Medical Tuesday Blog
A Review of Local and Regional Medical Journals
Rita Rubin, MA | JAMA | March 27, 2019
JAMA. 2019;321(15):1443-1445. doi:10.1001/jama.2019.1704
For more than 17 years, Kim Schrier, MD, held what she considered to be the perfect job: pediatrician. But after the 2016 general election, when Republicans began trying to dismantle the Affordable Care Act, Schrier felt another calling.
Although she had virtually no political experience, Schrier, a Democrat from Sammamish who practiced at a Virginia Mason Medical Center clinic, decided to run in the 2018 mid-term elections for Washington’s 8th Congressional District seat, long held by a Republican who eventually decided not to seek reelection. Schrier went on to win the Democratic nomination and defeat Republican Dino Rossi. . .
The 50-year-old Schrier, diagnosed with type 1 diabetes in her teens, is the first pediatrician and the second woman physician to serve in Congress. The first was Democrat Donna Christensen, MD, a nonvoting delegate from the Virgin Islands.
JAMA spoke with Schrier 1 month after she was sworn in. The following is an edited version of that conversation.
JAMA: You majored in astrophysics as an undergrad. Did you consider pursuing a career in that field instead of medicine?
Rep Schrier: I did consider pursuing a career in either astrophysics or physics. My dad was a physicist and worked on satellite systems, and I thought that was really interesting. Potentially, I could come out of an undergraduate education and go straight into the workforce. But I knew pretty quickly that I would not be as happy doing that as I would doing medicine.
JAMA: Did you know early on that you wanted to be a pediatrician?
Rep Schrier: I did not know. I knew that I wanted to work with people, that I wanted to apply science but with a very personal touch. I had a wonderful role model in my own pediatric endocrinologist, Fran Kaufman. She really was the perfect model for how you can take data and science and great interpersonal skills and have a very rewarding life. Her job seemed like the perfect job for me. I thought about endocrinology, but I went through medical school and found that pediatrics really was the best home for me.
JAMA: You’ve said pediatrics is the perfect job, so why did you decide to run for Congress?
Rep Schrier: Your question really points to how serious things have to be to take a pediatrician out of really a perfect job and go and launch into something completely new after establishing a very successful practice over 17 years. And really that thing was the 2016 election and its implications for the country that I know and love, for children, for families, and for people with preexisting conditions. And when I saw some of the changes happening under the new administration—threats to the Affordable Care Act and protections for people with preexisting conditions, environmental hazards, threats to nutrition programs and early childhood education—I just decided that maybe a better role for a person with type 1 diabetes who is also a pediatrician was to step up and represent the real needs of our district. . .
JAMA: You’ve said that as the only woman physician in Congress, you provide a critical voice. There are other physicians in Congress, including 2 Democratic men in the House. How might your perspective as a female physician differ from theirs?
Rep Schrier: I think we share some common goals of taking care of patients and wanting the best outcomes for our patients. We went into this helping profession because we wanted to take care of people, and I think that Raul Ruiz and Ami Bera are fantastic role models. [But] there was a time when there really weren’t women doctors. And I think it’s made a huge difference for women to have somebody who really firsthand understands they’re going to bat for women. I feel exactly the same way about Congress. If you really want a doctor who is going to put the interests of children and women at top of mind, it really helps to have a woman there. We know from the data that when women win, we talk about things like paid family leave and early childhood education and nutrition programs and what’s really best for the families in this country. It’s not that men don’t get it. It’s just that women get it on a different level. . .
JAMA: What are some of your biggest goals in Congress?
Rep Schrier: My list is long. My first is really to take on the role of special interests and big money in politics. And we have done that by introducing [House Resolution 1; “For the People Act of 2019”] that will essentially get corruption out of politics. It takes away the power of special interests and money, and it restores full voting rights. It’s going to be really hard to address prescription drug pricing when so many members of Congress and the Senate take money from the pharmaceutical industry. How can you really be an honest arbiter if you are being funded by Big Pharma? I would say the same thing about environmental policy and taking money from big oil and gas and coal. By giving our government back to the people where it really should be, we can then go pursue policies that really work for the people in this country and not for corporations exclusively.
I will then take on the cost of health care, making sure every family can afford the care they need, looking at insurance company profits, looking at the cost of prescription drugs and why we pay so much more in this country than in Canada. Why it is that EpiPens cost $600 here in the US and many of my patients have driven 3 hours north to Vancouver and filled their EpiPen prescriptions there for $50?
Next, of course, I want to be a great advocate for women’s reproductive rights and to really pursue education and environmental policies that show adequate respect for the next generation. We’ve got to take care of this planet.
Read the entire interview: https://jamanetwork.com/journals/jama/fullarticle/2729714
Editors Note: Because of the prestige of Physicians, the public frequently sees the physician as an expert even if she’s working or speaking outside of her expertise. Price controls never work. Pharmaceutical companies have to work round government restrictions and so they increase prices in response to governmental interference which will always seem exorbitant. Generic pharmaceuticals in America are quite reasonable at the discount houses for more than 400 basic meds at $4 a month, or for $10 for a 3-months’ supply. My diabetic and blood pressure pills cost me less than $50 a quarter. If I filled the proprietary medications that my specialist likes to prescribe, it would be more than $500 a quarter. Cost of health care can be controlled and is rather reasonable when the patient is in charge rather than the insurance company and the government.
The answer for cost containment is high deductible health insurance where the deductible portion is equal to the average cost of basic health care, defined as office calls, medications, laboratory, x-rays and electrocardiograms on a periodic basis, which are the items that are not considered insurable. These items may cost approximately $1000 a year which saves up to $10,000 a year of insurance costs in many cases for a family of four. There need not be any government involvement or controls since every patient will control her own costs since she is the one paying directly. Government involvement always increases costs.
VOM Is an Insider’s View of What Doctors are Thinking, Saying and Writing about
With more doctors in lawmaking and economically naïve, this also allows appropriate criticism which hopefully informs our professional colleagues.
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