Too Far

Too Far


Leonard Zwelling

It should come as no surprise to readers of this blog that this blogger views Peggy Noonan of The Wall Street Journal as the most clear thinking of editorialists. Her entry on September 7, 2019 is no exception and it is from that that I got the title for this blog.

Her piece focuses on how some of the key world leaders today are getting far out ahead of the people they lead in developing policies.

Example one is the Chinese and their policy toward Hong Kong. Basically Beijing is pushing Hong Kong too far. Hong Kong pushed back and the protestors too may be pushing too hard now that Carrie Lam, the chief executive of Hong Kong and Beijing’s puppet, has withdrawn her proposal to allow extradition of Hong Kong people to the Mainland. Everyone is over stepping. Let’s hope that the demonstrators don’t go too far and have Beijing call in the troops a la Tiananmen.

Noonan’s next example is the Democratic candidates for president. It seems almost none of them has found a liberal policy they cannot embrace. The notions that illegal immigrants ought to qualify for government health care and that illegal entry to the U.S. is not criminal are preposterous. There will be no doubt that Mr. Trump will seize on such nonsense in the fall election and beat the Dems to death with it. They are going too far. America MAY be looking for an alternative to Mr. Trump, but America is still a right of center country and not looking to radicalize federal policy on immigration. If anyone who wants to come in can and everyone who comes in gets what ever he or she wants, do we have a country any more?

The same is true when it comes to health care reform. As was in evidence during the September 12 debate in Houston, most of the Democratic candidates for president cannot really articulate the path from our current system of largely employer-provided insurance to a Medicare For All system. The in between is the so-called “public option,” but such a government program would likely degenerate into Medicare For All unless it is too pricey in which case it will just die. Someone needs to describe exactly how we get from where we are to where they want us to be without going too far and wrecking what many Americans like about their health insurance.

Finally there is the full-fledged lunacy that is threatening to drown Great Britain. It has been three years since the people of the British Isles decided to leave the European Union. Why their elected representatives can’t get this done is shameful. It may well have been a decision that in itself was too far. But it was a fair vote and the conclusion was unambiguous. Either declare it a mistake and have a new election (something that would not go down well with the previous winners, The Leavers) or get on with it.

It seems that in none of these instances does the leadership of the PRC, of the Democratic Party, or of Great Britain have a plan to move forward. As Noonan points out, Boris Johnson seems to be flying by the seat of his pants.

Finally, I would like, as usual, to turn your attention to the management of MD Anderson and other academic medical centers. What is the over-riding principle governing the manner in which these institutions are being led? I can’t figure it out.

It used to be pretty clear what academic medicine was about. It was about caring for the sick in new and innovative ways, doing unquestioned high quality research that pushed the barriers holding up progress against disease, and the education of the next generation of practitioners, investigators and academic leaders. Is that still the case? To be honest, I can’t tell.

It seems that there is a new instance of poor patient care or discrimination or sexual misconduct or research malfeasance occurring in academia on a regular basis. It will take a new generation of thoughtful leaders to stay ahead of the curve in restoring sanity to academia after a long period of the pursuit of money and the lessening of the quality of research. There is too much fraud; too much malpractice; too much abuse. In the pursuit of wealth and prestige the leadership of academia got too far ahead of the ability of faculty members to regulate their own activities and constrain their own greed.

Being out ahead is good. As Noonan says, you can appear visionary. Being too far ahead and you can push the system too hard and that system will always come back to bite you—in Hong Kong, election politics, Brexit or academic medicine.

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