Can the shrimpers’ doctor navigate the seas of partisanship?
Like most everyone in this small, scruffy city of boat builders and fishermen, Sammy Duffy tends to rave about surgeon general nominee Regina Benjamin and all that she has done for the hard-working people here who labor without the safety net of health insurance.
Duffy, a disabled 52-year-old who runs a fruit stand, knows Benjamin’s story well: how she will treat almost anyone in her tiny medical office; how she accepts payments in oysters and shrimp when patients can’t pay cash; and how she elected to stay in this backwater after her clinic was ravaged by two hurricanes and a fire.
“I think she’s done wonders for this town,” he said.
But ask Duffy what he thinks about the Democrats’ plan to broaden health coverage with a government insurance plan, and his brow furrows. Sounds like communism, he says. Or, at the very least, an overreach.
“Now we’re talking about [healthcare for] the whole United States, not just Bayou La Batre,” said Duffy, a wheelchair-bound victim of an auto wreck whose medical costs are covered by Medicare. “I just don’t know how that’s going to work.”
Such are the challenges facing President Obama and his congressional allies as they seek to revolutionize the American health system: Even here, where the president’s pick for surgeon general is a local hero because of her treatment of the uninsured, there is fierce disagreement over any solution that smacks of socialized medicine.
True, some residents of Bayou La Batre, a sweltering, struggling city of 2,500 near the Gulf of Mexico, see the Democrats’ proposed healthcare overhaul as a welcome extension of Benjamin’s two decades of service to her patients -- many of whom are, as she says, too rich for Medicaid but too poor to afford private insurance.
One of them, Edward Henson, 49, emerged from Benjamin’s office Thursday after being treated for a case of poison oak. The former oysterman and carpenter -- a leathery wisp of a man in a well-worn ball cap -- worked for years without insurance until an on-the-job head injury made him eligible for Medicare.
“I’m all for everybody getting better,” he said. “A lot of people can’t afford insurance.”
It is unclear what direct role, if any, Benjamin will play in the national skirmish over healthcare reform if the Senate confirms her as surgeon general.
Obama is pushing both houses of Congress to pass overhaul bills by their August recess, and it is possible that Benjamin may not face a confirmation hearing until the drama is over.
Though surgeon general is a largely ceremonial position, it also carries the potential power of the bully pulpit, and in some ways, Benjamin has already entered the fray.
After the president announced her nomination in the Rose Garden last week, Benjamin spoke about the need to inform the public about preventable diseases such as diabetes and hypertension, which killed her father, and lung cancer, which killed her mother.
But she also said that she hoped to ensure that “no one falls through the cracks” of the health system. She has since declined interviews, citing her pending confirmation hearing.
Some conservatives contend that Benjamin has become a weapon in the Democrats’ public relations battle, by dint of her personal story. That seemed to be the message from conservative talk-radio host Rush Limbaugh, who suggested last week that Benjamin would score sympathy points for being an African American and a Hurricane Katrina survivor.
The 2005 hurricane sent a 13-foot-high storm surge into Bayou La Batre, ruining Benjamin’s clinic and forcing her to work out of a trailer for months.
Limbaugh also claimed that Benjamin “does not believe doctors should make a profit,” adding, sardonically: “What more could anyone possibly want in a surgeon general?”
After her introduction to the nation, Benjamin, 52, left the White House for the considerably less glamorous trappings of Bayou La Batre -- pronounced Bah-you lah BAT-tree -- a muggy utilitarian outpost of docks, weedy yards and heaps of oyster shells.
On Wednesday, she was spotted giving a goodbye hug to a patient outside her clinic, a tiny repurposed house near the downtown’s metal drawbridge.
When informed of the comments that Limbaugh and others were making about her, she smiled and said that she was finding it difficult to hold her tongue, as the Obama administration had requested.
Surgeon generals, after all, have spelled political trouble for presidents in the past: President Reagan’s choice, C. Everett Koop, was confirmed after a bruising nine-month ordeal in the Senate. Joycelyn Elders famously embarrassed President Clinton with remarks about masturbation and the antiabortion movement.
Benjamin did accede to a quick tour of her clinic, introducing the small team of staff members who share the clean, cramped space. In one of her two exam rooms, she was hugged by another patient -- a beaming, sunburned man in his 50s who offered his congratulations and jokingly offered to be her new bodyguard.
Benjamin is single, Roman Catholic and, her friends say, deeply driven. She was raised by her waitress mother in Daphne, Ala., on the other side of Mobile Bay from Bayou La Batre.
After medical school in Atlanta and Birmingham, Ala., and a residency in Georgia, she was sent back to Alabama’s impoverished coast by the National Health Service Corps, which helps young doctors with their tuition if they agree to work in areas with a doctor shortage.
Her decision to stay in Bayou La Batre came at no small cost. After starting her own practice in 1990, she moonlighted at faraway emergency rooms on weekends to pay the clinic’s bills.
Reporters and editors noticed her dedication. A 1995 New York Times headline called her an “Angel in a White Coat.” Reader’s Digest came. So did Time and Ebony.
At the same time, Benjamin became deeply involved in healthcare policy at the state and national levels. Last year, she received a “genius grant” from the MacArthur Foundation, which credited her with forging “an inspiring model of compassionate and effective medical care in one of the most underserved regions of the United States.”
That meant more time away from her Bayou La Batre Rural Health Clinic, but her friends said she used the experience to advocate for better healthcare in rural areas -- and to drum up new grants and donations.
Friends worry about the toll the work inflicts on her.
“She might not have a whole lot of healthy things going on herself because she’s been involved so much in this clinic,” said Joseph Mitchell, an Alabama state representative who is the clinic’s board chairman.
The magazine profiles have invariably mentioned such sacrifices, and the salty working-class characters she has treated over the years for ailments including shark bites and shrimp poisoning. They are still here, still relying on her.
In May, Susan Baker, 49, an uninsured cashier at the Bayou Bait Shop, racked up a $47,000 hospital bill for treatment for a lung ailment. Benjamin, her physician, visited her every day in the hospital, and charged her almost nothing.
In November, Baker voted for John McCain, who did not offer a government health plan. These days, Baker is pulling for the Democratic reform.
“I need insurance,” she said. “With my body, there’s things that need to be taken care of.”
But Bayou La Batre is a town of entrepreneurs and small-business owners. Boatyard owners and others, while fond of Benjamin, are worried about the effect greater government involvement will have on their bottom lines.
Greg Marshall, owner of Marshall Marine Supply, called Benjamin a “fantastic choice” for surgeon general. But he feared that the Democrats’ healthcare plan would sink small businesses like his.
“You’re not going to find too many people here in the business community behind the idea of a government healthcare system,” he said.
Benjamin’s friends and supporters say she is the perfect person to navigate Washington’s choppy seas of partisanship. They note that she rose to the top of the state’s conservative medical establishment by building consensus and listening to her opponents.
“I don’t expect her to be a polarizing figure,” said U.S. Rep. Artur Davis, an Alabama Democrat. " . . . She’s someone who builds comfort in people.”
It’s a bedside manner that is sure to be tested in the days to come.