Leadership Days
I have just participated in what is likely my 25th annual attendance in the American College of Physicians (ACP) Leadership Days in Washington, D.C. One day of meetings exploring the medical issues of the day, with speakers from Congress, was followed by a day of lobbying on the Hill to promote bills of importance to internists on behalf of their patients.
Leadership Days provide an opportunity to meet with internists from around the country. The face to face meetings provide an important opportunity to learn about local health issues, and to socialize with friends. I have always looked forward to seeing my fellow politically active colleagues, and learning their insights on the current state of affairs.
Lobbying serves a number of purposes. It allows ACP to “show the flag” and advocate for passage of laws to maintain primary care fiscal solvency and further the maintenance of needed vaccines in this country. It also is a wonderful teaching experience for the younger physicians. It hones their skills in public speaking, and acquaints them with the workings of our government. Congresspeople and their legislative aides are especially attentive to the students and residents in training. They are the future of medicine, and their concerns shape what internal medicine can be over the next generations. Their involvement in lobbying can also spark a further interest in becoming more active with the ACP. We need the infusion of young people into our organization to maintain vitality and to learn about issues of importance to the new generation of physicians.
I cannot help but despair, however, of what we can accomplish during this second annus horribilis in health care. The last two years have seen the worst assault on our profession since I became a physician 45 years ago. There are, of course, problems with our do nothing Congress, and their complicity with the harms that medicine and science have had to go through in the past year. To its credit, Congress has restored funding to agencies such as the NIH in its budget. But it also has passed the horrendous One Big Beautiful Bill Act (the Orwellian name still grates on me), which will result in millions of Americans losing health insurance through the Affordable Care Act (ACA) and Medicaid.
Absent a change in the composition of Congress, there is very little we can do about the demolition of so many components of our health care system.
It is not so much Congress, but the executive branch that is the leader in this destruction. We still have anti-scientific cranks leading that branch. The ACP, along with other major health organizations, have worked valiantly to prevent destructive changes to our immunization schedules, achieving recent victories in court to put a hold on the composition of the ACIP and their anti-scientific decisions.
MAHA, the right wing manifestation of the back to nature and anti-establishment left wing movements started in the 1960s and 1970s, is still a leading voice in current government health policy. What distinguishes it from past “back to nature” movements is in its religiosity and its exhortation to eat meat. The New York Times reported on a Carnivore convention where one attendee wore a T-shirt saying “Eat Meat, Love Jesus, Be Happy”.
It is beyond irritating to have to discuss the importance of pasteurization, vaccination, and the importance of fluoride in our drinking water, which have been established science over the past one hundred years or so. One has to discuss the great success in Covid science in hushed tones, lest we arouse contempt. mRNA vaccine funding has been cut, slowing what has been a major scientific breakthrough for years.
Despite my despair, we must soldier on and do what we can to reverse these trends to bring us back to the 19th century. William F. Buckley, a right wing ideologue with whom I agreed with very little, once said that we must stand athwart history and yell stop! We must do the same with MAGA and MAHA.