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Tilting at windmills.

The American Medical Association is distributing leaflets in its members' waiting rooms that ask "Is the Clinton proposal for health reform good for you and your family? You need to think about these 10 questions." Heading the list is "Will I be able to see my own doctor?" My guess is that this will prove to be an effective tactic.

Clinton could have avoided the problem by adopting the Canadian plan which, of course, lets patients choose their own doctor. Ironically, the insurance companies, the fear of whose wrath apparently led the Clintons not to go for the Canadian plan, are also now planning to use the "you can't choose your own doctor" argument against the very plan the Clinton administration adopted to avoid making them angry.

The AMA used another clever lobbying ploy when it hosted a three-day weekend at the Greenbrier for congressional staffers who will help shape the health legislation. "Interest groups often use posh getaways to woo senators and representatives, but," points out The Wall Street Journal's Timothy Noah, "the lavishness of the Greenbrier [minimum rate $425 per night] as a setting to court congressional staff is extravagant even by Washington's somewhat jaded standards. Its use in this case points up not only congressional staffers' importance in affecting legislation, but also the enormous stakes in the coming health-care debate."

It appears that the lobbies against health care reform are covering every base. They've even hired Paul Tsongas, the man who gave Clinton the most trouble in last year's Democratic primaries. The opposition is so strong that the only hope I see for the cause of reform is for the media to do a good enough job reporting the case for change to balance the propaganda that will flow from the AMA and the insurance and pharmaceutical companies. And the chances that the media will do that are slim indeed. [See "Dead On Arrival," by Ton Hamburger and Ted Marmor, in this issue.]...

If you want to see the tip of a federal iceberg, consider the U.S. Embassy in Grenada. For three American employees, there are six cars, sex blenders, nine toasters, 29 tables, and 49 chairs. Multiply that by all the military and diplomatic posts we maintain abroad and you get some idea of how the U.S. treasury might benefit by putting in a call to Sonny's Surplus....

And if you want to get an idea of the efficiency with which all these posts operate, consider the case of Sheik Omar Abdel-Rahman, the Muslim cleric with the predisposition for befriending people who like to plant explosive devices in public places. To begin with, the State Department failed to add his name to its suspected terrorist list for seven years after his proclivities had been clearly manifested. Even after his name was added to the list, the Sheik made seven applications for visas, only one of which was rejected on security grounds. On that occasion, the State Department did notify the INS, but the INS failed to catch Rahman either entering or leaving the country. He received at least two other visas to the United States after his name was on both the State Department and INS lists. Finally, while the INS office in New York was trying to deport the Sheik, another INS office in New Jersey was giving him permanent residence status

Incidentally, on all six occasions when the U.S. consulates failed to spot the Sheik on the terrorist list, the culprit was as CIA undercover agent....

Another classic tale of government comes from Chicago where it seems that, hours before Mayor Richard Daley was to escort Health and Human Services Secretary Donna Shalala on a tour of the Ida B. Wells housing development, crews arrived to clean the streets and spray silver paint on the rusty fences. A van that offers free immunization was rerouted so it could offer a backdrop to TV cameras. Colorful balloons and a trampoline were provided to attract children and bring appropriate smiles to their faces. Cops were there to keep the gang members away.

"We're not stupid," one mother from the project told John Kass of the Chicago Tribune. "Once Daley and that lady from Washington go, the gangbanging will start again. But they won't be here to see that. They'll be in their own homes, watching themselves on TV."....

Richard Reeves' unsparing but fair new book on JFK's presidency reminds me that even though this government is all too often the depressing joke that the foregoing items have portrayed, it can do great things - from the NASA of the sixties to Robert Kennedy's Justice Department to the Peace Corps I was privileged to be part of. Earlier in my lifetime, during the Roosevelt administration, such agencies as the Tennessee Valley Authority and the wartime Office of Price Administration provided shining examples of effective government. And of course, the post office, at least through the thirties, forties, and fifties, demonstrated that government could provide an essential service efficiently and effectively. So government can do the job but, as the sad stories that begin this column and the subsequent decline of some of the agencies I've just described illustrate, it won't work if we don't mind the store. We have to make sure that it attracts the kind of worker that came to Washington under the New Deal and the New Frontier and that it has the kind of accountability it had when your postmaster knew he could be fired if you didn't get your mail on time....

