Dr. Koop and What Ails America

A week ago, former surgeon general C. Everett Koop died at the age of 96. I most remember Dr. Koop as the spokesmen for Life Alert, maker of a necklace that helps senior citizens call for help. He was also notable for absolutely rocking the Abe Lincoln/Amish-style beard. But as the country continues to fall victim to manufactured partisan showdowns, the good doctor’s impressive career holds some hopeful lessons.

Dr. Koop was a social conservative who personally opposed abortion and homosexuality. These views led to his appointment as surgeon general by President Regan in 1981. But the doctor, after reviewing the medical facts about abortion, decided that it was a safe procedure. As the New York Times reports, Dr. Koop’s opposition to abortion was rooted in moral reasons, and he did not think his office should be used to promote those beliefs.

The AIDS epidemic was just beginning when Dr. Koop assumed office. Despite the protest of many social conservatives who viewed AIDS as a “gay disease,” he labeled it a “no-fault disease” and argued for the use of condoms as a preventative measure. It’s easy to forget how hostile much of the country was toward homosexuals, and how that hostility fueled the panic about AIDS. As the Washington Post notes in a great piece about Dr. Koop, “Rep. Bill Dannemeyer proposed rounding up gay men and quarantining them on a South Pacific island, sought to criminalize the transmission of HIV and read graphic descriptions of sexual acts into the Congressional Record.” Dr. Koop fought against such bigoted and unscientific views.

Dr. Koop might be best known for his crusade against smoking. The doctor squared off against legislators from tobacco states, many the same social conservatives who opposed his other stances, and made smoking a public health issue. The Times notes that “When Dr. Koop took office, 33 percent of Americans smoked; when he left, the percentage had dropped to 26.”

It’s easy to dismiss praise of Dr. Koop as mere liberal lionization of a social conservative enemy. But this is unfair to the doctor, especially in light of his personal beliefs. Dr. Koop’s career shows that it is possible to separate personal morality and pragmatic policymaking. It’s impossible to completely divorce policymaking from morality, and I don’t think we should. But Dr. Koop realized that imposing morality through policymaking, especially when faced with populations with urgent needs, is dangerous.

An interesting, modern-day coda comes from Texas, where lawmakers slashed funding for family-planning clinics in 2011 over fears that clinics were affiliated with abortion providers. As the Texas Tribune reports, “Now, amid estimates that the cuts could lead to 24,000 additional 2014-15 births at a cost to taxpayers of $273 million, lawmakers are seeking a way to restore financing without ruffling feathers.” The Texas example shows that it’s easy to cloak policymaking in moral terms, but that policymaking has pragmatic consequences regardless of how it’s justified. I applaud Dr. Koop for choosing to stand for the public health above all, and I hope today’s policymakers can learn from his example.