The first incarnation of the US Surgeon General was established in 1871 to oversee the administration of the US Marine Hospital System. In the intervening years, the role of the Surgeon General has evolved into “America's Doctor”—a spokesperson and advocate for the pressing public health issues of the day.
In 2013, Vivek Murthy was nominated by President Barack Obama as the next Surgeon General. A Harvard and Yale-educated internist and former emergency room physician who has served in a public health advisory capacity to the President, Murthy is a highly qualified candidate. The same passion for promoting and safeguarding the health of Americans that brought Murthy to the attention of the Obama Administration, however, has also put his confirmation in jeopardy.
At issue is a tweet that Murthy wrote after a mass shooting in December, 2012, that took the lives of 20 elementary schoolchildren and six staff in Sandy Hook, CT: “Tired of politicians playing politics w/ guns, putting lives at risk b/c they're scared of NRA. Guns are a health care issue. #debatehealth” and a January, 2013, letter on which he is a co-author that urges Congress to support an assault rifle ban and to require mandatory firearm safety training and waiting periods for those who wish to purchase guns. Seizing on this, the National Rifle Association (NRA) has charged that Murthy's fitness for the position is undermined by his support of “radical gun control measures” and has mounted an aggressive campaign to block his confirmation.
The NRA considers itself the largest and oldest civil rights organisation in America and has exerted that position in a long history of political advocacy. With a budget of around US$230 million and a membership of 5 million people, the NRA is a formidable opponent in numbers and in political sway. The simple senatorial majority required to confirm Murthy may well hinge on ten senators—all Democrats from conservative states such as Alaska and Louisiana where the influence of the NRA is most entrenched—who will be up for re-election this year. Under escalating pressure, there is a real concern that those ten senators may vote against Murthy, quashing his confirmation.
What is fascinating and chilling is the NRA's selective interest in the role of the Surgeon General. There is no precedent for a special interest group blocking a fully qualified candidate from the Surgeon General position. There is, however, a clear precedent for the Surgeon General to favour bold action, which may be counter to their brand of political advocacy.*****