February 06, 2024
Politicians, lobbyists and legislative staff are common sights when the California State Legislature is in session. Yet, nearly every summer for the past decade, a group you might not expect can also be found in the halls of the Capitol: students from the UC San Diego (UCSD) School of Medicine. Thanks to the “Introduction to the Politics of Medicine” class taught by Assistant Professor of Anesthesiology Robert Hertzka, M.D. – which he started in 1988 – medical students are able to step out of their usual clinical confines and gain firsthand experience working at the intersection of health care and legislation.
Below, Matt Allen, a UCSD medical student who recently took Dr. Hertzka’s class, shared his experience and takeaways after participating in the program.
Through the UCSD School of Medicine’s Health Policy course, I was able to spend the final weeks of the 2023 legislative session in the office of California State Senator Josh Becker. I had hoped to work with a techy individual from Silicon Valley, and Senator Becker was perfect. During my experience, I sat in on meetings surrounding the controversial “Delete Act” and prepared reports on health policy topics such as long-term care insurance and Medicare Advantage fraud. Here are a few takeaways:
Most people – on both sides of the aisle – are good, sincere people. Politics is notoriously divisive, and the disagreements are real and important. However, almost everyone I met seemed to be a thoughtful person trying to make a positive impact. I especially enjoyed watching a fun, bipartisan softball game. I think respectful disagreement and teamwork, despite our differences, is something our nation needs more of.
Being a legislator is hard work. You have to continually jump from complicated issue to complicated issue – many of which are outside your area of expertise – with everyone needing something from you.
Pressure to publish exists in politics, too. This takes the form of passing bills. I was astounded to learn that the California legislature typically introduces over 2,000 bills per year. Maybe lawmaking and academic publishing both need a push in the quality vs. quantity direction
You’re a subject matter expert, even as a medical student. I realized that, even as a student, I have substantial experience and knowledge about how medicine and health care work that can benefit those considering health policy questions. Realizing that made me feel confident about speaking up and contributing to policy discussions relating to health care and medicine.
There is great distance from ideas to policy to implementation. I did this internship because I believe in the power of political and social drivers of health. Almost every day I would have an idea to fix some health policy issue. Upon researching the issue, I would typically realize that a) there are already numerous people working on the issue; b) the issue is a lot more complex than I realized; and c) even if my idea was feasible from a policy perspective, actually implementing it would require overcoming major hurdles. Government needs to do a better job of engaging end-users in policy making rather than thinking of implementation as a concern down the road. This is part of why physicians – the end users of many health policy innovations – and other experts working on the frontlines of health care need to get involved in the process!
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