Physicians: Your Political Advocacy Could Save Lives
If ever there was a time to re-up the call for political advocacy from physicians, that time is now.
Five years ago, during the first few months of the worst of the COVID-19 pandemic, I wrote a piece in The Guardian about why doctors needed to become political activists. At the time it was about the first Trump administration’s mishandling of the pandemic with lack of testing and the deaths that were happening unnecessarily. More unnecessary deaths occurred throughout 2020 and far beyond from disinformation about the safety and efficacy of the COVID-19 vaccines.
That disinformation has bled into the wider vaccination debate, and RFK, Jr, an avowed anti-vaxxer, is now our Secretary of Health and Human Services. And just last week the Republican Congress passed, and Donald Trump signed, a monstrous bill that will take away healthcare from 14-17 million Americans and result in the closure of hundreds of mostly rural hospitals.
If ever there was a time to re-up the call for political advocacy from physicians, that time is now.
As a result of Trump retaking the White House and Republicans retaking the majority in the US Senate and maintaining a slim majority in the US House, the budget reconciliation bill passed, enacting the greatest transfer of wealth from poor Americans seeking affordable healthcare to millionaires and billionaires in the form of permanent tax cuts.
The results of elections matter, because Republican senators voted 50-50 (with a JD Vance tiebreaker) to send their version of the bill back to the House last week. A used car salesman, Bernie Moreno, beat Democrat and champion of working people Sherrod Brown in Ohio by less than 5%, and neighboring incumbent Bob Casey of Pennsylvania lost to multi-millionaire carpetbagger Dave McCormick by only 15,000 votes. Moreno and McCormick were among the 50 YEA votes that secured passage in the Senate. Had just one of these incumbent Democrats won, the bill would have been DOA.
Most doctors are patient advocates on a patient-by-patient basis when seeking affordable prescription drugs or coverage of a test or a treatment plan from Big insurance. All of us were trained in residencies funded by the public through Medicare. Most of us seek a healthcare system that is just and affordable for our patients and our neighbors.
But a just system is not the default. Corporate interests and greed dominate the political landscape when it comes to decisions about the funding of our system. And this is not just a MAGA phenomenon. In fact, the MAGA movement at its base has largely been anti-corporate and anti-status quo. With the passage of the Republican Budget Reconciliation bill, it is clear that standard-fare Republican orthodoxy – disdain for social programs and the social safety-net, a zeal for tax cuts for the wealthiest Americans -- has co-opted MAGA. Trump ran a campaign talking about lowering costs for everyday Americans, and he signed a bill that will lower taxes for his billionaire buddies and raise costs for everyone else.
As doctors, we will have a front row seat to the devastating effects of this disgusting bill, much like we had front row seats to the suffering of the mismanagement of the early days of the COVID-19 pandemic, and the later disinformation about the COVID-19 vaccines. In the rural community where I work, it was clear that people were getting their medical information from right-wing news sites like Fox News, making our jobs much harder and costing them their lives.
And again, many Trump supporters are getting misinformation about the devastating Medicaid cuts signed into law from Trump. And Fox News is again at the forefront of spreading the mis/disinformation. The right-wing spin machine is distracting people by focusing on the totally made-up “20- to 30-something men playing video games in their parent’s basement and collecting Medicaid checks.”
Medicaid does not work that way. Medicaid is insurance, and when someone needs to see a doctor or have a medical test or procedure, Medicaid pays that bill. Well-paid right-wing podcasters and Fox anchors may not know how Medicaid really works in the real world, but they shouldn’t. propagate the myth of the basement gamer to serve their true purpose: giving Trump and Republicans cover for ripping away healthcare from poor people to pay off their billionaire donors and buddies for financing their campaigns and sometimes salary-defying lavish lifestyles.The fact is, nearly 93% of those covered by Medicaid are working, disabled, in school, or caring for others. Even if the remaining 7% were taken off the program, the savings cannot come close to the $1 trillion in cuts to the program that Congress passed and Trump signed into law.
In fact, the much touted “work requirements” are nothing but a morass of red tape and administrative burden that actually increases the number of uninsured without putting people to work. When implemented in Arkansas in 2018-2019, 18,000 Arkansans lost insurance and employment did not increase. In Georgia, work requirements turned out to waste taxpayer dollars, costing nearly seven times more than in states that did not require recipients to jump through bureaucratic barriers for their health care.
As this moment presents itself and Republicans in Congress have violated their oath in voting to cut Medicaid and harm our patients, the time has come for us to uphold the oath we took as physicians, which in a translated excerpt goes as follows: "I will use treatment to help the sick according to my ability and judgment, but never with a view to injury or wrongdoing. I will keep them from harm and injustice... Whatever I see or hear in the lives of my patients... I will keep secret, as considering all such things to be private."
If we truly mean to “keep (our patients) from harm and injustice” what choice do we have other than to hold accountable those who would do, have done, them harm. Clearly, Trump and Republicans in Congress are threatening grave harm to millions of Americans. These are the people to whom we have sworn our oath. The Republican elected officials who voted for this monstrosity have forsaken their oaths. We cannot do the same.