Meet Our Candidates: Dr. Richard Carmona for U.S. Senator

The Arizona general election will be held on November 6, 2012, with early voting starting on October 11. After the many recent legislative challenges to reproductive health care access, both nationally and statewide, the importance of voting in November can’t be overstated. To help voters, Planned Parenthood Action Fund has endorsed candidates who have shown strong commitment to reproductive health and freedom. Along with those endorsements, we are spotlighting our endorsed candidates in a series called “Meet Our Candidates.” To vote in the general election, you must register to vote by October 9 — and can even register online. Make your voice heard in 2012!

[W]hen announcing Dr. Richard Carmona’s endorsement by Planned Parenthood Action Fund, President Cecile Richards said that “Arizona women need a champion who has long fought to protect and promote women’s health representing them in Washington” — and as a former U.S. surgeon general, Carmona is uniquely positioned to advocate for scientifically driven, rather than agenda-driven, policies on health and medicine.

“Health care should not be politicized.”

Carmona already has experience fighting for evidence-based health policy in an increasingly polarized political climate. After leaving his position as surgeon general, Carmona testified before Congress that the George W. Bush administration continually hampered his attempts to present scientifically sound public health policy when it conflicted with their political agenda. As Carmona said in his testimony, the Bush administration silenced him on many issues, including emergency contraception and comprehensive sex education — and the public was denied access to the latest unbiased evidence on important public health issues.

Carmona is running against Republican challenger Jeff Flake to succeed Jon Kyl as U.S. senator from Arizona. Flake’s congressional voting record is problematic, and includes support for an amendment to the Affordable Care Act to prohibit abortion coverage, support for defunding Planned Parenthood, and a vote against expanding the Children’s Health Insurance Program (CHIP).

As a U.S. senator, Carmona can bring his lifetime of experience as a physician and public-health expert to the legislature. When it comes to our medical care, no matter our political affiliations, we all need access to the best scientific evidence, and we need someone who will be a champion for our health in the U.S. Senate.

Dr. Carmona generously took time for an interview with us via telephone on October 3, 2012.

Many of us, including myself, are becoming increasingly concerned about the hostility toward science exhibited by some of our current lawmakers. What can you do to inject reason and scientific evidence into an increasingly politicized discourse about public health?

Well, first and foremost, if you remember my tenure as surgeon general, I had to do that. There was a lot of ideological, nonscientific-driven sentiment, and when necessary I stood up and I addressed the issues appropriately. It wasn’t a perfect world, especially when you have many of those ideologues thinking differently, but nevertheless, I will do the same thing as a senator.

And I think I enter the Senate with, if you will, the imprimatur of being a surgeon general and a trauma surgeon and a registered nurse and a paramedic. I bring all those years of cumulative science to the table as I discuss things with my colleagues. And although they may be ideologically driven, and I will certainly acknowledge their personal beliefs, that’s not science and it’s not fact.

So do you think that your background in public health and medicine will inform your ability to evaluate evidence in other areas as well, outside of just health?

My approach to most everything is analytical. Whether we’re talking about energy policy, national defense policy, there’s an algorithm in my mind that’s always working. What is it people are trying to do? How do we get there? What’s the most cost effective? What are the risk issues involved? What are the intended and unintended consequences of any policy? I approach everything the same way — more or less in an engineering mode, very analytically, and stay out of the bias and the preconceived ideological drivers, which are killing us now, you know?

I think the greatest example of that is Congressman [Todd] Akin in Missouri making those outlandish comments about “legitimate rape.” He claimed that he was talking to doctors. I thought, “I didn’t go to that medical school.” That is really outlandish, ideologically driven stuff. The fact that somebody has risen to that level and is able to be entertained for such a high public office, that really troubles me.

Sixteen years ago, in 1996, we started federal funding for abstinence-only sex education programs, which have been shown over and over to be ineffective. Arizona, like other states that do abstinence-only education, has a sky-high teen pregnancy rate. I wanted to know what you thought could be done on a federal level to address this problem and improve the education children are receiving?

Well, in fact we don’t have that problem now with the current administration. When I was surgeon general, my opinion was always clear: Abstinence-only works when part of a comprehensive sexual education program. Based on the science, it has to be part of comprehensive sexual education. That’s where I am today, and I am going to continue to say the same thing until science proves otherwise, which I don’t think it will, based on the cumulative science we have for many, many years.

