As
part
of
MedPage
Today‘s
series
on
healthcare
clinicians
running
for
office,
Washington
Editor
Joyce
Frieden
spoke
with
Annie
Andrews,
MD,
a
pediatric
hospitalist
who
is
running
as
a
Democrat
for
a
U.S.
Senate
seat
in
South
Carolina.
The
interview,
which
was
conducted
via
phone
with
a
press
person
present,
has
been
edited
for
length
and
clarity.
As
a
pediatrician,
what
are
your
thoughts
on
President
Trump’s
executive
order
on
separating
the
measles,
mumps,
and
rubella
vaccine
into
three
vaccines?
We
know
that
the
changes
in
Trump’s
executive
order
championed
by
[HHS
Secretary]
Robert
F.
Kennedy
Jr.
had
nothing
to
do
with
an
evolution
of
the
science
or
evidence
when
it
comes
to
routine
childhood
immunizations.
What
they’re
doing
is
deeply
destructive,
injecting
distrust
and
disinformation
into
the
American
public
health
infrastructure
and
our
healthcare
system.
We
see
firsthand
the
ramifications
of
RFK
Jr.’s
disinformation
campaign
that
he
has
been
leading
for
decades,
where
we
had
a
measles
outbreak
here
in
Spartanburg,
South
Carolina,
with
nearly
1,000
documented
cases
of
the
measles.
I
have
seen
over
my
20-year
career,
slowly
but
surely,
rates
of
vaccine
refusal
and
vaccine
hesitancy
creep
up
and
up
and
up.
Parents
do
not
know
where
to
turn
for
evidence-based
recommendations
when
it
comes
to
protecting
their
young,
vulnerable
infants.
And
sadly,
right
now
we
cannot
trust
the
medical
recommendations
that
are
coming
from
the
highest
levels
of
our
federal
government.
So
I
encourage
parents
to
talk
to
their
own
healthcare
providers,
talk
to
their
pediatrician,
and
listen
to
what
the
American
Academy
of
Pediatrics
is
saying
about
routine
childhood
immunizations.
Because
if
we
continue
on
this
trajectory,
if
vaccine
refusal
rates
continue
to
rise,
we’re
going
to
see
a
resurgence
of
a
lot
of
diseases,
not
just
diseases
like
the
measles.
We’re
going
to
have
increased
cases
of
flu,
respiratory
syncytial
virus,
bacterial
meningitis,
pneumonia,
whooping
cough,
and
it’s
just
never
going
to
end.
And
that
is
one
of
the
reasons
I
feel
such
a
sense
of
urgency
about
winning
my
election,
so
we
can
put
a
stop
to
RFK’s
current
reign
at
HHS.
So
you
would
want
to
see
him
go?
Yes,
absolutely.
It
would
be
a
priority
of
mine.
And
along
with
removing
RFK
Jr.
we
certainly
need
to
fully
fund
the
CDC
and
the
NIH
and
return
the
scientists
to
their
positions
at
those
once
well-invested
medical
and
research
institutions,
so
that
we
continue
to
be
a
leader
in
medical
research
and
medical
technology
innovation.
Tell
us
about
your
background.
What
makes
you
qualified
to
work
on
healthcare
issues
if
you
are
elected
to
the
Senate?
No
one
is
better
prepared
to
fix
America’s
broken
healthcare
system
than
healthcare
providers
who’ve
worked
on
the
front
lines
of
the
broken
healthcare
system,
as
I
have
for
20
years.
I
decided
to
be
a
doctor
when
I
was
4
years
old.
It
was
always
my
goal
to
be
a
physician.
I
went
to
medical
school
at
the
University
of
Cincinnati
and
did
my
third-year
pediatrics
rotation
at
Cincinnati
Children’s,
and
I
really
fell
in
love
with
hospital-based
pediatrics
the
first
day
of
my
third-year
clerkship,
and
knew
that
that
was
going
to
be
the
place
for
me.
So
I
completed
my
residency
there.
Then
I
moved
down
to
Charleston,
South
Carolina,
where
I
did
an
academic
generalist
fellowship
at
the
Medical
University
of
South
Carolina,
practicing
clinically
as
a
pediatric
hospitalist
as
well
—
and
also
got
my
Master’s
degree
in
clinical
research
and
conducted
mostly
asthma-related
health
services
research.
And
I
practiced
as
a
pediatric
hospitalist
from
the
completion
of
my
fellowship
in
2011
to
the
end
of
my
congressional
race
in
2022
at
the
Medical
University
of
South
Carolina,
and
I
was
doing
a
combination
of
clinical
care,
research,
and
education.
I’m
board
certified
in
both
pediatric
and
pediatric
hospital
medicine.
