While learning about truth, honesty, civility and camaraderie in school, the real world of hidden agendas creeped in. New and improved Fruit Loops tasted  exactly the same as the old Fruit Loops. Two box tops and $2.00 did not get you “life sized action figures” but ant sized plastic toy soldiers. Reality only accelerated with age. “This VCR  is state of the art and will remain a standard for years,” the Circuit City salesman told me with a straight face in 1982 as I drained my bank account of $1,200.  Obviously, the advertising on cereal boxes and a stereo salesman suffered from hidden agendas or conflicts of interest.

The world of medicine brought its own litany of hidden agendas. Pharmaceutical representatives extolling the virtue of their brand name products when a generic and a lower cost substitute achieved the same goals. I entered the profession during the era of drug sponsored free Caribbean vacations, five star restaurant outings,  and “free” basketball playoff tickets. Was there a potential for bias in prescribing habits when you’re cutting into a filet mignon paid for by an acid reducer you haven’t used before? One would have to think so.

Transparency in medicine became clearer when government edicts regulated Pharma’s gifts to the medical profession. The trips, five star restaurants, and  sporting event tickets disappeared.  Finally, even complementary pens and trackpads were forbidden. Quite rightly, transparency in prescribing was demanded by consumers. Today, the consumer can check on their provider’s lunch reimbursements, Medicare payments, and Big Pharma consultant fees. A simple internet search will quickly reveal the truth regarding your doctors financial ties—if any— to pharmaceutical companies and the like.

Regretfully, most of the world operates with hidden agendas and conflicts of interest unbeknownst to the consumer or general public. However, to the world of medicine’s credit, regulatory agents have collectively required physicians to publicly reveal conflicts of interest.  For example, if you are a physician presenting a paper at a meeting regarding your research on a drug, you must disclose any conflict you have with the company making or marketing said drug.  Furthermore, your research paper must cite any conflict you have as well.

Certain areas of the field of medicine have escaped transparency and issues of reporting conflicts of interest.  Lobbying has produced the DSHEA Act of 1994 which stripped regulation and FDA oversight from over-the-counter pharmaceuticals. Many over-the-counter medicines have not been subjected to vigorous oversight or proof of efficacy.  Billions of dollars of products are bought that may have little or no assurance that they help or improve what it professes to do on the package information. Fortunes have been made from this lack of transparency to the patient slash consumer.  It would seem, in the public’s interest, that a warning indicating that a product that has not been rigorously tested and proven in its stated efficacy, should be placed on the product packaging.

It seems that physicians and some areas of medicine are leaders in self-reporting conflicts of interest and public available transparency of these conflicts should be the standard applied to all businesses that interface with the public at large.  For example, politics operates in the world of dark money facilitated by Citizen’s United and the death of campaign reform.  So when a politician publicly espouses a certain political opinion, why do they not have to disclose any influence or conflicts of interest they might have that would benefit from their political stance on an issue?  Doesn’t the American citizen need this transparency to be an educated voter?

Furthering this argument, Journalists in a variety of communication forums report information in the public’s best interest.  Under their by-line in a newspaper or in a chyron on the bottom your television screen there should be a clear statement of any conflict of interest the journalist might have.  If you own stock in a company that spilled oil into the ocean, I’d like to know that when you present information on the oil-spill.  

A rational world should apply the rules that govern conflicts of interest or hidden agendas in a schoolyard playground the same as they should in the world of medicine, politics and journalism to name a few.  Self-reporting, fairness, and truthfulness should be a minimal requirement for all who interface with the public who are purportedly looking out for your best interest.  

Let’s level the playing field. 

“I’d like to renegotiate my cable and internet bill” I typed earnestly. 

“I understand you want to add Hulu Plus to your service” Oliver calmly stated. 

“No, I believe my charges are excessive and I would like to change my service,” I pleaded.

 “You would like to add services to your package,” Oliver proclaimed. 

I was in a “Tower of Babel” loop! My only potential escape was to offer multiple pleas for human interaction. Finally, a human took over the chat function and perused my angst ridden communication. 

“I’m here to help, but I need to ask you a a few questions. What kind of entertainment do you like and how many devices will be on the internet?” 

Having been a veteran of prior aimless Cable Service queries, I politely asked for a reconsideration of pricing for the service. One hour had passed in my efforts already and when we were on the precipice of talking money, the chat abruptly ended. 

“You are not authorized to negotiate price on this account and you must call our Service line, goodbye.” 

The telephone queue serenaded me with easy listening tunes as empty minutes passed. A service representative interrupted my torpor, cheerfully asking how he could help. I summarized my case, explaining much lower rates for TV and internet in other areas from other providers and my desire to remain a loyal Cox Cable consumer. 

“I understand your frustration and I’m here to help you,” 

The same questions were asked— from the Cox script— eroding my patience and taxing my silent mantra. The minutes passed and ultimately, the  ‘cable to irked customer’ or ‘anger stage’ was in full force. 

“As a loyal and responsible customer, we can offer you a special rate. Doing some quick math, I calculated a $5/month reduction.” 

 Two hours into the beginning of my quest, I was as hot as the sidewalk outside my door.

 “Let me speak with your supervisor,” I insisted.  I was hoping to get to someone with authority who could respond as I moved from the anger stage into denial and bargaining.

 Calming music played in the background as I waited for the supervisor.  My managerial contact sounded like a bartender with a   marriage counseling background. I was assured that the litany of participants I had been with the past few hours were just doing their job and  I would ultimately receive fair treatment.  Nothing was going to change as the conversation proceeded and I decided to bring out the defining statement: “ I am going to cancel the service.” 

 “If you cancel your account you will need to return your 4 cable boxes.” 

“Wait,” I stammered, “I only have three TV’s and three cable boxes. I never received a fourth box and would have no use for it.” 

“We have an invoice from three years ago that we shipped you 4 cable boxes to your address and have charged you 4 cable box monthly rental fees for the past 3 years,” the manager insisted with a tone of authority.

 “This was an obvious error, I said, and I want a refund for the excess box charges for the last 3 years.’

 “Our invoice is the document we make decisions from. Cox is not   responsible for its delivery to you. If you did not receive four boxes, you should take this up with your home owner’s insurance company.”

 “So I have paid a monthly fee for 3 years for an outdated piece of technology that I never received and you are refusing to remove the charge?”

 “If you only want to pay for 3 cable boxes, you will have to return the 4th box or pay for its replacement.”

 By this time, 3 hours had elapsed since I started my ordeal.  I was clearly  moving through the depression stage. It was time to cancel and change providers. I scoured the internet for Scottsdale internet providers and regretfully found my answer. Cox had a virtual monopoly in Scottsdale. Their only competitor had a worse customer score. Checkmate, game, set and match, I thought, as I folded my cancellation strategy and sheepishly accepted the $5 dollar/month saving and agreed to pay for a ‘lost’ apocryphal cable box charge on my next bill.  Ultimately, I was now in the acceptance stage.

Could I abandon television and the internet for books?  Perhaps board games with the family and spirited discussions could be substitute entertainment? No! The pull of watching Wheel of Fortune and Jeopardy in the Sonoran Desert was too strong of an urge. Maybe someday T mobile can outfit the Saguaro with cell towers and bring me QVC and C -span outside the Cox universe. In the meantime, I will contact my insurance company about that ‘lost box.’ I’m sure I’ll have better luck with them.