A Remedy for What Ails Us

More Doctors in 111th Congress

Posted January 6, 2009 at 3:41pm

As Dr. Steve Kagen watched a mounting number of prescriptions go unfilled because his patients couldn’t afford the medication, he realized the way to have a more significant effect on his patients’ lives was to confront problems within the health care system head-on — by running for a seat in Congress.

Now a second-term Congressman, the Wisconsin Democrat is part of a growing club: With the start of the 111th Congress, Capitol Hill will welcome 15 medical doctors. All of them want to work to help fix the health care system this Congress.

Rep. Parker Griffith (D-Ala.) decided to run for office after working behind the scenes with elected officials on health care issues. As an oncologist, Griffith noticed firsthand that physicians were not seeing some patients early enough to cure them and wanted to work toward improving early diagnosis in the future.

“Good public health policy has the potential to save more lives than all the chemotherapy and radiation therapy given after the fact,” he said.

Three other new Members with medical degrees were elected with Griffith this fall — a climb from 12 to 15 doctors in Congress. The 13 physicians in the House and two in the Senate include five obstetricians, a heart surgeon and a psychiatrist. It is the highest proportion of doctors that Congress has seen in decades.

Deputy House Historian Fred Beuttler said the main reason behind the escalation is the increase in Congressional involvement with health care reform, particularly in the 103rd Congress during the Clinton administration’s attempt to act on the issue. The number has steadily increased since the 101st Congress, which had just three doctors in the House.

Beuttler said he expects the trend to continue, thanks to growing interest in health care reform. The American Medical Association counted about 39 candidates with medical backgrounds who ran in the past election.

Almost all of the doctors in Congress expect health care to be a major issue in the next Congress, particularly with rising costs and an aging population. Comprehensive health care reform is needed to improve the long-term fiscal outlook for the nation, according to a recent report by the Center on Budget and Policy Priorities. It found that health care costs are the leading problem contributing to long-term debt, which it projected will hit 279 percent of the gross domestic product in 2050 without reform.

“We and many other analysts believe the nation cannot get a handle on the long-term budget problem without reforming the entire health care sector,” said Richard Kogan, a senior fellow at the center and author of the report, in a recent conference call on the report.

Physician politicians say their desire to run for Congress is linked to their sense of the government’s power in health care. “It’s not doctors that determine who will live and who will die. It’s politicians,” said Kagen, an immunologist before coming to Capitol Hill.

Rep. Phil Roe (R-Tenn.), an ob-gyn elected this past November, said that the federal government had increasingly affected his ability to work as a physician in recent years and that the struggle pushed him to politics. In his last surgical cases, Roe said he spent more time on the phone getting procedures approved than it actually took to do the surgeries. Freshman Rep. Bill Cassidy (R-La.), a family doctor, agreed that physicians turn toward being a part of public policy when they find themselves inhibited by it.

As the number of doctors in Congress grew, the influx led to the creation in 2005 of the Medical and Dental Doctors in Congress Caucus, chaired by Reps. Phil Gingrey (R-Ga.) and Vic Snyder (D-Ark.). Though the caucus has not met frequently in the past couple of years, Rep. Tom Price (R-Ga.) said he would like to see more action by the caucus in the future. He hopes the caucus can work to create a unified message on health care reform. “There’s obviously greater authority in numbers, and I would hope we can come to a conclusion and recommend general principles for health reform,” Price said.

The AMA is also encouraging doctors to play an active role in public policy. It provides campaign schools and workshops for physicians wishing to run for Congress. The workshops cover everything from crafting a message to organizing voter drives or getting the message out in different mediums, AMA President-elect James Rohack said. He noted that some recently elected politicians have attended the workshops, including Roe and Cassidy.

Rohack emphasized that the AMA is working with both political parties. Griffith said physicians can bring perspective to an issue that is often plagued with partisan bickering. “There are no Republican or Democratic cancers,” he said.

Even with this session’s growth, the number of physicians with seats in the House and Senate is still a fraction compared to other professions, such as lawyers or businessmen. Rep. Michael Burgess (R-Texas) said that proportion should change, given the large amount of federal funding provided to health care. In fact, he said, the proportion of Members with medical backgrounds should equal the percentage of the GDP spent on health care. The U.S. currently spends about 15 percent of its GDP on health care.

Observers have several theories about the historically low numbers of physicians in Congress. Many doctors consider it a step down, especially in the wage department, Beuttler said. Griffith added that he is encouraged to see more doctors getting involved in politics. “For so long, physicians felt politics was beneath them, that it was something that might get them a little dirty,” he said.

Many policymakers don’t have a real understanding of the problems that can be encountered in the health care system, ranging from a lack of health insurance to massive wait lines at emergency rooms, Griffith said. “Most of the people in the rooms who are discussing health care really don’t have a problem with health care,” Griffith said. “It’s a theory to them.”

Rep. John Fleming (R-La.) said he hopes he can help a broader range of patients from his new spot in Congress, instead of aiding the afflicted one at a time. Fleming hopes Louisiana, with three physicians in the 111th Congress from the state, will be the tip of the iceberg in the health care debate.

Issues from obesity to home oxygen access for seniors to improving children’s health care have already been dealt with by physicians in Congress. Kagen introduced legislation last session calling for an end to discrimination through health insurance, and he hopes to further work on the issue this Congress.

While many of the physicians in Congress were prompted to take their seats because of health care, they also have broader concerns about issues that will affect their districts, including infrastructure, housing and energy security, as well as dealing with the economic meltdown.

But even without their stethoscopes, the doctors still stand out from their peers in some key respects. While speaking with some of the physicians on Capitol Hill, Beuttler has found many still seem more like doctors than politicians and consider medicine their first love. Kagen, for instance, refers to himself as “Dr. Steve” and said he doesn’t consider himself a politician or “walk and talk” like one. Kagen is even distinct from his physician colleagues. When he first arrived on Capitol Hill, he declined medical insurance until his constituents could be offered the same deal. He is the only Member to do so. Some doctors see it as an opportunity for public service after their medical careers. Roe said he doesn’t expect to become a career politician and compared it to joining the army.

The only physician who left after the 110th Congress, Rep. Dave Weldon (R-Fla.), an internist, retired to return to his medical practice.

Some new Members are hoping to continue honing their medical skills while in Congress. Roe intends to spend time at a Virginia medical clinic, if it is deemed acceptable by the ethics committee. Cassidy was still working in his scrubs and teaching students in Louisiana about a week before his move to Washington, D.C.

Though the new doctors in Congress will miss their scrubs, the freshman Members are eager to don suits and tackle their roles as legislators. Roe said he didn’t feel like himself when he first stopped practicing medicine but is eager to represent the people in his district.

Despite the challenges ahead with an economic crisis, Roe said he doesn’t expect them to compare to some actions he had to take as a doctor.

“I’ve never, ever made a vote, nor will I ever make a vote in U.S. Congress, as difficult as sitting by a patient’s bedside and telling them there is nothing more you can do,” he said.