By George Weiner, MD

2008-03-01

Dr. Weiner is from the Holden Comprehensive Cancer Center at the University of Iowa.

Editor's Note: This is the first in a series of articles illustrating how hematologists can become involved with the presidential election. ASH members are encouraged to take advantage of opportunities to become involved in the election and particularly to share their views about health-related issues with the candidates.

As an Iowan, I accept the fact that most influential members of national government and media consider Iowa "fly-over" country. That is, of course, except for once every four years when the Iowa Presidential Caucuses take place.

The Iowa Caucuses are a remarkable tradition. National political campaigns focus on reports from pollsters, production of political advertisements, and participation in staged events. The grassroots nature of the face-to-face interaction that takes place during the Iowa Caucus is very different. During the Caucus, dialogue takes place that would not be possible from 30,000 feet. Over a period of months leading up to the Caucus, Iowans meet the candidates in person in intimate settings and are not shy about asking questions that, in a typical Iowa way, are challenging but untinged by arrogance or cynicism. We become a state of policy wonks where dialogue among family and friends focuses on the relative merits of the various candidates. A man dressed in overalls and a baseball cap is as likely to ask a candidate about Medicare Part B, stem cell research, or Darfur as he is about farm policy. Iowans learn where the candidates stand. More importantly, the candidates learn from talking to citizens in an unscripted fashion. Anyone with an opinion who is willing to make the effort can be heard. As the process progresses, the candidates refine their positions based on this dialogue.

As my neighbors and fellow Iowans did, early in the process, I reviewed the policies put forth by various candidates. One of the candidates (to whom I will refer to as "Candidate X"), spoke about his/her support for biomedical research when asked, but had not addressed such research in his/her formal platform. I took an opportunity to contact Candidate X's staff, and offered to share my thoughts about the importance of biomedical research. In a move that would have been highly unlikely in a national campaign and only possible in Iowa, a couple of weeks later, I found myself seated next to Candidate X in a motorcade going from Des Moines to an appearance he/she was making in Ankeny, Iowa, expressing my concern that his/her formal platform did not address biomedical research. Candidate X was fully engaged in our discussion and asked excellent questions as we talked about biomedical research, health care, and disease prevention, and he/she asked me to provide comments for his/her platform based on the principles we had discussed to his/her staff. I have no doubt similar discussions about other issues took place around the state with all of the candidates.

Now, the Caucuses are done, and all is back to normal in Iowa. The politicians and national media have packed up and returned to the centers of power, and Iowa is content to be fly-over country once again. Iowa's role in the process of selecting presidential candidates has received considerable criticism as being disproportional, and it is unclear whether we will have the opportunity to serve in this unique capacity again. Nevertheless, as an Iowan, I am proud of the role our state played in the process and believe the nation is well served by presidential politics beginning at the grassroots level where individual voices can be heard.

Visit the Policy and Practice section of the ASH Web site to read about the presidential candidates' positions on health-care reform, Medicare, stem cell research, biomedical research funding, and other health-related topics.

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