AUA ADVOCACY Health Policy in Action: Highlights From the Hill
By: Ruchika Talwar, MD, Vanderbilt University Medical Center, Nashville, Tennessee | Posted on: 25 Oct 2023
As the AUA’s 2022-2023 Logan H. Holtgrewe Legislative Fellow, I had the honor of participating in a summer Congressional fellowship on Capitol Hill, in the office of Congressman Darren Soto (D-FL-09; Figure 1). Over the span of nearly 2 months, I took over the Congressman’s health care portfolio, which, as a member of the House Energy and Commerce Committee that handles health issues, often included integral legislation on Medicare payment and coverage, prescription drug pricing, improving maternal health coverage, and preserving access to reproductive health care services. Further, I was responsible for attending health care hearings from various Congressional committees and federal agencies, then briefing the Congressman and his legislative team on these hearings. As a health fellow, I also met with all constituent and stakeholder groups who wanted to discuss any health-related issue—much like the urologists who discuss the AUA’s legislative priorities during the annual AUA Summit. This time, I sat on the opposite end of the table.
It’s hard for me to quantify the amount that I learned during my time on the Hill, although I can list some of my favorite moments (including filing a bill, submitting amendments to the NDAA [National Defense Authorization Act], and meeting the Democratic Whip Katherine Clark; Figure 2). As opposed to spelling out all of these individual experiences, instead I’d like to focus on the most valuable takeaway from the fellowship experience: my renewed optimism in our systems of government.
Any time you scroll through your Twitter/X timeline or turn on the news (regardless of whether it’s CNN or Fox), it’s easy to feel that our elected representatives are always at odds with one another, struggling to agree, deadlocked in their obstinance. This is exactly what I expected to walk into on my first day. Thankfully, I could not have been more wrong. Although the stories of compromise, teamwork, and decency don’t make headlines (because they don’t sell), the vast majority of interactions between members and offices are cordial, goal-oriented, and solve actual problems. Remember, almost every aspect of Congress is bipartisan. Every committee has Republican and Democratic members. Nearly every Congressional letter has a Democratic and Republican lead. To successfully be passed, most bills also require bipartisan cosponsorship. There is no way around teamwork and compromise—and stuff really does get done. Even in my short tenure in Congress, I witnessed firsthand this spirit of camaraderie between Congressman Soto, the member I worked with and a Democrat, and Congressman Neal Dunn, a Republican and retired urologist, during a meeting I led to discuss innovative solutions to drug pricing and insurance reform (Figure 3).
My passion and drive for urologic and health advocacy were renewed when I saw how often the legislative staff in my office referenced prior constituent meetings during discussions about positions that the Congressman should take on a specific issue. Our voices as physicians really do matter, and our elected representatives rely on us to share our expertise as they try to improve the US health care system. I was always called upon to provide input on issues that were directly or indirectly related to health care, and the team valued my practical experience as a patient-facing clinician. But you don’t need to be on Capitol Hill to develop this kind of relationship with your member. In fact, by offering yourself as a resource to your local office, you’d be surprised how often the legislative team will reach out asking for your opinion.
I am grateful for the support of the entire AUA community and AUA leadership for my time as Congressman Soto’s Health Fellow, but I know that this experience is only the start of a strong partnership with the Congressman to improve the quality of urologic care that we provide for our patients.