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Donald Saelinger: We are America divided and that cannot stand; we must find common ground


“United we stand, divided we fall” is a phrase that can be traced back to the 6th Century B.C. American extremism has grown to epidemic proportions and divides us into rigid camps: Democrat vs. Republican, pro-choice vs. pro-life, progressive vs. conservative, black vs. white, and even Pro-America vs. Anti-America. What has happened to compromise and respect for each other? Subgroup division and friction create in us what makes us American.

However, extremism seems to restrict this natural friction and the desire to come together (“Disagree with me? You’re a bigot, homophobe, racist, privileged, etc.”). The American experiment has worked well for 250 years. We have been divided in the past and survived a devastating civil war.

I am, however, worried and concerned about our ability to bring the divide to the middle. I am a seasoned physician. I am “middle of the road” politically, and I strive to understand the views of both ends of the divide. Several vital issues divide us, and I will try to find that coveted middle ground. I do not advocate for any politician or any political party but will look only at both sides of the most pressing issues.

Dr. Don Saelinger

The integrity of our politicians: I suspect that most would agree that our political leaders should demonstrate a high level of integrity regardless of their party, religion, race, creed, or ethnicity. Additionally, they should be in good health, intelligent, and understand our country’s institutions, Constitution, and history and should have American citizens’ wellbeing as their top priority. It seems that our political leaders (members of congress and senate) should have the same type of compensation formulas and benefits as all Americans without special treatment. Political leaders are our elected representatives and not our royalty.

Health care:  As I note in a 2019 paper, the American Healthcare system is broken (AMERICAN HEALTH CARE). High-quality, cost-effective healthcare should be a right and not a privilege for all Americans. The current healthcare model in the United States is economically unsustainable. The United States spends over 3.5 trillion dollars (approximately 20% of the gross domestic product) annually to provide Americans healthcare. This is roughly $10,000 for every person in the United States. Despite these inflated costs, our care quality is significantly inferior to that of other developed countries, and it does not provide universal coverage. Our politicians seem reluctant to take on the cost/quality of care issues in the United States. The Affordable Care Act focused on ensuring improved healthcare access but does not address cost, complexity, and quality of care. It seems that the middle ground between “Medicare for all” and the current broken system would require increased federal intervention. This may include regulations that reduce administrative costs, improve value (cost/quality), and change our current reimbursement model from fee for service to capitation (also referred to as value-based reimbursement). Additionally, it seems reasonable that Medicare and other government programs should be able to negotiate with pharmaceutical companies and delivery systems for favorable pricing.

Care of the weakest of our citizens: I suspect that most would agree that it is the responsibility of a sophisticated, civilized society to take care of its children, elderly, sick, homeless, and disabled. That does not mean that our money should be taken and given to those who don’t want to work. It seems that men and women who are hardworking and entrepreneurial and smart should do better; however, I have a problem with 10% of our population having 80% of our country’s wealth. Perhaps a middle ground would be a reasonable revision of our tax code such that the 10%/80% becomes more like 30%/70%. Yes, I understand that this may sound a little leftish; however, it may be the middle ground we cherish. This does not mean that our free enterprise system, which has sustained our country for 250 years, should be diminished.

Immigration Policy:  It seems that a country is not really a country unless it has borders. The extremes are building a wall at the border versus a more lenient immigration policy. Indeed, the unrest in Central America and Mexico is not necessarily the United States’ problem to fix; however, all humans are members of the planet earth and creatures of the Almighty, thus deserve compassionate treatment. Perhaps a reasonable compromise might be to figure out how to stabilize Central America’s corrupt governments and help them with their political and drug-related issues. Additionally, a center position may include providing illegal entrants and “dreamers” a more compassionate pathway to citizenship. This, in turn, would bolster our economy and promote our diversity. We are, after all, a nation of immigrants.

Gun Control: It is reported that the United States has 120 guns per 100 people, which is the highest total per capita number in the world. The Second Amendment states: “A well-regulated militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.” There are strong arguments on both sides of the divide. It seems that a reasonable middle ground might include background checks before one’s ability to purchase a gun. Does it make any sense that we would allow a criminal or a psychiatrically impaired citizen to own a gun? How is it reasonable that one would be able to purchase a machine gun? The murder rate in our cities is out of control, and it seems appropriate that some gun control efforts could meet the middle of the divide. It is difficult to imagine that Americans would not support common-sense gun control legislation.

