As long as the current leadership remains in control and determined to repeal the Affordable Care Act in all respects, access to healthcare for millions of Americans will remain in jeopardy.
Run-of-the-mill politicians can trot out whatever cruel partisan ideology they imagine justifies sacrificing the health of so many people on the altar of corporate profits. But what about the doctors in Congress? As healthcare professionals, do they have a different and special duty?
Virtually all state medical license boards require physicians to adhere to ethical standards of the profession. The physician licensing regulations of many if not most states incorporate by reference the ethical principles established by the American Medical Association. When it comes to access to health care, the core AMA ethics principles are crystal clear:
IX. A physician shall support access to medical care for all people.
“Shall” is strong language. It reflects the AMA’s deliberate assessment that access is critically important to the public health and welfare of our nation. “Shall” means that supporting access to medical care for all people is neither optional nor a matter of circumstantial convenience or expediency. When you are sick, need help, and can’t get it, that is a national disgrace. How can Americans feel proud to live in a country with great health care resources when the doors to the clinic or hospital or pharmacy are shut to so many of us?
So when physicians who serve in Congress acted to deprive over twenty million people of health insurance by voting to repeal the Affordable Care Act without replacing it, how should those votes be judged?
This question hits close to home because my incumbent TN-01 Congressman, Phil Roe, is a physician who also co-chairs the sixteen-member GOP Doctor’s Caucus. He votes automatically with the Trump administration (about 96% of the time) and in 2017 he voted with enthusiasm to repeal the Affordable Care Act.
Roe, whose current candidacy for a sixth term also betrays a long-standing promise to limit himself to five terms, now faces an unprecedented challenge in a Democratic contender who, like Roe, is also a physician. Marty Olsen, M.D., Roe’s confirmed opponent in this unique “Doctor vs Doctor” mid-term, has said that he entered the race because he knew that by voting on the wrong side of this key issue Roe was betraying his constituents, betraying his former patients, and betraying his profession.
Congressmen are not totally immune from ethical review and discipline by state licensing boards. For example, having sexual relationships with patients can get even a Congressman in trouble, as shown by this case of an errant Tennessee physician-congressman whom, to my knowledge, Roe has welcomed onto the Doctor’s Caucus and never criticized.
But, a line is drawn when it comes to immunity for legislative actions. So Roe and his fellow Doctors Caucus members get an automatic pass on any professional ethics inquiry into their voting record even when — contrary to basic ethical principles of their profession — they act to undermine access to medical care.
The good news is that legislative actions are not immune to review by voters. When elected representatives betray their constituents, they can be held accountable in the ballot box.
The bad news is that Tennessee sadly ranks dead last in voter turnout among the states. Apathy, not accomplishment, is how guys like Phil Roe can break promises and represent the people’s real interests so badly and still expect to be re-elected.
So, if you are an East Tennessee voter, or if you know one that you can help get to the polls this November, it’s time to do something. Speak to your friends and neighbors. Post links on Facebook. Put signs in your yards. Donate or volunteer if you can. And then, damn it, when November comes, get up and go vote and take a buddy or a new acquaintance with you. Our country, our community, and our health depend on it.