Monday, March 11, 2013

Follow-up of my DC trip


After the debacle of “Snowquester” had passed, Washingtonians were feeling quite sheepish about shutting down the federal government for a non-event. Because of that, they were very accommodating to out-of-town visitors whose schedules had been needlessly disrupted so I had little difficulty rescheduling all my “Hill visits” for the following day.

Well stocked with talking points, charts and graphs, and “leave behinds,” I headed for Capitol Hill and a day of visiting members of the Minnesota Congressional delegation. As I met with members of Congress and their staffs in the Hart Senate Office Building or the Longworth or Rayburn House Office Buildings, the conversations generally focused on the need, despite budget deficits, to support basic public health infrastructure for the long-term benefit of our state and country. Specific discussions also occurred around the Public Health and Health Services Block Grant (something MDH has received since 1981 to support state and local public health services throughout Minnesota), the Prevention and Public Health Fund (part of the Affordable Care Act that funds Community Transformation Grants, quality improvement efforts, and environmental public health tracking, among others), Section 317 Immunization grants, and several more. However, as important as these issues are, most of the conversation revolved around Sequestration which had just gone into effect six days earlier.

There seemed to be consensus that Sequestration was not a good tool for making budget cuts, yet there was also consensus that it wouldn’t get resolved quickly. A great deal of blame and hostility was evident on both sides of the political aisle. Recognizing the animosity and divide between the two political parties, I left the Hill discouraged because it is obvious that the effort needed to sustain an effective public health system is going to be long and difficult.

On my way back to the hotel I saw a week-old sign in a bookstore touting the birthday of Theodor Seuss Geisel. [His birthday (3/2/1904) was the day after the Sequester began.] The day’s experiences made me immediately think of one of my favorite Dr. Seuss books, The Butter Battle Book, which begins:

On the last day of summer, ten hours before Fall…
my grandfather took me out to the wall.

For a while he stood silent. Then finally he said,
with a very sad shake of his very old head,
“As you know, on this side of the Wall we are Yooks.
On the far other side of this Wall live the Zooks.”

Then my grandfather said, “It’s high time that you knew
of the terribly horrible thing that Zooks do.
In every Zook house and in every Zook town
every Zook eats his bread with the butter side down!”

“But we Yooks, as you know, when we breakfast or sup,
spread our bread,” Grandpa said, “with the butter side up.
That’s the right, honest way!” Grandpa gritted his teeth.
“So you can’t trust a Zook who spreads bread underneath!

While the nuclear arms race was the basis of that story, Dr. Seuss could just as easily have used Sequestration or health care reform as his inspiration because, in Washington and throughout the country, people are using their Boom Blitzers, Blue Gooers, and Big-Boy Boomeroos to throw invectives at those who think differently than they do about deficit reduction and health care reform.

And what has this gotten us – a stalemate on most issues that affect the health and quality of life of everyone in our country and mutually assured destruction of anyone who tries to collaborate or compromise. Ironically, as Dr. Seuss clearly points out, what most people want is exactly the same – their bread and butter issues are similar. Most public health issues (safe food and water, safe and healthy environments, control of infectious diseases, healthy people at all ages, etc.), are bread and butter issues. Whether the butter is up or down, they shouldn’t be partisan issues.

As I continued on my cab ride, I wondered what it would take to get away from our current polarization on seemingly every issue of importance to our overall health. How could the voice of reason be heard among policy makers so they could come together and collaboratively develop rational health policies? It was then that it dawned on me that I wasn’t the only person from Minnesota visiting our congressional delegation on that day. At every office I saw Minnesotans raising their voices as they advocated for expanded bicycle use, affordable housing, women’s health, improved nutrition, expanded wetlands, and better health professional training in human and animal health. And these were just the ones I talked with in the waiting rooms. I’m sure there were many more throughout the day.

It was then that I realized the answer to my question also resided in another of my favorite Dr. Seuss stories, Horton Hears a Who.

"This", cried the Mayor, "is your town's darkest hour!
The time for all Whos who have blood that is red
To come to the aid of their country!", he said.
"We've GOT to make noises in greater amounts!
So, open your mouth, lad! For every voice counts!"

I hope my voice will help make a difference. That’s why I took the time to go to Washington. But I do know that my voice combined with your voice and those of our neighbors, family, and colleagues will certainly make a difference. For the collective good of our society, every voice is needed and every voice counts. For democracy to be effective it needs to be noisy. So, use your voice for public health and make some noise.


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