Getting the Word Out About Candidates' Health

Should we put an independent panel of experts in charge of evaluating the evidence?

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The presumptive Democratic and Republican presidential nominees have each released their health records, albeit by different methods and to different degrees. John McCain allowed access to a veritable phone book's worth of information to a selected group of reporters. A week later, Barack Obama's personal physician publicly issued a one-page statement largely limited to vital signs and giving few details.

"I give both of them a B minus for disclosure," says Howard Markel, coauthor of a commentary in the current Journal of the American Medical Association proposing a more standardized process of releasing relevant health information. McCain's controlled release kept most reporters—including the M.D./journalist who covers the topic for the New York Times—from seeing the records with their own eyes, while Obama's statement gave few particulars on his past smoking habit. (The Wall Street Journal's Health Blog used the Framingham Risk Score to compare the candidates' odds of developing heart disease.)

Markel, a physician who directs the Center for the History of Medicine at the University of Michigan, and his colleague Alexandra Stern have a better idea: a panel of "independent, impartial, multispecialty physicians and ethicists, lawyers, and healthcare scholars" appointed by Congress to six-year-terms whose job it would be to evaluate the health of presidential and vice presidential nominees.

Of course, personal medical information can be more sensitive than, say, financial data, which is why the process would be voluntary, and candidates could elect to withhold information that is irrelevant to the job (reproductive health history, for example, or genetic information that might also apply to the candidate's family). "There are ways of doing it that would protect privacy" to some extent, says Markel. But he argues that because of the potential for the health of the president to influence the country and indeed the world, details of his or her physical and mental health are essential. (In a story about McCain, U.S. News's Liz Halloran wrote recently about how the history of presidential health has been characterized by obfuscation, to put it kindly.)

And as for the sitting officeholders? The same panel would create standards for the disclosure of the president's relevant health information and would evaluate him or her as often as necessary and report back to Congress and the White House. The panel's independence would distinguish its findings from the current annual physical, usually done by military doctors and often including the president's personal physician, whose results are summarized and disseminated by the White House. (I wrote recently about the pros and cons of a souped-up physical supposedly modeled after the president's own.) Markel is aware that the issue may fade away now that the current candidates have released information, but he's hopeful that his proposals will get serious consideration. "What we need to do is have regular people who vote say, 'You know what, I want to know about his tax returns, and his health, too,' " he says.