Guest Editorial: The Politics of Influence

    My local newspaper, Long Island Newsday, does a fair job of keeping me abreast of happenings on my home front.

It also features a few highly polished gems, such as Saul Friedman’s “Gray Matters,” a weekly column for senior citizens. Friedman, a 1963 graduate of Harvard, has had significant personal experience in our healthcare system¹ and offers his opinions in delightful prose. In his March 12, 2005 article, he writes, “This argument over Social Security is too often, in Shakespeare’s words, ‘a tale told by an idiot, full of sound and fury signifying nothing.’ So it’s a relief to listen to quieter voices that don’t fling charges about but simply question the wisdom of dismantling part of the nation’s premier social insurance program in favor of private investment accounts.”²

    Over the past few months, Friedman has explained in plain English exactly how the changes envisioned in the Medicare and Social Security programs will affect the average citizen. His remarks are a worthwhile read for everyone receiving Ostomy/Wound Management, if not every citizen of the country. Friedman presents the official government view on many of the issues, distilling policy to language everyone can understand while pointing out the disconnect between citizenry and leaders. One example is his column dated February 26, 2005. He provides excerpts of an official White House transcript in which the President explains how private accounts would help preserve Social Security. He quotes the President as saying, “Because the — all which is on the table begins to address the big cost drivers. For example, how benefits are calculated, for example, is on the table. Whether or not benefits rise based upon wage increases or price increases. There’s a series of parts of the formula that are being considered. And when you couple that, those different cost drivers, affecting those — changing those with personal accounts, the idea is to get what has been promised more likely to be — or closer delivered to what has been promised. Does that make any sense to you? It's kind of muddled. Look, there’s a series of things that cause the — like, for example, benefits are calculated based upon the increase of wages, as opposed to the increase of prices. Some have suggested that we calculate — the benefits will rise based upon inflation, as opposed to wage increases. There is a reform that would help solve the red if that were put into effect. In other words, how fast benefits grow, how fast the promised benefits grow, if those — if that growth is affected, it will help on the red.”³ [Ed. note: This is quoted unedited directly from the source.].

    Assuming we understand the President intentions, will these changes be good for our patients? Not likely. Keep in mind the wound care specialist reading this journal is not high on the list of priorities. We are not on the event horizon. But we should be.

    Can we do anything about it? Yes, if we put our hearts, minds, time, and wallets into the effort. But if you don’t play the game, you can’t make or influence the rules. Consider, if you will, the Political Influence Pyramid (see Figure), presented at an American Academy of Dermatology conference a few years ago by Michael E. Dunn. Dunn is founder of Michael E. Dunn and Associates (https://www.dunnassoc.com/), a firm that, among other goals, was created to “grow political action committees, build internal and ongoing grassroots lobbying programs, deliver motivational and substantive political training and high-level leadership presentations, and change the culture of an organization to succeed in government affairs.”

    As the pyramid indicates, the majority of the population, comprised of people who do not or cannot vote, is essentially disenfranchised, as are those who vote for the losing candidate. People who vote for the winner rank a bit higher because they agree with his or her policies but they have not influenced them. Folks at the top, who have contributed, volunteered, did both or engaged others to do either or both, have influence. Does this influence allow them to influence their candidate’s vote on Congressional matters? No. But it does allow them to be heard and taken seriously — to stand out from the rest of the electorate and provide like-minded colleagues the opportunity to present a potent, focused voice.

    Dunn and others who work in this field know the mechanics creating this powerful voice. Even if you are not a trained lobbyist, you can voice your opinions. The Center for Responsive Politics⁴ website puts you in contact with corporate sources of influence, allowing you to search using any combination of name, company, state, zip code, and occupation of the donor and the recipient. Additional searches also yield fascinating results. For instance, Blue Cross/Blue Shield donated soft money of $1,333,236 to both parties in the 2003 election cycle, while many thousands more were donated by employees to political action committees across the political spectrum. Another valuable site is the Federal Election Commission, where you can learn the rules about political contributions and the like.⁵

    Once you are armed with the drive and knowledge to speak out, write to elected representatives. The Thomas Legislative Information website is a good place to start.⁶ It provides information on bills going though the Congressional system, valuable information about the activities on Capitol Hill, and links to other relevant sites. Links include the US House of Representatives website,⁷ where you can find out your Congressman’s name simply by typing your zip code; the Senate website⁸; and the White House website.⁹ (Always remember that official government sites end in .gov — (whitehouse.org, for example, is a comical parody site and other domain suffixes are a mixed bag.)

    When contacting your elected officials, be respectful and rational. Another tip: use fax or email — snail mail must go through security screening before it gets to the addressee. Keep in mind that most likely the intended recipient will never see your letter; in most cases, a staff member will read it and respond unless you have some particularly interesting points (from their perspective) or know the Congressman or Senator personally.

    I will end this missive with a request: Do something! Write. Donate. Get active. And let OWM know what you are doing. Compose a commentary describing your actions. Mobilize others. Heal thyself, heal thy patient, and heal thy government.

1. Nieman Reports, Winter 2003. Available at: http://www.nieman.harvard.edu/reports/03-4NRwinter/97-102V57N4.pdf. Accessed March 31, 2005.

2. http://www.sun-sentinel.com/news/nationworld/ny-saul4171765mar12,0,7291887.column?coll=sfla-newsnation-front. Additional columns are available: http://www.sun-sentinel.com/news/nationworld/ny-saulfriedman,0,1884884.columnist?coll=sfla-newsnation-front. Accessed March 31, 2005.

3. http://www.sun-sentinel.com/news/nationworld/ny-saul4157736feb26,0,4539363.column?coll=sfla-newsnation-front. Accessed March 31, 2005.

4 . Donor Lookup: Find Individual and Soft Money Contributors. Available at: http://www.opensecrets.org/indivs/index.asp. Accessed March 31, 2005.

5. Federal Election Commission Disclosure Data Search. Available at: http://www.fec.gov/finance/disclosure/disclosure_data_search.shtml. Accessed March 31, 2005.

6. Thomas Legislative Information on the Net. Available at: http://thomas.loc.gov/. Accessed April 1, 2005.

7. United States House of Representatives. Available at: http://www.house.gov/. Accessed April 1, 2005.

8. United States Senate. Available at: http://www.senate.gov/. Accessed April 1, 2005.

9. Welcome to the White House. Available at: http://www.whitehouse.gov/. Accessed April 1, 2005.