Wind in the Windy City

Posted 7/29/07 (By Travis)

Wind in the Windy City (SOMA, AOA Chicago Convention)

7/24/07 Neoperspectives.com

So, I thought for this piece I'd mix the personal and the political and write about my trip last week to Chicago. Retrospective apologies, I started out intending to touch mostly on medical/health policy, but soon gave into the tempting digression of wading into the cesspool of Chicago politics.

Upon landing, literally the first thing I saw, and a rather fitting greeting at that, was:

'Daley' is the notoriously corrupt mayor of Chicago, who runs a tight political machine, using 'big government' as a tool to maintain power and, like all big city liberal mayors, as a side effect of such policies and those of his precessors, is hemorrhaging citizens. In fact, Chicago has lost 1/3rd of its citizens, nearly a million people, since the 1950s.

Case in point, after exiting the airport I became stuck in the following:

The above is a picture of a massive hour long que for taxi cabs.

Now, we've always maintained that shortages are generally caused by government policies; even traffic, for example, is little more than a shortage of roads. The situation is no different here. Readers may recall a recently posted story describing the government policies in New York and how a taxi cab 'license', aka a 'medallion', is now worth $500,000. Upon inquiry, a Chicago medallion is 'only' worth $80-90k, still prohibitive enough to discourage any upstart taxi entrepreneurs.

Even more interesting were the responses I received upon discussing this with my fellow waiting citizens. One lady, while somewhat sympathetic to my views, said she thought getting rid of all oversight without any regulations was, "sort of extreme and would lead to chaos." I pondered the meaning of this response as I stood in the disorganized hour long line, with shouting government workers herding us here and there, blaring horns, irate cab drivers, and exhausted and exasperated pedestrians.

When I finally got a cab the first thing I noticed was that those responsible for the disaster at the airport were taking responsibility, by laying out some of the regulations they were burdening the taxi industry with and attaching their names in bold letters.

But, on second thought, maybe this wasn't the intention. Perhaps mayor Daley and some government commissioner were plastering their names all over the cabs in an act of political nepotism, simply to garner importance and name recognition. Of course, the latter is what was actually occurring and such acts are rather common and, IMO, one of the worst abuses of power a government official can engage in.

For a recent example, we need look no farther than the chair of the powerful house 'ways and means committee' Charlie Rangel (D, NY). Last week Rep Rangel inserted an earmark for $2 million dollars to create:

...the CHARLES B RANGEL Center for Public Service. That's right, this left wing Democrat who has probably never voted against a tax increase in his life wants to appropriate millions in federal tax dollars to go towards a building named after... HIMSELF!

But wait, there's more.

According to the marketing materials provided by Rangel himself to his colleagues, this center includes a library to house the Congressman's future papers, a "well furnished office" for him, and an endowment. There is even mention of a librarian to work on the organizing of his papers. Apparently this last part is worded thusly in the paperwork: "The Rangel archivist librarian will organize, index and preserve for posterity all documents, photographs and memorabilia relating to Congressman Rangel's career."'

In any event, the main reason for my arrival in Chicago was the AOA (American Osteopathic Association) Convention and SOMA (Student Osteopathic Medical Association) Convention.

I can say it was quite a sight to behold; hundreds of physicians filling a vast hall and voting on issues effecting the entire profession, the medical field, and patient care. I was happy to see many, many issues affecting DOs were decided by a private entity, the AOA, rather than the Federal Government. Unfortunately, the Federal and State governments often usurp or negate the powers of national and state professional associations, and equally disturbing, in many cases artificially enhance what powers they do possess by granting said organizations monopolies over sectors of the service economy.

At one meeting we viewed a video describing the AOAs involvement in Chinese health policy, training, and advice. It described how the Chinese government was 'retraining' thousands of specialists as 'primary care docs', relocating physicians, and pursuing various other what I would characterize as top down 'big government policies'. I was disappointed to see this; one would hope that the AOA would seize such an opportunity to advise the Chinese away from such statist approaches and promote a more American market economy approach to medicine. Then again, perhaps the video was misleading, or I was inferring something that was not implied.

There were also some good discussions regarding residencies and the rapid growth of the Osteopathic profession. It is projected that the percentage of physicians who are osteopathic physicians (DOs) will rise from the current 6% to over 20%. It is interesting to note there is not a shortage of residencies in the lower paying specialties; in fact, in some areas there is a glut. One speaker even, wisely in my opinion, asked whether certain struggling DO residencies should be opened to MDs (the reverse is true). It is probably the case that scare residencies are competitive in large part because they are 'high paying'. But why are they high paying? Is it because the 'public interest and safety' necessitate the attraction of impeccably 'qualified' applicants, or because the policies/regulations intrinsic to those subspecialty societies make the residencies scarce, thus raising the salaries of those in the field? In my mind, the latter possibility is most likely and certainly worthy of investigation, as the negative repercussions reverberate through the entire profession and indirectly harm patient care by increasing the cost of healthcare, thereby decreasing access. Doctors and residents in those subspecialties have little incentive, if we consider the unconscious permeating feedback loops, to change the present system; in fact, it is medical students who gain the most from advocating a fix; therefore it seems this issue is one meriting student led discussion and investigation.

This trip also solidified, in my mind, the usefulness of continued political involvement, even in organizations which may not share many of your own ideals and values. I was happy to discover there are many likeminded freedom valuing individuals within the AOA and the various student groups. I often wondered why people like Rod Paige and other conservative blacks remained members of the NAACP, or why anyone with conservative/libertarian values would stay a member of certain unions, especially teacher's unions. Now I understand why. By leaving various groups you are, in effect, conceding the ideology of those organizations to beliefs in conflict with your own. Every group is, to some effect, a product of the opinions of its members, even if those at the top give into the temptation to abuse or hijack their derived power. Individuals can make differences and the infusion of the ideals of freedom into organizations by active individuals more than offsets any financial or personal reluctance implied by membership support.

To end, a pic with myself and the newly elected AOA president, Peter B. Ajluni, DO. He seems like a great guy!