Former GOP leader out of Senate but still guiding on health issues: AMNews interviews William H. Frist, MD

Washington -- Former Senate Majority Leader William H. Frist, MD, may have retired from Congress after 12 years, but that doesn't mean his pace has slowed. He's still forging ahead on some of the issues he's worked on for years: health care, poverty and animal welfare.

The general surgeon teaches courses on health policy as a visiting professor at Princeton University, his alma mater. He is co-chair of an effort to make global health and extreme poverty high-profile issues in the 2008 presidential election.

Dr. Frist is the chair of Survive to 5, a campaign by the charity Save the Children to reduce early childhood mortality by two-thirds through basic preventive health care. And he's the chair of the Mountain Gorilla Veterinary Project, which provides care for gorillas in Rwanda, Uganda and the Democratic Republic of Congo.

This marathon of work will have to replace the regular races he used to run as a Tennessee senator. Although he lost his right kneecap in a motorcycle accident as a young man, he was able to run seven marathons in 10 years. Several months ago, however, his right knee became painful, so he switched to walking.

"My age has caught up with me," said Dr. Frist, 55, the youngest Senate majority leader ever. He spoke to American Medical News recently about health system reform and the lessons of politics.

AMNews: What did you learn from being a senator?

Dr. Frist: I learned that politics is not easy. It is challenging. But at the same time it's a noble profession that has to be a calling, but one that has huge power to influence good for mankind generally.

AMNews: What was your most humbling moment as a senator?

Dr. Frist: In terms of a personal defeat, it was the failure to get a piece of legislation through that I'd worked hard on, that being asbestos reform. I found the trial lawyers to be too powerful and could not overcome their special interest lobby.

I was on the floor about three weeks fighting for that legislation -- common-sense, reasonable reform so that the money that is allocated actually gets down to patients who deserve it, but I failed.

AMNews: What was your proudest moment as a senator?

Dr. Frist: From a legislative standpoint, it was passing appropriate reform of Medicare, which included affordable access to prescription drugs for 40 million seniors who otherwise did not have affordable access through Medicare.

In terms of policies outside of Medicare, it was ensuring that the two most recent Supreme Court nominees were confirmed without delay. The impact of that will be felt by generations in terms of an impact on everyday life through our court system.

AMNews: Having worked as a surgeon in Massachusetts, what do you think of the state's Commonwealth Connector reforms?

Dr. Frist: I congratulate [former] Gov. Romney and the state Legislature for embarking upon a bold, inclusive and creative plan to extend coverage for the Commonwealth. It is clearly a program in progress, an experiment in many ways, but one which I applaud. It is important that we have laboratories of change, and that should be bold change. I would encourage other states to embark upon similar programs tailored to the needs of their population.

AMNews: When it comes to health system reform, what do you think about requiring people to have insurance?

Dr. Frist: I am opposed to mandated health insurance. By addressing the two fundamental issues of cost and coverage, we could make huge headway by having a system that is more transparent in terms of pricing -- that is a healthy amalgam of public and private programs that focuses on allowing the private marketplace to allow a consumer-driven system to flourish but at the same time recognizes the government must step in and help those who might not otherwise be helped: the aged, the poor and children.

AMNews: Do you see the U.S. adopting some sort of universal health care system in the next few years?

Dr. Frist: The issues of cost and coverage will be the focus, I believe, of the first four years of the next presidency. The fact there are 47 million people uninsured today is inexcusable in a country as prosperous as ours. That coverage must be extended. I believe it should be extended in such a way that is consistent with a consumer-directed, patient-centered, provider-friendly system that is driven by 21st-century information and choice.

AMNews: How much responsibility does the West have in Africa's problems?

Dr. Frist: First, there's a moral imperative in that a child born in the developing world has 20 times the chance of dying as one born in Nashville, Tenn.

Also, what happens in terms of health development in nations around the world also influences our own national security. A society where there is hollowing by HIV/AIDS of policemen, teachers and civil servants is to become an unstable society, which leads to a lack of hope. Out of a lack of hope there is bred an anti-West sentiment, a terrorist sentiment, all of which has a direct impact on the safety and security of the American people.

The third issue is that communicable disease can travel on an airplane eight to 20 hours and enter this country at any time.

AMNews: You and your former political opponent and predecessor Tom Daschle are working together but in a more nonpartisan way?

Dr. Frist: Tom Daschle, former Democratic Senate majority leader, and I have united behind a campaign called One Vote '08, the purpose of which is to engage the American people and ultimately each of the candidates who are running for president of the United States on the issues of extreme poverty and global disease. These two issues are important, whether it's from the moral imperative standpoint, the national security standpoint or the safety standpoint.

AMNews: Were there any hard feelings to resolve with Daschle?

Dr. Frist: What America doesn't see is the behind-the-scenes relationships that occur among political figures, in particular in the U.S. Senate, where most of us, Democrat and Republican, do spend each and every day together. We both set aside any political differences to unite on this issue and many other issues, especially issues that have such a dramatic impact on the future of the United States and the global community.

AMNews: Are you finished with politics for good?

Dr. Frist: I stated very clearly that I would go into the political arena for 12 years -- that I would leave my medical practice for that period of time and then return home to Nashville to live under the laws that are passed. I am fulfilling that promise and extending my reach in many ways by now focusing on global health issues as they relate to people in this country and around the world. Whether or not there is a role for me to play politically in the future, I don't know.