Four More Years!

After almost four years of active campaigning, the time has come.  In just a few days, America will collectively choose a president.  On November 6th, I will be casting my vote for our current president Mr. Barack Obama.  I believe this decision is important and complex enough to expound upon somewhat further; not for reasons of persuasion or justification, but rather for communication and documentation.

The Economy.  This topic is incredibly complex and is wrought with dueling statistics and expert panels.  Even the most ignorant of the myriad experts on either side know much more than me on this topic, so I will not deign to try to judge among them.  However, I believe that Mr. Romney’s plan for the economy relies entirely too much on trust.  Trust that the economy will grow at an accelerated rate to help him afford his tax cuts.  Trust that “job creators” will reinvest  their tax savings to hire more workers, rather than cash in profits or take them overseas.  And finally, trust that we will forget that the “Reagan Recovery” he so hopes to emulate led to one of the largest explosions of the national debt in history.  Mr. Obama inherited an economy in free fall, which arguably hit its nadir about six months into his presidency.  To expect us to be completely recovered in only three years is to defy the cyclical nature of history.

Foreign Policy.  Mr. Obama’s foreign policy can seem at first glance to be somewhat muddled and haphazard.  However, I believe this stems from the inherent complexities of international relations in our interconnected world.  I much prefer Mr. Obama’s painstaking deliberation to treat each situation uniquely as well as his wholehearted attempts at multilateralism to Mr. Romney’s one-size-fits-all, with-us-or-against-us approach.  Mr. Romney’s attempts to attack Mr. Obama for being “soft” in Iran or Syria leave no room for him to maneuver except to embroil the United States in more foreign wars which we cannot afford.  Further, while it is vitally important for us to have an unquestioned staunch ally in a volatile region like the Middle East, that is no excuse to equate Israel’s national interests with our own.  While they often do align, and mutual protection is a foundation for our alliance, our national interests must be our own, and must be the President’s focus at all times.

Health Care.  It actually matters very little who becomes President in this regard.  The fact is that Medicare is an extremely expensive entitlement program our nation can no longer afford.  For political reasons, neither side is willing to directly cut benefits to voters, and both sides have pledged to save money.  This must necessarily result in reduced reimbursement to healthcare providers–and subsequently to indirect reductions in benefits through more providers dropping Medicare patients, rationing of care, or the market producing less or lower quality physicians.  The one alternative solution, sweeping malpractice tort reform, has unfortunately not made it to the conversation during this cycle.

Civil Rights.   Mr. Obama has been no saint on civil rights, from failing to close Guantanamo to quietly continuing warrantless wiretapping and other surveillance.  However, the Republicans have squandered the Muslim vote for a generation through a replay of their Southern Strategy.  By systematically demonizing Muslims at the party level, they have made it impossible for us to vote for them.  Michelle Malkin (who advocates placing all Muslims in internment camps) may be a fringe player in the Republican party, but Michelle Bachmann (who advocates a Muslim witch hunt to root out Muslims in the federal government), Herman Cain (who would apply a Muslim litmus test prior to hiring anyone), Newt Gingrich (who compares Muslims to Nazis), and Tom Tancredo (who advocates bombing Mecca and Medina) are most certainly not–in fact, all of them ran for president under the Republican banner.  Add to that the right’s insistence of propagating the Obama crypto-Muslim story as a slur and you have a veritable definition of Islamophobia.  Even the current nominee, Mr. Romney, said in a debate he would not consider a qualified Muslim for a cabinet level post since Muslims do not constitute a large enough proportion of the population to justify it–a reasoning that should also exclude a Mormon from becoming president.  Hiring or not hiring someone based on their religion is a violation of their civil rights and fundamental American principles, and no American (Muslim or otherwise) should allow such violations to creep into governing philosophy.

Leadership. This is perhaps the toughest to judge, and the toughest to quantify.  However, certain anecdotes truly cement this in Mr. Obama’s favor.  First is the decision to green-light the mission to kill Osama Bin Laden.  While in retrospect it seems like an easy decision, prospectively it is much muddier.  There are a myriad of ways this mission could have gone disastrously wrong.  Imagine being engaged in Pakistani airspace by fighter jets we had sold them.  Or storming the compound and mistakenly killing innocent women and children only to find intelligence about Osama’s whereabouts were wrong.  Or having Osama escape, and chasing him through a sovereign country’s streets only to have our strikeforce overcome by a violent mob of Pakistanis.  Almost any alternate scenario would have been an international embarrassment or worse, and would have led to a premature end to Mr. Obama’s political career.  Yes, it is easy for Mr. Romney to say in retrospect he would have done the same thing now that the outcome is known.  It takes leadership and courage to proceed with an uncertain outcome.

