Paul doesn’t mention Prince by name the next day when he gives a speech and does a Q&A with medical students at the University of Louisville. But she might well have been on his mind when he was asked whether health care is a commodity or not.
“There’s a philosophic debate which often gets me in trouble, you know, on whether health care’s a right or not,” Paul, in a red tie, white button-down shirt, and khakis, tells the students from the stage. “I think we as physicians have an obligation. As Christians, we have an obligation. . . . I really believe that, and it’s a deep-held belief,” he says of helping others.
“But I don’t think you have a right to my labor,” he continues. “You don’t have a right to anyone else’s labor. Food’s pretty important, do you have a right to the labor of the farmer?”
Paul then asks, rhetorically, if students have a right to food and water. “As humans, yeah, we do have an obligation to give people water, to give people food, to give people health care,” Paul muses. “But it’s not a right because once you conscript people and say, ‘Oh, it’s a right,’ then really you’re in charge, it’s servitude, you’re in charge of me and I’m supposed to do whatever you tell me to do. . . . It really shouldn’t be seen that way.”
On the day he does the surgeries, Paul also goes to the Paducah Rotary Club to deliver a speech. On the ride over in a tan Prius, which belongs to one of Paul’s staffers (“We’re just trying to save the planet,” Paul says wryly, and then talks about the jobs created by Toyota’s Kentucky plant), Paul says his only eye problem is that he needs reading glasses — a common condition for someone his age.
Paul first became interested in ophthalmology as a child. His grandmother on his mother’s side, Carol Wells, had significant eye problems: Over the years, she suffered from cataracts, glaucoma, and macular degeneration, and even had a corneal transplant. “As a kid growing up, I went to the doctor with her several times,” Paul remembers. She remains in his thoughts: In his foyer now hangs a 1930s photograph of Wells participating in the rifle team at Ohio University.
Paul’s mother, Carol Wells Paul, had cataracts at 48. “She had trouble seeing, telling the difference” between colors, Paul recalls. “My little sister used to ride around with her, saying, ‘Mom, it’s green, it’s red’” when they came to traffic lights.
At medical school, Paul became involved in research related to corneal transplants, and he decided to pursue ophthalmology. (His father, former congressman and ob-gyn Ron Paul, observed that his son had picked a medical field more conducive to getting sleep.) Paul kept his ophthalmology practice active until he became a senator, right on through the heated primary and general-election Senate campaigns in 2010.
He didn’t care what his patients’ politics were, but as Paul became a statewide figure during the campaigns, patients started bringing it up. “As I was running for office, I got slower and slower seeing patients because everybody wanted to talk about politics,” he recalls wryly. “I don’t bring it up typically. . . . It doesn’t matter to me whether you’re Republican or Democrat or whether you agree with me or not” when you’re one of his patients.
And while politics didn’t influence his work as a doctor, his experience in health care has affected how he views health-care policy. “Having been a physician, I see people from all walks of life and I see how it works and how it doesn’t work,” he remarks. In particular, his experience has made him an advocate of increasing price competition in health care.
“Insurance doesn’t cover Lasik surgery, the surgery to get rid of glasses,” Paul remarks. “So it started at about $2,000 an eye, maybe even $2,500 an eye, and it’s down in some communities to under $500 an eye because competition works and people call on average four doctors to get the price and see how much it’s going to cost.”
Paul also cites the cost of contact lenses, which don’t tend to be covered by insurance either. “When I sold them,” he recounts, “I was within pennies of Walmart, because you gotta compete.”