NEW ORLEANS — Physicians should consider becoming more involved in politics to help steer the critically necessary changes, political power couple Mary Matalin and James Carville said here at the American Academy of Physical Medicine and Rehabilitation (AAPMR) 2016 Annual Assembly.
The morning after the final presidential debate, and just 19 days before the election, the long-married, high-profile duo enjoyed a rare moment of consensus in an auditorium packed with more than 3000 spectators. They agree that ongoing political turmoil in Washington is "sinking the ship" and affecting the ability to make improvements to the healthcare system.
But they do not agree that physicians carry the skill set to be successful in the highly contentious field.
"Being a doctor and wearing a white coat, people trust the profession," said Carville, a Democratic commentator and lead strategist for Bill Clinton's presidential campaign. "In politics, everything is an argument."
Matalin, a former Republican who changed her party affiliation to Libertarian in May, countered that physicians, and physiatrists in particular, might be well-suited to the field of politics because of their ability to unite people toward a common goal. The 17 physicians currently serving in Congress are a small but increasingly powerful group, she pointed out.
"Your discipline, your success, is based on consensus and persuasion," said Matalin, who appeared with her husband on CNN for more than a decade, was President George H. W. Bush's campaign director, and was an assistant to President George W. Bush. "That's what it takes to bring people together."
During their spirited plenary session appearance, rife with their trademark verbal jabs and good-natured sparring, Matalin and Carville also tacitly agreed that Hillary Clinton will likely win the upcoming election. Predictably, however, the New Orleans–based couple had different perspectives on what that potential outcome would mean for efforts to overhaul healthcare.
Donald Trump "isn't the disease, he's the symptom" of the Republican Party's precipitous decline, said Matalin.
Healthcare expenditures account for an astounding 18% of the gross domestic product in the United States, she reported. But technologies such as telemedicine, electronic health records, and big data analysis can be used to "infuse efficiencies and cut costs."
"Obamacare isn't the answer, but we can fix it," she added. Clinton "has stalled what needs and has to happen. We're in a knowledge economy. Everything is changing. And the most laborious change is in government: It's antiquated and resistant to change."
Healthcare Costs 18% of GDP
In his thick Louisiana drawl, Carville contended that the only alternative to the Affordable Care Act (ACA) is to "kick 12 million people out of insurance" coverage. He acknowledged that he does not like the ACA philosophy of mandating health insurance for those who otherwise would not purchase it, but said, "there's a lot of truth to the idea that you can't unring a bell."
"As a society, we make a choice. If we want people to have healthcare, that's how we do it," added Carville, who teaches politics at Tulane University in New Orleans.
Matalin said younger physicians moving through the ranks should take charge and make the healthcare changes that the government, in its current state of turmoil, seems incapable of achieving.
"What can change it is the infusion of the next generation and their organizing principles," she said. "The principles in your discipline are outcomes-based. But politicians aren't outcomes-based. The outcomes-based modus operandi in your field, and in all other sectors, is ultimately what's going to impact this from the ground up."
Then she took a dig at both Clinton and Trump. "The way voters are trying to impact this," she explained, "is not by electing leaders, it's by unelecting failures."
The couple's lively discourse "about the dramatically changing and unstable political landscape" affecting healthcare was valuable, said Jonathan Finnoff, DO, medical director of the Mayo Clinic Sports Medicine Center in Minneapolis, Minnesota.
Dr Finnoff said he agrees that physicians should increase their participation in politics, whether as elected officials or in government agencies.
Matalin and Carville "reaffirmed what we're seeing on a regular basis now in the TV debates and political commentary. It's hard for either party to be successful," he told Medscape Medical News. "And I thought it was interesting when they said that right now we're not voting in the best candidate, we're voting against the worst candidate. It's a sad commentary."
Matalin's shout-out to Millennials was appreciated by Erin Andrade, MD, a physiatrist at the Wenatchee Valley Hospital and Clinics in Washington, who recently finished her residency training.
"It was great that they recognize the potential Millennials have to make positive changes," Dr Andrade told Medscape Medical News. "It can be true that we're idealistic, so it's very important that we work with mentors and peers with more experience to develop plans we can make happen."
"It's impossible to predict the future of healthcare, but we need to be willing to promote our importance in it," she added. Physiatrists "really have a huge role in providing quality care and improving patients' function."
Dr Finnoff reports receiving royalties from Demos Medical Publishing and speaking honoraria from a variety of universities and healthcare institutions. Dr Andrade has disclosed no relevant financial relationships.
American Academy of Physical Medicine and Rehabilitation (AAPMR) 2016 Annual Assembly. Presented October 20, 2016.
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Cite this: Political Pundits Dish on Healthcare Weeks Before Election - Medscape - Oct 21, 2016.
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