Is anyone out there truly “fair”?

2012 is the year of the “fairness debate”. Politicians and laypeople argue daily about what policies are or are not fair. The Merriam Webster Dictionary defines fairness as, “marked by impartiality and honesty: free from self-interest, prejudice, or favoritism”.  Nowadays, “fairness” is tossed about like a football, something concrete, tangible, and easily discernible. The dictionary would support an objective use of the term; yet, in fairness, the term is being used in an entirely subjective manner; what is considered fair to one is often quite unfair to another. It seems our debaters are misusing the word. They are judging fairness to suit their needs, even when aspiring to portray impartiality and generosity. Let’s examine some examples.

Ben Affleck recently told Bill O’Reilly that he wanted to pay “my fair share of taxes”. O’Reilly quickly retorted, “You want to pay 45 or 50%”, to which Affleck stated in an unfiltered fashion, “No, I thought we were going back to the pre-Bush tax level.” Translation, “that’s more than I bargained for. That would not be fair.” But what makes an Affleck tax of 35, 40 or even 60% fair? In fact, as Affleck can earn $10,000,000 for a role in a single movie, why shouldn’t he pay 90% in taxes? That would still leave him with a cool million for simply playing a part in a movie. Most might think that earning well over ten times the annual income of most teachers for a single movie gig is more than fair. Affleck of course would disagree. And so “fairness” should not be part of his vocabulary with regard to his views on tax reform. He is not impartial.

How about the fairness of our current medical system? Would the homeless family struggling to stay together and put food on their makeshift table think it’s fair that our country puts healthcare for all before shelter and food for the needy? Probably not. But most Americans do believe this to be fair. That is why we are in the process of expanding our medical coverage. And so the minority dwellers of the street have their sense of fairness trumped by the majority. It’s not fair, but it is the way our country works.

The football players strike when they earn less than they feel they are entitled to, and yet they make millions… for playing a game. Doctors have had their incomes systematically shredded over the last few years. Cardiologists for example have had their primary sources of income cut 40 to 50%! Fair? Consider what it takes to become a cardiologist. (Full disclosure – I am one). First you have to be a serious junior high school and high school student. That is correct; you must focus at a young age, abandoning the frivolities of normal youth. Then you must attend college, typically an excellent private University to enhance your chances of entry into medical school. I attended Columbia; price tag today, approximately $240,000. Then there’s Medical School. That’s another four years with an additional price tag of about $300,000. Most parents cannot afford these costs and so they spend everything they can and pay the remainder in loans. Consequently students often begin their next phase of medical training already saddled with well over $200,000 of debt. To become a cardiologist you then must complete three years of internal medicine training and an additional 3 years of dedicated cardiology training. That’s six years after medical school and ten years after college! Meanwhile, don’t forget the lost opportunity this student of Medicine has experienced. While he or she has accrued mind-boggling debt, his or her college friends have had ten years in the workforce to climb the ladder, earn money, buy homes, and start families. But that’s not it for our budding cardiologist. Say he wants to specialize further, to become an interventional cardiologist so he can save you when you’re in the throes of a heart attack. That’s another two or even three years. So how much should this super-trained doctor earn? Should it be more than the football player or the actor in a movie? When you are in the midst of a heart attack looking up at him from the gurney, what do you tell yourself he’s worth? What’s fair?

Let me digress for a moment as you might be saying to yourself, “but for doctors it shouldn’t be about the money. They should go into medicine to save people’s lives, to help the sick and keep the healthy well.” And you would be correct. Doctors shouldn’t practice medicine for the money. And most of them, myself included, don’t. But there are pragmatic issues. We too have families to support, children to send to college (and hopefully Medical School), houses that develop leaky roofs, and yes, food to put on the table. So early on, when we decide what path to take in life, these practical issues merit consideration. We are not choosing to go into the priesthood as some would suggest; we are truly selecting a career path. And the balance sheet of pros and cons that everyone considers in making important decisions must be looked at with a discerning eye. That is after all the smart way to do it. And believe me; you definitely want your doctors to be smart. So please don’t get hung up on whether or not doctors ought to think about their incomes. They do because they must.

Back to fairness. Whatever side you are on in this highly contentious political and social moment in history I simply want to suggest that the fairness card should not be on the table. “Fair” is intended to be an objective concept, but who among us has the genuine capacity to be completely unbiased? Instead of clothing the debates in false garments, let’s instead examine the real issues. Let’s look at how we see ourselves, our country, and most importantly our children’s country. No one is right or wrong here. It’s simply an issue of divergent visions for our nation. My suggestion to us all is to find a way to be as open and honest with ourselves as possible. We must educate ourselves to the best of our ability, swiping away bias and false information like bothersome gnats on a hot summer’s night. Then we can look at the issues with clarity and on November 6th go to the poll and pull the lever that feels right for us.

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