Editor’s note: Jon Margolis is VTDigger’s political columnist.
‘Full disclosure,” Sen. Bernie Sanders promised last October, shortly after his heart attack.
“People do have a right to know about the health of … someone running for president … we will make all of our medical records public.” he said.
Well, maybe not. On second thought (or perhaps third) Sanders released letters from three of his doctors, but said he will not make all his medical records public. Because, he said, “you can start releasing medical records and it never ends.”
Sure it does. There’s no law requiring candidates to release medical records. Instead, there’s a law (HIPAA) protecting everyone’s right to keep medical records private. Even presidential candidates can stop releasing them as they choose.
So that’s not why Sanders is clamming up about his health. The real reasons are more complicated. And while Sanders himself is not blameless here, his decision to evade may say more about the general political culture than about any one candidate.
To begin with, he is doing what he is doing because he can. Donald Trump did. Trump released no medical records, merely a 2015 letter from a doctor claiming that Trump “will be the healthiest individual ever elected to the presidency.”
That didn’t pass the laugh test. It didn’t matter. Trump enthusiasts didn’t care, just as they didn’t care when Trump refused to release his tax returns.
Neither, at least so far, do Sanders enthusiasts seem to care that he isn’t being candid about his health (he has released his tax returns). Maybe, as with Trump, they’re too enthusiastic to care. Or maybe (again as with Trump) they don’t trust those telling them they should care.
After all, those telling them they should care come from “the establishment” –- the prominent and polite voices in politics, academia, and media, the talking heads, the punditocracy.
They are dismissed precisely because they are “the establishment,” enforcing (or at least supporting) “norms” the currently fashionable term for standards of behavior which are not required by law but remain vital for democracy to thrive.
At least according to the prominent, polite voices, to “the establishment,” whatever that is. The term is never defined, meaning it may not exist. No matter. Some people still dismiss what they consider to be its message. These people have their enthusiasms and do not want to be bothered by facts or “norms.”
And in fairness to them and to Sanders, these “norms” have not always been that normal. President Dwight Eisenhower’s staff first called his massive 1955 heart attack “indigestion.” John F. Kennedy hid information about several ailments, including Addison’s disease. Sanders is by no means the first candidate to try to accentuate the positive and eliminate the negative news about his health.
Then there’s the question of whether the public really has to know everything about a politician’s physical condition. Maybe even people running for president deserve some personal privacy. Almost everyone has minor physical annoyances and peculiarities that don’t diminish their abilities but might be embarrassing to disclose. Kennedy’s infirmities, for instance, did not seem to have diminished his effectiveness as president.
But Bernie Sanders is 78. No one that old has ever been a major party’s presidential nominee. Neither has anyone ever before run for president who had a heart attack the year before the election. That combination raises legitimate questions about how long he is likely to live and (because heart problems can lead to dementia) how long he is likely to remain rational and coherent. Answering these questions need not require disclosing everything about Sanders’ health. Nor would it start a process that would “never end.”
Last weekend, NBC News quoted Dr. Richard Kovacs, the president of the American College of Cardiology, saying that the information released by Sanders’ doctors omitted one “standard” measure of heart health: the left ventricular ejection fraction. Kovacs said there is a correlation between that fraction and a patient’s future heart health.
Jay Olshansky agreed. Olshanksy is not a physician, but a professor at the School of Public Health at the University of Illinois at Chicago who specializes in gerontology. In addition to the ventricular ejection fraction, Olshanksy said it would be helpful to know “the percentage of the closure of the coronary arteries, and any progression or change (in the closure) across time. That’s pretty important information.”
Information not in the letters from Sanders’ doctors, though one of them does say his “heart chamber sizes, wall thickness, estimated pressures, and heart valves are normal.”
Letters from a physician, Olshanksy said, are of limited value because “we can’t tell based on those words alone … what’s going on inside the body.” Despite the invasion of privacy, he added, “my general view is, release it all. Ninety-nine percent of it will be lost on the voting public, but at least it will be out there. Remove the filters, because I don’t trust filters.”
Sanders has decided not to release it all. No need to wonder why. Candidates do what is in their political interest and refuse to do what is not. If releasing more information would help his candidacy, he’d release more information.
He isn’t, because the information might harm his candidacy by raising doubts about his health and vigor.
Leaving two questions: Is he physically fit to be president? And is he ethically fit?
Or do those questions impose now-outmoded norms?