Last August a 24 year old man from Rockville, Maryland, was killed by a reckless driver who was going 60 miles per hour in a 45 miles per hour zone and sheared off the side of the victim's car. The driver was an alcoholic who had previously been cited 12 times for speeding and had had his license revoked five times in Massachusetts. Yet he was allowed to drive in Maryland.

We see the same problem in medicine. Repeatedly, doctors whose licenses have been revoked in one states are permitted to practice in another. Don't these facts begin to make you suspect the current system of licensing that permits highway drunks and operating room butchers to move from state to state with impunity? Why not have national licensing?....

Further evidence of Clinton's terrible slowness on appointments comes from the Congressional Research Service, which found that by July 4 of his first year John Kennedy had filled 93 percent of the top Pentagon posts, and Jimmy Carter had named 76 percent. Clinton's score is a miserable 33 percent....

One reason the Clinton economic plan had a rough time in Congress is that it was consistently described in media leads as raising taxes. That the increase in income tax would fall solely on the affluent was usually mentioned far lower in the story, which on television often means not at all. The cover of the August issue of Money magazine, for example, supplied the Republicans with this slogan: "Beat the Biggest Tax Hike Ever." Although The New York Times later revealed "the biggest ever" was a lie, it was a lie that gave Bill Clinton fits.

The Wall Street Journal even contended in its Notable & Quotable section that "Support for redistributive economics has never rallied a majority; even in the thirties, polls showed that Franklin Roosevelt's redistribution was not a vote getter."

Doubtless those polls used the same scientific techniques that produced the Literary Digest poll that predicted an FDR defeat in 1936.

Actually, after Roosevelt came out in 1935 with a plan to use taxation to secure "a wider distribution of wealth," he won the presidency by a tremendous landslide, sweeping all states but Maine and Vermont.

If there was any American who was even more beloved than FDR during that era it was the comedian Will Rogers. Interestingly, he too wanted to "arrange some way of getting more equal distribution of wealth in the country."

Will Rogers fascinates me for other reasons. He was, at least in his public persona, absolutely innocent of the snobbery we have endured from the fifties on as more and more Americans try to emulate the rich. He was Huck Finn grown up, and that was what the average American aspired to be back then. As one contemporary puts it in Ben Yagoda's fine new biography of Rogers, "Wise in years, young in humor and love of life, shrewd but gentle, he is what most Americans think other Americans are like."

To some extent Henry Fonda and James Stewart were able to carry on his tradition, but since they too have faded away, there is now a danger we will forget that Huck Finn is what we are at our best, and that is a very great loss for this country.

The fact that there are fewer Huck Finns around means that there is less support for redistribution economics today. Another factor is that in the thirties, 90 percent of the people were getting the shaft where today the figure is 68 percent. These are the people with family income of under $50,000. But they are still a clear majority and I am convinced they will rally to the cause if Clinton does a better job of explaining and the media does a better job of reporting. The discouraging thing here is that so many of the major media stars are now in the affluent class and are tempted to identify with its interest. For example, my old friend Mickey Kaus, who argued in The End of Equality that redistribution is a lost cause, just bought a house in Georgetown where he's going to find a lot of folks who agree with him....

Another example of the errors of the media (and politicians as well) are the figures typically cited on the increase in the national debt under Clinton's proposals. Everyone says essentially "it will go up by $1 trillion over five years."

Yet anyone who bothered to look at page 33 of Clinton's April 8 budget knows the news is worse. (And if Republicans and Perot bothered to look, they'd find better ammunition than they already have.) There one finds that the administration proposed adding $1.4 trillion to the national debt over four years. (What's half a trillion between friends?) That's compared to Bush's $1.53 trillion over four years. Anyone who's watched budget forecasts knows this means that with a little bad luck, Clinton will end up being the biggest-borrowing president in the history - not a good thing to run on in '96 when you've racked up this debt with broad tax increases and without the fig leaf of divided government.

