Cervete

I was born in a small Ohio town. It’s not small anymore, but its name used to be synonymous with quaint, small-town life of years past (if the Twilight Zone show had anything to say about it). Now, what’s left of Willoughby’s original downtown crossroad is nothing more than a traffic hazard on the way to where the real action is. The town quickly grew into a bustling city equipped with hospitals, strip malls, and factories. The downtown no one remembers anymore is like an unused appendix, remaining in place to maintain a lost sense of nostalgia for a time no one is left to pine over. It grew, as its people did, with the surrounding communities. Not like a neon beacon of development amid a field of farmland, but with the tide of growth that kept flowing from nearby Cleveland and washed half-way to the Pennsylvania border. Willoughby didn’t try to grow- it had no choice. And, as I’ve discovered, that wash of industrialism deeply affected the growth of the people in more than just numbers. It grew their perspectives as well.

Perspective. Much is said about the importance of keeping it. But how can you know when it’ lost? Can you yell at someone “Do Better!”, and actually expect more than just a blank look in return? How can you do better at whatever you should be doing, when you have no idea what ‘better’ looks like? What’s the difference between what you’ve been doing, and someone else’s opinion of it? Worse, how can you form a plan to improve yourself  when the sum total of what you’ve been told  is “Do Better”? Yes, the devil is in the details. But guess what, so is enlightenment.

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I understand the financial pressures modern city leaders are under. A downturn in the economy affects us all. But, there are other, more insidious pressures traditionally inherent in local government leadership.

Mismanagement costs from bad information still riddle small-city projects. Relying on local vendors and expertise makes constituents and political donors happy, but also forces leaders into using information which isn’t always the best. Remember, people successful enough will tend to migrate to the larger cities. The people left behind are the one who didn’t make it. And they, most than not, didn’t make it because they simply weren’t as good at whatever they choose to do.

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The time-old vice of corruption is always present in government, wherever it may be. And, it spans every level of power. An example? How about one I’m personally familiar with.

Corruption can be explicit, like the sale of a government agency to a political lobby. The Federal Government’s National Institutes of Health (NIH) was sold to ‘Big Pharma’ lobbying interests for purposes of marketing expensive medications.  Remember when a blood pressure of 120/80 was normal? After corporate takeover of the NIH under the Bush administration, the NIH began promulgating new ‘analysis’ showing that 120/80 should be the HIGH LIMIT for blood pressure, and anything below was healthy. The number itself didn’t change, just the wording.

That minor change garnered little attention in the press, but allowed for fundamental changes in vascular care.  Now, 90/60 is technically NORMAL, even though it would mean immediate unconsciousness for most ‘healthy’ humans. With 120/80 now being officially abnormal, drug-manufacturers can push physicians to prescribe blood-pressure medication (one of the most lucrative drug-lines ever created, second to cholesterol) to the widest segment of the population, regardless of actual need. This is why physician-insurance and pharmaceutical companies work so closely together. All liability insurers use NIH guidelines to determine wrongdoing in physician practice (for purposes of insurance premium calculations). Any physician who does not follow NIH guidelines to the letter, regardless of validity, can be immediately bankrupted by boosting insurance rates if something happens (regardless of actual fault). So, all physicians intentionally over-medicate patients to keep premiums low. Subsequently, the drug companies sell more drugs than they normally would, rake in record profits, and all with the plausible deniability needed to appear completely innocent in the process. The purchase of a government agency from a willing government is a prime example of explicit corruption.

Corruption can also be implicit, like a Municipal government using those same corrupted NIH standards to knock it’s employees off the municipally-sponsored health insurance, and save money. Knowingly using fake statistics to keep expenditures low at the expense of your own employee’s health may be a more subtle form of corruption, but its effects are more immediately tangible to the average person; especially when that person sees their deductibles rise from $500 to $2000 dollars just for being healthy.