Another major test of leadership came this summer, when Mr. Biden unwittingly dragged his boss into the fray of gay marriage.  Mr. Obama was already fully engaged in a re-election campaign which he knew very well would be a fight for the center-ground of the electorate.  Yet, he used the opportunity to state his own personal viewpoint (which risked alienating many middle ground voters) without pandering or massaging it, and without forcing its acceptance by others.  Mr. Romney, by contrast, has shown time and again that he is unwilling or unable to stand up to even the fringes of his party, as evidenced by his newfound criticism of Planned Parenthood–an organization that he found worthy of charitable contribution just a few short years ago.  I simply cannot and will not cede the right to appoint lifetime Supreme Court Justices to someone who has shown a remarkable inability to withstand political pressure.

Mr. Obama has not been a perfect president by any means.  He has not been the president I imagined he would be nor, I venture, the president he imagined he would be.  However, he has certainly made considerable progress amid formidable challenges and united opposition.  Mr. Romney, by contrast, has revealed himself as weak-willed and short-sighted.  On November 6th, I will proudly vote to give Mr. Obama the second term he has earned.

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  1. Emory

     /  October 20, 2012

    As always, I appreciate your latest blog on the reelection of Barack Obama. Given the kind of thinking that represents so many in the House of Representatives these days, only Mr. Obama and the Senate stand between attention to our welfare and complete indifference to the needs of the American people. So, I applaud and say Bravo to Dr. Jamali.

    Note also the attached.

    Emory J

  2. Ten second analysis of the candidates: Neither Obama or Romney has proven to be a saint; they both lie and flip-flop and they are both supported financially by Wall Street. Ten second analysis of the winner: People usually vote with their pocketbook and most people feel that they are worse off after four years under Obama. Edge to Romney; Wild card: Watch and see who has control of the voting machines, particularly in states like Ohio.

  3. I voted for him last time. Even I don’t think he deserves a second term. But it’s really the philosophy I am voting for, not the figurehead. Let’s remember, according to my father, a career politician, they are all politicians, so they are inherently deceptive, and have to make promises they can’t keep. But I am sure everyone can justify his or her opinion. And I could still be wrong.

    I just wish the belittling of one man or the other would stop, like when one says they could never vote for one man or the other because he is so reprehensible. You are voting for the party and its main philosophy, not the guy and the fringes. Both parties goals are admirable, but the means are different.

    I don’t even know why I am going on like this. Maybe I need my own blog.

    • Ben… you should write your own blog, it is great therapy! I appreciate your open minded views. Like in medicine, we have our own opinions, but respect the ability of other rational, intelligent people to disagree… I wish this could be more possible in politics. The fact is, nobody can see the future, and thus claim ownership of being “right”. What bothers me, and I am sure bothers you, is disintegration into personal attacks. While both sides have a responsibility here, their responsibility is not equal. The Republicans have clearly made an effort to personally attack Mr. Obama by actively or tacitly encouraging attacks on his race and his religion, as well fearmongering by calling him a socialist and comparing him to Hitler, Stalin, Lenin, Il, or Mao. It is my strong conviction that the Republican attacks on Muslims alone (as briefly noted in my post) should disqualify them from this office. While most of the population is not Muslim, it is imperative that they stand up to this kind of entrenched bigotry. As Niemoller said so eloquently:

      First they came for the socialists,
      and I didn’t speak out because I wasn’t a socialist.

      Then they came for the trade unionists,
      and I didn’t speak out because I wasn’t a trade unionist.

      Then they came for the Jews,
      and I didn’t speak out because I wasn’t a Jew.

      Then they came for me,
      and there was no one left to speak for me.

  4. Adnan Hamid

     /  October 21, 2012

    I think there still is this false pretense where equating success in business is precursor to success in government. As we have learned most recently with the Governator and President George W. Bush, their business leadership skills did not lead to government success. Recently, I had the opportunity to listen to Ted Koppel at a recent conference talking about last week’s debate. Couple of comments he made continue to resonate with me. In understanding the five trillion dollar tax cut, he made an analogy of thinking about a company that began when Jesus Christ was born and this company losing one million dollars a year. If that company was still in existence, we would only be halfway to 5 trillion dollars. Also, how can we say we are going to get tough on China when we borrowed money from them to fund our two most recent wars. Would any of us talk like that to a bank if we borrowed huge amounts of money? Bottom line, one can not run a government like a business- to think so is just foolish.

    As much as I had hoped that the election of Barack Hussein Obama would usher in a new era of politics, the folks at both Fox News and MSNBC have stymied any such change for ratings sake. As much as I admire Governor Romney’s success especially his wealth, I support President Obama to finish what he started.

    • Adnan, in business, the primary objective is to make money for the owners, and the rest of the employees are merely tools to accomplish that goal. If we are OK with our economy going the same direction… ie, its primary goal being to make money for the owners (the 1%), while the rest of the population serves as merely a tool to be used at their pleasure, then Mr. Romney’s experience would be appropriate. In government, unlike business, the leaders have a responsibility to foster upward mobility… Mr. Romney’s business experience is the exact opposite of that.