The reason people get it wrong is that they usually add up the projected annual deficits and think that's the number. Of course, these annual deficits don't represent the increase in the national debt (gross debt - the $4+trillion number our kids are on the hook for), because they don't include the trust fund borrowing.

Republicans should argue this way - and of course will, when it becomes plainer. What's amazing is that Ross Perot can't get these numbers right. You'd think he could hire someone to look at the budget! David Broder's tough columns critiquing the administration early on for not doing more have packed that much more punch with the higher number and the argument it permits. The only journalist who's gotten it right is Jonathan Rauch in The National Journal in an excellent piece called "Clintonomics - The Sequel."

The point is that such facts are easy to find with simple effort. Journalists should not get it wrong. And Ross and the Republicans would be wise to get it right too, since it will prompt the administration to turn to the needed budget round two earlier when they realize that being the biggest borrowers in history won't look good in '96....

The most novel explanation I have heard of Vincent Foster's suicide comes from Inside Washington's Carl Rowan, who told viewers:

"You get a man who's very close to the president, a confidant, his head is full of our most secret information, and because of the excesses of a John Sununu he can't get a car ride home." In other words the suicide would not have occurred, or, in Rowan's words, "we would at least have some idea of what happened" if only the White House still provided drivers for officials of Foster's rank. This takes me back eleven years ago to a time when I was on this same show and made some anti-perk remarks only to be rebuked off-camera by Elizabeth Drew, who allowed that she liked to be picked up by a limousine and by Rowan, who said he refused to fly unless it was first class.

We all like comfort, but the problem with the Drew-Rowan attitude among journalists is that they let their own taste for luxury encourage Washington official to insulate themselves from the problems of the rest of us, like having to take the bus or subway or hail a cab at rush hour - finding generous health insurance, not coincidentally, is a cinch if you work for the White House, Congress, or the major media...

A Johns Hopkins study of depression in 104 different professions found the highest proportion of victims was among lawyers. This is one reason why I am constantly warning young people not to go into the law unless they truly feel a real calling, or enjoy actual practice. If such tests were strictly applied by all lawyers, the ranks of the profession would be instantly cut by at least two-thirds.

According to Amiram Elwork, the coauthor of a recent research study "Lawyers in Distress," a very large proportion of lawyers "are either very dissatisfied with their careers, suffer from some form of mental illness, or have been problem drinkers. Today's lawyers work in conditions that are remarkably similar to the |sweat shops' blue collar workers endured several generations age. Such law firms push productivity to the limit of human capacity and constantly function in a crisis mode."

The result, Elwork told The Washington Times, is that "mental illness and substance abuse are leading causes of malpractice suits and ethical disciplinary actions against attorneys."

In the fifties, I was fortunate enough to work in a small firm in a small city with some non-workaholic partners and a variety of clients who represented a cross-section of the community and its problems. But I still found that half the work was either boring - imagine what researching a land title is like - or even when interesting, as in trying cases, was often for causes of marginal merit. I was much happier in public service in the state legislature of West Virginia and with the federal government here in Washington, work that I have tried to continue with this magazine.

Of course, there are a few lawyers who love their work and make a valuable contribution to society. But most would be happier doing something else. Not only would they be better off but so would the rest of society because many of the unhappy lawyers are bright and able people who could do great good in other kinds of work....

Did you happen to see the story in The New York Times about the third-year medical student who after working his 15th straight hour fell asleep at the wheel and was crushed to death in an accident caused by his driving the wrong way on an exit ramp? The abuse of medical students, interns, and residents is even worse than that which young lawyers have to endure.

There are two reasons: (1) Older doctors want their youthful brethren to endure the same hardships they did, and (2) Hospitals profit from having slave labor. There is a simple solution: Have older doctors with hospital privileges do night duty just a couple of times a year for modest pay. There are enough senior doctors - meaning those past residency - to free the young from the ghastly burden they have today....

We have often tried to explain that, although court dockets may be overcrowded, American judges have displayed a remarkable ability to keep their own work schedules on what might be charitably called the light side. Consider that the United States Supreme Court Justices have to be there for the approximately 40 days set aside for oral arguments and the roughly 30 Friday morning on which they meet to discuss cases. That leaves the justices 295 days to schedule as they please. Justice Scalia chose to use the freedom by taking 20 trips in 1992 alone. Among his destinations, according to Linda Greenhouse of The New York Times, were Venice, Innsbruck, Oslo, and Genoa.

