The trouble with second terms
Medicine

The trouble with second terms


For the past half-century, history hasn't been kind to American Presidents who were fortunate enough to be elected to second terms. Whether through their own hubris or regression to the mean, re-elected Presidents seem unable to escape personal health issues, scandals, or disastrous domestic or foreign policies. Dwight Eisenhower suffered a stroke early in his second term and later fumbled through the embarrassing U-2 incident. After completing JFK's first term, Lyndon B. Johnson won a second and promptly passed Medicare and Medicaid, but finished his presidency hopelessly entangled in Vietnam. His successor, Richard Nixon, resigned in disgrace midway through his own second term rather than be impeached for his role in Watergate. Ronald Reagan won again in 1984, but his second term was marred by the Iran-Contra Affair, colorectal cancer, and (possibly) the onset of Alzheimer's. Bill Clinton fell to Monica Lewinsky and the Starr Report. George W. Bush: Iraq and the collapse of Wall Street. So in addition to asking if our current President deserves a second term, undecided voters might consider what stumbles he would make if he wins.

I didn't vote for Barack Obama in 2008. I thought that he had neither the leadership experience nor the political stature to unite the nation, and the events of the past four years haven't changed my impression. Any hope his campaign may have had of earning my vote in 2012 was dashed by two incidents that occurred when he was my boss (and I, a federal employee): trotting out the Secretary of Health and Human Services in November 2009 to disavow the USPSTF's new recommendations on screening for breast cancer, effectively throwing the Task Force under the health reform bus; and again permitting politics to trump science by cancelling the Task Force's November 2010 meeting to delay the release of a similarly damaging statement about screening for prostate cancer - then adding insult to injury by covering it up.

Do I have a higher opinion of Obama's competitor, an oft-caricatured tax-evading multimillionaire who wrote off 47% of Americans who pay no income taxes and wants to "end Medicare as we know it"? I guess it's all about perspective. Mitt Romney is a flawed man, but it's hard to believe that his motivation for pursuing the Presidency is to only make life better for the so-called one percent. If Romney had wanted to amass a greater fortune and not be lampooned by late-night comedians, he would have stayed put at Bain Capital and passed on saving the Salt Lake City Olympics or becoming Governor of Democratic-dominated Massachusetts. (He also could have chosen to hang on to more of his supposedly tainted earnings, rather than giving to his church and charities as much money each year as many others - even those in a similar income bracket - do in a lifetime.) Whatever Romney's view of the Affordable Care Act is, he worked with political polar opposite Ted Kennedy to pass a bipartisan health care plan 4 years before the ACA. As for his running mate throwing Grandma off the Medicare cliff, that advertisement may sway a few voters in the critical swing state of Florida, but could, like the original Harry and Louise ads, move this country even farther from tackling the problem of skyrocketing health costs.

I admit to hesitation and second-guessing about using my blog, which I think has earned a reputation for being evenhanded on the most politically charged of health care issues, to explicitly endorse a Presidential candidate. Perhaps some of you will think less of me or, worse, post all sorts of vitriolic comments, although I hope not. But for what it's worth (which isn't much at all, since I live in the District of Columbia), this Common Sense Family Doctor will cast his ballot for Mitt Romney for President on November 6, 2012, and encourages all who are reading to do the same.




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