Jeff Flake, your opponent, is in favor of restrictions on abortion, allowing pharmacists to refuse to fill prescriptions for contraception, and defunding Planned Parenthood. How do you respond to his opinions on access to family planning services?

Well, Congressman Flake and I disagree on most everything. On this particular issue, it’s a bigger issue than two or three things you mentioned. This is about restricting access to women’s health care. And that’s a big problem for me. Because as the surgeon general of the United States, I recognize, probably better than anybody, the more you restrict someone’s access to their health care — and in this case if we talk Planned Parenthood and the thousands of women they see to do Pap smears, breast exams, sonograms — these women eventually are going to end up in somebody’s emergency room with some problem that could have been diagnosed and prevented.

So this is very short-sighted because it’s being ideologically driven. The fact of the matter is what we should be doing is ensuring that every woman has access to comprehensive sexual health education, and if we do that, the number of unwanted pregnancies predictably will drop. Abortions will drop. Women will be healthier. Cost of care will go down. It’s the right thing to do.

Lastly, I wanted to ask you a couple of questions about the Affordable Care Act. In one of your campaign commercials you said something about how you think that both the Democrats and Republicans have gotten it wrong. How do you think we can continue to refine the ACA in order to make improvements to ensure greater health care access for all Americans?

I don’t see ACA as a static document — it is something in evolution. And I’ve been critical about parts of it. But I’m a strong supporter of health care for all. As surgeon general of the United States, I repeatedly spoke out in public that it was a shame that the greatest industrialized nation in the world doesn’t have a basic set of health benefits for its public. And I don’t mean the government provides them. The private sector could provide them. But let’s put together a platform that everybody has access to basic health care.

I was critical because it’s a 2,500-page document. It got rolled out fast. It scared people. It scared young people because they didn’t know what it meant for them. It scared old people because they weren’t sure … Are you changing my Medicare? Nobody was certain what it was. And because of the uncertainty, political parties then had the opportunity to use this as a divisive wedge in the political battle.

Health care should not be politicized. The fact of the matter is that we should all aspire to provide health care, but the things we need to do, we need to emphasize prevention more — about 75 cents of every dollar we spend on health care is really sick care, so we waste a lot of money. There’s a whole list of things we can do to make the system more effective, cost-effective, and efficient.

But no matter what we do, we have to engage the American public. Each and every citizen has to be educated in health literacy to the point where they pursue optimum health and wellness every day. If we don’t, then it doesn’t make any difference whose plan you accept because the cost of care will continue to rise and we’ll go from 18 percent of our G.D.P. to close to 25 percent of our G.D.P. That’s 208 trillion up to five and a half, six trillion dollars a year. It’s unsustainable now. If you double it, it’s going to be unsustainable even more. So the public has to become engaged and be an active participant in pursuing health. The government ensures that there’s an infrastructure, and in a partnership with the private sector, we put the system together that is most effective and efficient. That’s what has to happen.

How do you think we can strengthen the state Medicaid programs so we can address this on a state level to ensure access for all citizens?

The state Medicaid programs have become a political football also. Some states saying they are going to opt out, other states are opting in. There’s a lot of variability in how these programs are going to be adjudicated.

The bottom line is: Whatever state you pick, the toughest state that says, “We’re not going to accept any money and we’re cutting Medicaid” — that’s great, you cut it. Now what happens? Thousands of people don’t have health insurance. Children aren’t getting vaccinations. The incidence of disease will rise, the incidence of vaccinatable diseases that could be prevented will rise. People will show up in emergency rooms and they will be cared for, and the costs will be transferred to society.

Let’s make sure that we put together programs that reach out especially to those health-disparate populations, raise their health literacy, engage them in pursuing optimal health and wellness, and that in itself will drive down the cost of care over time. But again, the citizens need to be engaged in this process. It can’t be just government giving you a card and saying, “Go get help.” And of course it’s much more complicated when you deal with health-disparate populations where you have a single mom, low-income, in an underserved area, [with] so-called latchkey kids on their own, and you start to see that the social determinants of health play very much into the actual potential for success for a child and a family. So those have to be addressed as well.

Thank you so much for your time.

Oh, you’re welcome. And thank you, and everybody at Planned Parenthood, for all the great work you do every day.

To find out more about Richard Carmona’s candidacy, you can visit his official campaign website,, as well as his Facebook page. You can also follow him on Twitter @CarmonaforAZ. Contact us if you’d like to volunteer for any of the candidates who have been endorsed by Planned Parenthood Action Fund or Planned Parenthood Advocates of Arizona.