Novermber 2000

Electile Dysfunction

By Michael J. Katin, MD

We have gone through months of excitement, anticipating the climactic event of the year 2000. But now that the Nebraska-Oklahoma game is history, it's time to turn attention to Election Day, November 7.

We continue to have trends toward simplification of issues. This results in the major candidates having what seems to be blatant ignorance of medical issues, either despite or because of their having attended Ivy League institutions. Maybe this is a trend towards simplification that is dramatically illustrated by the decrease in the length of Presidential names, from Washington (10 letters) and Jefferson (9 letters) to Lincoln (7 letters) to the next President being only the second to have a name as short as 4 letters. Nader (5 letters) and, especially, Buchanan (8 letters), don't stand a chance. Maybe Kenny G will run in 2004. But I digress. There is little incentive for the candidates to address the issues important to us as Oncologists, since most of the voting public doesn't care about its health until it goes bad. But perhaps we now have a golden opportunity to get their attention.

This occurred to me at the 2000 ASTRO meeting, when the meeting schedule on October 24th was disrupted to allow Senator Edward Kennedy to speak. Why was he there? His re-election to the Senate is taken for granted, against a Republican disowned by his own party. Certainly nobody expects Massachusetts to swing out of the Gore column.

No, the reason suddenly became obvious. Every poll has been showing a virtual dead heat not only between Mr. Bush and Mr. Gore but also indicates a reasonable chance that both the Senate and House of Representatives may be split 50-50. I realized that he had come to address the largest block of potential voters that could be isolated on that date.

I'm not the shrewdest political brain in the world. For example, my suggestion for handling prescription drugs for seniors is to have the government charter large buses to take them to Mexico to buy cheap drugs, rather than have some complicated system of reimbursing different percentages depending on their income, age, and astrological sign. But I still knew why Senator Kennedy had come to see us.

As it turns out, his efforts probably backfired since the several changes in the schedule to accommodate him resulted in wrecking the plans of hundreds of people in terms of intersecting with colleagues, interviewing job applicants, browsing the exhibit hall, and even attending educational sessions. I don't think we even got CME for his session, although all I remember from it is that the Democrats will make sure it's OK for us to give pain medications to our patients.

But as long as we're now being courted, we might as well make the most of it. The endorsement of David Hussey could be as valuable as that of other celebrities (the Oak Ridge Boys and Marilyn Manson for Bush, Cher and Stevie Wonder for Gore). Most importantly, we might even have a chance to negotiate for concessions to our advantage. I can imagine the short list: daily management fees; special codes for more sophisticated procedures, such as IMRT; accelerated depreciation for new equipment; and government subsidies for RTT training.

What we'll probably settle for: please don't hurt us too badly with the next HCFA guidelines.

email: mkatin@radiotherapy.com