Saturday, January 30, 2010
Sunday, January 17, 2010
I'm more than a little surprised at that. I've voted in every presidential election since I was first eligible, and that was quite a long time ago. But I'm quite sure I have never read a political campaign analysis cover to cover like I did with this book. It's well written and, even though we all know the outcome of the campaign, David Plouffe manages to convey just the right amount of suspense and tension throughout. It is a fascinating look at the inside management of an American presidential campaign - and one of the most unusual, difficult, and exciting campaigns that our country has ever seen.
I confess. I was an Obama supporter from the beginning and I am very glad to this day that he won the election. But putting that aside, I think this book makes good reading for anyone who wants to know how our election system actually works. And how that system may have been permanently changed by the Obama campaign. It's not just for political science wonks - or Obamamaniacs. I started reading it of curiosity. I finished reading it out of a desire to understand a part of our political system. Even if Mr. Plouffe had not run a winning campaign, he would have to take pride in the fact that his book was interesting and educational to a politi-phobe like me.
Here are a few things I learned from the book:
- American democracy appears simple upon first glance. Go to the voting booth, cast a ballet, and elect a president. Upon reading this book, I realized we have one of the most complex and intricately designed systems in the world. I don't have enough space here to elaborate. Read the book.
- An American presidential campaign is brutal and non-forgiving. The candidates and the campaign workers don't sleep, don't eat, don't stay in one place for longer than 24 hours, and don't have a life outside of the campaign until the election results are called. It's inhumane but certain people, like David Plouffe, have chosen campaign management as a career path and seem to thrive on the stress and deprivation. (Although one manager did end up in the hospital at one point from pressure and stress.)
Here are few things I learned about the 2007-08 Obama campaign:
- By the time of the election, the campaign had 6,000 staff members and 90% of them were under the age of 30. This was a campaign planned, executed, and won by a new generation of voters, using techniques not seen in previous political arenas.
- The campaign focused early-on on non-traditional groups: first time voters, sporadic voters, minorities, residents in small or non-essential states, and detached independent voters. They outmanuevred the Clinton machine by taking no one for granted and courting people who were often ignored by bigger candidates.
- Technology played a major role. Around the time McCain was admitting that he did not know how to send an e-mail, the Obama campaign had an e-mail list of 12,000,000 active addresses. They were able to communicate directly to their voters, without media filters or time delays. I was on that e-mail list, so I experienced it first hand. Information from the campaign was often in my mailbox hours or even days before the news came through traditional channels. And their Twitter followers had the info long before I did.
- On-line fundraising exceeded the campaigns wildest dreams. In the beginning, two surprising groups were responsible for the bulk of the contributions: college students and retirees. The average contributions were between $25 to $50 but they kept coming and coming and coming. After Sarah Palin's nomination and subsequent attacks, donations began spiking and were sometimes coming in at rates as high as $500,000 an hour. Ultimately, the campaign raised a mind-boggling $750 million - most of it from small donors.
- The candidate himself was intimately involved in every aspect of the campaign and set the initial tone for goals, communications, and strategy. While Axelrod, Plouffe, and Gibbs were responsible for implementing the strategy, Obama had the final word and did not hesitate to over ride the campaign managers if the messages were going off-track. His background as a "community organizer" gave him an unusual connection to the thousands of volunteers, young staffers, and supporters and they were included in activities to an unusual degree.
Really, you'll have to read this one for yourself to get the full impact. I suspect Republican campaign managers will be studying it closely over the next 3 years. Get ready for red colored e-blasts in 2012!
Anyway, now I can read about the medical profession without actually putting anyone in danger. Routine Miracles is the latest title I found at the library. It's not a memoir, but a collection of essays and chapters in which he examines the astonishing advances which have been made in the last 25 years. And in which he examines the widespread negativity and dissatisfaction within the medical profession and amongst the students and interns he works with on a daily basis. According to Dr. Fisher, we are living in a time when the health professions should be filled with excitement, pride, thankfulness, and reward, due to the "miraculous" tools which have been developed and which are saving lives which would have been lost only 5 or 10 years ago. He examines cardiac advances, intrauterine fetal surgery, HIV drugs, corneal transplants and many more. But regardless of these advanced treatments and techniques, the medical community is still downtrodden and pesimistic.
Dr. Fisher attributes this to 4 primary factors, not necessarily in this order of importance:
- The high costs of medical training: apparently it's not unusual for a new physician to begin his/her practice facing six-figure debts from medical school and advance training. After spending 8-12 years, or more, in post high school education, the new MD can then face $100,000 to $200,000 in school loans.
- The tradition of medical school teachers and older physicians to berate, criticize, and belittle their students. Dr. Fisher asked one of this classes, "Has anyone been told you are the best, better than the faculty?" No hands go up. "Has anyone here been told you are worse than students in the past, that you are not diligent, devoted, or hardworking?" 80% of the hands go up. He compares this to a football coach telling his team that they are the worst players he's ever had, and then wondering why the team is despondent.
- The health insurance industry. This subject comes up over and over throughout the book, and states studies in which 92% of physicians identify insurance companies as their #1 problem, 7% identify insurance companies as a major problem, and 1% feel insurance companies are not a problem. He feels very strongly that the control insurance companies have over the medical profession is limiting advancement and decreasing the routine miracles we are coming to expect.
- The pharmaceutical industry. The need for profit with the drug industry is creating some interesting situations. For instance, Dr. Fisher states that there are now 12 drugs for erectile disfunction, while research for malaria prevention and treatment has diminished. Why? Market share. American men have the dollars and interest in ED drugs, while malaria occurs mostly in poor, 3rd world countries where the Return on Investment in very, very low.