The nation will be one step closer to getting a new top doctor Tuesday.
The Senate Health, Education, Labor, and Pensions Committee will consider the nomination of Vivek Murthy to the position of U.S. surgeon general. Murthy is President Obama's nominee, and Democrats likely have the votes they need to attach the panel's seal of approval.
But since Obama took office, nothing in health care has come easy—and Tuesday will be no exception. Republicans contend that Murthy is an overtly political appointment, and not a particularly well-qualified one, for a position that is supposed to be apolitical.
Murthy, 36, is the cofounder and president of the advocacy group Doctors for America, founded in 2008 as Doctors for Obama. His political affiliation and his relative lack of experience have raised concerns among Republicans about his nomination—as well as provided another opportunity for them to raise criticisms about the Affordable Care Act.
But such nominee squabbles have become a constant facet of Congress's perpetual playacting, and everyday Americans will most likely tune much of it out anyway. But if they ignore the surgeon-general debate entirely, they'll miss the selection of an official whose decisions reach far into their everyday lives. Here are a few examples.
1) Surgeons general impact policy. The surgeon general's biggest and broadest role is to bring matters of public health to national attention. The official has the ability to prioritize health issues and direct conversation and policy in addressing them.
Different surgeons general may focus on different issues depending on the problems of the day, ranging from obesity, AIDS, suicide prevention, health literacy, and tobacco control.
Surgeons general have led the charge in reporting harmful effects of smoking,with the 50th anniversary Surgeon General Report on Smoking and Tobacco Use released earlier this month. The first, released in 1964 by Surgeon General Luther Terry, historically linked cigarette smoking to lung cancer.
"The reports are quite effective—certainly on smoking—in creating a national public consciousness on the issue," says Dick Woodruff, vice president of federal relations at the American Cancer Society Cancer Action Network, which supports Murthy's nomination. "It's almost as if the surgeon general is the one who starts at the beginning and lays the groundwork for developing a national consensus on how to lead in public health; policy makers then act on it." The reports get media interested and pressure lawmakers to take action, creating a "cascade" of national attention, he explains.
"The Cigarette Act labeling law probably would not have happened in the absence of [Terry's] report," Woodruff says.
2) They advise elected officials. The surgeon general is expected to offer public health guidance to elected leaders across the government.
"The surgeon general is not the ultimate authority—that lies with the president and Congress—but he has the ability to weigh in based on credibility and knowledge," says Richard Carmona, who served as surgeon general in the George W. Bush administration. "In addition to being an adviser to Congress, the White House, and the [HHS] secretary, I worked with just about every [agency] secretary, including agriculture, food safety, and defense."
"You're essentially the caregiver or service-giver for public and private organizations where there are no other providers, or no other expertise," says Carmona.
3) They have national and global impact. The surgeon general oversees the U.S. Public Health Service Commission Corps, one of seven uniformed services in the U.S., including the Army, Navy, and Marine Corps. The corps is made up of more than 6,500 public health professionals who work in medically underserved areas, address disease control and prevention, and work with other countries to address public health issues.
"The surgeon general is the senior doctor over an army of health warriors," Carmona says.
4) They focus on prevention. As public health officials, rather than clinical health professionals, surgeons general have historically had a prevention-focus. This was reaffirmed by the 2010 establishment of the National Prevention Council, chaired by the surgeon general. The council was formed under the Affordable Care Act—the only part of the role linked to the health law—and convenes officials from across government departments to develop and implement strategies for health advancement.
5. They're actually doctors. Surgeons general have extensive backgrounds in medicine and public health, so their guidance is based on data, not election outcomes.
"For anyone in the government in a high profile decision-making role, it's hard to be completely removed from politics," Woodruff says. " But the surgeon general is a health professional—in that sense he has to be viewed as having the public health of the nation as his first interest."
Why you shouldn't care. This isn't about Obamacare! It isn't really even about politics. Everything in Washington in political, but the job of the surgeon general is to cut through party divides and bickering for the sake of health.
"[The surgeon general] needs to rise above that," says Carmona. "People expect to him to tell the truth about the science. [To say,] here are the facts about the issue; here's really what's important."
Carmona disapproves of Murthy's nomination not because of politics, but because he believes he lacks the experience and credibility to succeed in the role.
We'll see what members of the HELP Committee think today.