Incidentally, each trip was financed by a non-profit institution, which may help explain why the law is so tender in its treatment of these organizations, letting them get away with the kind of abuses that recently have been reported about one Blue Cross chapter after another....

In hindsight, it seems clear to me that we should have provided enough military aid to the Bosnian Muslims to give them a fair chance against the Serbs. Cyrus Vance and David Owen were guilty of grave error last year when they counseled against such aid on the grounds that it would keep the Bosnians away from the peace table. It was the lack of such aid that kept the Serbs away from the table. They knew they could win more by their unfair military advantage than they could through serious negotiations. The only time they showed a sign of reasonableness was in March when Clinton threatened them with both air strikes and aid to Bosnia. They were falling all over themselves in their rush to the peace table until our NATO partners rejected Clinton's pleas and the Serbs returned to shelling Sarajevo....

Morton Mintz, who I believe will rank as one of the greatest investigative journalists of our time, recently revealed that the ACLU had taken $500,000 from the tobacco companies while the ACLU was publicly arguing, supposedly on the basis of the purest principle, that restrictions on cigarette advertising could violate the First Amendment. The ACLU had not revealed that it was on the take from the merchant of death, a.k.a. tobacco companies, on the grounds - you're going to love this - hat it had to protect the companies' right of privacy.

How could anyone seriously believe that advertising of harmful products is protected by the First Amendment? Obviously the newspapers and magazines that fatten their profits with cigarette advertising have a reason for wanting to cloak their sins under the righteous mantle of free speech. And so do all the lawyers who represent or hope to represent them. When you add all of those lawyers to the lawyers who work for the tobacco conglomerates you can see that an impressive array of legal talent has a stake in peddling the notion that James Madison really intended to protect R.J.R.'s right to use Joe Camel to lure children to smoke.

If you want to know how wrong these guys are, read Democracy and the Problem of Free Speech, a brilliant book by Cass R. Sunstein, professor of Jurisprudence at the University of Chicago Law School, in which he explains why commercial speech should not be accorded the same protection that we should give to political discussion.

Like Alexander Meiklejohn, another great First Amendment theorist, Sunstein believes that political speech is the heart of the First Amendment. It is this liberty that is key to all others and for this reason I have told our advertising people that, although I would not accept any advertising that glamorized smoking, I would reluctantly accept an ad for the Tobacco Institute saying that tobacco companies have the constitutional right to advertise. That would be a political argument that I would not have the right to suppress.

On the other hand, I have taken great pride in refusing to run all ads that attempt to persuade people to smoke. I wish more publications would join me as the Seattle Times recently has. Unfortunately most papers and magazines accept, even solicit, cigarette advertising. I can't understand how decent people like the Grahams and Sulzbergers can live with this practice. The Post, by the way, ran the Mintz report on page A13, which is just the kind of placement it gave to his many exposes of corporate malfeasance during his long career at the paper. In defense of the Post, it did pay Mintz a salary and it did run his stories. But the frequent obscurity of their placement in the paper betrayed a lack of enthusiasm for truth that might offend advertisers....

I am disturbed to learn that 70 percent of the 1,400 national service volunteers who gathered in San Francisco from all across the nation in June turned out to be black. This is a strong indication that what we're going to get from Clinton is not a service but a poverty program. I support programs designed to help needy youth, but they should not be confused with service programs whose purpose is not to give people jobs but to ask them to give of themselves....

The long distance phone companies have learned a great secret of the monopoly game. Even though one company doesn't have exclusive control of the market, the happy result of monopoly can be achieved by unwritten agreements to keep overall prices up while appearing to compete with clever ads that promise dramatic savings - savings that just happen to be unrealizable for the average customer. It usually turns out that you can only save the promised 50 percent if you make a hundred calls to Nome, Alaska, and Anniston, Alabama, every month....
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Title Annotation:health care reform and other current events
Author:Peters, Charles
Publication:Washington Monthly
Date:Sep 1, 1993
Previous Article:Making Americans: An Essay on Individualism and Money.
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