Prescription Politics 

Two District 9 candidates and a surrogate discuss healthcare issues at LeBonheur.

Although his positions were well represented by his campaign manager Kevin Gallagher, District 9 congressional candidate Steve Cohen did himself no obvious favors Thursday night by missing a candidates’ forum on healthcare issues, hosted by Metrocare Physicians and LeBonheur Children’s Medical Center. Cohen, the Democratic nominee and presumed frontrunner, opted out at the last minute to attend a fundraiser hosted by Memphis mega-celeb Cybill Shepherd.

Republican candidate Mark White seemed to be somewhat out of his element in this arena, but he was sincere, and confident when delivering traditional conservative talking points on issues like tort reform, and the businessman-turned-politician displayed genuine concern discussing Memphis’ infant mortality rate and the insurance woes of small business owners. Cohen’s mild-mannered substitute lacked the fire of a candidate, and his boss’s gift of gab. His occasionally faltering conversational style, diminished the impact of well-reasoned comments, and paled compared to independent candidate Jake Ford’s polished, if overly mannered delivery. In spite of the forum’s altered dynamic, the two actual candidates, and lone stand-in expressed three distinct, cohesive views on healthcare issues in America.

On the topic of malpractice, Mark White declared, “Tort reform Now!,” and made a case for setting caps on awards to the victims of negligent doctors saying, “Malpractice is destroying healthcare, and preventing doctors from practicing their trade.” Ford, in a seeming contradiction to his declaration that he was a “people” candidate, not a “profit” candidate agreed with White saying he was “definitely” in favor of tort reform, a measure that many view as being pro-industry and anti-people as it sets a maximum amount a plaintiff can receive regardless of medical negligence and the damage done.

Ford distinguished himself from White by suggesting that the value of the caps should be raised from the GOP standard of $250,000 to $750,000. He asserted that this policy was “necessary for the health and viability of the medical industry.” Gaallagher took a completely different approach by holding lawyers financially accountable for introducing frivolous lawsuits, rather than capping awards for those who have come to genuine, perhaps permanent harm as a result of negligent doctors. “Blanket caps undermine justice,” Gallagher said suggesting that that in some cases arbitration might provide a viable option to litigation.

White told the assembled crowd that schools could play a big role in reducing childhood obesity. He recommended healthier fare in cafeterias rather than sweet treats and fatty foods. Reinvigorating our schools’ physical-education programs, he said, could also make a big difference. Speaking on Cohen’s behalf, Gallagher moved squarely into Republican territory by making childhood obesity an issue directly related to traditional family values. He gave it a more liberal spin by connecting it to childcare access, and economic issues.

Gallagher took the part of working families, and parents who work two jobs to make ends meet by highlighting the difficulties these families have putting healthy home cooked meals on the table, and making time for taking walks, and engaging in other physical activities with their children. Ford took a more technocratic approach and looked beyond America’s borders by using the expression, “Globesity,” a term coined by The World Health Organization to describe emerging weight problems in the developing world. He also outlined a four point plan that included reform in the food service industry, school nutrition, empowering kids, and prevention.

Occasionally White seemed to be running as much against his own party’s mainstream in Washington as against Cohen and Ford. He repeated concerns over pork barrel spending and “Bridges to nowhere,” an expression coined by maverick Republican Senator John McCain to describe a $2-billion bridge-building initiative put forward by two powerful Alaska Republicans, Sen. Ted Stevens and Rep. Don Young. In that spirit White defended the Deficit Reduction Act of 2005, which included deep cuts to medical benefits while calling out those specific cuts as being, “bad.”

“We can reduce the deficit without cutting medical benefits,” he said forcefully, but without explaining how, exactly, that might be accomplished.

Ford said he would work to reverse the Deficit Reduction Act, announcing that he was ready to fight for Medicaid. Rather than directly offering a solution Gallagher provided a thumbnail sketch of the problem.

“Benefit cuts trickle down to state and communities with greatest needs,” he said. “Poorer cities need more dollars but fewer are available.” He concluded by noting the fact that when it comes to providing services, healthcare related industries play by a different, more flexible set of rules than healthcare consumers, and called for a leveling of the playing field between industry and consumer.

On the subject of recruiting new doctors White once again railed on tort reform, while Gallagher stressed the importance of shoring up high school science education, and working to insure that students don’t emerge from Medical, or nursing school with crushing debt. Ford looked to role models and suggested programs that bring kids in contact with the medical profession, creating “heroes” other than the sports stars and celebrities kids see on TV. White, whose solution seemed to primarily involve the creation of educational choices and charter schools, painted himself into a bit of a corner by saying, “99 percent of the kids [in our schools] are performing great,” only to turn around and acknowledge that we also have close to a 50 percent dropout rate.”

Addressing Memphis’ shame, the soaring infant mortality rate in the city’s poorest zip codes, both candidates, and Cohen’s surrogate delivered strong responses. White pointed out that the mortality rates were higher than Iran, and Vietnam, while Gallagher stressed that sweeping social change and economic empowerment could save more lives than any social program. Ford, quoting The Commercial Appeal’s Amy Edmondson, said that the infant mortality rate wasn’t just a barometer for Memphis’s healthcare problems, but of “all the community’s ills.” He made it clear that the neighborhoods in question were poor and black, and pointed out the need for better education, safe, affordable housing, and other social and economic improvements.

Ford’s position on insurance reform was as murky as his stand on infant mortality was clear and strong. He acknowledged TennCare for kids, and said there was a need for state and federal governments to work with the private sector to come up with a solution. Gallagher took a familiar position by stressing the need for economic growth saying, “We can’t create or sustain universal healthcare without economic development.” He also stressed that there needed to be a graduated reduction in medical benefits based upon an individual’s ability to pay. White, taking the part of small business owners, was confounded by the fact that the US Senate has twice rejected proposals for small businesses to combine their insurance purchasing power in order to buy large group plans across state lines.

It was a particularly good night for Ford, who, being present and reasonably well prepared, was easily the most dynamic figure onstage. White’s condemnation of “bridges to nowhere” didn’t do much to set him apart from poorly polling members of the current, GOP controlled congress. The substance of Gallagher’s answers were impressive, and he did his best to represent Cohen’s views and show how all the various issues discussed over the course of the evening were interconnected. He stressed that each problem was the symptom of a much bigger disease best treated by the social changes that come with economic empowerment. But for all of that, he was still a stand in, and somehow that made otherwise relevant debate seem less impressive than it should have been.

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