Rheumatologist Advocates for Health Care Equality

Issue: August 2017

Charles Radis

For much of his life, rheumatologist Charles Radis, DO, did not seek out leadership roles.

“Even going back to high school, I was never president of the class, and later, I was not involved much in hospital politics.”

However, Radis’ commitment to public health issues, global charity work and affordable health care has set him on a path of substantial leadership. In addition to running for the state legislature in Maine in 2016, establishing a non-government organization (NGO) dedicated to helping Sudanese refugees and advocating for a single-payer health care system in Maine, he also maintains a part-time rheumatology practice.

“This was driven by my interest in public health, which goes back to my first job,” Radis said. “I was involved with public health issues. I have never lost that interest in the health inequities we have in this country, and eventually wanted to see if I could do that on a slightly larger stage.”

Public health beginnings

Radis began his career with an internship and residency in internal medicine in Portland, Maine, where he currently resides. At the job, Radis cultivated the devotion to public health that has driven much of his professional life.

“I was placed as a public health doctor out here, in the Casco Bay Islands of Maine,” Radis said. “From the beginning, I was a generalist. I was not practicing as a rheumatologist. I was involved with public health issues locally here.”

The job also enabled Radis to consider the issue of health care affordability from a generalist’s perspective.

“I was taking care of people as a primary care physician and had to come up with novel ways of getting them their medicines,” he said. “I did not get paid for a lot of this medical care and I understood that. I was in the community and could see how difficult it was for people to afford health care. I saw it from a primary care lens.”
Radis’ awareness of these public health matters did not end when he became a rheumatologist. In this specialty, he said physicians often become the primary physician for many patients with rare autoimmune diseases.

“For a young woman with lupus, for example, who does not have any other diseases, we may be her only doctor,” Radis said. “You get to know these folks over decades and you see the struggles they have with finances, particularly because our drugs have become so incredibly expensive.”

Radis said as a rheumatologist, he has seen patients who could have benefited from certain medicines they could not to afford.

“I am angry that some of my patients have not been able to get the care they should because of the expense of these medications,” he said. “The biologics have moved rheumatology forward into extraordinary care, but $30,000 to $40,000 per year is not reasonable. The programs to qualify patients are complex.”

So when Radis was invited to a state leadership training program about 5 years ago, he decided to explore the possibility of addressing these issues at a state level.

“At the end of the leadership program, they were asking if any of us were interested in running for the state legislature because there are few physicians in politics,” he said. “I had been in practice a long time; I was in my early 60s and decided that I would cut back my practice, I could practice part-time.”

Although Radis did not win the 2016 election, his candidacy gave him the opportunity to consider and elucidate his political priorities in a more focused way. He has not ruled out running again, he said.

“I am not sure. I have about 8 months before the next election cycle starts up to think about that,” he said. “I think they do great work in the Maine state legislature. It is not as adversarial as it is on a national level.”

A single-payer vision

One goal Radis has championed for years is the concept of a single-payer health system. Although he believes strongly that such a system would provide greater equity and simplicity, he recognized the challenges involved in introducing such a system.

“To be honest, I think developing a national single-payer system to take the place of other systems would be incredibly disruptive to the economy,” he said. “I think what makes sense is to expand the federal system that works well now, which would be Medicare, and transition to that without disrupting the economy.”

In Radis’ vision, this would be achieved by dropping the qualifying age for Medicare by 5 years every 3 years to 4 years until eventually, it extends down to all Americans.

Through this “soft landing,” the transition to Medicare would occur during a period of years. In the single-payer system, Medicare would be the primary payer and health insurance companies would then compete as secondary payers.

Radis said he believes that overall, seniors are happy with Medicare, and — contrary to popular belief — so are physicians.

“I am sure there are plenty of exceptions, but in general, I think doctors enjoy the fact that reimbursements from Medicare are prompt and reliable,” he said. “They do not have to go through crazy prior approvals. Things are not denied by Medicare, and Medicare has low administrative costs.”

Radis said while such a system is unlikely to be implemented on a national level, he is encouraged by Canada’s system, which was adopted by individual provinces until most provinces had single-payer systems.

“Then, the national program began,” he said.

With recent efforts by California to introduce a single-payer system, Radis said he believes the concept could gain momentum at the state level.

“There is a big movement, in fact, in Maine to develop our own single-payer system in the next few years,” he said. “It is difficult, but it may actually come from the states first.”

Global efforts

Radis’ commitment to promoting equity in health care is not restricted to American patients. He and his wife, Sandi, have been offering assistance to African refugees and asylum seekers for the past several years through the Maine-African Partnership for Social Justice (MAPSJ). Radis first met some of these refugees in his hometown.

“Through Catholic Charities, Portland, Maine is an entry point for a large number of immigrants and asylum seekers, particularly from Africa in recent years,” he said. “Portland High School has large numbers of South Sudanese, Congolese and Somalian refugees. My children went to school with a lot of refugees and asylum seekers.”
As Radis got to know these refugees as members of his community, he became interested in providing quality health care and educational support to this population. He began 9 years ago by starting a nonprofit dedicated to the James Angelo Scholarship, awarded annually to first-generation African asylum seekers and immigrants.

“The scholarship is to attend a junior college here in Portland,” Radis said. “It has been well-supported by the community. We have a nice awards assembly every year at Portland High School.”

Five years ago, Radis began traveling to the Kit River region of South Sudan to offer public health services. When 60,000 South Sudanese fled to Uganda during South Sudan’s civil war, MAPSJ transferred its operations to the Kiryandongo United Nations Refugee Settlement in northern Uganda. This settlement has taken in several hundred South Sudanese refugees who MAPSJ had been assisting.

Radis said when he visited the settlement in April 2017, he was prepared to find the devastation of a humanitarian crisis. Instead, he said, he was met with a pleasant surprise.

“I could not believe how well this settlement is run,” Radis said. “The kids are back in school, and the public health programs we had going in South Sudan are continuing in the refugee settlement.”

With the cooperation of Uganda and the United Nations, the settlement also offers 1 acre of farmland to every family, quality drinking water and jobs or entrepreneurial opportunities in the nearby town of Bweyale. MAPSJ and other funders are currently supporting the Bidong primary school in the camp and have purchased a solar unit to provide electricity.

Radis makes trips to Africa a few times a year, and at home, he is involved in fundraising efforts and planning discussions.

“It is not a top-down kind of program. We are trying to fill the needs they identify that are not being helped,” Radis said. “It is a large refugee settlement. There are 60,000 people in it, and we are focused on about 500 South Sudanese there.”

Radis’ approach to providing public health services is the same whether he is in Sudan or Portland, he said.

“My mission is to treat the whole patient,” he said. “I have been lucky enough to be in situations where I have gotten to know not only my patients, but also their families. My goal is to give patients optimism, to encourage them not to let their disease stop them from living normal, happy lives.” – by Jennifer Byrne

Reference:

www.mapsj.org

For more information:

Charles Radis, DO, can be reached at 51 Sewall St., Portland, ME 04102; email: cradis@maine.rr.com.

Disclosure: Radis reports no relevant financial disclosures.