4th November 2026
The American midterm elections have produced an interesting development that deserves attention beyond the immediate battle between Democrats and Republicans. Among the candidates attracting attention are medical professionals who have decided that treating patients is no longer enough. They want to influence the policies that determine how healthcare is funded, organised and delivered.
One particularly interesting example is Dr Annie Andrews, a paediatrician who entered the South Carolina Senate contest as a Democratic candidate.
Her professional background gave her campaign a different emphasis. Rather than approaching healthcare simply as a political argument about government spending, she could draw on her experience of treating children and dealing with families facing difficult medical decisions.
It raises a wider question: are American voters increasingly interested in candidates who have practical experience of the services they are seeking to reform?
Healthcare was already a major election issue
The significance of Andrews' victory becomes clearer when we look at what voters were saying before the election.
A survey published in October by the Kaiser Family Foundation (KFF), which regularly researches American healthcare and public opinion, found that:
- Six in ten voters were worried about being able to afford healthcare.
- Around half said healthcare costs were extremely important when deciding which candidates to support.
- Healthcare costs ranked alongside the cost of living as one of the two issues voters most wanted candidates to address.
- Democrats held a substantial advantage over Republicans in voters' confidence in their ability to tackle healthcare costs.
In the survey, 42% trusted Democrats to handle healthcare costs, compared with 22% who trusted Republicans.
These figures help explain why healthcare became such an important campaigning issue. For many Americans, it is not an abstract argument about government policy. It is a monthly insurance bill, the cost of prescription medicines or the fear of receiving a hospital bill that the family cannot afford.
A record number of healthcare professionals stood for election
Andrews was not alone.
According to a CNN report published immediately before election day, at least 125 doctors, nurses and public health experts were standing for elected office across America.
That was an unprecedented number.
Some had become politically active during the Covid pandemic. Others had become frustrated by decisions made by politicians who, in their view, did not fully understand the practical consequences of healthcare policies.
Their argument was that professional experience could bring something different to political decision-making.
But there is an important distinction: being a doctor does not automatically make someone a good politician, just as being a politician does not mean someone cannot understand healthcare.
The question is whether voters believe practical experience is an advantage when decisions about hospitals, insurance, medicines and public health are being made.
The American healthcare system is under financial pressure
To understand the political importance of healthcare, it is necessary to appreciate how different the American system is from the NHS.
Although the United States spends considerably more per person on healthcare than Britain, millions of Americans still worry about the cost of obtaining treatment.
Many depend on employers for health insurance. Others purchase their own policies or rely on government programmes.
Medicare mainly supports older people and some people with disabilities, while Medicaid provides healthcare assistance to eligible people on lower incomes and those with particular needs.
Changes to government funding, insurance subsidies and eligibility rules can therefore have considerable consequences for household finances.
The cost of medicines is another major concern. Americans can find themselves paying substantially different prices for the same prescription depending on their insurance arrangements.
This creates an unusual political situation. Healthcare is both a public policy issue and a direct household affordability issue.
It also helps explain why candidates from both parties have increasingly talked about challenging pharmaceutical companies, insurance providers and other powerful interests in the healthcare industry.
Did Trump's healthcare policies become an election liability?
Healthcare also became part of the wider debate about the Trump administration's policies.
Democrats argued that changes to federal healthcare funding and assistance programmes threatened access to treatment, particularly for lower-income families.
Republicans, meanwhile, have argued that the existing American system is expensive and needs reform, with greater attention to competition, efficiency and controlling public expenditure.
These are genuine differences in political approach, but voters ultimately judge policies by their practical consequences.
A family facing higher insurance premiums may be less interested in the political arguments about how the system should operate than in whether it can afford to keep its existing cover.
This is where healthcare and the cost of living become closely connected.
The election of a paediatrician sends an interesting message
Annie Andrews' victory in South Carolina deserves particular attention.
She defeated Republican Darline Graham in a state where Republicans had won every Senate election since 1998.
Her victory was an unexpected Democratic gain.
However, it would be misleading to suggest that healthcare alone delivered the result. Andrews also benefited from wider dissatisfaction with the Republican campaign, questions about her opponent's experience, strong fundraising and the political environment surrounding the Trump administration.
The Associated Press reported that voters' concerns about Graham's experience were an important factor.
Nevertheless, Andrews had something unusual to offer voters: years of experience treating patients and seeing the financial and practical difficulties families face when healthcare becomes unaffordable.
She will now take that experience into the United States Senate, where decisions about healthcare funding and regulation are made.
AP News+1
What can Britain and Scotland learn from this?
There are some interesting comparisons with Britain.
We do not have the same reliance on private health insurance, but the NHS faces its own difficulties.
Waiting lists, GP access, hospital capacity, staffing shortages and the availability of social care have become major political issues.
In Scotland, the Government is now considering a substantial reorganisation of NHS management, potentially reducing the number of territorial health boards from 14 to two.
That raises questions about whether administrative restructuring will actually improve the services patients receive.
There is also an important difference between having professional experience and having responsibility for political decisions. Doctors understand patients and clinical needs, but running a national health service also involves finance, workforce planning, competing priorities and difficult decisions about limited resources.
Perhaps the most useful lesson is that politicians need to understand the consequences of their decisions for the people who depend on public services.
A changing relationship between voters and politicians?
The appearance of more doctors, nurses and healthcare professionals on American ballot papers may represent something broader.
Voters are increasingly concerned about the practical effects of government decisions on their everyday lives.
Healthcare, housing, food prices, energy bills and employment are not separate subjects when families are trying to balance their household budgets.
A doctor standing for office can speak from professional experience, but voters will still expect that person to demonstrate an understanding of the wider economy and the responsibilities of government.
Annie Andrews' election does not prove that Americans are abandoning traditional politicians in favour of professionals. Nor does it establish that healthcare was the single deciding issue in the midterms.
But the combination of a record number of healthcare professionals standing for election, widespread concern about medical costs and an unexpected Senate victory for a paediatrician makes this a development worth watching.
Perhaps the underlying message is that voters want politicians who understand what happens in the real world, not just what appears in government reports and election manifestos.
For both America and Britain, that is a question worth asking.