Police and violence: It is difficult to imagine that defunding the police is reasonable. However, it does seem plausible that improved vetting and training of police officers would be a compromise. There is clearly an element of racism in recent police events. The United States clearly has a blighted and embarrassing race relations history (Native American and African American treatment). Thomas Jefferson, in the Declaration of independence, notes that “all men are created equally.” Of course, black lives matter, but does that mean that our historical icons need to be torn down or our streets and businesses burglarized, burned, and destroyed? I am concerned that “systemic racism” is a term used as “political fodder” rather than seriously examined.

Education:  Some say that free college education and student loan forgiveness are a part of their agenda. Some also say that government subsidies can only be provided to the local public schools and not private, charter, or religious schools. I suspect that all would agree that high-quality primary and secondary education are critical elements for our country’s ongoing success. For many, the return on investment in a college education is low. For those whose interests are in careers that require a college education, would it not be more reasonable to have lower interest rates for student loans? From an “old school” physician’s perspective, what happened to college students working at night and weekends to pay for their college education? Clearly, education is the key to a sophisticated, prosperous society. However, it seems reasonable that parents should decide what school their child attends, whether it be a charter school, a religious school, a private school, or a public school with similar public sector support.

Abortion Debate: Most agree that a single issue should not be a “litmus test” for any political candidate; however, many believe that the abortion issue should be such a test. I recall, while a physician trainee in the mid-1970s, I witnessed a late-term abortion. I saw a baby capable of living outside the womb, suctioned, and cut up into pieces (arms, legs, head, etc.) while in the uterus. I continue to have nightmares about the scene, some 50 years later. I cannot imagine that anyone with a moral conscience would think that this is ok. From a Christian perspective, any abortion is morally objectionable. This is likely an issue where there may not be a middle ground. Late-term abortion clearly seems most egregious. From our Constitution’s religious liberty perspective, it does not seem reasonable that our tax dollars should be used to pay for abortions at any stage (the Hyde Amendment). Perhaps abortion regulation should be a state’s issue.

Climate change: There seems to be no doubt that global warming and climate change are real. There is insurmountable data to support this fact. There is, however, some divide on the data concerning the cause. After reviewing much of the data, I believe that fossil fuel use and carbon dioxide and other greenhouse gas emissions are major contributors. The question, however, is what can be done about it? I am not sure where the middle ground lies with this issue. More importantly, I am not sure that anything we do will make a difference in the long run.

News Media: Our news media is very polarizing. It is CNN vs. FOX, New York Times vs. The Wall Street Journal, etc. It is left-wing vs. right-wing “talking heads.” What happened to the news’s objective reporting, and yes, whatever happened to Walter Cronkite and Huntley and Brinkley? I suspect it is all about the money, and not sure we will find a middle ground until these opposing organizations begin to understand that they are a significant part of the problem.

COVID-19 response:  As a physician, I know that this pandemic is the most significant medical issue in my 50 years of medical practice. It is not a political issue but a health issue. There is no middle ground in this arena. We must follow our medical and science experts (CDC, WHO, physicians, etc.). It seems that the government’s role in this pandemic should be to provide financial and public relations support for our healthcare institutions and to provide all Americans with direction for preventing transmission of this virus.

I worry about government over-regulation and its negative impact on the economy; however, in a large, diverse, and divided society, it seems that reasonable laws, rules, and regulations are needed to preserve our country’s ongoing success and prosperity. My goal is not to solve the country’s problems but to encourage us to see both sides of the divide, respect each other, and each other’s values and views. I worry about our future, our children’s future, the country’s future, and the planet’s future.

Dr. Don Saelinger is a distinguished physician, an internist, and gastroenterologist, who founded Patient First Physicians Group in NKY in 1976. He sold it to St. Elizabeth Health care in 2009. It became St Elizabeth Physicians and Dr. Saelinger became Sr. VP of St. Elizabeth Medical Center. He retired from St. Elizabeth in 2010 and has been involved in various consulting roles for Healthcare business and policy around the country. He has also been involved with various locum tenens (definition: one filling an office for a time or temporarily taking the place of another) positions in Gastroenterology. He recently retired as GI section chief and Medical Subspecialty division chief at Straub Medical Center and Hawaii Pacific Health in Honolulu, Hawaii, and has returned to locum tenens roles in Gastroenterology and healthcare business consulting. He is the oldest of ten children of William and Marcella Saelinger of Northern Kentucky. See his full bio here.  


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