      • Maybe if we get Romney’s dad to spot the US some start-up money, his presidency will be as successful as his businesses.

  5. Anant

     /  October 21, 2012

    The easiest solution to the problem of medical costs (including malpractice) is to follow the lead of countries like the UK and France (or our own VA system for that matter!), or alternatively Canada’s hybrid system. The single largest component of waste in the medical system is excessive profit and more importantly, self-licking administrative costs (e.g. a clerk at the hospital coding and filling out forms processed by a clerk at the Insurance company and designed to maximize the chance of being able to reject a claim — it doesn’t help deliver care either directly or indirectly). This core adversarial relationship then replicates itself in distrust and adversarial/defensive behavior further down the chain. (e.g. consumer-advertising of prescription medicines and medical devices, lawsuits initiated by insurers to avoid paying claims, lawsuits initiated by patients because the system can’t say “sorry, let me do my best to make things right” in-kind, etc…) Medicine should be about mutual trust and ethics, in the face of real uncertainty that there is nothing we can do anything about right now because our understanding of medicine is just too primitive. By having a global picture, we’d see that public-health interventions (encouraging people to walk more, socialize more, not eat processed foods, etc…) are worth doing. But the private system can’t capture the benefits from public-health interventions and so they aren’t done. (While people make money by selling things that encourage the opposite to good behaviors.)

    • Anant, your comments are very astute. I would especially like to highlight what you already realize, but many don’t… The primary mission of insurance companies is to reject claims, their business model depends on that. Many people mistakenly think that insurance companies are in business to pay for care, when actually it is just the opposite. the ACA (Obamacare), by requiring everyone to buy their product, was a huge giveaway to insurance companies; but at least it begins to address some of their most grievous excesses (pre-existing conditions, etc). There is an INCREDIBLE amount of waste in the healthcare system, and MOST of it is driven by litigation or fear thereof. I counted for fun once, and a four hour admission for an outpatient procedure at our hospital generated over 100 pages of paperwork, most of it was documentation aimed at protection from litigation. When I was in medical school, one of the biggest controversies was whether a CT scan was necessary to diagnose appendicitis. Today, it is considered anathema to even consider not doing a CT scan to diagnose appendicitis (which should be a clinical diagnosis)… in fact, most ER doctors joke about having patients come through a CT scanner on their way in the door. This is all to protect from lawsuits, but sold to the patients as “complete and thorough care” who are more than happy to accept it, since the check is not being written from their pocket.

  6. It is obvious that you are very passionatepassionatepassionate about this election. Your views show that you are very informed on the issues and have drawn the right conclusions. My concern is that Romney seems to be gaining in the polls and that the most ignorant amongst us may be responsible for his being elected. Take a look at this article.
    I talk to people all the time and the Romney supporters don’t understand the economy nor do they understand foreign policy. They just think there are to many taxes and that Romney will lower them. It is a pretty sorry situation if Obama loses considering that the 47% who don’t pay taxes should be voting for him, although some of these people will probably vote for Romney because they are so uninformed, and everyone on Medicare should also be voting for him. I am really concerned that Romney and Ryan don’t really have a clue as to what it takes to run a country and thierthierthier talk about cutting taxes with no idea of how to replace the lost revenue is truly frightening. The country actually did better when higher tax rates were in place. Most DemocratsDemocratsDemocrats realize that there is no free lunch and are more than willing to pay increased taxes if it is for the good of the nation. Republicans just don’t get it. Trickle down just doesn’t work. Medicare could become solvent if you increased the tax from something greater than 1.4% of payroll. Just increase it one half percent and the shortfall would probably be closed.
    Also, what has really impacted our national debt is going to two wars and never increasing taxes to pay for them. This is unheard of in this nations history. All of this is so evident and there are still all those out there who think they are paying too much in taxes. The rich get richer and the middle class goes away. This makes me sick to even talk about it.
    I think Obama definatelydefinately won the last debate and I think he’ll win the next one. However, there are so manymany people out there with blinders on that they will side with Romney winning the debate. I have a really hard time dealing with ignorant/uninformed people. What really scares me is that they have such a large say in my and this countryscountryscountrys future.

    Hank Stefanotty

    • I think Romney is dangerously underestimating the irreparable harm to our economy that will come from confronting China on their currency manipulation. The fact is that they hold much of our foreign debt and we rely on their imports to keep our current extravagant lifestyles affordable. (How much would an iPAD cost if it was built in Indiana?). If we confront China, we will see interest rates skyrocket as they come calling on our debt, and prices skyrocket as goods become more scarce. That is no way to “broaden the base”.

  7. I think you forgot Rep. Peter King in the “conservatives who are demonizing Muslims” category.


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