Rich (-adj, ridiculous or absurd)

Today's Jackson Sun contains an intriguing article quoting retiring Congressman John Tanner's criticism of 8th District GOP candidate Stephen Fincher's recent tour of the Milan Army Ammunition Arsenal. Why intriguing? Not only has the outgoing congressman been virtually invisible to the media since he announced his intention not to seek re-election, but it's unusual for a retiring incumbent to insert himself into the opposing party's primary. As so often is the case in politics there's more here than meets the eye.

You see, Fincher's opponent in the GOP primary is an avowed friend of and political contributor to John Tanner. Tanner's criticism of Fincher is clearly calculated to help his friend Ron Kirkland in the primary election. The GOP nominee will face Democrat Roy Herron in November's general election. It's hard for me to believe Tanner's criticism isn't coordinated with an assist from the Kirkland camp.

My own sense is that Republican primary voters will see Tanner's comments as a badge of honor for Fincher. It often seems that we live in an Orwellian political world where truth is subjugate to "spin." Kirkland's effort to portray Fincher as somehow a tool of Washington insiders is a perfect example of such nonsense.

I know both Fincher and Kirkland. I've served on the board of directors of The Jackson Clinic with Kirkland, and he's the insider. Kirkland is the friend of congressmen and the Washington elitists. He's the supporter of and believer in the get-along back-scratching culture of power where there's not a dime's difference in Republicans and Democrats. Surely the GOP won't let Kirkland get away with smearing a farmer who's spent his life raising his family, spreading the gospel, and feeding America and the rest of the world.

It's always wise to remember the adage, when hearing criticism, consider the source. Considering who's criticizing Fincher, I'll stand with him.

Huck's Main Street Steamroller

I'm posting tonight as the final tallies are being made of Iowa's caucus votes. With Mike Huckabee's strong victory, the mainstream conservatives who make up the backbone of the Republican party have spoken loudly and clearly. The elitist "thought-leaders" of the GOP have been humbled by a man whose very campaign is anathema to establishment Republicans. The margin of Huckabee's victory over Romney tonight surprised even me, and I've been hoping for a Huckabee win for months. I will say that Huck's margin would have been even greater but for his recent unwarranted attack on the Bush foreign policy, but that error will likely be forgotten in the avalanche of favorable press from tonight's big victory. Even now, the television talking heads do not appreciate the strength of the Main Street Steamroller, but I believe Huckabee can win the GOP nomination and the Presidency.

How can Mitt Romney overcome the hard truth that three out of four Iowa GOP caucus voters, after intense media exposure to Romney, chose someone else? I don't think Romney can overcome tonight's result. McCain will clean Romney's clock in New Hampshire five days from now, but I do not believe Republicans will nominate McCain for President. McCain has alienated too many GOP faithful with his apostasies on immigration, tax cuts, and First Amendment free speech restrictions. I also do not believe Thompson's 3rd place tie with McCain tonight is enough to keep his candidacy alive. Huckabee will blow him and everyone else away in South Carolina, forcing Thompson's withdrawal and leaving Giuliani as the sole alternative to Huckabee.

I am surprised by the results on the Democratic side. I would not have thought, prior to today, that Hillary could possibly finish worse than second in Iowa, but it looks like she may finish behind Edwards. I do not believe Edwards did well enough tonight to survive. He needed a victory or at least a close second to make a legitimate case for viability. I'm happy with this result, because I feared Edwards as the strongest general election threat for the Democrats. Obama's strength amazes me, and I wonder how Hillary will frame the debate in New Hampshire over the next five days. I suspect lots of muck and mud will be thrown at Obama in New Hampshire, and if Hillary loses that primary, look out! At that point, Democrats would be in full self-destruct mode.

I look forward to the next five days. We live in interesting times.

Huck's Mistake Involves Integrity

"George W. Bush has resolutely led our nation on a new course, a course not sought by America on September 11, 2001, but a course that rightly affirmed the value of honor and liberty and life. I thank God for his wise leadership and his calming and steadfast policies, policies that in some ways with hindsight could have admittedly been improved, but policies all too quickly attacked, and now being vilified despite the best news from Iraq in over a year." These are the sentences that should headline any foreign policy apologetic by any mainstream conservative seeking the Presidency.

