10.20.14

Would a Surgeon General Help in Ebola Response?

Washington (CNN) -- As newly picked Ebola czar Ron Klain gets started, some are wondering if America could also use a new surgeon general.

As Republicans criticize the Obama administration's appointment of Klain, Democrats are intensifying their push for a vote on the delayed nomination of Dr. Vivek Murthy for surgeon general.

"Given the public's increasing fears regarding the spread of the disease, it is imperative that we confirm a Surgeon General who will play a significant role in educating the American public about the disease and how to best protect their health," write Democratic Reps. Barbara Lee, Judy Chu and Ami Bera and dozens of other House Democrats in a letter being sent this week to Senate Majority Leader Harry Reid and Minority Leader Mitch McConnell. "The American public would benefit from having a Surgeon General to disseminate information that is desperately needed."

Murthy, a doctor and entrepreneur from Boston, was nominated last fall after Vice Admiral Regina Benjamin stepped down. His pick ran into controversy because of some of his political advocacy and statements saying guns are a health care issue. In 2008 he co-founded a group Doctors for Obama which backed Barack Obama's campaign and his push for health care reform. The group later was re-named Doctors for America, which advocated for some gun control measures.

In an editorial Thursday the Boston Globe said: "It's a bad time to be without a surgeon general; dismayingly, Obama's appointment of Dr. Vivek Murthy of Brookline sank earlier this year because of [National Rife Association] opposition. But the president needs a confidence-inspiring figure to lead and explain the nation's Ebola efforts — or should be prepared to step into that role himself."

As the editorial notes, the nomination stalled after the NRA in February wrote to Reid and McConnell saying it "strongly" opposed Murthy. "Given Dr. Murthy's lengthy history of hostility towards the right to keep and bear arms," the NRA said "there is little reason to believe that he would not work to further a gun control agenda if confirmed as Surgeon General."

How much difference would a confirmed surgeon general make in the Ebola response?

Currently there is an acting surgeon general, Rear Admiral Boris Lushniak, but he has not taken a major public role during this crisis.

The job of surgeon general is not known as one of the most powerful health care positions in the administration. He or she reports to an assistant secretary of health, does not directly supervise any of the agencies responsible for dealing with the Ebola outbreak but does oversee a group of 6,800 uniformed public health professionals working for the government.

"It was stripped of its power in the 1960's," said author Mike Stobbe describing the power of office of the surgeon general. "Since then the surgeon general has been a health educator, a spokesman. It has been up to the government how much reign they want to give that person," Stobbe, author of the book "Surgeon General's Warning: How Politics Crippled the Nation's Doctor," added.

In some past recent health crises either the Health and Human Services Secretary and/or the head of the Centers for Disease Control and Prevention have been the frontline spokesmen for the government.
So far Health and Human Services Secretary Sylvia Burwell, who took over in June, has not publicly stepped out as a public voice of the government's response. She did one round of the network morning shows last week. CDC Director Dr. Tom Frieden instead has appeared on many television shows and been most commonly the administration's choice for briefing the public on the status of the Ebola outbreak in the U.S.

Known as the "nation's doctor," a confirmed surgeon general could fill a void as the administration's face on Ebola although as some former officials have said the office doesn't have much direct responsibility and is rather weak.

The White House says however it wouldn't hurt.

"In terms of what role the surgeon general would play in this specific response, I guess what I would say about that is it's hard to imagine it would hurt, and that we would only benefit from a scenario where we had a dedicated public health professional who was involved in helping us communicate with hospitals and medical professionals all across the country to ensure that these protocols, the proper protocols, were in place and closely followed," White House Press Secretary Josh Earnest said last week.

Some of those who have served in the job also said they had helped with government preparedness in past crises.

"As surgeon general I was involved in a lot of the training, education, working with my colleagues at [National Institutes of Health] and CDC to ramp up after 9/11 to ensure we had the best preparedness programs in place which included bio agents. The problem is after these things happen, our memories start to fade. Our government stops to fund programs. Research is not as robust as it should be and so on, so there's a rippling effect that goes out," Dr. Richard Carmona, who served in the job in the George W. Bush administration, told CNN's "New Day" last week.

Stobbe said some of the most successful recent surgeon generals were independent and "were willing to say what they thought the truth was even if it wasn't according to the script of the White House." He specifically pointed to doctors who took prominent positions on issues which were not directly related to ongoing health care crises -- C. Everett Koop, who spoke out about smoking and AIDS and Jocelyn Elders, who was very public about her views on sexuality.

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