What
healthcare
issues
are
you
hearing
about
from
your
constituents?
We
never
expanded
Medicaid,
so
we
have
a
high
rate
of
uninsured
and
underinsured
South
Carolinians.
We
have
a
lot
of
deep
racial
and
rural
health
inequities
across
the
state.
We
have
15
counties
without
an
ob/gyn,
and
because
of
the
impending
Medicaid
budget
cuts
we
have
rural
hospitals
that
are
on
the
chopping
block.
We
have
some
rural
health
clinics
that
have
already
closed,
both
in
the
Columbia
area
and
the
Greenville
area.
So
I’ve
been
crisscrossing
the
state,
talking
to
voters
in
every
corner
of
South
Carolina
for
over
a
year
now,
and
one
of
the
issues
I
hear
most
commonly
is
concerns
about
access
to
healthcare.
There
are
so
many
places
in
South
Carolina
where
it
is
difficult
to
find
a
primary
care
physician
or
a
mental
healthcare
provider
or
an
ob/gyn,
and
there
are
many
folks
who
have
to
cross
county
lines
to
seek
emergency
care
services,
and
that
is
before
the
Medicaid
budget
cuts
go
through.
In
addition,
I’m
hearing
complaints
about
premiums
rising
because
of
the
ACA
[Affordable
Care
Act]
tax
subsidies
expiring,
prescription
drug
prices
going
up
and
up
and
up,
on
top
of
the
fact
that
grocery
prices
are
high,
gas
prices
are
high,
and
it’s
hard
to
find
affordable
childcare.
And
when
you
have
to
choose
between
prescription
drugs
or
paying
your
utility
bill
or
putting
food
on
the
table,
these
families
are
left
with
really
impossible
decisions,
and
these
problems
are
only
going
to
grow
worse
and
worse
if
the
Medicaid
budget
cuts
come
through.
What
issues
concern
you
related
to
providers?
The
more
healthcare
providers
and
physician
colleagues
I
have
talked
to
over
my
20-year
career,
the
more
disillusioned
we
get
with
this
system
that
is
clearly
broken
and
clearly
not
meeting
the
needs
of
our
patients
most
importantly,
but
also
not
meeting
the
needs
of
providers.
Over
the
course
of
my
career,
I
spent
more
and
more
and
more
of
my
time
dealing
with
the
administrative
burden
of
providing
healthcare
compared
to
the
time
I
was
able
to
spend
at
the
bedside
of
the
sick
and
injured
children
I
was
caring
for.
That
frustration
is
almost
universal,
whether
you’re
a
pediatrician
like
me
working
in
a
children’s
hospital;
a
pediatrician
working
in
an
outpatient
clinic
who’s
being
asked
to
do
more
and
more
and
more
with
less
and
less
time
and
lower
reimbursement
rates;
or
a
subspecialist
who
has
a
waitlist
of
9
to
12
months
long
because
we
have
a
workforce
shortage
here
in
South
Carolina.
So
providers
are
recognizing
that
the
system
is
not
working
for
them,
and
it’s
not
working
for
their
patients.
And
they’re
eager
for
leaders
to
have
serious
conversations
about
how
we
can
shift
from
this
profit-motivated
healthcare
system
to
the
patient-centered
healthcare
system
that
we
all
understand
our
patients
deserve,
and
that
will
allow
physicians
to
practice
with
less
of
an
administrative
burden,
allowing
them
to
spend
more
time
at
their
patients’
bedside,
and
reduce
the
high
levels
of
burnout
we
have
in
our
profession
right
now.
I
worry
so
much
about
Medicaid,
but
the
Medicare
program
has
a
lot
of
flaws
as
well.
The
Trump
administration
recently
decided
to
allow
those
Medicaid
Part
D
subsidies
expire,
which
will
raise
the
rate
of
prescription
drug
prices
for
25
million
Americans.
So
I
think
there’s
never
been
a
more
important
time
for
us
to
elect
physicians
and
other
healthcare
providers
at
all
levels
of
government
—
local,
state,
and
federal
—
so
that
we
can
have
meaningful,
productive
conversations
about
health.
Prior
authorization
is
another
issue
that
concerns
physicians.
Is
a
legislative
fix
needed
for
that?
Absolutely.
I
do
not
believe
that
insurance
companies
should
be
telling
doctors
what
medications,
what
treatments,
or
what
tests
their
patients
need.
I
know
we
need
accountability
in
the
system.
We
must
reduce
the
amount
of
wasted
medical
spending.