Unfortunately, Governor Huckabee has sunk disappointingly to the level of others who've forgotten the GOPs Eleventh Commandment. Not only has the lightly regarded pseudo-Commandment been breached, far more Huckadamage has been done with his patently fact-challenged attack on the Bush Administration's "arrogant bunker mentality." I say patently false because of those pesky things, facts, that get in the way of a good poll-tested focus group opinion. Never mind the support of England, Poland, Australia, and numerous other countries. Military personnel of these countries are fighting and dying, not because they're stupid, but because their nations' leaders see the same Islamofascist threat that Bush sees.

I don't think a man of integrity ought to be so driven for personal gain that he impugns his own President in time of war and energizes those opponents of our nation's success, both foreign and domestic. I especially believe this when the President has plainly stated his case for his actions, and when after hard times his plans seem to be beginning to work.

Huckabee's poll numbers took a noticeable dip a couple of days ago, a timing coincident with his "arrogant bunker mentality" quote. That Huckabee would write such a screed gives one pause to reconsider other claims of ethical lapse against him. My point is not that the other accusations have merit, nor would they have any traction absent "arrogant bunker mentality," but it is that this whole blunder was completely and totally avoidable, and is even now fixable with a simple apology. I pray that an infection of good sense will gently waft throughout Huckabee headquarters, and that said apology will be forthcoming.

Huckabee's Mistake

Here's a quick post on a wonderful snuggly rainy Saturday. Family games in front of the fire and Miracle On 34th Street are on tap for later. I wanted to post today because I'm concerned about the first real mistake I've seen the Huckabee campaign make.

Mike Huckabee's decision to write an article for a respected (ie mainstream elites) foreign policy magazine was probably necessary, but he's made a pretty severe tactical error by his forceful criticism of the Bush Administration's so-called arrogant "bunker mentality." What, pray tell, would Huckabee have had George Bush do in a post-9/11 environment when the consensus of the intelligence community pointed toward Irag's possession of weapons of mass destruction? Remember that the leadership of France and Germany based their foreign policy on opposition to America's interests. Remember the noxious corruption of the UN, evidenced in the Oil For Food scandal. Remember that, conversely, many nations, including England, Australia, Poland, and others have been staunch allies of Bush Administration policies. Remember also that, pre-9/11, candidate George Bush campaigned on a platform of "humility" in American foreign policy. The recognition of the civilized world's mortal danger from Islamic terrorists forced the change in Bush's foreign policy approach, and thank God for George Bush's willingness to face the threat. I certainly don't agree with everything the President has done, but it's helpful to no one at this point for Republican Presidential candidates to use such incendiary rhetoric.

Not only am I disappointed in Huckabee for making these statements, but it raises legitimate questions about his willingness to stand up to the liberal elites' conventional wisdom on any number of other issues. I've been a huge Huckabee supporter, in part because of his willingness to stand up for social and cultural truths unpopular on the East and West Coasts. Huckabee allayed my initial concerns about his commitment to limited government and personal liberty with his Second Amendment support and his advocacy of the FAIR Tax. If his purpose in writing this article was for short-term media approbation, his character is not as strong as I'd thought. If he actually believes such silly claptrap, his judgment and philosophy are suspect. I admit I haven't read Huckabee's article, but only seen excerpts from it, but even if the reporting on the article is incorrect, Huckabee should have had the good sense to see how the article would be portrayed.

None of the exogenous attacks on Huckabee that I've seen could harm him significantly, in my opinion. Unfortunately, this unnecessary and self-inflicted blunder has the potential to stall the enthusiasm of his supporters and his appeal to those voters for whom national security is the paramount issue. Even if Huckabee survives the Romney and Thompson attacks in Iowa and New Hampshire, this article supplies Rudy Giuliani with plenty of ammunition to use against Huckabee later in the nominating process. What a big mistake! I hope Mike Huckabee has the good sense to back away from these comments, and the quicker the better.

Quick Political Round-Up

I'm writing tonight after a several week period of being too busy for my own good, and too busy to post. Tonight's subject is political prognostication. I'm gratified to see, in the GOP race for the Presidential nomination, that my favored candidate, Mike Huckabee, is surging. Huckabee has succeeded in courting the mainstream media, who do not understand that a big-time pastor has the same skill set as a major corporate CEO. I now believe Huckabee will win Iowa, and he is approaching an even money shot at winning the nomination. I do not believe any of the attacks on Huckabee I've seen so far will stick, and the attacks may actually serve to legitimize him.

