Superpower: America’s Role
in the World At-Large, MD Anderson’s Role in Oncology
By
Leonard Zwelling
Without hesitation, I bought the book. It is called Superpower: Three Choices for America’s
Role in the World by Ian Bremmer.
As
is not atypical, I learned about it from one of my best and most frequent instructresses,
Peggy Noonan in her column in the Wall
Street Journal, Saturday, June 6. (How appropriate to read about America’s
role in the world on D-Day, the day we saved civilization!)
I await the book’s delivery from amazon, but Ms. Noonan
describes the three choices Mr. Bremmer outlines thusly:
free from foreign entanglements and concentrates on its own wellbeing as a
nation. We go back to caring for our own people with the energy and money we currently
put into the rest of the world, usually in military equipment. We go back to building
roads, repairing bridges, and not resting until every child has access to a
laptop with high-speed Internet and three square meals. Once and for all we say to Western Europe, the
Middle East, and the Pacific Rim, we love you all, but charity starts at home.
We are out. You are own your own against Russia, ISIS, each other (Middle
East), and the panoply of natural disasters that may befall you. After Katrina,
we have our own.
safety. We have an eye toward the rest of the world, but for our own
self-interest. We will join with other nations, but not always lead or foot the
bill. We do this primarily because everyone else is—an awful reason to do
anything that comes under the heading of moral relativism and is an excuse for
all kinds of bad behavior from Enron to Iraq.
policeman. This is the “exceptionalist” view of America. Our principles become
our most important export as we democratize and free the rest of the world. If
we need more money to do this, we will just print it and the hell with what it
does to the rest of the world’s currency.
Ms.
Noonan finishes her column by noting how difficult this choice would be for
most politicians to make because this choice would entail making a real
decision and implementing policies that adhere to an overriding philosophy,
something that we have not seen in American politics since George H. W. Bush
liberated Kuwait from the Iraqis using a coalition and the brains to NOT go to
Baghdad. He got tripped up by a bad economy and Slick Willie’s claim to be able
to fix it. I guess he did with the help of the dot-com bubble.
Apparently,
according to Ms. Noonan, Mr. Bremmer chooses door number 1. I will wait to read
the book.
Where
I am going with all of this is to my favorite topic, MD Anderson, an
institution with a problem much like that of the US. Having emerged from an era
of integrity analogous to that of the US after WWII, in 1996 MD Anderson took
off on a spending spree and building campaign that not only grew its stature,
it grew its need for cash which was fulfilled once patient referral was no
longer needed to get through the front door and Hilary Care passed over the House of Lee Clark like the Angel
of Death over the houses of the Jews in Egypt during the tenth plague.
Much
like the US after Korea, in the subsequent years after 2001, MD Anderson tried
to run all three strategies at once. The independent MD Anderson focused on
building up the physical plant on Holcombe, Moneyball MD Anderson signed every
contract around with hospitals and practices in the US, and indispensable MD
Anderson sought to spread the gospel of Ron throughout the world. That’s no
strategy and all it guarantees is the need for greater and greater amounts of
cash and, unfortunately, unlike the United States, MD Anderson cannot print
money.
Once
the current crew is gone, and I predict that is only about a year away now that
Mrs. DePinho has been dethroned and Ron’s buddy at A and M got canned, the new
crew will have to elect one strategy or another, much as each of the
Presidential candidates will have to if he or she is to be taken seriously.
(Did I just say that?)
Like
America, MD Anderson needs a real plan guided by a real philosophy with real,
measurable goals. The drift that has characterized the last 15 years has to end
if MD Anderson is to stay on top, or get back there.
I
share Mr. Bremmer’s choice for the country in my choice for MD Anderson. Let’s
focus on patients that can be uniquely helped or can uniquely advance research
at 1515 and send everyone else to the regional centers. Let’s stop putting the
MD Anderson name on the side of “weapons of mass construction” in Spain, Arizona, and New Jersey. Let’s eschew the need to be the best at everything and dominate
the market. Let’s uniquely do what we do best—care for the sick and do research
and stop trying to commercialize every invention or take stock from any company
who does not have the money to actually pay for MD Anderson’s participation in
a new venture.
Let’s
get back to the future.
I
really don’t want the ear candy of MD Anderson to be the sound of coins like
the ear candy of America is the sound of Taylor Swift.
MD
Anderson’s name has always stood for a superpower in oncology. But it’s
slipping. With a little strategic choice, MD Anderson could be back where no
name stands out now. It’s a “blank space. Let’s write the name” of MD Anderson.
