Feldman is a physician from 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.
Our Q&A with Steven Feldman
What would be your plan for ensuring the future security and strength of Medicare?
The greatest threat to Medicare is its escalating cost. As it becomes too expensive to maintain, it will not be available to the people who need it. I believe the best way to control costs is to give people incentives to choose resaonable lower cost options, creating competition to reduce prices and giving providers incentives to improve quality. I think market-based care is the best way to achieve these ends, and I would seek solutions that empower Medicare recipients to make wise choices of health care resources, to choose reasonable, low cost options from a broad range of competitive providers whose reputations will depend on the quality of care they deliver.
What would you support in Congress as a plan to help control health care and pharmaceutical costs?
I see three policy changes that could have an immediate and positive impact on our ability to control health care costs:
- Convert government-funded programs to high deductible plans that encourage patients to use healthcare resources wisely.
- Give patients the freedom to buy medication from wherever they want, even from other countries. This freedom would come with the responsibility to make wise choices.
- Reduce regulations that limit access to and increase the cost of healthcare services and pharmaceutical development.
Where do you stand on time limits for Medicaid and work requirements for the program?
First, address root causes. To help keep people from needing Medicaid and to reduce the amount of time people need to be on Medicaid, we can reduce government regulations that limit access to good jobs. Second, I favor allowing and encouraging states to manage their Medicaid programs as they see fit, so that we can see what time limits and work requirements work best in the real world.
How do you think Congress can improve access to child care?
This is primarily a state issue. State business regulations may make it hard for people to enter the market to provide childcare services. Federal subsidies, while well-meaning, could be counterproductive; subsidies would cause the price of childcare services to increase, making child care even less affordable for those who don’t qualify for the subsidy.
Congress can focus on improving American infrastructure that would permit more people to work from home. This would reduce the demand for (and therefore the price of) childcare services.
Where do you stand on federal abortion limits? What gestational limits, if any, would you set?
Abortion or reproductive rights is an issue for which there is no reasonable compromise. The government should—absolutely—not try to control women’s bodies. The government—absolutely—should not condone murder. These two “no compromise is possible” principles are at odds, and some balance must be found.
A reasonable, balanced policy could include:
- Keeping government out of funding abortions.
- Making abortion illegal after a certain period of gestation, with proper consideration for the health of the mother.
- Allowing different states to adopt different regulations, based on the views of the people in those different states. My preference would be a gestational age limit based on viability.
What can the federal government do to support rural hospitals?
Much of this falls on state-level licensing and regulations that limit who can provide services. I’d like to see those impediments reduced.
At the federal level, focusing our resources here at home, rather than on military spending abroad, will allow us to provide better infrastructure (roads and internet) to improve access to both physical health care facilities and telemedicine services.
Spending less on the military and more on service work within our own country would help meet the workforce needs of our rural communities.
Where do you stand on restoring funding for the Affordable Connectivity Program?
The founding fathers of our nation saw a robust mail system as critical to the nation’s welfare. The modern “robust communication” system is Internet connectivity, replacing mail as the essential communication tool. Government support for private efforts may be the best way to achieve universal access to high-speed communication service.
PFAS contamination is a country-wide issue; How do you balance public safety and business interests with this issue?
First, it would be helpful to understand the magnitude of the problem. PFAS has been associated with an increased risk of cancer in some studies. For kidney cancer, a hazard ratio of 1.1 was reported. The increased cancer rate, assuming it is directly related to PFAS, translates to about 11 kidney cancer deaths in every 2,000 people exposed to PFAS compared with 10 kidney cancer deaths in that population if they weren’t exposed to PFAS. We need to accurately assess and balance the effect of PFAS on the population to the costs of not having PFAS.
Do you think the federal government is ready for the next pandemic? Why or why not?
This is a complex, multifaceted issue, but a key component is the public’s confidence in the government and the information the government provides. That confidence is lacking. I support far greater transparency in government. I support making government agency recommendations advisory, not compulsory. People should have the freedom and responsibility for their own decisions.
What steps would you take to improve access to mental health services and to address the opioid overdose crisis?
Reducing regulations at the state level could increase the supply of mental health services. Market-based healthcare would lower the costs and increase access, too.
Government should restrict people from hurting others but otherwise let people live their lives as they choose. There’s no perfect solution to the opioid overdose crisis, but our experience with alcohol has shown that legalization is better than prohibition. Legalizing or decriminalizing drugs at the federal level would:
- Allow us to rely on personal & family responsibility, rather than government force
- Reduce imprisonment and its associated costs
- End the destruction of communities caused by illegal drug traffic and government efforts to control it
- Reduce racial disparities in drug crime sentencing
- Make opioid treatment easier to access with less stigma
Do you think the federal government should enforce stricter requirements for nonprofit hospitals to justify their tax exemptions? Why or why not?
No. Generally, I believe that government regulations are, while well meaning, counterproductive. More rules and regulations mean more resources get spent gaming the system to circumvent the rules. Less government intrusion gives businesses — including hospitals — greater flexibility to meet their customers’/patients’ needs.
Are there any other health issues you’d like to weigh in on?
As a physician caring for patients, I see how our system leads to high costs and limited access. When insured, patients have little incentive to choose reasonable low-cost options. Insurers, lacking unlimited resources, are forced to ration care. Single-payer “free care” helps assure care for everyone but limits choice and makes government ration care. Plus, it isn’t free; it’s paid by taxes or, worse, by laying more debt on future generations. My preference is to encourage market-based care. Markets give people incentives to choose lower cost options, create competition to reduce prices and give providers incentives to improve quality.