Ousting RFK Jr. Among the Priorities for This Doctor Running for Senate

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.