s physicians, many of us receive solicitation from political action committees (PACs) seeking our financial support. We receive requests from the American Medical Association PAC, ASAPAC, our state medical PAC and subspecialty PACs, and some physicians even receive requests from their groups’ corporate PAC.

With these requests, we may ask ourselves whether our involvement is worthwhile. One important determinant of the effectiveness of a PAC is the percentage of eligible donors who actually contribute. The range of participation in PACs ranges from low (e.g., ASAPAC at about 10 percent) to very high (e. g., trial lawyers and nurse anesthetists). An outside observer, for example a legislator, might well conclude that the one group is not as strongly committed to its goals as the other groups are committed to their goals. Because participation is important, it is worthwhile addressing some of the barriers to greater participation. One common barrier is the concern that a PAC may support a politician of a party different from the one that the potential donor prefers. A variation of this concern is that the PAC supports politicians who hold views on controversial social issues such as gun control or abortion that the potential donor does not share. Is this a legitimate reason to decline to participate in a PAC? I’m going to argue that it is not.

First it is important to address the matter of money in political campaigns. Candidates for public office need money — a lot of money. In 2000 the average campaign for the United States Senate cost about $7.4 million. This means that over a six-year Senate term, a politician planning to run for the Senate had to raise about $3,400 a day. Likewise in 2000, the average campaign for a House seat cost about $850,000, meaning that the candidate had to raise about $1,200 a day over two years. Maybe that is too much money. However, of the ultimate recipients of that money (campaign staff, media consultants, advertising personnel, the kitchen staff of a campaign stop, etc.), who is getting too much money? If we believe in a free economy, then we have to accept that all those who work, directly or indirectly, to get a candidate’s message out are entitled to receive what the market will bear for their services. In 2000 the market told us that everyone (from kitchen staff to consultants) involved in a Senate campaign could command a total investment of $7.4 million. In the future it will be more. One way to participate in the political process is to contribute money to a PAC that helps candidates to pay this expense. Participating in the political process by supporting a PAC is a way to have input, not determinative input — but input into the process.

What about the concern that a contributor’s money could go to a candidate with whom the donor does not agree? At the time of the ratification of our Constitution, there was a great deal of disagreement about the appropriateness of the form of government it established. Benjamin Franklin stated that while he disagreed with some of the proposed Constitution, he felt that the overall objective of forming a better government was more important than his concerns or the disagreements that any individual could have with the document. He encouraged every delegate to “doubt a little of his own Infallibility, and to make manifest our Unanimity…”¹ An opponent of the Constitution writing in the Boston Independent Chronicle under the pseudonym “Z” argued against Franklin’s position, believing that concerns about the Constitution should not be set aside in the hopes that the new government would be well administered.² The essays of both Franklin and Z are well worth reading and have much to teach us about how to approach a PAC.

Any group of people will have diverse opinions on a number of issues, and it would be impossible to find a PAC that would satisfy every individual political preference. Individuals in a group must set these differences aside to demonstrate cohesion around the issues that are important to the group. Those individuals also should not simply hope that a PAC will be well administered; they should stay informed on the issues, follow the decision-making process of those administrating the PAC and provide feedback to the members of the PAC’s administrative body.

Finally, we need to recognize that we have several roles as citizens and professionals. An important way to fulfill our professional responsibilities is to find a PAC (or PACs) that advances our professional interests, contribute to that PAC, and monitor the performance of that PAC in advancing our professional interests. An equally important way to fulfill our responsibilities as citizens is to support the candidates of our choice by contributing to them (or to PACs that support them) and voting for them. There is nothing hypocritical about supporting one politician because of professional interests and another because of personal beliefs. The more diverse the input to our political process, the better the overall results that will come from that process. In fact the first amendment of our Constitution states that there is a “…right of the people…to petition the Government for a redress of grievances.”³ A PAC is a way to petition our government in an effective manner because a PAC has the expertise to allocate an individual’s contributions among those politicians who can most effectively address those grievances.

In short, as unsavory as it may seem, money is necessary to the political process. This process will produce the best results if everyone pursues their professional and personal interests actively in the appropriate forum.

References:
1. Franklin B. Benjamin Franklin’s speech at the conclusion of the Constitutional Convention. In: Bailyn B. ed. The Debate on the Constitution: Federalist and Antifederalist Speeches, Articles, and Letters During the Struggle Over Ratification. Part one. New York: Literary Classics of the United States, Inc.; 1993:3-5.
2. Z. “Z” replies to Franklin’s speech. Ibid:6-8.
3. Ibid:982.

Robert E. Kettler, M.D., is Associate Professor of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin.