Steven Feldman is a physician in Winston-Salem who has lived in North Carolina for over 40 years. Feldman received his medical training at Duke University and the University of North Carolina at Chapel Hill. He is married to his wife Leora and has two sons.
Steven Feldman is a physician in Winston-Salem who has lived in North Carolina for over 40 years. Feldman received his medical training at Duke University and the University of North Carolina at Chapel Hill. He is married to his wife Leora and has two sons.
Candidate Q&A
Answers provided by email.
What do you see as the biggest financial and administrative challenge to implementing the work requirements for Medicaid that were included in the One Big Beautiful Bill?
We all want people to have good jobs, and we all want good access to care for ourselves and others. The biggest challenge is lack of good jobs. Mountainous federal debt crowds out investment that could grow our economy and help people find work. Our broken health system costs way too much and contributes to our debt problems.
Other well-intended laws have unintended consequences. Licensing laws demand hundreds of hours of training to braid hair. Licensing boards shut out people with old criminal records. Zoning and child care rules drive up costs. Each was well-intended. Together, they keep people out of work.
Add this legislation’s costly verification bureaucracy run by overburdened county offices, and we risk cutting people off for paperwork rather than idleness. The better solution is market forces that make health care affordable for rich and poor alike and fewer regulations that limit job opportunities.
What would be your plan for ensuring the future security and strength of Social Security and Medicare?
Social Security and Medicare are needed for people who count on them.
Social Security was never a savings account. Workers’ payroll taxes pay today’s retirees. In 1950, about 16 workers paid in for every person collecting benefits. Today it’s about two and a half. The retirement fund runs dry in 2032, triggering automatic cuts of about 22 percent. For decades we’ve promised more than we’ve paid for and passed the bill to our children.
I’d start phasing in a higher retirement age now, relying on disability insurance for those who can’t keep working, and curtail benefits for well-off retirees. It’s painful but necessary. The sooner we rip off the bandaid, the less it will hurt in the long run.
Medicare needs market forces. Give patients choices and make doctors, hospitals, and drug companies compete on price. My profession needs more competition, not less.
What would you support in Congress as a plan to help control health care and pharmaceutical costs?
Health care costs worry nearly every family. To reduce the burden, we can return to Americans their freedom to buy prescription drugs wherever they want, including from other countries.
I’d also let patients see and pay the cost of their care. I once offered a patient with mild psoriasis a $4 generic, a $200 brand-name cream, and an $800 combination product. Well insured, the patient said, “Give me the $200 one and the $800 one, and I’ll see which I like better.” The patient had no reason to choose wisely, so drug companies had no reason to offer a low price. Health savings accounts, funded by redirecting money we already spend, would make patients shop for value.
To keep innovation alive, I’d cut the cost of developing drugs by shifting the FDA to an advisory role. Patients would have more choice; they know better than bureaucrats what’s best for themselves.
What steps would you take to improve access to health care in rural areas? How do we make the Rural Health Transformation Program successful in North Carolina?
Families in rural North Carolina shouldn’t have to drive so far to see a doctor. They deserve the freedom to get care from anyone they choose, but rules keep too many providers away.
First, let nurse practitioners, physician assistants, and pharmacists practice to the full extent of their training. Too often the choice isn’t between a doctor and a nurse practitioner. It’s between a nurse practitioner and no one.
Second, open telehealth without borders. A rural patient should be free to choose a physician licensed in any state, a dermatologist in India at a fraction of the cost, or an AI.
Third, end certificate-of-need laws, which protect existing hospitals from competition, not patients from harm.
The Rural Health Transformation Program should be judged by results: more appointments, shorter drives, fewer clinic closures. Removing barriers to care doesn’t cost taxpayers a dime.
The rollout of AI is moving fast, including in health care, and leaders in that space are calling for things to slow down. What federal moves should be taken to regulate it, if at all?
There’s excitement and unease about how fast AI is moving. AI may be the biggest advance in health care in my lifetime. I use it in my practice to help diagnose and treat patients. Slowing it down has costs we won’t see: delayed diagnoses, drugs that could have been developed and alternative sources of care.
