There are 12-step programs for alcoholics, drug addicts, compulsive gamblers, sex addicts, overeaters, and just about any addiction, compulsion, or abuse known to man. These programs usually are self-help programs, structured as “step programs” (one step at a time), so that if the steps are followed, a reasonable, satisfactory result will occur.Such programs are often quite successful, and I give lots of credit to those who participate in them.


Published 7/1/2011
S. Terry Canale, MD

A 12-step program for politicians

S. Terry Canale, MD

But after hearing and reading about all the shenanigans in Washington, D.C., over the past several months, I guess that there should be a 12-step program for “wayward” politicians to avoid “run-away” behaviors and hold them to all those promises they made while campaigning for office.

If you’ve been reading these editorials all along, you realize that my political leanings are just to the right of Attila the Hun. So in my personal opinion (and let me make it clear that these are strictly my views—not those of the AAOS or any of its leaders), a 12-step program for politicians would include the following steps:

  1. Admit that our healthcare system is financially unmanageable and that current efforts to reform it (the Patient Protection and Affordable Care Act) have more to do with insurance policies than health care. Politicians should also admit that the regulations and systems they’ve adopted (such as the sustainable growth rate [SGR] formula) are contributing factors to the current mess.
  2. Entirely reform the tort system to eliminate frivolous lawsuits and restore a degree of sanity to the physician/patient relationship. This will cut down on the number of procedures performed by physicians as part of “defensive medicine” and help reduce overall healthcare costs.
  3. Fearlessly cut government programs to balance and reduce the federal budget. Which programs are cut is debateable, but both sides of the aisle must realize that current levels of funding are unsustainable and work together to address the deficit and the budget.
  4. Eliminate some bureaucratic departments in Washington and taxpayer funding to private organizations. I’d vote for eliminating Education and Energy, among others.
  5. Enforce existing laws concerning illegal immigration. Apply the laws equally—to growers who use illegal immigrants to harvest their crops, to employers who hire illegal immigrants rather than pay a wage that attracts Americans, and to politicians who have illegal immigrants in their households and on their payrolls as well.
  6. Search for a “fix” for our Social Security system, realizing that although some individuals would appreciate and benefit from multiple investment options, others will need a basic safety net.
  7. Admit that a temporary fix of the SGR is not the answer and seek a permanent fix in 2011. Temporary fixes have helped create the more than $200 billion hole we currently face. The prospect of a 30 percent reduction in payments in 2012 does nothing to ensure access to care or attract students to medicine.
  8. Seek to devise a fair tax system. This will be an immense task. Taxes—whether on the federal, state, or local level—are a burden not only to individuals but also to businesses, particularly small businesses such as orthopaedic offices.
  9. Be willing to become energy independent, without maiming our environment. If we could send a man to the moon, we can certainly save the earth.
  10. Admit that “earmarks” are wrong and eliminate all of them from all proposed legislation. Politicians who do their jobs properly won’t have to rely on earmarks to get re-elected.
  11. Humbly seek term limits for all legislators, especially those in the House of Representatives. A 2-year term is barely enough time to find your way around the halls of Congress, and most of it will be spent campaigning. So maybe individual terms should be a little longer, giving the elected time to get some work done. But surely, 25 terms is too much!
  12. Make a searching inventory of yourselves and pass no laws for Americans that do not also apply to members of Congress. Conduct this personal inventory before you decide to run for office and spare us all the craziness of media hype, apologetic tears, ethics investigations, and drawn-out court cases. The decision to become a public servant opens private lives to scrutiny. Make sure you pass the test.

If this 12-step program doesn’t work for some politicians, then they should be admitted to an R3 (representative-rehab-recovery) center (established with entitlement dollars) until their egos can be altered, their depression treated, and their medication schedule firmly maintained.

Well, that’s my 12-step program for politicians. What would yours look like? E-mail your reactions, both pro and con, to