That Moment

That Moment


Leonard Zwelling

         In the Wall Street
last week, Peggy Noonan again shows how well she can take the pulse
of the American electorate–the good, the bad and the very ugly.

         Her piece is called “The Moment 2016 Hits You” ( and like all her pieces, this one distills the
essence of collective American feelings into objective reality.

         You will see if you read it how she traces the various
courses her friends and their families have taken to come to the notion that
2016 is so much less than this country deserves. The people vying for the
Presidency are small, intellectually dishonest, far off to the left or right,
or simply common criminals. I agree on all counts.

         It is the comparison with past races and previous
candidates, winners and losers, that makes this one seem so petty and small.
Despite the fact that the problems the country faces today are every bit as
large as the Missile Gap (JFK), the Civil Rights inequities (LBJ), the opening
of China (Nixon), or the threat of the Soviet Union (Reagan), those from whom we
get to pick to lead us seem so inadequate for the task.

is going to fight ISIS?

is going to be an example to our daughters?

is telling me what is right and wrong?

have got to be kidding!

         I believe the same to be true in American medicine as we
have neither the intellectual leaders nor the social reformers that have
characterized great American medicine of past years (Osler, DeBakey, Koop,
Salk, Watson).

         The academic leaders are only worried about making a financial
“margin” (i.e., profit) and many are trying to do so by bowing to capitalistic
conversion of public largesse in the form of NIH grants to private wealth in
the form of intellectual property discovered on those grants, by their faculty,
and patented for the benefit of the university. This is small potatoes.

         Others are not even pretending to be ethical leaders making
deals with big pharma for millions while giving the drug companies access to
data and/or patients from the medical centers they lead.

         The pharmaceutical companies themselves are greedy and spend
more on marketing than they do on research and use the inequitable health care-industrial
complex of the US to mark-up the price of their drugs. They claim they need the
high prices. For what? More TV ads for Viagra?

         The hospitals are no better trying to cut more and more
favorable deals with insurers while not really being able to quantify the
quality of the care they give. They react to the government and its definition
of “meaningful use” instead of reminding the government that it too is in
service of patients.

         And the insurers. A more unscrupulous group of leaches has
never existed. They suck up 30% or more of the health care spending in the
country providing—nothing.

         This is not the great era of American politics or of
American medicine. Until we correct these flaws by having new campaign finance
laws, rolling back Citizens United, attracting the best into public service,
and making access to quality health care the right that it should be, this will

I fear that 2016 will not stand out as the exception, but rather appear to be the
beginning of a new rule. Oh heavens!

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