As part of 鶹ý's occasional series on healthcare clinicians running for office, Washington Correspondent Shannon Firth spoke with Herb Conaway, MD, a primary care physician and Democratic state lawmaker running for an open U.S. House seat in New Jersey.
Conaway, a former U.S. Air Force captain, has passed more than 300 bills into law, including one that enshrines the right to an abortion into state statute.
Conaway completed a bachelor's degree from Princeton University in New Jersey, a medical degree at Jefferson Medical College in Philadelphia, and a law degree from Rutgers Law School in Camden, New Jersey.
鶹ý also requested an interview with the Republican candidate running against Conaway, Rajesh Mohan, MD, but received no response.
This interview has been edited for brevity and clarity.
What do you see as your biggest healthcare achievements at the state level?
Conaway: In terms of its impact on the present and the future, my biggest achievements include things that are directed at our children, including and all the attendant negative consequences that spring from that. Secondly, passing the legislation that established .
Healthcare is a right that we need to secure for our population for many reasons, certainly for the individuals and also for our competitiveness as a nation. A healthy population that can get to work or be in school or any training program, that brings benefits to all of us.
With respect to mental health services, one of the things I'm proud of is getting school-aged children screened for mental health issues, which often go undiagnosed or unaddressed for far too long. Depression and anxiety will lead to poorer school performance, which, of course, impacts income and everything else. On the other hand, early diagnosis, early identification, and early referral to a proper care setting provide enormous benefits to individuals and, again, to our society at large.
If elected to Congress, what is one healthcare issue that you'd like to help tackle?
Conaway: We really have to do something to fix how we pay for physician services in the Medicare program. Physicians are making 20% less in today's dollars than they did 20 years ago or even less time than that. We have not made the appropriate adjustments to physician payment, and what that portends are increasing numbers of physicians who will no longer accept Medicare patients into their practice. We have to get this right. We have to prioritize access to care for the more elderly members of our society.
If elected, I also want to advocate to make sure that, across NIH and CDC and SAMHSA [the Substance Abuse and Mental Health Services Administration], we're doing all we can to fund critically needed research that will bring forward cures of today and tomorrow.
One of your focuses as a lawmaker has been . If Donald Trump is elected president again, how would you address health equity under that administration?
Conaway: If President Trump is elected to the White House, there will be very little progress on these issues, because he has shown that he is, quite frankly, a racist and really doesn't care very much about issues of equity. He has just recently been involved in denigrating the Puertorriqueños. He has been involved with misogyny and racist attitudes about Latinos. And far too many people in his own party are apparently prepared to endorse these attitudes. And so I think it would be a very tough road.
My approach in this kind of a setting, and one of the things I did during the pandemic, was to make sure that we in New Jersey were measuring the conditions that impact the community at large, so that we could determine whether certain disease conditions were more prevalent in the LGBT community, or the Black community, or the Latino community. That way we could then address all of those disparities as they appear with appropriate interventions on the part of the government.
In my own caucus, we raised these issues and tried to insert language in bills that would at least allow us to study what's happening and provide data on that. Maybe that's something that can get over the dam.
What is your position on reproductive rights, and what will you do in Congress to advance that position?
Conaway: I believe questions around whether to increase the size of a family or not, with all the attendant considerations that go into such a decision, are to be made by that individual.
We're in a state today where women in this country are not equal to men. I can make all my healthcare decisions, but women, sadly, today after 50 years of progress are now being put to the back of the bus. And I think it's horrendous.
Future congresses are going to have the ability to do something about that. If elected, I'll vote to codify Roe v. Wade into law, because in the absence of that, we're going to see, as we've seen, one-third of the women, especially those living in the South, where their lives are going to be in danger as a result of a pregnancy.
If Democrats in Congress lack the votes to reinstate the right to abortion, what else can lawmakers do?
Conaway: Pregnancy is a high-risk state. This idea that physicians will be jailed for practicing evidence-based medicine really needs to be addressed. A woman should not have to wait until the brink of death before interventions can be taken. And hopefully, we can get some common sense to prevail around that question.
I also think there's been a long-standing problem, particularly for poor women and women of color, in having access to reproductive services because of prohibitions on payment. I supported legislation in New Jersey that would help poor women and the institutions that support them get access to reproductive healthcare.
Where do you stand on the issue of gun reform?
Conaway: There were shotguns in our family room and hunters in my family. I respect the right of a hunter to hunt and for someone to own a gun for self-protection. My issue is with these military-style weapons that are all the rage, that have been driven by gun manufacturer marketing, and the easy access to them.
I think we ought to have background checks. I think these (private sale exemptions which sidestep background checks) need to be addressed as well.
In New Jersey, I had our and how to deal with "ghost guns" (handmade guns), which are going to become ever more prevalent because they allow people to escape routine and required surveillance. I would support a ban on these weapons or greater efforts to determine where they're being produced and manufactured and how they're being modified to increase their killing capacity.
What more can be done both within and outside of medicine to address the opioid epidemic?
Conaway: Medical science needs to, again, lead the way to make sure that we are appropriately prescribing and appropriately identifying people who might be at special risk for addiction. And we need as early intervention as we possibly can achieve.
I vividly remember taking care of a patient who had just left prison and who went to live with his son. Someone had gone to pick up groceries and came back to find the father foaming at the mouth. He died 3 or 4 days later in my hospital.
We need to ensure that for those who have an addiction to opioids in their medical history and are leaving incarceration, we give them a shot of Vivitrol (naltrexone) or some other medication to prevent an overdose.
Another thing we've pushed for here in New Jersey is bringing mobile units to various communities to offer access to mental healthcare and addiction services. I think funding those kinds of outreach programs, where the healthcare system and social service system meet people where they are, is important.