By Lee C. Rogers, DPM
Dr. Rogers is a podiatrist and health policy expert. He was a candidate for US Congress in 2012 in California. His SDN username is diabeticfootdr. The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions of The Student Doctor Network or Coastal Research Group.
The 113th Congress, which began in January, includes 25 Doctors. Congress started the year with a full plate of health care issues. The last vote of the 112th Congress was the fiscal cliff deal which provided a temporary ‘doc fix’ to avert the scheduled 27% Medicare provider reimbursement cut. The expertise of the slate of doctors will be sorely needed as Congress is expected to debate the Independent Payment Advisory Board (IBAP), a 2% sequestration cut to physician reimbursement, funding and implementation of the Affordable Care Act, and increases to mental health funding as part of gun violence reduction.
A list of the Members of Congress who are doctors and their specialties is in the table below.
Twenty-one of the doctors in Congress are physicians, from disciplines including family medicine, emergency medicine, cardiothoracic surgery, obstetrics and gynecology and orthopedic surgery. Additionally, there is one podiatrist, one dentist, and two veterinarians.
Most of the doctors are Republican (20). Only one, Donna Christensen, is a woman, and she is a non-voting member from the U.S. Virgin Islands. They are outnumbered by lawyers (173), businessmen (130), and educators (51). There is a GOP Doctors Caucus, which was started in 2009 by to oppose the Affordable Care Act.
Doctors in Congress tend to vote along party lines and not uniformly as a group of medical providers. For example, the fiscal cliff deal, which avoided the massive physician pay cut, was only supported by three doctors in the House of Representatives.
Other caucuses in Congress address specific medical issues like the Congressional Brain Injury Task Force, the Congressional Diabetes Caucus, Congressional Complementary and Alternative Medicine Caucus, the Congressional Kidney Caucus, and the Global AIDS Emergency Task Force.
Doctors in Congress are not without medical-related controversies. You may remember in the 2012 election for US Senate in Missouri, Rep. Todd Akin (not a physician) said that if a “legitimate rape” occurred a woman is unlikely to get pregnant because her body has a way of “shutting that whole thing down”. These comments ultimately led to Akin’s loss to Democratic incumbent Claire McCaskill. Recently, the chair of the GOP Doctors Caucus and OB/Gyn Phil Gingrey (R-GA) supported Akin’s comments saying he was “partly right”. He drew the ire of victim’s advocates when he said “we give advice to women who are infertile from lack of ovulation to ‘Just relax. Drink a glass of wine. And don’t be so tense and uptight because all that adrenaline can cause you not to ovulate.’” The American Congress of Obstetricians and Gynecologists (ACOG) immediately refuted his comments pointing out that ovulation often occurs before insemination and fertilization.
Another doctor, Phil Broun (R-GA), denounced modern science with his comments this year stating “All that stuff I was taught about evolution and embryology and the Big Bang Theory, all that is lies straight from the pit of Hell”. He added, “I don’t believe that the Earth’s but about 9,000 years old”. Believe it or not, he’s on the House Committee on Science, Space, and Technology as well as Chairman of its Oversight Subcommittee.
During the debate on the Affordable Care Act, doctors in both parties pointed to similar problems with health care delivery, but there was little agreement between partisans on how to solve the problems. How doctors behave inside the walls of Congress is probably due to external pressure from lobbyists and party bosses. It helps one understand the results of the recent Gallup survey showing the public ranks doctors and nurses as having very high honesty ratings and Members of Congress having very low honesty, just edging out car salespeople.
Some doctors have become quite notable as politicians. Former Rep. Ron Paul (R-TX) and Former NH Governor Howard Dean (D-NH) both ran for President. William Henry Harrison, 9th President of the United States, was almost a doctor. He attended medical school at the University of Pennsylvania but left early to fight American Indians, was the first president to die in office and the oldest president until Ronald Reagan. Former Senator Bill Frist (R-TN), a cardiothoracic surgeon, was the Senate Majority Leader from 2003-2007. In foreign countries, doctors have held the chief executive position in Chile, Brazil, Nicaragua, Uruguay, Angola, Haiti, Norway, Malawi, and Iraq.
In the United States Congress, mired in gridlock, it should be no surprise that physician politicians would behave like any other politician. We can only hope that the 113th Congress will be more successful in addressing the health care issues faced by our nation than the last, who voted symbolically to repeal the Affordable Care Act 33 times. Three major fiscal deadlines are quickly approaching, which could all affect providers. If the debt ceiling is not raised by mid-February, the government could default on its obligations. But before it defaults, it will prioritize payments. There could be delays in Medicare payments and student loans distributions. Sequestration will cut provider reimbursements 2% if not addressed. Negotiations to avoid sequestration may include defunding parts of the Affordable Care Act, Medicare funding for doctors, and student aid. And finally the annual budget. Congress hasn’t passed a budget in four years and has just been operating under temporary stop-gap measures called continuing resolutions. In order to reduce the budget deficit, health care funding could be cut. However the health care discussions come up over the next two years, we’re counting on the doctors in Congress to put aside their partisan differences and vote in the best interest of patients.