Doctors and Politics

The field of medicine is being reshaped by politics like never before.  Doctors, for the most part, have been caught flat-footed as laws like the American Recovery and Reinvestment Act of 2009, Patient Protection and Affordable Care Act and  Health Care and Education Reconciliation Act of 2010 were enacted.  Many  provisions of these bills, written in large part by special interests and lawyers, weave through aspects of US Social Security and tax codes so complex that even a US Supreme Court justice joked that the task of having to review the complex bill violated the Eighth Amendment’s ban on cruel and unusual punishment.  It has become increasingly clear that if politics is in medicine, then doctors had better be in politics.

But what does it take for a doctor to enter politics?  Would you ever consider it, given the drastic changes that are underway in medicine?

It’s an interesting question to ponder.  So it’s not every day a candidate for a State Senate seat in Illinois comes from your neighborhood, so I was fortunate to have the opportunity to pose these questions to Illinois state Senate candidate, Dr. Arie Friedman. 

By way of background, Dr. Friedman is a general-practice pediatrician in the Northern suburbs of Chicago and holds a faculty teaching appointment with Northwestern Medical School.  He is married, has five kids and, like me, is a former Navy veteran (so he can’t be all bad).

What prompted you, a physician, to enter politics?

First of all, Wes, thank you for this opportunity. I am a huge fan of yours. Your writing captures the practice of medicine in a way that even a simple country pediatrician like myself can identify with. I have also been influenced in a big way by your frustrations and concerns about health care reform. That’s really the reason why I jumped at the chance when you suggested this interview.

In regards to your question, I initially became interested in politics because I was very concerned about what was happening with health care. This was back in 2009 and what I knew about health care reform worried me. At that time, I decided - very much on the spur of the moment - to run for U.S. Congress. Although I lost that primary, I made some great political connections and that experience has formed the foundation of my current campaign for the Illinois State Senate. Illinois faces a fiscal crisis of unprecedented scale. If we don’t fix the State’s fiscal situation, all Illinoisans will be hurt in ways we can’t even begin to foresee.

What did you actually have to do to become a political candidate in Illinois? Why a Senate seat as opposed to a one as State Representative?  Where does the money come from for such an effort?

The process of becoming a candidate has a number of technical steps. The most critical is the petition process of actually getting your name on the ballot. In Illinois, a prospective candidate for the State Senate must submit between 1000 and 3000 valid signatures to the Illinois Board of Elections. That seems like a lot of signatures until you start gathering them at which point you realize that it is a really really lot of signatures! We were actually one of only two GOP campaigns to submit a full 3000 signatures.

After getting your name on the ballot, the campaign comes down to voter contact, name recognition and getting your message out there. The money for this effort comes from from contributions. The amount of time a candidate has to put into raising money from friends, family, and complete strangers is extraordinary. Getting over the reluctance I had in asking people for money was one of the most difficult hurdles I’ve faced. Now, I’m pretty open about it. If you want things to change, you have to contribute to political campaigns. Without contributions, a political campaign is dead in the water.

What kind of time commitment is there for you to do this?  How do you manage family, a practice, and this effort? 

Running for office is second full-time job. The only way anyone can manage this process is if they have a very supportive family. My wife is a full partner in this project. It’s a sacrifice for me to be this busy, but Michelle and I believe what we are doing is very important. On the professional side, my partners have picked up the slack and will be doing more of that as November comes closer.

I chose this particular State Senate seat because I thought it was the best opportunity to have a voice in Springfield. The 29th has been redistricted in a way that makes it very attractive for a candidate like me. In the end, you can only vote on legislation if you are able to win an election.

What words of advice would you give to a doctor who might want to consider entering politics?

Give me a call! Seriously, I’ve learned a huge amount about the mechanics of running for office and would be happy to discuss them. Also, get involved in your local party organization. Contact your county and township party chairmen. These individuals are usually old political hands and are very eager to welcome newcomers. In my case, my county and township chairmen have become mentors, strong supporters and good friends.

Why are doctors important for politics anyway?

Health care is a huge part of what government does. Here in Illinois, we spend about half of our entire general budget on health care. Despite that, if I’m elected I will literally be the first physician in history elected to the Illinois General Assembly. If physicians care about the future of health care we simply have to begin earning seats on the legislative side of the table. Regardless of party, I believe physician have a very special insight into the needs of our patients and the role of government in health care.

Any ideas as to how you might start to fix the Illinois Medicaid funding crisis?

The current crisis in Illinois Medicaid cannot be exaggerated. Over a relatively brief period of 10 years, the size of Medicaid has doubled. The current yearly cost of Medicaid is approximately $14 billion out of a general state budget of $33 billion. One way to get the cost of Medicaid under control would be to reduce the number of people enrolled. 10 years ago, the number of Illinois Medicaid recipients was approximately 1.4 million. Now, it’s 2.7 million. Unfortunately, the federal health care law prohibits significant reductions in our Medicaid rolls. That leaves us with the sort of unsavory reductions in services and reimbursement rates that we saw this year as the only other budgetary solution. Ultimately, the rolls will have to be reduced one way or another due to the unsustainability of the current system. Remember, things that can’t continue won’t.

One last comment. If we were able to get Illinois’s economy turned around with a pro-growth and pro-jobs agenda, we would improve the situation  a lot. That’s because we would then have more taxpayers and more revenue to go around. For that reason and many others, I’m a big advocate of pro-growth policies.

What are your thoughts on tort reform in Illinois, especially given the current political climate?

Remember, Illinois has passed major tort reform legislation three separate times on a bipartisan basis. The only reason these laws are not in effect is that they were overturned by the Illinois Supreme Court. I think there’s a developing consensus in Springfield that tort reform should move forward and that it should focus on ideas such as expert witness panels, medical courts, and loser-pays rules. Further, I have been amazed at how many non-medical professionals and business owners are supportive of these changes being applied broadly to Illinois’s judicial system. However, the trial lawyers are powerful opponents. They have already contributed significantly to my opponent and I’m sure they will spare no expense to avoid having a physician in the State Senate.

How can doctors who don’t want to become candidates themselves still help those who do?

Contribute money, volunteer for a campaign and get your friends involved. The American electoral system rewards those who show up. Pick a candidate who stands for what you believe in and do everything you can to help. Doctors have a reputation being politically apathetic. Honestly, it’s somewhat deserved. It is an uncommon physician who contributes regularly to candidates and assists with campaigns. Those who do are highly regarded as advisers and trusted volunteers. Don’t underestimate how much our fellow citizens - elected office holders and candidates included - trust and look up to us. If you want to have a very rewarding experience, contribute to and get involved with a political campaign.

Thanks for taking a bit of your precious time, any last thoughts you’d like to share?

I want to reemphasize the importance of getting involved. Three years ago, I was just another spectator throwing pillows at the TV set. Once I made the decision to get involved, I found that I could really have an impact. Regardless of your profession, if you are concerned about the political situation you simply must take it upon yourself to contribute to the dialogue in some way. Whether it be through donating money, volunteering your time or actually running for office, it is your personal responsibility to make your voice heard. Otherwise, it won’t be - it’s as simple as that.

You can read more about Dr. Friedman’s political efforts at his website: http://www.friedmanforsenate.com/

-Wes