Being a doctor is easier than being a member of Congress.
At least, that’s what Rep. Brad Wenstrup has found—first as a physician working as an Army combat surgeon during the Iraq War, and later at home, as a podiatrist.
“It’s a lot more difficult now to fix things,” said Wenstrup, now a Republican congressman who represents Ohio.
From trying to figure out a way to make health insurance accessible and affordable for his constituents to convincing colleagues about the potential unintended impacts of their legislation, finding a fix is just more complex.
Wenstrup is one 14 members of Congress uniquely positioned to weigh in on top healthcare issues: They're doctors.
“You have people making healthcare decisions who have never seen a patient,” Wenstrup said in an interview with FierceHealthcare.
It seems especially pertinent at a time when voters indicated in a June poll (PDF) by NBC News and The Wall Street Journal that healthcare is the number one issue that will decide their vote for Congress in the November elections.
Their stance on the ACA
Twelve of the physicians serving in the 115th U.S. Congress are Republicans and two—both representing districts in California—are members of the Democratic party. All of them are male.
And just as the fate of the Affordable Care Act has divided members of Congress mostly along party lines, whether to repeal and replace so-called Obamacare also split the doctors along party lines.
Republicans, including the Republican doctors in Congress, have pushed for the demise of the ACA even as many physician groups, including the American Medical Association, opposed efforts to repeal the law. Those groups have said repeal would result in millions of Americans losing their health insurance coverage, destabilize health insurance markets and decrease access to affordable coverage and care.
“It depends if you are buying into the hype,” Wenstrup said, adding there are already 24 million uninsured Americans. Those getting insurance through the ACA exchanges would have free market options if they choose to get insurance, he said.
Rep. Phil Roe, R-Tenn., who was an OB/GYN for 31 years, said the Congressional Budget Office projection that 22 million people would lose insurance coverage if a Republican plan to repeal the ACA was passed was unintentionally misleading.
The projection didn’t take into account that people who wanted insurance could turn to the private insurance markets, he said in an interview with FierceHealthcare. Meanwhile, the ACA was supposed to cut costs and give people quality insurance, Roe said. “The ACA did not deliver on that promise.”
In Republican Rep. Ralph Abraham's district in Louisiana, many people have opted to take a penalty rather than buy insurance on the ACA exchanges, he said. For doctors, it is frustrating to hear about high deductibles and high premiums and to find they can't refer a patient to a specialist because that doctor is not in-network. He knows. The 63-year-old family practitioner still works pro bono in a small, rural clinic seven or eight miles from his home several times a month.
"We can say they have insurance, but do they really?” Abraham said.
The doctors who are Democrats have not yet responded to requests for comment.
Bringing a doctor's perspective to Congress
As a physician, Abraham feels doctors' frustration over issues such as the time drain from the use of electronic health records and insurance company denials.
"Let us decide what the patient needs," he said.
The GOP Doctors Caucus allows the healthcare professionals serving in Congress to meet with Centers for Medicare & Medicaid Services and Health and Human Services officials and provide their perspective. "They've been listening, I hope," he said, about the government's efforts to reduce regulatory requirements and unnecessary paperwork to give doctors more time with patients.
Doctors who have run their own practice bring their experience as business people to the table, Roe said. “They also have an incredible insight into how complex the healthcare system is,” he adds.
Roe said Congress could use more doctors within its ranks.
“The one thing I would tell you, despite all the talk about the swamp and the acrimony in Washington, I get up every day in the capitol of the freest, greatest country in the world. That’s not a bad job."