Letter: Simple standards should guide our votes

Published 1:11 pm Monday, June 3, 2024

The 2024 U.S. election involves dramatic choices, with no perfect answers. Every American will decide individually, but maybe my experience in organized medicine helps explain — in a less polarized way — how I think about elections.

For the last nine years, I’ve had the privilege of representing the American Association of Public Health Physicians in the AMA House of Delegates, the governing body of the American Medical Association (AMA). For most of this time, I’ve been the voting delegate, with one of about 700 votes for all of the AMA’s elected positions. My Public Health colleagues and I love our profession. We want our AMA to do well. How do we decide whom to vote for?

Here’s how I think about these choices. For me, the most important factors in every election are policies, character, and external effectiveness.

POLICIES:

The policy role of the AMA president is generally very limited. While some AMA elections are primarily about policy issues, most are not.

In the U.S. government, however, the president can influence policy by hiring decisions, by executive orders, and by appointing federal judges. A member of Congress can influence policy by getting legislation passed. So in our federal government, a president’s or Congress member’s policy preferences are extremely important.

CHARACTER:

In complex systems, unexpected circumstances arise during every elected official’s term of service. So the official’s character is very important.

I look primarily at the person’s motivations, as shown in their actions over time. If someone has shown courage, competence, and respect of others within the organization, and if their actions are consistent with their stated policies and principles, they are well on the way to convincing me they will serve well.

Those who have never taken an unpopular and principled stand — or, worse, who have impeded others’ efforts because others’ success wouldn’t make them look good — appear to me as more interested in their personal power than in the group’s well-being. I have little use for those who appear to serve themselves, rather than the whole organization. That’s a character flaw. It’s likely to be worsened, not helped, if unprincipled people are given the power they seek.

In U.S. military and foreign policy, those with influence — especially the president — face constant decisions about how to protect the nation’s secrets, and the safety of those who serve us (whether openly or secretly). The president can command military forces to protect the nation’s allies, or for any other purpose.

The president can use his or her influence, publicly or in secret, either for the nation’s benefit or for his or her own benefit. So, in evaluating candidates, character, motivation, and truth-telling are vitally important to me.

EXTERNAL EFFECTIVENESS:

In both the USA and the AMA, the president is the group’s primary spokesperson. In both, the group’s primary power is the power of working within effective alliances. Organized medicine can’t achieve most of its goals by “going it alone.”

Those who represent the AMA must be able to speak publicly in Congress and the media, responding to new information and questions in a way that inspires confidence. They must represent both the interests of physicians and the demands of the public interest, and they must be honest when those two principles appear to be in conflict.

A commitment to others, and a willingness to sacrifice for the good of the team, is important to success in any team endeavor. Teamwork is crucial to a successful marriage; to a successful professional association; and to making one’s country a long-term success in the world.

Despite our country’s great power, we cannot prevail if the world ever unites against us. An unpredictable leader can benefit from their unpredictability — but only in the short run. To accomplish the most in the long run, the leader must be trusted.

SUMMARY:

I don’t always vote for the most brilliant candidate. I look for the one who knows how to select goals wisely and carefully, and to enlist his or her peers — whether they be other health care professionals or the leaders of other countries — to sacrifice toward a common goal that is good for everyone.

We are all trying to be good citizens together, choosing wisely for our country’s future. This is especially important in 2024, when candidates seem to differ so widely in their policies, in their character, and in their likely external effectiveness.

DAVE CUNDIFF

Ilwaco