Regulation can become a moat against competitors and a shield against accountability. Instead, we can rely on the threat of lawsuits to make companies careful before anyone gets hurt. Federal rules can weaken that protection: in 2008, the Supreme Court ruled FDA approval shields certain medical device makers from many injury lawsuits. AI companies that hurt people should answer for it, like anyone else.
Where do you stand on federal vaccine policy? What should be done to prevent future disease outbreaks?
Medical decisions are very personal, not something we want bureaucrats making for us. My wife and I vaccinated our children, and we keep our vaccinations up to date. We made those decisions with the help of our physicians and pediatricians. As long as we aren’t hurting others, government shouldn’t tell us what to do with our bodies.
The government and medical organizations can make recommendations, but the final decision belongs to parents and their doctors, not Washington. That freedom comes with responsibility, for our families and, importantly, for the people around us.
Every parent wants to protect their children from diseases like measles. The best protection is trust. When vaccine guidance becomes political, trust and vaccination rates fall. Health agencies should stick to the science and admit uncertainty. And we need to know the truth about what role, if any, our government’s research funding had in creating COVID.
We’ve had some high-profile food contamination outbreaks, yet the federal government is pulling back on regulation of food, air and water. What level of federal regulation do you support and why?
Every family wants safe food on the table and clean water from the tap.
Regulation may be needed when people are harmed by exposures they didn’t choose. I’m skeptical of regulation that protects people from their own choices.
Pollution is the clearest case. A company that dumps chemicals in a river harms people who never agreed to bear that cost. That isn’t freedom. It’s trespass, and polluters should pay for the damage.
Food safety is similar. What protects the public best is the certainty that companies who poison customers will pay dearly. Government’s most valuable role is detecting outbreaks, tracing them, and telling the public.
Private oversight can also work. I’m Jewish, and growing up, we ate only kosher food, so I learned early to rely on a private seal of approval. Major grocery chains already require suppliers to pass independent safety audits. Consumers can choose which seals they trust.
PFAS contamination is a nationwide issue; how do you address it while balancing public safety and business interests?
As a skeptical physician-scientist, I ask how big the risk really is. In my field, severe psoriasis roughly triples a young adult’s risk of heart attack. That sounds bad, but a 25-year-old’s risk is about 1 in 50,000 a year. Three times that isn’t a huge risk.
Like nearly every American, I have PFAS in my blood, and I’m not losing sleep over it. Serious contamination, though, is another story. By EPA’s estimate, its 2024 rule would prevent about one death per 10,000 people over a lifetime, at $1.5 billion a year; utilities say nearly triple that. EPA says replacing lead pipes delivers up to 13 times its cost. Let’s start where we protect the most people.
Where contamination is heavy, like downstream of Chemours on the Cape Fear River, the polluter, not ratepayers, should pay to clean it up.
The building and placement of data centers have become a big issue, particularly in many rural communities. What should be the federal government’s role, if any, in how these are developed?
Rural communities have real concerns about data centers: noise, water use, and higher power bills. Still, the federal government should stay out of it. Where data centers go is a decision for property owners, local communities, and state regulators, not Washington. That cuts both ways: no federal rules blocking data centers, and no federal favors speeding them along. And whoever builds a data center should pay its full costs, including the power it needs, rather than passing them on to families who never chose it.
Is there anything else you’d like our readers to know?
Fiscal responsibility and civility have health implications.
This year, Washington will spend about $1 trillion on interest, more than on Medicaid or defense. That’s money unavailable for patients or other productive uses.
Political vitriol is a health hazard. Chronic hostility is linked to heart disease. Pat Harrigan and Ashley Bell and others seeking office are caring people, not our enemies. And violence, from school shootings to wars overseas, is a health issue. We need a culture that honors civility over violence.
I’m not a major party candidate, and I’m free to say what I think. Medicare for All would improve access, but quality can suffer and waits can be long. I saw it firsthand on a recent trip to England. I’d rather bring competition to health care.
A vote that sends a clear message in support of fiscal sanity and civility isn’t wasted. Learn more at stevefeldmanforcongress.com.
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