Do no harm? Not these GOP doctor-politicians

Those of us who went through the Obamacare wars will recall that one of the most clarifying moments came during a Republican presidential primary debate in 2011. When one of the candidates, Texas Rep. Ron Paul, was asked if an uninsured 30-year-old patient should just be left to die if they needed life-saving medical care, members of the audience cheered and applauded. The congressman, who had served as a flight surgeon in the U.S. Air Force before becoming an obstetrician-gynecologist, responded that people should take responsibility for themselves. 

Most people already understood that this was essentially the right’s philosophy about healthcare, but it had rarely ever been expressed so honestly. Republicans believe that healthcare is a commodity, and if you can’t afford it, or if you fail to buy it, you’re simply out of luck. 

Needless to say, part of what made Paul’s comment so startling was the fact that he was a medical doctor himself, a man who took an oath to first do no harm. Allowing someone to die for lack of insurance would seem to fall under the “harm” category, but the congressman wore his libertarian beliefs on his sleeve and didn’t pull any punches, regardless of his obligations as a physician. Unlike the rest of his party, Paul didn’t obfuscate that with phony assertions about “the market” providing adequate coverage or “competition” being the answer to lowering prices. He just plainly stated that people have a responsibility to care for themselves, and if they don’t, whatever happens to them is their own fault. If health insurance is expensive, well, you need to go out and make enough money to pay for it.

One assumes that most doctors don’t believe that. It wouldn’t be good for their bottom line, if nothing else, and presumably they generally have a conscience. But 15 years later, there are some GOP doctor-politicians who come from the same general philosophical school as Paul. 

Among them is another obstetrician-gynecologist, Kansas Sen. Roger Marshall. While he didn’t leave patients to die if they couldn’t pay, he did sue them — over 700 in total, according to a recent report by the New York Times — leading to dozens of arrests.

Marshall’s practice covered several poor, rural areas, and most of his patients were mothers, many of whom lacked the cash to pay their bills or co-pays up front. Instead they signed an agreement with the doctor to pay on time — at a usurious 18% interest rate. If the patients failed to meet that obligation, they would be sued, and if they didn’t pay they would have their wages garnished. If they didn’t show up to their required court date, they could be arrested. One woman interviewed by the reporter, Sarah Kliff, was arrested three times for failure to pay a bill related to a Caesarean section she had years before, a bill that, because of the exorbitant interest rate, eventually ballooned to over $7,000. 

Kliff asked experts in the field of health law and was told that while it’s not entirely uncommon for doctors to sue, especially now that deductibles and co-pays have become so much more onerous, most choose other ways to handle the situation. Some turn the debt over to collection agencies, while others simply write it off. But the experts all agreed that only a small minority resort to such extreme measures as wage garnishment and arrest. 

As shocking as these revelations were, Marshall has long shown his true-blue MAGA colors as a senator. Selling himself as an expert in rural medical care, he has taken the extreme side on every medical issue since he was elected in 2016. Marshall voted to repeal the Affordable Care Act, as did almost every other Republican senator. He voted in favor of the One Big Beautiful Bill Act, which drastically cut Obamacare subsidies and slashed Medicaid, provisions that will harm those rural constituents he represents. 

Marshall is even something of a vaccine skeptic, deploying misleading rhetoric to sow confusion and doubt. Speaking of Dr. Anthony Fauci and the Covid-19 vaccine in an interview with Fox News, Marshall said, “Who didn’t have a friend who took this vaccine and had some time of complication? A stroke, a blood clot, a young man getting some type of heart inflammation. That’s what destroyed the trust in the American people for our government.” 

This is clever, if weasely, phrasing. Note that he doesn’t come out and say that the vaccines killed people. Instead, Marshall suggests that the side effects were so common that we all know someone who had them, which is a blatant lie. All the while, he blames the vaccines themselves for sowing mistrust in the system instead of the liars and obfuscators who led people to believe the shots were more dangerous than a disease that killed a reported 1.3 million people, many of them Republicans, in the United States alone in two years. As a physician, Marshall knows better. But he’s gone so far down the MAGA rabbit hole that he’s little more than a GOP propagandist at this point. 

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To be fair, the Kansan is not the only Republican doctor who is more of a professional political actor than a physician. There is also Kentucky Sen. Rand Paul, the son of Ron Paul. As an ophthalmologist — accredited by a board he himself helped to create — he has made it his life’s work to destroy the reputation of Fauci, who led the National Institute of Allergy and Infectious Diseases at the National Institutes of Health for nearly 40 years. Paul calls Medicare “socialized medicine” and proposes that its sick, elderly patients pay a huge deductible to “bring down costs.”

Then there’s John Barrasso, an orthopedic surgeon who serves as Senate majority whip. The Wyoming senator is more a standard-issue right-wing Republican than a MAGA fanatic like Marshall or an eccentric gadfly like Paul. But he too claims to have special expertise in rural healthcare, and yet he voted for to slash Medicaid and Obamacare, which will negatively impact his own constituents. Like all Republicans, he is adamantly opposed to Medicare for All. (To his credit, Barrasso is not opposed to vaccines.) 

There is also the sad story of Dr. Bill Cassidy, the Louisiana senator who clearly still has a conscience but just can’t be moved to act on it when it counts. Although he knew very well that Robert F. Kennedy Jr. is a crank and opposes his crackpot vaccine policies, Cassidy nonetheless cast the deciding vote to confirm him as health and human services secretary. To show his gratitude, Donald Trump endorsed Cassidy’s primary opponent, and he lost his seat.

There are quite a few more of these types in the House, including Texas Rep. Ronny Jackson, Trump’s favorite, and there are even some in the Cabinet, most famously Dr. Mehmet Oz, who was appointed as the head of the Centers for Medicare and Medicaid Services. Oz made his reputation as a snake oil salesman on afternoon television, heavily promoted by Oprah Winfrey. Back in 2014, he was even called to testify before Congress about his bogus cures. 

This week, Oz had the chutzpah to go on TV and talk about medical fraud. “These charlatans are shockingly effective at being grifters,” he said. “We have normalized fraud. We have normalized stealing from the poor.” He’s right about that, actually, and his presence in the president’s Cabinet proves it. 

I’m sure there are Republican doctors in politics who adhere to their oath and genuinely try to do their best by their patients and constituents. But if they voted for the Big Beautiful Bill and to confirm people like Kennedy and Oz, or if they disseminate anti-vaccine propaganda — knowing full-well that it’s a potentially lethal lie — they are among the worst of the GOP. They know better, and yet they are doing it anyway. But then you look at someone like Marshall, who is currently in the fight of his political life in a surprisingly close race in Kansas, and you realize it shouldn’t be all that surprising.

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