(TNND) — With Dr. Casey Means’ nomination to be the next surgeon general stalled in the Senate, a Cato Institute policy scholar is questioning the need to even have a surgeon general.
The nation has gone over a year without one, and Dr. Jeff Singer, a practicing general surgeon and a senior fellow at Cato, said the absence of the “nation’s doctor” hasn’t really made a meaningful difference in Americans’ lives.
“I don’t think anybody’s noticed,” Singer said. “I think the only time they notice it is when they hear … a controversy surrounding the surgeon general. And then probably most people, when they hear about it, they think, ‘Oh, so we don’t have one right now?’”
Singer wrote a recent article for Reason about his view that the government should just eliminate the role of surgeon general rather than hold a debate over who should fill it. The article was a follow-up to policy analysis he helped craft for Cato last summer, calling the surgeon general and the U.S. Public Health Service Commissioned Corps directed by the surgeon general both unnecessary relics of the past.
The surgeon general’s role dates back to the late 1700s, when Congress created a supervising physician to oversee hospitals serving merchant mariners. About a century later, Congress formalized the title of surgeon general as a political appointment.
The position grew in influence over time, at one point overseeing major public health functions, before being eclipsed in the 20th century by the creation of larger federal health agencies, including what is now the Department of Health and Human Services.
Today, the surgeon general oversees the Public Health Service Commissioned Corps, a uniformed service of about 6,000 members, and serves as a national voice on health issues.
Singer didn’t weigh in on whether Means, a Stanford-educated physician and public health influencer, is qualified to be surgeon general.
“Whether or not you think she’s a good nominee, it doesn’t matter to me,” he said. “We don’t need one.”
Singer said he began questioning the need for a surgeon general during the tail end of the Biden administration, when Vivek Murthy was still in office.
Singer contended that surgeons general have grown more political over time, with their advisories tied more to the ideology of the administration they serve than to public health concerns. He questioned advisories under the former surgeon general that dealt with gun violence and parenting.
“Why is the surgeon general telling people how to parent their kids and suggesting federal daycare and all that? What does that have to do with dying from epidemic diseases?” Singer said. “And that’s what sparked the whole study.”
Meanwhile, Singer said the Public Health Service Commissioned Corps overseen by the surgeon general should be phased out and replaced with civilian contractors.
Public Health Service Commissioned Corps members work in over 30 federal agencies, half of which have a minimal relation to public health, according to Singer and his colleagues.
For example, members could be dispatched to provide medical care in federal prisons.
The Public Health Service Commissioned Corps members aren’t part of the military, but they are part of a uniformed service. And they receive many of the same benefits as members of the armed forces.
Singer and his colleagues pointed to a 2010 report from Health and Human Services that found replacing the Corps officers with civilians could cut costs by 15%.
“Now, it’s not a huge budget item compared to a lot of the other things like defense and Medicare, Medicaid, etc., but still, it’s an unnecessary waste,” Singer said.
Oklahoma State University politics professor Seth McKee said the surgeon general role is low priority but still useful.
“I’m sort of ambivalent about the surgeon general role, because you don’t really need an infrastructure behind it,” McKee said. “So, I think I’d agree with the Cato Institute (scholar) on that, where you don’t need to prop it up with money, so to speak. But I’ve sort of always liked the surgeon general as an authority on health if you can trust them.”
McKee noted former Surgeon General C. Everett Koop, who served under Ronald Reagan and waged an anti-smoking campaign.
“At least historically, they have played an important role of trying to make us live better, if you will,” McKee said.
However, McKee said President Donald Trump should probably “cut bait at this point” on his current surgeon general pick, Means.
Amid concerns over Means qualifications and the lack of momentum in the Senate, McKee expressed skepticism that Means will get approved.
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