I just drove through this part of the country and it is intensely bereft. One extreme of how we neglect each other.

Surgeon General Once Paid in Oysters Pushed Health Care to All

By Alex Nussbaum

July 14 (Bloomberg) -- After Hurricane Katrina, Regina Benjamin took only what her patients could afford to pay: bushels of oysters or lumps of Gulf Coast crab meat. Her Alabama health clinic was destroyed and still she helped, navigating through the mud in a pick-up truck to make house calls.

Katrina’s destruction in 2005 was just the latest challenge to medical care in Bayou La Batre, a rural shrimping village that had fallen on tough economic times, said Mayor Stan Wright, recalling Benjamin’s actions during the storm. The two decades of medical care she supplied to the town’s neediest residents make her an ideal candidate as surgeon general, he said.

President Barack Obama yesterday named Benjamin, 52, as his nominee, saying the family physician would ensure patients have “a voice at the table” as policy makers overhaul the U.S. health-care system. In Bayou La Batre, Benjamin saw first hand the doctor shortages and inefficient care Obama has vowed to end, said David Satcher, a former surgeon general.

“Her life really has been what Obama’s been talking about,” said Satcher, director of The Satcher Health Leadership Institute at Morehouse School of Medicine in Atlanta, Benjamin’s alma mater. “She’s lived the commitment to the underserved. She’s lived the commitment to quality preventive care.”

Satcher taught Benjamin when she attended the medical school, and she stood out even then for her interest in serving the poor, he said in a telephone interview.

Below the Poverty Line

Bayou La Batre’s residents earned $9,928 per capita, less than half the national average, in 2000, the latest year for which U.S. Census figures are available. More than a quarter of residents lived below the poverty line.

Obama, at a White House ceremony yesterday, restated his support for winning passage this year of legislation to cover the estimated 46 million uninsured in the U.S. and rein in medical costs. Benjamin, whose nomination needs Senate approval, will be a crucial voice in the debate, he said.

Benjamin has “seen an increasing number of patients who have had health insurance their entire lives suddenly lose it because they lost their jobs, or because it’s simply become too expensive,” Obama said.

Benjamin said she was dedicated to preventive treatment that would keep more Americans healthy. She cited the deaths of her father from diabetes and high blood pressure, her mother from lung cancer brought on by smoking and her brother from an HIV-related illness.

‘Preventable Diseases’

“My family’s not here with me today because of preventable diseases,” she said at the White House. “I can be a voice in the movement to improve our nation’s health care, and our nation’s health, for the future.”

The surgeon general’s position was created in 1870 to serve as supervising surgeon for the U.S. hospital system and later as the administrator for the federal public-health system, according to the surgeon general’s Web site. It has evolved since then, with the surgeon general becoming a national educator on public-health matters, said Douglas Henley, chief executive officer of the American Academy of Family Physicians.

The post propelled Surgeon General C. Everett Koop to fame in the 1980s as a leading proponent of action to curb the AIDS epidemic. In 1993, Jocelyn Elders resigned from the post after saying schools should consider teaching children about masturbation as part of programs to prevent sexually transmitted diseases.

In an administration dedicated to revamping health-care, Benjamin will be one of the few physicians in a high-profile position within the Obama administration, said James Rohack, president of the Chicago-based American Medical Association.

‘Bully Pulpit’

“She will have the bully pulpit to speak with credibility,” Rohack said by telephone.

Benjamin, an Alabama native, founded Bayou La Batre Rural Health Clinic in 1989, the clinic’s Web site says. She arrived in the town through a National Health Service Corps program that paid for medical school in exchange for service in impoverished communities, Benjamin said in her White House statement.

The clinic says its mission is providing primary care “to people of any age regardless of their financial situation.”

The clinic was destroyed by Hurricane Georges in 1998 and seven years later by Katrina, a storm that also left many in the town of 2,300 homeless, Wright, the Bayou La Batre mayor, said in a telephone interview yesterday.

“As soon as the waters receded with Katrina, she was in her four-wheel drive in all the mud and muck,” said Wright, a clinic trustee. “She was going door to door to check on all her patients. She takes them all very personally.”

After a 2006 fire leveled the rebuilt clinic, Benjamin led efforts to replace it, Wright said.

First Black President

Benjamin grew up in Daphne, Alabama, according to the University of Alabama at Birmingham, where she received her medical degree in 1984. She was the first woman and first black to serve as president of the state’s medical association. She also was the first black woman elected to serve on the American Medical Association’s board of trustees.

Last year, she received a so-called genius grant from the John D. and Catherine T. MacArthur Foundation.

Satcher, the Morehouse professor who was surgeon general from 1998 to 2000, said he expects his former pupil to press for more funding for primary care doctors and better access to care in low-income and rural areas.

“She will put more focus on what patients go through in this country trying to access health care, and she will put more focus on what doctors have to go through trying to practice in underserved communities,” he said.

To contact the reporter on this story: Alex Nussbaum in New York anussbaum1@bloomberg.net.