The dermatologist in Congress

By | May 17, 2019

A year ago, Rep. John Joyce, R-Pa., was a full-time dermatologist alongside his wife in his hometown of Altoona. Becoming a politician was never his plan, but when a congressional seat opened up in 2018, Joyce threw his hat into the ring because, in his opinion, none of the other candidates adequately addressed healthcare.

For Joyce, 62, it was an abrupt transition from medicine to politics. He and his wife Alice had worked in their Pennsylvania hometown for years, raising their three kids and working side by side at their own dermatology practice. They’d been together since, after medical school, John followed Alice to Naval Hospital Portsmouth in Virginia, where she was an active-duty physician and he was a civilian. He jokes that his wife outranked him then and still does.

Though Joyce had never held public office, he said he “always wanted to serve” and knew he “had the ability to do that through being a doctor to many patients.”

“People in my district would ask me things like, ‘Why do my prescriptions cost so much?’ ‘Why does my copay go from $ 20 to $ 50 every time I go see a physician?'” he said. “It encouraged me to continue with this pursuit.”

Healthcare, not small business or environmental issues, was the No. 1 priority for Joyce’s soon-to-be constituents in Pennsylvania’s 13th Congressional District, a largely rural district that includes about 5,000 working farms.

Joyce wanted to get to work on improving access to health services as soon as possible. Just five months after being sworn into office, he sponsored his first bill, which is meant to lower drug prices.

The legislation aims to speed up the process of approving generics and putting them on the market. It would require the Food and Drug Administration to check that countless requests pouring in from individuals and health organizations to renew brand-name patents actually come from the citizens, rather than from drug manufacturers seeking to protect exclusivity for their drugs.

The FDA has long dealt with industry interference in the form of “citizen petitions” meant to thwart generic drug approvals. It’s a problem that former Commissioner Scott Gottlieb was forced to address last year.

Joyce teamed up with Rep. Anthony Brindisi, D-N.Y., to draft the Ensuring Timely Access to Generics Act of 2019. The Senate version of the bill also has bipartisan co-sponsorship. An optimist, Joyce says the bill’s bipartisan and bicameral support will lead to “small but significant changes.”

He says small changes are really all a freshman representative in the minority party can ask for. His mentors in the GOP Doctors Caucus told him early on that he will have to “make small cuts into the apple, you’re not going to get the whole apple,” but that even incremental change is change.

“This [bill] allows me to do this,” Joyce said. “You can take pieces of the apple without thinking you’re going to go in and get half the apple, and make changes in healthcare.”

Still, he is determined to make changes on a bigger scale, including to Obamacare.

As the owner of a private practice, Joyce says he saw prices and copays for simple procedures increase sharply when Obamacare was enacted.

Joyce continued to practice in the run-up to the election. One day, a new patient came to see him. He had recently started his own business cleaning offices, but a wart on his foot pained him with every step. The procedure to remove it was simple, and after receiving wound care, the patient thanked Joyce for waiving his copay. Confused, Joyce asked what he was talking about.

The patient, who had enrolled in an Obamacare plan, had a copay of $ 165 for the visit, but the administrative staff waived the fee because they could not rationalize charging that much money for what Joyce called an easy procedure. The patient told Joyce that he enrolled in an Obamacare plan, believing it would be an affordable way to get coverage, but noticed that fees for essential health services were unsustainable. Healthcare had become one of his biggest financial strains.

Joyce said this was not an isolated incident. He had seen numerous patients enrolled in Obamacare plans come in, having been led to believe their out-of-pocket costs would decrease, only to find the opposite to be true.

Joyce understood during the campaign that he was an outsider with no experience in politics, but he won over 70% of the vote in the general election. He compared his own political rise to that of President Trump, another nonpolitician who saw quick success. Even without strong political credentials to back him up, Joyce said Pennsylvanians listened to him.

“Working in the healthcare field and keeping in the lane where I want to be, working for my constituents and advocating for affordable healthcare … that defines why I’m here,” he said.

Healthcare