Doc Running for Congress Calls RFK Jr. ‘Dangerous and Incompetent’

As part of MedPage Today‘s series on healthcare clinicians running for office, Washington Editor Joyce Frieden spoke with Richard Pan, MD, MPH, a pediatrician and former state senator who is running as a Democrat for a U.S. House seat in California. The interview, which was conducted via phone with a press person present, has been edited for length and clarity.

How did you end up working in healthcare?

I wanted to be a physician since I was fairly young. I started as a biophysics major in college at Johns Hopkins, and I like to say that my career journey is from the micro to the macro.

So I started off wanting to discover the next great cure. I was looking at gene expression, protein structures, all that stuff. I did the lab work, and then through my training in medicine and through my career, I started getting more involved in the role of community in health and access to healthcare — what people call the social determinants of health.

I went to medical school at University of Pittsburgh, and actually ended up spending some time with the U.S. Public Health Service Commissioned Corps. With the measles outbreak in Pennsylvania now, they say that the last measles deaths were 35 years ago — that was in 1991 during the Philadelphia measles outbreak, and I was there. We had nine children die and over 1,000 people get measles, and that was during my last year of medical school.

I went to Boston for residency, and I was at Mass General, where I was a pediatric chief resident, and did a fellowship at Boston Children’s Hospital in both child advocacy and primary care research. Then I became a faculty member at the University of California Davis in Sacramento, and that’s how I got to California.

Eventually I became a residency program director and started a program to teach resident physicians in pediatrics, and we expanded that to include social determinants of health and community health. And if you’re teaching about community health, you have to model that for your residents, right? So I was involved here in Sacramento, and served on a county commission for early child development.

I also served on the United Way board and started a not-for-profit that helped 65,000 children get healthcare coverage in the area. And then when the Great Recession hit, I didn’t plan on a career in politics, but of course through that journey, I recognized the important role government had to play in health, so I ended up running for the state legislature.

People thought I had no chance of winning because I was in the wrong party and never had run for public office before, but I won. So that’s how I was in the state legislature for 12 years, and then I termed out in 2022.

I went back to teach at UC Davis, and then [the Trump] administration happened, including Robert F. Kennedy Jr. becoming HHS secretary. I decided that I needed to run for Congress because this administration was undoing all the things I had done in the state legislature to try to improve health for the people in California.

How did you get involved with vaccine legislation?

Before I even entered the state legislature, I was leader in the California American Academy of Pediatrics, and one of the things that I did was survey our members about our strategic plan, and the top issue for the membership was not reimbursement — it was actually immunization rates because they seemed to have been declining over the years, and we saw more and more kids whose parents had decided to opt them out of vaccines.

In California at the time, we had a personal belief exception — parents just said, “I don’t want to vaccinate my child,” and then the vaccine requirements didn’t apply any more. So it was a very low bar. The percentage of parents who wanted an exemption for the vaccines remained constant through the ’70s, the ’80s, and even the ’90s, but then in the late ’90s, you had the Andrew Wakefield paper [falsely linking autism to vaccines], and then the rise of social media amplified a lot of the disinformation.

So we saw more and more parents coming in and saying they didn’t want to get their kids vaccinated, and so that was beginning to be a big concern because if it gets too high, you don’t have herd immunity. And in fact, that’s exactly what happened in 2015 here in California, when we had a case of measles in Disneyland, and it led to an outbreak of over 100 people. Most of the cases were in communities where there are lower rates of vaccinations.

That wasn’t the first disease where this problem popped up — in 2010, there was a large pertussis outbreak in California and 10 infants died. It was terrible. So in my first vaccine bill in 2012, we tried to make exemptions a little harder — we said that if you want to get an exemption from the vaccines, instead of just saying, “I don’t want to get vaccinated,” you actually have to show proof that you talked to a doctor about the disease, so you understood what you were opting out of. That bill was modeled after a law in the state of Washington, and it passed.

What happened next?

I had just gotten elected to the state senate, and state senator Ben Allen (D-District 24), who was a former school board member, came to me and said that he was really concerned about school safety because school districts, if they had a school that had a low vaccination rate, they could not do anything about it [because of the statewide vaccine exemption]. This was also when the outbreak at Disneyland was happening, so we authored a law that abolished the non-medical exemption in the face of that bad outbreak.

Then Kennedy came to Sacramento [the state capital] and he called vaccines a “Holocaust,” although he did apologize for it later. But he came to oppose our bill. Mary Holland, who is now the head of Children’s Health Defense [founded by Kennedy], came and testified at the state judiciary committee and said that vaccination is rape.

We got death threats. But I was not going to be bullied. If they had science on their side, if they had facts on their side, they would present them. Then they would not have to resort to death threats and threats of violence towards people who they disagreed with. But they didn’t, so that’s what they resorted to.

We got that bill passed, and in 2019 there was another round of measles; actually, we almost lost our measles elimination status because there was a large outbreak across the country, but thanks to the law that I authored, in California, we didn’t. But I had to author another bill because, unfortunately, a small number of doctors were literally selling their medical exemptions, so we had to exert oversight over that.

Do you agree with the calls to oust Kennedy from his position as HHS secretary?

I do because I think he’s dangerous and incompetent. Let’s just talk about outcomes. We have thousands of cases of measles right now in the United States; we already have four deaths of measles this year, and before he became secretary, we hadn’t had deaths from measles in 10 years. And then on top of that, it’s not just vaccines. Think about the number of food recalls we’ve had, like for Cyclospora and Salmonella. We have someone who is doing everything he can to sow confusion, to undermine trust … and is actively putting the American people in danger.

What other healthcare priorities would you have if you were elected to Congress?

Families are struggling with cost of living, and poverty is a social determinant of health. When households are falling farther behind economically, they’re not able to make ends meet, and that’s also not good for their health. And people are unable to afford healthcare, and some of that is because [Republicans] are slashing Medicaid by almost a trillion dollars. There are also the cuts to the Affordable Care Act exchanges, and the tax credits that some people got to help pay for [those plans] are gone. These are not wealthy people. These are basically middle-class people who have just seen their premiums double or triple.

For people on Medicaid, they’ve created more bureaucracy in the Medicaid program, including the work requirement. Even when people qualify, it’s much harder for them to get enrolled because of the burden of documentation. We’re expecting a large number of people who actually qualify to not be able to do it right.

Environmental safety is also interesting. Kennedy’s former group, Children’s Health Defense, used to be called the World Mercury Project because he was fighting against mercury in vaccines. But he has been OK with increasing the amount of mercury in the air. All of those ingredients they said are so horrible in vaccines, they want to massively increase the amount of the same things in the air that children are breathing.

One thing physicians are concerned about is Medicare physician pay. Do you see that as an issue?

Yes, the physician payment system in Medicare is dysfunctional. Physicians are the only providers who basically have to meet budget neutrality requirements. And with further cuts to Medicare, we could see physicians basically opting out of Medicare. I think most physicians really try not to because they want to take care of seniors, the people on Medicare, but they keep forcing more and more cuts. We’re going to see bigger access problems in Medicare, and that’s something that people aren’t really talking much about.