Monday, February 06, 2017

Local inequality activism through social media with doctors and dentists

One underlying theme of my political writing on this blog is that the laws and public policies that we bemoan today are implemented almost exclusively with the support of the 1%. From awful "free trade" laws (think NAFTA), to right to work laws to the lenient attitudes that government has towards polluters, we can lay it all at the feet of the 1%. The surreal inequality, the wars, the pollution, the social unrest are all results of the public policies implemented by the 1%. I think it's time to start asking them why they allow this stuff to happen. Directly.

I base the above statements on evidence I've collected over the years, which you can find peppered throughout my articles on this blog. I'd say that the most interesting scientific evidence that I've found so far to support the idea that the 1% are running the show is this study, "Testing Theories of American Politics:Elites, Interest Groups, and AverageCitizens". In that study, they surveyed more than 1700 issues over 20 years and found that ordinary citizens like you and me have next to zero influence on public policy. Instead, they found that the greatest influence can found among American elites and wealthy business interests.

I know of one economist who has researched additional evidence that I use to support my contentions above: Dean Baker at the Center for Economic and Policy Research. Baker is the author of numerous books (like this one) and the Beat The Press blog. In his blog, Baker offers critical analysis of the economic news in our mainstream media with a pinch of dry humor. He has been consistent in his observations and, as far as I know, he is one of 6 economists who published predictions of the collapse of the housing bubble long before it happened. I can't say that I take his word as gospel, but he's one of the most accurate economists I've found to date.

One theme of his articles is that doctors and dentists get protection from international competition in trade agreements, while the rest of us are pitted against third world countries in manufacturing and service work. Baker consistently points out how doctors and dentists have been able to influence public policy, including trade agreements, with their money. 

Baker has also made it clear that this influence imposes an implicit tax on the rest of us. By their influence, they are distorting the market to increase their income. How do they distort the market? They use their influence to create shortages in their profession relative to demand. For example, doctors and dentists have sought and received restrictions that limit the number of doctors and dentists that can practice here. Doctors must complete a US residency program here. Dentists must graduate from a US dental school here, too.

This is all a matter of public policy, which professionals like doctors and dentists supported with their direct and indirect contributions to the political campaigns of conservatives and neoliberals (read "conservative Democrats") who profess support for "free trade". It would seem that for doctors and dentists, their idea of free trade is that they can pull down on average, twice what their counterparts in Europe and Japan can earn. They don't seem to mind that we're paying twice as much in GDP for health care that other industrialized countries are paying.

It's also worth noting that they belong to a union of sorts. For doctors, its the American Medical Association. For dentists, it's the American Dental Association. Both of their unions are powerful lobbies in Congress. Their unions make significant contributions to those same politicians who profess support for free trade, just so long as doctors and dentists are not involved.

While I enjoy reading Baker's short and interesting articles, I've never really thought about what I can do with them. I often include links to Baker's articles and books in my blog articles because I find his evidence compelling. Then one day, a couple years ago, I tweeted a link one of his articles to the Twitter account of the company my dentist is a partner in, just to see what would happen. On my next visit, there was no charge for me but they did charge me for my wife and kids in future visits. They have consistently waived the co-pay for me on every visit since.

You know your doctors and your dentists. You visit them from time to time so they see you face to face just about every year. With very little discomfort, you can now raise awareness with them about the policies that they support with their campaign contributions. You can do the same thing with their professional unions, too.

Caveat: don't assume that you know what they're thinking. Your doctor, and even his or her group, may already have strong reservations about this sort of discussion. They have feelings and they are human. Assume ignorance before malice. Doctors and dentists do what they do because they enjoy helping people. Since this relationship between the economic power of doctors and dentists and trade agreements is not very well publicized in mainstream media, they are almost certainly unaware. Treat them as if they are innocent and pursue your contact with them to raise awareness not to cast blame. Raising awareness is the higher road. Take it.

Before you begin your journey on that higher road, pick a good example article like those show below:

Or this one: 

There are many to choose from at the Beat the Press blog, but I think these are the most pointed and they're fairly recent. Now that you have your link, you can search for your local dentist or doctors office with your search engine of choice. Dentists typically work in small partnerships, and that will make your contact a bit more visible to them. Doctors tend to work in larger organizations, but if your doctor works in a smaller organization, your action will again be more visible.

When you search for your doctor's medical organization, look for their Twitter account or Facebook page. Now you can post the links to them and offer a polite comment to let them know you're thinking of them. Remember, the goal here is to raise awareness, not just to them, but to their other customers. We can point out, nicely and politely, that their influence on public policy has allowed medical and dental costs to balloon. We can be specific and say that we now pay roughly double the GDP in health care costs than most other industrialized nations.

We can also point out that the public policies they have supported have helped to increase the state and federal budget deficits. How do they do this? There are health care programs run by the state and federal governments, Medicare and Medicaid. They are financed by separate employment taxes that we see on our pay stubs. Their costs increase when doctors use their political power to reduce the supply of doctors despite increasing demand, to increase their income. All at the expense of everyone else.

At this point, we can reasonably ask them to withdraw their support for policies which distort the market in their favor. We can politely ask them to withdraw their support for politicians and organizations who support such policies. Note that if you're shy about contacting your doctor's or dentist's local offices, there is still the American Medical Association and the American Dental Association.

Then you can let them know that you want to buy their products and services, not their politics. Advise them that you came to them without regard to their politics and that it's not fair for them to use their money to influence public policy, economic policy with money you paid for their services, at your expense. Now we can understand why Citizens United was so important to the elite. No one wants to be named as someone who provides support to policies that would place the working class, the middle class in peril.

Be careful, your doctor and dentist may not even be aware that he or she has directly or indirectly paid for protection from international competition at your expense. Just assume that they are innocent and let them respond if they choose to do so. Be as neutral as possible in your wording while raising awareness of the problem you wish to address.

One or two people doing what I did might not matter. But if millions of people began to openly discuss this apparent conflict between doctors and dentists and their customers, that might arouse their conscience. They might do some investigating themselves to see how their influence in politics is being used. And don't forget to send the same message to the American Dental Association and the American Medical Association.

Yes, doctors and dentists do have a conscience and the vast majority of them do their work with a sincere interest in their patients. But knowingly or not, they have supported public policy decisions that have placed their customers in economic peril. I like my dentist but I'm not friends with him. I like my doctor, but I don't ask him out to a friendly lunch to share personal anecdotes.

It is a tenuous relationship between those who have political power and those who do not. That relationship would be strained even more if millions of Americans started unloading this kind of frustration upon the members of the professional class that are most immediately accessible to millions of Americans, their neighborhood doctor and dentist. That's why it's important to tread on this subject lightly. You want them as an ally, not an adversary.

If you should decide take up this call to engage, be mindful when you do. Be polite. Remember, they are human beings just like you. They are doing what is in their best interest. Do not descend into name calling or make any threats of any kind. The goal is to raise awareness by asking a simple question and put them on the spot. The question, in so many words is this, "Are you aware that you your political power has allowed you to gain at the expense of your customers?" That is all we want to ask.

Post your link and your question, say little else and stay on point if they should engage in a dialogue. Let them answer, let them defend their point of view. You do not have to speak for them. Let them speak for themselves. Ask the question and wait to see what happens. You are not responsible for the results once you ask the question. They are.

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