Last week I attended a function where Representative Paul (Skip) Stam (R), the NC House Majority Leader was the guest speaker.  I just happened to sit at the same table with him and we exchanged a few comments.  In listening to his presentation there were several issues, not just at the state level but also relevant nationally, that were too much to get into there.  So I issued the following to his office.  In looking at two of the issues, 1) deregulation to the benefit of business at the expense of the public, and 2) special interest contributions to legislators during the healthcare reform debate, I wondered why there would be any question about the emotion being expressed at the Occupy Wall Street movements around this country.

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Dear Skip:

I sat with you at the Cary Rotary luncheon last week; you were familiar with my wife Mary who ran for Mayor of Cary in 1998.  I write some of what follows having been a corporate officer in a regulated industry, pharmaceuticals (part of the health care sector).  Additionally, I have been a successful business founder/CEO in this state.  The difficulty I had with parts of your presentation involves what I believe to be poor, and even misleading, representation of certain issues.

Regulation and Job Creation

There is a long history of business placing profit over public well-being – thus the need to regulate.  For example, would you want to know that if your grandchildren were to take a medication that it would not kill them by poisoning, or that the medication actually had the opportunity to provide them relief from pain, suffering, and even save their lives?  It was only just a few decades ago that companies were regulated to provide evidence of positive benefit/risk – in the 20th century, one product was released that killed well over 100 people through poisoning, and the thalidomide matter formed the basis of the 1962 Kefauver-Harris Amendment.  The industry was successful over a long period of time in holding off regulation saying that the cost would be burdensome – we hear much of this same story in other areas today.

My belief is that repeal of certain regulation and failure to regulate has had a much greater negative effect on employment.  In recent years, for example, repeal of Glass-Steagall; the failed attempt to regulate and bring transparency to OTC derivatives by CFTC’s Brooksley Born at the hands of free market ideologues and Wall Street lobbying efforts (she was decimated on Capital Hill); the big 5 Wall Street investment banks successfully petitioning SEC to allow them to carry more debt and reduce the ‘haircut’ on risky assets (Lehman levered up 30:1 prior to its collapse that shook the world credit markets); and the predatory lending practices of financial institutions that led to a devaluation of US real estate: all have been considered significant contributors to the Great Recession, the collapse of our financial markets and devaluation of retirement accounts, and the loss of millions of jobs.

Your treatment of this matter was quite one-sided.  Bottom line is that business objection to regulation tends to be more about reducing the cost of doing business (increasing profits) than about job creation; and certainly not about public nor environmental well-being.

Healthcare Reform

The ‘mandate’ does not require one to buy health insurance as was presented; what it says is that if one does not have health insurance (that they will be able to buy on a competitive exchange) they will be taxed (this fine being less than the cost of an insurance policy).  The reason being is that virtually all people in this country will use the healthcare system at some point and they will be treated regardless of whether or not they have insurance – and that cost is passed to other policy holders; e.g., the issue with free-riders.  In medicine, there is an ethical ‘mandate’ to treat – there is not a group of emergency room physicians that would permit an individual to bleed out on the table regardless of insurance status.  As this ethical mandate exists, I see no reason that a mandate should not exist to either carry insurance or pay a tax.  We can demand that individuals who drive a car carry insurance, and we can revoke that right if they fail to do so; however, we can not ethically revoke an individual’s right to life saving medical treatment.

What I took offense to in the objections to healthcare reform was that in this country we are losing an estimated 45,000 citizens/year due to lack of access to essential care (Harvard Medical School study); included in that figure are up to 6 military veterans who lose their lives every day because of lack of access to essential care in a country where they put their lives on the line.  I took great exception that those individuals who either could not afford, or were denied, coverage were required to pay income tax to support our federal legislators healthcare benefits while those same legislators received substantial sums of money from special interest groups to help them keep their jobs.

The reform is not as strong as it could be because of the political process, but it is a start and can be improved over time.  And there are some truly good points, such as reducing cost by improving medical practice; e.g., imposing penalties for high rates of hospital readmission or nosocomial infection.  Additionally, in medicine an ounce of prevention is worth a pound of cure, and more broadly available health insurance will allow for better preventative medicine.

Marriage Amendment

This amendment was portrayed as limiting marriage to one man and one woman.  It actually goes much further than that as the language used in that amendment is exceptionally broad and will affect the rights of individuals in such relationships as civil unions (even objected to by Renee Elmers) and ‘committed relationships’.  Legal opinion I have read states that the language in this amendment has not been part of any prior NC law, nor used by any other state.  My personal belief, looking at the language of the amendment advocates, both the public in rallies and Senator Forrester’s comments, is that religious definition is being applied to common law – and that should not be occurring.  Additionally, the rights of a minority should not be put to a vote by the majority.  My belief is that this amendment, should it find its way into law, will result in numerous instances of litigation.

In closing, you stated during your presentation that you are not always popular with what you do.  That goes with the turf of being an elected official or even an executive in the private sector as I have been; can’t please all the people all the time.  But what the public does deserve is a fair treatment of the issues, and I did feel that [your presentation] fell short.

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Dr. Art Kamm