea, and it won’t automatically set right the many shortcomings in our health system. But if that option is killed in gestation, then we’re back to Square 1 and there’s little hope of progress in solving the vast challenges confronting us.
So, President Obama, don’t listen to the A.M.A. on this issue. Instead, for starters, call your doctor!