But
I
cannot
tell
you
how
many
times
I
have
had
to
sit
on
hold
on
the
phone
to
talk
to
a
provider
—
who
does
not
have
the
clinical
experience
I
have
—
to
justify
why
I
have
prescribed
a
certain
medication
or
ordered
a
certain
test
for
a
patient.
It
is
wildly
frustrating.
Would
you
say
you’re
a
proponent
of
Medicare
for
All,
or
universal
coverage
in
some
form?
I
believe
that
healthcare
is
a
human
right.
I
am
also
an
incredibly
pragmatic
person,
and
I
understand
that
in
this
profit-driven
healthcare
system
we
currently
operate
in,
given
the
political
realities
of
this
country,
we’re
not
going
to
shift
from
this
profit-driven
system
to
a
true
patient-centered
healthcare
system
like
universal
healthcare
overnight,
but
we
cannot
let
perfect
be
the
enemy
of
the
good.
In
my
view,
the
first
thing
we
need
to
do
when
Democrats
take
the
House
and
the
Senate
in
November
is
work
towards
passing
a
public
option.
Because
with
a
public
option,
people
like
me
who
don’t
have
employer-based
health
insurance
who
have
to
buy
a
plan
from
the
ACA
exchange
would
have
a
new
option
of
buying
a
plan
from
the
federal
government,
which
would
eliminate
the
profit
motive
in
that
transaction.
And
over
time,
as
more
and
more
Americans
choose
to
buy
plans
from
the
federal
government,
it
would
reduce
the
level
of
influence
our
private
insurance
companies
have
over
the
whole
system,
and
private
insurance
companies
would
be
forced
to
offer
more
comprehensive
benefit
plans
at
lower
premium
rates.
And
then
as
more
and
more
Americans
realize
the
public
option
is
working
really
well
for
them,
only
then
can
we
have
a
real
productive
bipartisan
conversation
about
[instituting]
meaningful
healthcare
reform
in
this
country.
You
mentioned
earlier
that
South
Carolina
has
an
ob/gyn
shortage.
Can
you
talk
about
your
position
on
reproductive
rights?
Yes,
I
believe
—
as
a
woman,
as
a
doctor,
as
a
mom,
and
as
a
serious,
common-sense
person
—
that
reproductive
healthcare
is
healthcare,
and
we
must
restore
a
woman’s
right
to
make
decisions
about
her
own
body.
I
also
believe
that
if
you
couldn’t
pass
a
pop
quiz
about
women’s
reproductive
anatomy,
you
should
have
nothing
to
do
with
the
process
of
writing
laws
about
what
any
woman
does
in
any
part
of
her
body.
But
unfortunately,
in
a
state
like
South
Carolina
that
is
currently
under
Republican
supermajority
rule,
the
majority
white,
male,
Republican
legislature
continues
to
try
to
pass
even
more
extreme
abortion
bans
—
bans
that
would
criminalize
the
provision
of
reproductive
healthcare,
throwing
doctors
and
women
in
jail,
making
it
a
crime
to
cross
state
lines
[for
an
abortion],
and
as
a
result,
ob/gyns
are
scared
to
stay
here
and
practice.
So
some
of
them
have
left
the
state.
People
don’t
want
to
come
learn
how
to
be
an
ob/gyn
in
our
residency
training
programs
because
they
don’t
want
to
be
told
by
these
nonhealthcare
professionals
in
the
state
House
how
to
do
their
jobs.
They
don’t
want
to
have
to
withhold
life-saving
evidence-based
care
when
a
woman
shows
up
bleeding,
because
they’re
worried
they’re
going
to
be
thrown
in
jail.
And
so
I
will
always
be
a
champion
to
restore
a
woman’s
right
to
make
healthcare
decisions
about
her
own
body.
We
need
to
go
back
to
the
provisions
and
the
protections
that
we
had
under
the
Roe
v.
Wade
decision,
and
I
will
be
a
vocal
champion
to
do
that
as
a
woman
here
in
South
Carolina
who
has
seen
firsthand
the
devastating
impact
of
these
anti-woman
extreme
abortion
bans.
What
about
maternal
mortality?
Is
that
a
big
issue
in
your
state?
Absolutely.
When
you
have
uninsured
and
underinsured
people,
when
you
have
15
counties
without
an
ob/gyn,
all
of
those
factors
are
directly
related
to
our
sky-high
maternal
mortality
rate
and
infant
mortality
rate.
Not
to
mention
the
fact
that
we
have
deep
racial
health
inequity
embedded
within
both
of
those
problems.
Black
women
are
four
times
more
likely
to
die
from
pregnancy-related
causes
than
white
women
in
the
state
of
South
Carolina.
And
these
problems
must
be
addressed
because
they’re
only
growing
bigger
and
bigger
by
the
day.
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