Rebecca Quigg, MD, is a cardiologist and former director of the Heart Failure and Cardiac Transplant Program at Northwestern University in Chicago. She ran unsuccessfully for the chance to replace Tom Price, MD, in Georgia's 6th Congressional District. This is the first in a two-part series in which she describes what motivated her to run and what she learned in the process.
Throughout my 25 years of practicing medicine, like many physicians, I observed the progressive refusal of insurers to provide coverage for needed medical care. By the early 2000's private insurers refused to sell individual policies to those who had any pre-existing condition whatsoever. Prescription drug prices were skyrocketing. If you didn't have employer-based insurance, you were out of luck.
As a heart failure and cardiac transplant cardiologist, many of my patients who were without insurance were required to raise funds to be listed for transplant. Even those who had coverage, in many instances, were denied by their insurer because they had reached their lifetime limit of $1 million. This was especially heart breaking for young adults with congenital heart disease. Despite fund-raising, the exorbitant cost of life-long immunosuppressant therapy was a major impediment to long-term survival for those who lacked coverage. It appeared that we had become a country with several tiers of medical care -- good, inadequate, and none. That's what I called rationing.
When I left clinical practice to raise my two sons as a single mother and pursue a consulting practice, I was shocked to find that I was uninsurable because of a car accident 20 years before -- considered a pre-existing condition. My son's insurer would not cover his needed speech therapy. As a physician, mother, and patient, I knew that something had to change. In 2009, President Obama's signature healthcare reform plan, the Affordable Care Act (ACA), was under revision by Congress in efforts to provide coverage to over 44 million uninsured Americans. I followed this law through passage and implementation with my full support.
The ACA was passed in March 2010 so that all Americans could access quality affordable healthcare, whether or not they had pre-existing conditions. The law was designed to prevent and treat diseases in their early stages to decrease morbidity and mortality while reducing medical costs and uncompensated care. All policies were required to cover annual preventive care including mammograms 100% pre-deductible (the incidence of invasive breast cancer decreased over the first 4 years of the ACA), and 10 essential health benefits including maternity and neonatal, mental health and rehabilitation filled holes in many terribly inadequate health insurance policies. Substance abuse treatment was covered 100% helping millions who were desperate for treatment. Medicaid was expanded to cover those with incomes up to 138% of poverty level, now implemented in 33 states and DC. Annual and lifetime limits were eliminated and over 4 million young adults under age 26 were covered on their parent's plans.
In 2013 I volunteered with "Get Covered America" to educate the public and enroll hundreds of patients for the new marketplace plans for 2014. I was finally able to purchase a quality healthcare plan myself, and I offered education programs to physicians about the benefits of the law. Having been politically active all of my life, I supported state and federal candidates who were advocates of the ACA and wanted to expand and improve the law.
The ACA now covers over 30 million Americans. Despite this success, over the past 6 years Congress has refused to amend and improve the law and instead has made over 50 attempts to repeal some or all of the ACA. Tom Price, an orthopedic surgeon and my U.S. House representative from Georgia, spearheaded these efforts. When Donald Trump was elected in 2016, it was clear that the ACA was on the chopping block. To my further dismay, Trump quickly nominated Price for Secretary of Health and Human Services.
In January 2017 I organized the first protest in Atlanta against Price's nomination where I spoke to the crowd about the benefits of the ACA and what Price would do as HHS Secretary to dismantle and repeal the law leaving millions uninsured. Patients would suffer and the huge financial burden of uncompensated medical care would again fall on the shoulders of healthcare providers, especially nonprofit rural hospitals that were already closing in record numbers in states like Georgia who refused to expand Medicaid.
I researched why physicians in Congress had made little objection to the seemingly endless repeal efforts. To my surprise, there were only eleven physicians in the House: nine Republicans and two Democrats and three Republican physicians in the Senate, with the majority having voted for ACA repeal along party lines. Given the fact that healthcare is one of the most important issues before our country, it was unclear why there were so few physicians in Congress to represent the current crucial perspective on this matter.
When over 63,000 participated in the Women's March in Atlanta, I knew that Georgia was on a progressive pathway. This year would be the year of the woman and that women would ultimately run for state, federal, and local office in record numbers. Once it was clear that Price would be confirmed at HHS, I decided to run for his seat. My message: "We Need a Doctor in the House who Cares About Patients and the Health of our Country." Over 43,000 constituents of the Georgia 6th District depended upon ACA plans and thousands of others with employer-based insurance were unaware of the benefits they received under the ACA. My goal was to explain the real facts of this misunderstood law and take that message to Congress.
The special election in Georgia was unusual -- a "jungle primary" where 18 candidates, including five Democrats (including myself), 11 Republicans, and two independents ran for the seat. If no candidate received more than 50% of the vote the top two candidates would proceed to a runoff. Unlike most primaries, the campaign lasted only four months. I took a stand on the other issues pertinent to the campaign: Medicare and Social Security, public education, strengthening the Environmental Protection Agency, women's rights and the lack of a rapid transportation system in the Atlanta. Candidates were invited to speak almost daily at events, for newspaper and radio interviews, and several debates. My message was unique as a physician with healthcare reform expertise and was well received. The four month campaign was exhilarating and exhausting – somewhat similar to my internship with little sleep! Yet it was one of the most exciting experiences of my life.
In Part 2, appearing later this week, Quigg reviews the campaign and its outcome, as well as the lessons for other physicians considering a run for office.