Last weekend I attended the National Family Planning Forum in Washington DC. It is a meeting of reproductive health professionals, both clinicians and researchers. In the midst of all the talks and posters about the cutting edge research were a number of talks about policy. As you may or may not be aware, 2011 was a landmark year for legislation on reproductive health. On the positive side, HHS added contraception to the list of preventive services which must be covered one hundred percent by insurance plans. I have no doubt that as health plans adopt this regulation women and men will ask why this didn’t go into place sooner. On the other hand, this year has been an incredibly active one regarding access to abortion. Among the bills passed around the country this year are: mandatory ultrasound, waiting periods, bans on insurance coverage and health center regulations.
Because there is so much legislative activity recently, a renewed focus has been placed on educating and activating reproductive health physicians to be politically active. But, it is easy to feel small and ineffectual in a huge system. How can one doctor make a difference? I heard two stories this weekend about how a single conversation between politician and a physician changed the course of health care policy.
The first is a story of about President George H.W. Bush and his physician. President Reagan approved a regulation that banned health care providers who received federal funding from discussing abortion as an option with patients. This regulation was to be implemented under President Bush. The story is that President Bush’s physician opposed this regulation and spoke with the president about it. While this regulation wasn’t overturned under President Bush, it also wasn’t enforced and was eventually overturned by President Clinton. This single conversation may have prevented a gag rule from being implemented in the U.S.
The second story is about a conversation Dr. Warren Hern had with a candidate for Colorado governor. The candidate had as attorney general participated in prosecuting cases regarding abortion restrictions regarding minors. Dr. Hern believed the prosecution in these cases had been unfair. Dr. Hern met with the candidate and afterward put out a statement that, “While the candidate is a nice man, I do not believe he supports choice.” There was public outcry but despite this, the candidate was elected. However, the governor admitted a change of heart regarding these cases involving minors and another was not prosecuted during his time in office.
While I will be the first to admit that there may be a bit of urban legend to these stories, I still felt emboldened by these stories and even more motivated to talk with and establish relationships with the politicians in my area. We physicians really do have a unique voice and power, we need to use them more. It makes a difference.