It’s A Miracle That Americans Are Living As Long As They Do

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Red Kool-Aid  Blue Kool-Aid

Leonard A. Zwelling, MD, MBA,

with Marianne L. Ehrlich,

Franklin Scribes, San Antonio, Texas, 2014

This book is many things. While the author sets out (successfully mind you) to tell us how partisan politics and greed undermined the value of ObamaCare, his greatest contribution to the reader is an inside look at how some bad laws are made and some good ones blocked, in Washington. But also hidden deep between the lines (and often not so deep) is his regret about how he and his science of medicine were treated in both his own profession and by others who very much needed to hear what he had to say. On the one hand, one can read in his words the feeling of regret and even sour grapes, and on the other, many who have been treated similarly in their own careers, could easily shout out, “Preach it brother and thank you for telling it like it is.”

Leonard A. Zwelling is not afraid of hard work and his career in medicine for some forty plus years has proven it time and again. Having risen to the position of Vice-President of Research Administration at the University of Texas, MD Anderson Cancer Center in Houston, circumstances caused him to move on to the position of a Robert Wood Johnson Foundation health policy fellow serving on the minority staff of the US Senate Committee on Health, Education, Labor and Pensions. How all that came about, what it meant to him as a person, what he learned in Washington, and why no “real” health reform will likely come to America in our generation or that of our children and grandchildren are the key themes of Red Kool-Aid Blue Kool-Aid.

Older readers will clearly relate the use of Kool-Aid in the book’s title to the Jonestown massacres of 1978 when followers of the religious cult leader, Jim Jones, committed mass suicide by drinking cyanide-laced Kool-Aid in the jungles of Guyana at their leader’s command. Zwelling paints a similar picture of what goes on in Washington and especially Congress every day.

He sets out some premises: As recently identified, medical errors (most occuring in hospitals) are a top killer of Americans annually; everyone’s idea of health care ‘reform’ is the same – “I pay less!” [but if someone pays less, someone needs to make less – how well is that working for us?]; and reform’s three components being i) increased access, ii) decreased cost, and iii) increased quality (or better outcomes) – but all three are a “zero sum game”.  He points out that there is no supply and demand market curve in health care between the seller and the buyer of the services.  In fact, the ‘market’ is established by ‘surrogates’, namely, government, insurers, and payers.  Thus the impossibility of addressing the real needs of Americans.

Turning to the political side, Zwelling drives home probably what we’ve already learned from watching the networks: if the majority party sticks together, it wins; elected officials know little about anything they vote on and it’s their staff that determines their vote; groupthink sets in and creates a logjam; and elected officials and staffers from both parties, on the whole, have no regard for relevant scientific facts from experts unless those inputs agree totally with and support their own pre-selected decision on an issue.

As far as the actual ObamaCare bill itself that the Democrats rammed through goes, Zwelling (a dedicated Democrat who ended up working by chance for a Republican senator) says this: “In retrospect, it is clear that the forces blocking health care reform won, even though a bill was passed, for medicine is relatively unchanged by the 2010 ObamaCare legislation.” And, “It is far more likely that economic forces will determine the future of medicine, not legislative ones.” And, “A single payer universal system of basic health care was never in the cards.”  Zwelling believes we won’t be ready to deal effectively with real healthcare reform until we first decide whether healthcare is a right or a privilege. Not to do so will only result in our splashing around in a wading pool rather than swimming like adults further out.

There is a most interesting chapter on “If you’re right, but you’re rude, you’re wrong!” explaining how getting mad and shouting the truth will get you nowhere inside the system.  (Probably explains why Presidential hopefuls like Donald Trump needed to get outside of the system while others like Cruz and associates wanted a foot in each camp.)

Zwelling quotes a television news producer as describing Capitol Hill in a nutshell when he was asked what the key to success in TV news was. The producer is believed to have said, “Sincerity.  If you can fake that, you can fake anything.”  And there’s lots of that going around in Washington, according to the author.

He ends his book with a David Letterman-style Top Ten list of changes America could make in the system today to improve things.  That alone is worth the acquisition of Red Kool-Aid Blue Kool-Aid.

One thing I did not do enough justice to in this review is the personal agonizing that the author went through in leaving his employer and trying Washington and then having to go back to medicine. Many a professional senior citizen or baby boomer could well identify with the feelings Zwelling experienced.

Highly recommended for anyone interested in politics on either the Red or the Blue team, and from the perspective of an observer or a player. Or for someone who wonders how Americans are managing to live as long as they do.

--  By Ken B. Godevenos, President, Accord Resolutions Services Inc., Toronto, Ontario, May 12, 2016. www.accordconsulting.com

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