Health Care

No longer in ER, health lobbyist still gets rush

Dr. Georges Benjamin is an adrenaline junkie — at least when it comes to health care.

He used to work in emergency medicine, and loved the thrill of solving the emergency room puzzle — determining what’s wrong with his patients and how to help them quickly. And as the executive director of the American Public Health Association (APHA), now he gets a rush from legislative victories.

{mosads}“When we get a big policy win that influences a lot of people, I get the same buzz that I got resuscitating people in the emergency department, frankly, because it’s a win,” Benjamin told The Hill in a recent interview.

“You know you’re going to influence people; you know that it has an enormous impact on people’s health and wellbeing,” added Benjamin, who has served as the head of APHA since 2002.

The association is currently tackling multiple hot-button public health issues, including addressing climate change, advocating for gun violence prevention research, securing funding for public health programs and protecting ObamaCare.

And APHA — composed of about 25,000 members nationwide — has seen legislative wins on some of its key issues over the past year.

One victory on air pollution came after the Environmental Protection Agency (EPA) announced plans last June to delay the implementation of new ozone standards, saying it would wait an additional year to identify places that didn’t meet these standards.

The APHA, along with other groups, took legal action. The day after 15 states and D.C. sued, the EPA reversed course. But the delay continued, so the groups filed another legal challenge, prompted by the EPA missing an Oct. 1 deadline. Eventually, the Trump administration released the list of areas that aren’t meeting the new ozone standards.

Benjamin calls climate change today’s “most pressing public health problem.” Advocates for more environmentally friendly policies believe President Trump is on the wrong side of the issue, and Benjamin urges the administration to do more.

“This administration needs to acknowledge that climate change is real and really engage with the real world on this,” he said.

Another legislative win came last year, when the APHA was one of a wide array of advocacy groups that opposed Republican plans to repeal and replace ObamaCare. The group’s members have a long-standing history of supporting single-payer health care, an issue Sen. Bernie Sanders (I-Vt.) championed during his presidential bid and that is gaining steam among Democrats.

Benjamin, who is an opinion contributor for The Hill, says the  APHA hasn’t endorsed any particular single-payer plan. When asked if Democratic candidates should be running on the issue, he said, “I think they ought to be running on making sure everybody has quality, affordable health care and do the model that makes sense based on their own beliefs.

“By the way, I don’t think Democrats ought to just do that; I think Republicans ought to do it, too.”

The APHA is also a staunch supporter of allowing the Centers for Disease Control and Prevention (CDC) to study gun violence prevention, an issue which has leapt back into headlines following a rash of deadly school shootings. A spending bill passed earlier this year clarified that the agency can indeed research the issue, though Benjamin wishes it had been more explicit in its directive.

“It would have been nice had they said, ‘Yes, research is absolutely allowed’ — in that kind of clear language — ‘and here’s the money to do it,’ ” he said.

“They didn’t do that. They basically said that the secretary has said that it’s OK to do research and we agree … but they didn’t give direct money to do it.”

Experts have said the language doesn’t much matter without funding attached.

“Although CDC does not receive direct funding for firearm-related research, CDC has and continues to support data collection activities and analyses to document the public health burden of firearm injuries in the U.S.,” the agency said in a statement sent to The Hill Monday. “CDC would welcome the needed dedicated funding from Congress to move forward in this work.”

Researching gun violence is paramount to helping prevent deaths, Benjamin said.

“We know some things about how to reduce the risk of death and disability for firearms, but by no means nearly enough,” said the father of two and grandfather of three.

“It is clear that we can make firearms safer. We can make people safer with their firearms — and the broader environment safer with people in firearms in it — in that we can study it, and we can then focus our policy efforts on those things that make a difference and are most important.”

There’s another pervasive issue the association is constantly working to tackle: funding for public health programs. The APHA talks to Congress about how to maintain sustainable, reliable funding for public health, so that communities will be prepared when, say, a new disease begins to spread.

Yet “the national investment in public health is woefully inadequate,” Benjamin said.

Earlier this year, some federal agencies did receive some relief from Congress. The APHA’s advocacy efforts focus on boosting funding to the CDC and the Health Resources and Services Administration (HRSA), both of which saw more dollars in the fiscal 2018 spending bill passed in late March. The CDC saw a more than $800 million increase, and the HRSA received a more than $500 million bump.

Though Benjamin has advocated for public health funding in spending bills for more than 15 years, he got his start in health care as a doctor.

He trained in internal medicine, but fell in love with the emergency department. He migrated to emergency room care and also spent nine years in Army medicine, including time as chief of emergency medicine at what was then called Walter Reed Army Medical Center. He’s served in top roles in both Washington, D.C.’s and Maryland’s health departments.

During his career, Benjamin has witnessed firsthand the roles that federal, state and local governments play in health care — from both the medical provider and governmental perspective.

He is now working to lead a national effort that, in a way, marries the issues he’s seen throughout his career. The APHA recently launched an initiative, called Speak for Health, to raise the visibility of public health issues.

“We recognize that we are not the healthiest nation by any means. We die sooner. We pay twice as much for health overall. So we’re trying to lead a national effort for people to recognize that more, and for us to compete with our colleagues in the rest of the world and become the healthiest nation.”

He added: “We want to help improve our systems, we want to build a demand among the public for supporting health as a priority in all the things we talked about earlier — moving those up on the kitchen table discussion, making those voting issues.”