The Benjamin Rush Institute (BRI) “unites medical students, faculty, doctors, health care professionals and others from across the political spectrum, who believe that free enterprise and a direct patient-doctor relationship are the best means of ensuring optimal patient outcomes at affordable prices,” the organization’s website states.
BRI founder Sally Pipes says she started the group out of a concern medical student were receiving only one perspective on their chosen profession.
“It had become so clear to me, following several medical school debates, that the majority of professors were biased in their teaching of students—focusing solely on the need for a single-payer or ‘Medicare for All’ system,” said Pipes. “There was no discussion about the alternatives to such a system and why a complete government takeover of our health care system would be a disaster for doctors and patients alike.”
Hatching the Idea
Pipes says she was inspired by the work and success of the Federalist Society.
“I thought the society’s model for law students and lawyers was one that could be reproduced for medical students,” said Pipes.
Pipes and others met with Federalist Society leaders in 2008 to discuss the possibilities, and the new organization was born.
“The Benjamin Rush Institute was named after Dr. Benjamin Rush, a signer of the Declaration of Independence, a medical doctor, politician, and humanitarian,” said Pipes. “His views were very reflective of the objectives of our new organization.
“It was very important to me that students have the opportunity to establish chapters at their medical schools so they could set up and attend debates that focus on competing but balanced views on health care,” Pipes said.
Rebecca Kiessling, director of programs at the institute, says BRI’s mission is to promote free-market ideas at the beginning of medical careers while students are still in college, so they can have a strong influence on medical policy going forward.
“Medical schools as a whole are mostly funded by ‘big business,’ whether it’s by ‘big pharma’ or ‘big insurance,’ and because of that, information about free-market alternatives just isn’t getting to these students,” said Kiessling. “When I say students, that could be M.D., or D.O., or dental, or nursing students, so we’re trying to run the gamut of the medical profession.
“Our main mission is to promote and educate medical students in free-market and free-enterprise health care,” said Kiessling.
Kiessling says BRI uses informal rather than formal channels to spread its message.
“We try to start chapters, or a club,” said Kiessling. “We have a little more autonomy to put somebody like a direct primary care doctor or somebody from the Cato Institute as a visiting lecturer. It is difficult to do that in a medical school [setting] primarily funded by a big an insurance company, for example.”
Proceeding with Caution
BRI currently sponsors chapters in 50 medical schools in the United States and abroad. Year-to-year continuity of chapters has been a challenge but is improving, Kiessling says.
Speaking to Health Care Newson condition of anonymity, a medical student and BRI member says students’ limited exposure to free-market ideas results in a bias in favor of big-government policies.
“They have faith in single-payer health care because almost every authority figure within and without the medical system has told them consistently that people who believe in single-payer health care are good and those who do not are bad,” the student said.
The student said those who disagree with that perspective often feel like outcasts and are subjected to intimidation.
“They most often do it quietly, because they have either internalized the morality of their opponents, they do not believe anyone will back them up, they do not know any of their silent allies, or they are afraid of losing career prospects and prestige amidst their ideological opponents,” said the student. “It is usually a combination of the four.”
‘The Landscape Is Changing’
Kiessling says medical students can be a force for change.
“It’s very interesting to look back at the history of BRI and how health care in the United States has changed,” said Kiessling. “We’ve gone through the advent of the ACA and Obamacare, and now even with that being looked at again, the landscape is changing. And we have amazing doctors and policymakers looking at how to get language in where free market health care in some form is going be part of those changes, and how medical students are going to be part of that.”
Kiessling says many medical students are pursuing multiple credentials in addition to their medical degree, such as a master’s degree in public policy or public health.
“What we’re teaching them is that those letters after their name that they’re working so hard at getting are extremely powerful,” said Kiessling. “Some of them will be advocates. Some of them will be loud and picketing and doing things. Some of them go in to get their medical degrees already having their Master of Public Policy because they want to influence policy.
“Some will never go into free-market health care, and that’s OK, but they still believe in it wholeheartedly,” Kiessling said. “And so, they will influence it in different ways.”
Leo Pusateri ([email protected])writes from St. Cloud, Minnesota.