COVID, whether just talk of it or the virus itself, is in the air. Cases, though still low compared to the highs of 2020 and 2021, are increasing. There are more variants. Calls for masking in public, staying socially distanced and avoiding large groups are increasing. There are even new COVID vaccines coming out that many will likely be forced to take.

I’ve heard a lot in the last few weeks as COVID talk has increased. Both from our readers and the listeners of "Alabama Unfiltered Radio."

Statements like:

“We’ve got to stand up.”

“We’re not falling for this again.”

“We will not shut our businesses down. Not this time.”

You get the picture.

The desire to fight COVID mandates is evident. That is a marked change from the first go-round, where Americans largely followed the suggestions and in some cases, demands, of public health officials.

Some things in Alabama, however, have not changed since 2020. 

Just like in 2020, the Medical Association still chooses Alabama’s State Health Officer.

In fact, we are the only state where the head of public health is not appointed by the governor or by a board that is appointed by the governor. Instead, Alabama’s State Health Officer, a position currently held by Scott Harris (just like in 2020), is chosen by the Medical Association of the State of Alabama (MASA). 

That’s because, in another century, the Alabama Legislature decided that they didn’t want to create a new government agency to be in charge of public health. The doctors should be in charge! And how could you argue with that? The medical field is well-respected and is often given the benefit of the doubt. For the Alabama Legislature in the early 1900s, it seemed like, since they knew how to stop diseases, they should be in charge of that area of state government.

It’s important to note that MASA operates just like any other professional association does. It has its own leadership, its own practices, and its own decision-making bodies–all of which are determined not by the governor or by the people of Alabama, but by the physicians who fill the group’s membership rolls. What’s more? Advocacy is, according to their website, the “Medical Association’s primary focus.”

It’s not just our State Health Officer that is chosen by the physicians union, though. Our county health departments and health officers are chosen in similar ways. All under the strict influence and in some cases, direct authority, of the Medical Association. 

No other state in the union operates in this way. Even California’s Secretary of Health and Human Services is appointed and must be approved by the State Senate. Their system is more democratic and more conservative than ours.

Before we get too mad at the Medical Association, it’s important to remember that they’re just doing what we, the people, albeit at a different time, asked them to do. We, the people, elected our representatives in the 1900s, who chose to give them the authority they have today. 

We, the people, however, also elected the representatives we have in office now, who for three full sessions decided not to change this setup. For three sessions, the Alabama Legislature was aware of this problem, this strange anomaly in how our state operates and decided not to act. Our representatives opted to leave the power of the State Health Officer and county health officers in the hands of an advocacy organization.

To their credit, some legislators have made efforts to do so. But our Republican supermajority ultimately said “no.”

So as COVID talk continues, we would be remiss to forget that there are some easy changes our state could make if we don’t want 2020 to happen again. The Medical Association had an outsized authority in 2020, and it has an outsized authority today in 2023. 

This needs to change. It may have worked to give the physicians union all that power as our state was getting started, but today it’s just lazy governance. 

The Medical Association needs to be out of the business of deciding health policy. If Alabamians want to stand up against COVID restrictions, this is the area we need to focus our attention.

Parker Snider is the operations manager at 1819 News.

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