Politics & Policy

Doctor’s Orders

Sen. (and Dr.) John Barrasso makes the case for market-based health-care reform.

One of the most important opponents of Barack Obama’s health-care agenda may be a relatively unknown senator from America’s least populous state. Republican John Barrasso of Wyoming, who entered the Senate only two years ago, had little name recognition outside his home state until a few weeks ago. Yet he is emerging as a GOP expert on a hot-button issue. Barrasso brings a special perspective to the health-care debate: He is one of only two MDs in the Senate, the other being his Republican colleague Tom Coburn of Oklahoma.

You’ll find Dr. Barrasso on page 87 of The 50 Most Positive Doctors in America, a 1996 book profiling physicians across the country. An orthopedic surgeon from Casper, he has been called “Wyoming’s doctor,” a reference to his prominence on local radio and television as a medical expert. He has served as president of the Wyoming Medical Society and was once named Wyoming Physician of the Year. In his 25 years of practicing medicine in the Cowboy State, Barrasso has treated everyone from rodeo riders to senior citizens in Wyoming’s most remote rural areas. Even as he pursues his new career in public service, Barrasso remains a practicing surgeon, just as Coburn remains a practicing obstetrician. “I’m still licensed, I still get the medical journals, and I was in an operating room on Thursday with my old partners in a trauma case and a knee replacement,” Barrasso tells me in his Washington office. Like Coburn, Barrasso speaks knowledgeably and confidently about the details of health-care reform, making a strong case against expanding government management of the system.

So how did a rodeo doctor end up in the U.S. Senate? Barrasso had served nearly five years in the Wyoming state senate when the governor appointed him to fill the seat of GOP senator Craig Thomas, who died in June 2007. Barrasso promised to run for the seat in a special election in 2008, which he won by a large margin. One of the most conservative Republicans in the Senate, Barrasso says his values come from his parents. “I was raised in a solid American family that had great respect for our country, great respect for freedom, for the military, and for the free-market system.”

His family also instilled in him a love of politics and political institutions. “When I was eight, my dad took me to John Kennedy’s inauguration,” Barrasso says. “It has been a family tradition for us. We were at Kennedy’s, Johnson’s, all the way through. Our respect for the country and love of the country was such that our family came to every inauguration, no matter which party won.” As a high-school student, Barrasso came back to the capital on his own when he attended the Presidential Classroom for Young Americans program. He later graduated from Georgetown Medical School.

Despite all this Washington exposure — or perhaps because of it — Barrasso still flies home to Casper every weekend. “I still live in Wyoming and just work in Washington,” he says. “That’s the best way to stay connected.” This may be standard rhetoric from a politician, but the cowboy boots beneath his trouser legs suggest that his sentiments are genuine.

At the same time, Barrasso is willing and able to play the Washington media game. As the health-care debate has revved up, he has graduated from local to national television, appearing on Fox News and MSNBC. During a recent appearance on Ed Schultz’s show, Barrasso outlined the potential costs of a single-payer system while the liberal host struggled to get a word in. The Republican party would be smart to get Barrasso on TV more often; he sounds as trustworthy as your own doctor when he explains why government does not belong in the health-care industry. “If you have the government taking over the whole thing, it’s going to lead to increased costs and increased taxes and the rationing of care,” he says. “It’s denying care.”

Barrasso agrees that the high cost of American health care is a problem that requires fixing, but he stresses that individuals must maintain the freedom to make medical decisions in consultation with their doctors. “I think most people are very smart when it comes to their own money,” he says. “When they make decisions about their own spending, they make smart decisions. With health care, for the most part, people aren’t spending their own money. Even if they are paying for their insurance, they’re not spending their own money on the health care.”

To underscore the point, he relates a story about eight patients he once saw on New Year’s Eve. All the patients had met their deductible for the year and wanted to have operations that they would not have to pay for out of pocket. “They were very smart consumers using their own dollars with no necessary focus on the insurance company’s dollars,” he says.

The Wyoming senator is a voracious reader. He recently finished The Forgotten Man, Amity Shlaes’s book on the Great Depression, and is currently ripping through Paul Johnson’s monster A History of the American People. A self-professed “big fan” of William F. Buckley Jr., Barrasso says he has been reading National Review since the 1960s. In the course of our conversation about health care he cited no fewer than five recent NR articles.

When Barrasso looks at the current American health-care scene, his diagnosis is that Medicare is on course to break the whole system. “Medicare has never focused on trying to keep people healthy,” he explains. “It focuses on paying doctors and hospitals to do things to people.” He believes this neglect of prevention is Medicare’s biggest flaw, and he considers it a preview of what could happen to the entire health-care system if the Democrats get their way. “If a government single-payer system is anything like Medicare, there is going to be significant waste, fraud, and abuse — as well as a lack of coordinated care, and a lack of prevention,” he warns. However, he scoffs at the attempts by some liberals to insert “community” prevention provisions into a government plan. These programs, he says, aren’t about health; they are just ways of spreading a little pork around. “They’re gonna build sidewalks, jungle gyms, and street lights,” he says. “It’s like midnight basketball with Clinton.”

Barrasso isn’t interested in “smarter” government intervention; he wants to keep government out of the way of patients and doctors. “I think you want to tie a person’s own personal health to incentives to work toward a healthy lifestyle,” he says. He points to the company health-care plan used by grocery giant Safeway. “They individualize the incentives so if you get your weight down and your blood pressure under control, and your cholesterol and blood sugar, if you don’t use tobacco products, they know that will help save the company money, and they share that with you. So it’s money in your pocket to stay healthy. And the company saves money too.”

Barrasso stresses the importance of education. For years he has participated in Wyoming health fairs that seek to educate state residents about their own health by providing inexpensive blood tests and information on treatments. “We get lots of letters,” he says, “from folks that say, ‘If it weren’t for the health fair, we would have never detected this problem early.’”

John Barrasso thinks the key to reform is more information, not more government management. “It’s about getting people information they can use to stay healthy and keep down the costs of their care,” he says. As the health-care debate moves into a critical stage, look for Barrasso to play a prominent role in crafting and explaining the Republican message. His expertise is just what the doctor ordered.

Michael Warren, a Collegiate Network intern at National Review, studies economics and history at Vanderbilt University.

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