I still think Giuliani is the national front-runner. Romney will probably be crippled after New Hampshire, and finished after South Carolina. Here's why Romney will fade: John McCain will exceed expectations in New Hampshire, probably finishing a close second to Romney. A narrow and fading victory by Romney in New Hampshire will further shred an image that will be in tatters after Iowa. I don't think McCain has enough mainstream Republican support to capitalize on what I expect to be his New Hampshire success. Huckabee will dominate South Carolina, forcing Thompson's withdrawal. This will set up the February 5 battle which will probably decide the nomination, with the advantage to Giuliani over Huckabee on the basis of money and organization. This scenario should not be surprising, as I've for months predicted the GOP fight would wind up being between EITHER Huckabee or Thompson and Giuliani or Romney. Thompson's fizzle is the direct result of Huckabee's fire, though I had expected a better campaign performance than Thompson has thus far shown. It's all thrilling to watch for a political junkie like me. We'll see how my predictions turn out, but right now Huckabee is riding his wave, and I'm right there with him.

On the Democratic side, it's fun to watch Hillary squirm. Can you imagine the staff meetings with Hillary over the past two weeks as her internal polling has tanked? I have written before of Hillary's political tin ear, which I've hoped would doom her general election prospects. Until recently, I've never thought, though, that she could lose the Democratic nomination. Her organization looked too strong and her competition too weak. I've had to rethink this over the past two weeks, but I still cannot credibly imagine the Democrats handing their nomination to a candidate as weak as Obama or Edwards. If Hillary does indeed lose Iowa, and five days later does not win strong in New Hampshire, look for crisis-management mode among the Democrat muckety-mucks. It will likely manifest itself in the form of a major Draft Al Gore movement. All bets would be off at that point, with a major dogfight between Gore and the Clintons. In any case, I believe that scenario unlikely, and I still think Hillary is likely to win the Democratic nomination. Never underestimate the Clintons. They are capable of anything.

Thankful Thoughts

I'm posting today from beautiful Perdido Key in Orange Beach, Alabama. We arrived last night and have had a glorious morning playing on the beach. The weather is great, and the beach is perfect--with just enough other beachgoers for our children to make friends and have playmates, but by no means crowded. I've already had the chance to eat some gumbo and shrimp, so life is good.

It's an emotional trip for me. It's my first visit here in three years, since we evacuated this very place on the day Hurricane Ivan hit. Our two bedroom Gulf-front condo (which we co-own with another couple and the bank) took a pounding, and the restoration has been slow, difficult, expensive, maddening, and depressing. When I was here last, my children were babies, I was a partner and board member of one of the largest multi-specialty physician practices in the Southeast, I was busy in church teaching Sunday school every week and serving on the pastor search committee,and I was not yet forty years old. Today, I'm an exhaused almost-43 year old who has weathered a tumultuous year building my own solo internal medicine practice, a venture which has been both consuming and liberating, both frightening and comforting, and stressful yet strengthening.

This brings me to the title of this post--thankfulness. I am most thankful to my wonderful wife, who has stood by me while I have upended her life, and who has been instrumental in building what is now clearly a successful solo medical practice. Thanks to her unconditional love and her willingness to allow me to take risks, we have built what I believe is a unique medical practice, one that is making a difference in people's lives, and one that is positioned to withstand the turbulent times ahead for primary care medicine. Not only has Mary Kaye stood by me, steadfast, but she has home-schooled our children with measurable success, and along the way she's managed to complete re-licensure as a physical therapist to boot, providing much-needed financial support for our family during my practice start-up. Not one woman in a million could have accomplished what she's done, and I'm so proud of her I could burst. Oh yes, that's not to mention that I've also relied on her to take the lead in all the dealings required for restoration of our condo. In all things, in every aspect of my life, she has made better anything I've been part of. I love you, Mary Kaye.

I'm also thankful to God, who has blessed me with Mary Kaye and three wonderful, intelligent, rambunctious, and unique children. They are a joy. Granted, they are expensive, tiring, and exasperating, but they are mainly a joy. I revel in them even as I take seriously my responsibility to raise them. God has also blessed my practice, and I see His hand evident whenever I take the time to look. A close friend who has been a pastor has remarked to me how energizing it is to minister to people, even in the face of an exhausting schedule, and I see that also in my work--I feel a God-given sense of satisfaction and fulfillment when I help people through my medical practice. I almost feel that to talk about that God-given motivation may somehow cheapen it or open it to ridicule, so I won't dwell on it, but it's there, and it's real, and I'm thankful to God for His blessing in bestowing it.

The kids are studying the founding of America in their history lessons, and their study has opened my eyes anew to God's blessings on our nation. We all ought to be thankful to be Americans. I will often rant and criticize about political issues, but I must remember to be more thankful for our system of government. I do believe God had a special and unique plan in the founding of our nation, though I shudder in fear at how far we've strayed from His principles.

