What Impact Will Dr. Benjamin Have on Health Care?

Today, President Obama nominated Dr. Regina Benjamin to be Surgeon General.  A lot of time is going to be spent figuring out how she figures into the health care reform debate.  The blunt answer is she won’t have a lot to do with whether we get a bill passed or whether the bill is as strong as we can possibly make it.

And actually, her potential contribution to the quality of care is this country could be far greater than that.

Clearly the White House wanted to kick start a renewed focus on health care by the President by putting such an impressive woman forward.  Since so much of her life has been consumed with providing care for the uninsured and underinsured, regardless of ability to pay, she’s a stand-in for the “can do” spirit that was so absent from the last week of Congressional hand-wringing.  Obama made this blatant in his remarks, saying she represents  “doctors and nurses who give and care and sacrifice for the sake of their patients; those Americans who would do anything to heal a fellow citizen.”  Just being on the stage, she brings a number of issues to the forefront – care for the uninsured, the importance of primary care and prevention (she’s certified in family medicine), the disparity of care for rural communities like her own Bayou La Batre, and, yes, a physician workforce that doesn’t yet look like America – according to the American Medical Student Association, “Racial and ethnic minorities comprise 26% of the total population of the United States, yet only roughly 6% of practicing physicians are Latino, African American and Native American.”  Becoming the first African American woman to be President of the state medical society of Alabama is an impressive achievement in and of itself.

But this is a health care reform headline for a day – an opportunity for Obama to reassert that there is a plan, there is a schedule, and we’re going to get this done.  I’d expect Dr. Benjamin to talk a lot on TV about health care reform, make some nice speeches, and have zero impact on the final shape of the bills moving through the House and the Senate.

But there’s a life to health care reform even after a bill gets passed.  If we manage to get a robust bill passed with significant insurance regulation, limits on out-of-pocket cost, the definition of a standard benefits package throughout the country, and a “college try” expansion of coverage, that would be a historical accomplishment.  But the work of making us healthier and making our health care cost less through a better delivery system only starts there.

If Dr. Benjamin is confirmed as surgeon general, she’ll be able to talk about primary care and prevention from a personal experience that a neurosurgeon from CNN couldn’t match.  As Dr. Benjamin proved today, these issues aren’t just a good idea academically – fighting chronic disease is quite literally in her DNA:

Public health issues are very personal to me.  My father died with diabetes and hypertension.  My older brother, and only sibling, died at age 44 of HIV-related illness. My mother died of lung cancer, because as a young girl, she wanted to smoke just like her twin brother could.  My Uncle Buddy, my mother's twin, who's one of the few surviving black World War II prisoners of war, is at home right now, on oxygen, struggling for each breath because of the years of smoking.

The health of our nation will only improve if we can recruit and train even more primary care physicians than we have now – something that Dr. Benjamin, as a beneficiary of the National Health Service Corp, a chronically underfunded federal program that pays for medical student education in exchange for years of service in an underserved area, knows first hand.  It will require non-hospital ways of distributing that care, especially in rural areas – something that Dr. Benjamin, as the founder of the Bayou La Batre Rural Health Clinic in Alabama.  And it will require a real voice for patients in our health care system.  As health care blogger Duncan Cross knows all too well, health care too often becomes about everybody but the patient.  So it’s hopeful – at least – to hear the President describe her self-professed mission statement as:  “The one thing I want to do is make sure that this Surgeon General's Office gives voice to patients, that patients have a seat at the table; somebody is advocating for them and speaking for them.”

They may just be well-intentioned words.  But if she’s confirmed and if she turns them into deeds, Dr. Benjamin could have an even more dramatic effect on our health care system than any member of the Senate Finance Committee.

(Photo credit:  hot_tea on Flickr.)