I'll close for now, with plans to post again during our vacation. Beach and nap and seafood are calling, and I'm thankful for them, as well...

Progress Report

Today's post will not be my typical laser-focused gem of nuanced and knowledgeable insight. I am fighting off a cold and Mary Kaye is off to a scrapbooking convention, so today is a lazy day home with the kids. It is an opportunity to post on several topics I've touched on in the past, however.

Plans are apace for the Open House my office is having August 23. The Open House is being held to celebrate the completion of our first year of practice. We never held a Grand Opening because we were too busy from the start, but I wanted to celebrate what I believe is a successful start for our efforts at delivering primary health care in a different and better patient-centered model. We also wanted folks to see our expanded office space, which we just finished remodelling a couple of weeks ago. We have almost doubled our office's square footage, and have doubled the number of patient exam rooms. Another reason for the Open House is to introduce Tina McCall, our new nurse practitioner, to my patients. Tina's presence will help us tremendously as we strive to be conveniently available to patients, and we want to give folks a chance to meet her, as well as to publicize that work-in appointments, especially on Fridays, will be more available. Finally, we wanted to use the Open House in a low key manner to introduce the new Premier Wellness option that we are now offering. As I've noted before, Premier Wellness is an optional retainer-based program in which patients pay an annual or monthly fee in return for a wide-ranging annual Wellness Review, as well as guarantees of quicker work-ins and generally enhanced levels of office time spent discussing health issues.

I have developed the Premier Wellness program in an effort to insulate myself and my patients from what I fear are impending devastating public policies regarding reimbursement for health care services. My fear is that, as third party/government payors exert more and more influence on health care policy, the traditional and precious relationship between doctor and patient will be irreparably harmed. Only a socialist would argue that the individual's best interest is always concordant with society's, or the government's. Unless the patient is paying for the service, someone else is calling the tune. The practical result, I fear, is that without Premier Wellness or something similar, all primary care doctors will be forced into becoming "office visit mills" with limited time and little satisfaction for both patient and doctor. If I can develop a model in which patients feel valued and empowered and really "cared" for, a model in which the patients themselves decide the value of the services and whether to pay for them, then I will have protected some modicum of the traditional relationship between doctors and patients. I will have also salvaged that ideal which should motivate physicians--the concept of servanthood.

Too often, conservatives cede the moral high ground to liberals who preach generosity and unity, but the truth is that none of the ideals I've spoken of above can occur unless the staff is paid, the rent is paid, and the monthly bills are paid. I love the old joke about liberals, that they're so generous they'll give you the shirt off someone else's back. I'm here in the trenches, trying to care for folks, but I'm also saying that providing the care people want costs money, and that's a truth that needs to be faced. My Wellness option isn't for everyone, but neither is any other single option. The thrust of my position, however, is that patients need to control the system, and that will not happen unless they are also paying the bills.

With regard to Premier Wellness, I'm excited that the response to my initial offering has exceeded my expectations. I have already seen one patient this week as a Wellness patient, and I believe that this patient felt , dare I say it, pampered and well cared for. I was able to take the time to speak with a specialist about one of this patient's health problems, and arrangements were made for an expeditious office visit with the specialist. This was all able to be accomplished because I was able to allocate extra time with this patient. Time--that is the most important asset I have to offer patients, and the commodity that patients are being deprived of in today's system.

I am also trying to find other ways to add value to the product I offer Wellness patients. I have arranged a substantial discount for membership at a local water-based therapy center, and I hope to arrange access to an entity that offers gym and exercise equipment. I would also like to have my Wellness patients meet annually with a dietitian for nutritional counselling, and I'm going to try to add that benefit at no extra cost to the patient. Offering these and other benefits will help these patients achieve their goal of good health and access to personalized care that is convenient for them. I am proud to be part of the process.

I'll close with a word about Presidential politics. It goes without saying that all the Democratic proposals regarding health care are horrible. Among the Republicans, there is a glimmer of sense. Giuliani, whom I've slammed for his pro-abortion stance, has made headlines recently with an outline which seems to try to apply market principles to health care spending by making individual health care premiums tax deductible. This proposal is good in that it weakens the artificial and harmful linkage between employment and health insurance. Mike Huckabee, who I believe is the most engaging and credible conservative in the race, has a good strong tax policy proposal called the FAIR tax. I need to learn more about his health care spending proposals. Huckabee needs to do well in an upcoming Iowa straw poll next week. I hope he does.