WASHINGTON — As the governor of Virginia, Tim Kaine pushed to ban smoking in the state’s restaurants and made a priority of driving down infant mortality. As a senator, he called on doctors to stop prescribing so many opioids to help curb addiction.
Now, he’s the prevention candidate of 2016.
In picking Kaine as her vice presidential nominee, Hillary Clinton is putting the spotlight on an issue that many in the medical field believe gets short shrift: preventive health care.
Marilyn Tavenner, president and chief executive officer of America’s Health Insurance Plans, who served as Virginia’s health secretary while Kaine was governor, recalled that he saw the prevention of health problems as a top-tier goal.
“He was very interested in prevention and education,” she said.
That’s a new dimension that the Virginia senator and former governor is likely to add to Clinton’s campaign. Much of Clinton’s focus has been on the health care coverage side, and on medical research to find new cures.
But for Kaine, keeping people from getting sick — and taking care of their health care needs at the front end — is just as important as figuring out how to get the best medical care after they’ve gotten sick.
Tavenner, who also headed the Centers for Medicare and Medicaid Services under President Obama, recalled that Kaine made his interests clear when she interviewed with him for the health secretary job.
“He said, ‘Marilyn, maybe we should be a little more focused on health and a little less on the hospitals,'” Tavenner said — meaning, “the more we do on the front end, the less need we’ll have to send people to hospitals.”
The prevention issue is a good match for Kaine’s overall political image. Like Kaine himself, preventive health care isn’t buzzy. But health care advocacy groups say it’s important and often overlooked, and they’ve spoken up when they believe it hasn’t gotten enough attention in major initiatives, as in Vice President Joe Biden’s cancer research program.
Kaine has also stressed the importance of prevention to address the nation’s opioid epidemic. Legislation he introduced last year, which has since been approved by the Senate health committee, would encourage physicians to prescribe naxolone — a drug that’s used to reverse the effects of opioid or heroin overdoses — any time they prescribe painkillers.
“This is just one solution. Obviously the real solutions, the important ones, are still around prevention,” Kaine said in a Senate floor speech in November 2015. “Why do Americans get prescribed so many more opioids than folks in other nations? What do you do about prescriptions when the quantities that are given are too big, and then you end up with a lot of unused opioids that can be taken by young people or stolen and sold?”
“There’s a lot of issues that we have to solve. But there is this bit of good news — that naloxone saves lives, and it’s easy to administer, it doesn’t have a negative side effect, and if we can broaden access to naloxone for those who have been prescribed opioids, we’ve saved lives in the past and we’re going to save a lot more,” Kaine said.
As Virginia governor, Kaine signed into law a ban on smoking in most restaurants in 2009, a measure he had been pushing since he took office in 2006. He also commissioned a plan to fight obesity and visited classrooms to talk to schoolchildren about the importance of exercise.
Kaine also launched a campaign to reduce the state’s high infant mortality rate, noting in 2007 that “there is no excuse for a state with one of the highest incomes in the nation to have so many babies die in the first year of life.” By 2009, the state’s infant mortality rate had dropped to fewer than seven deaths for every 1,000 babies, though the reasons were unclear.
And Kaine said the health care system had to do a better job of encouraging people to live healthier lives.
“You’ll see me out there, getting my weight and blood pressure checked, getting my flu shot, walking, hiking and riding my bike,” he said in 2007. “I hope to see you there with me.”
Kaine has drawn attention for expressing his personal reservations about abortion, even though he insists he supports women’s right to the procedure as a matter of public policy. That has been a concern for abortion rights groups, who don’t want to see the Democrats nominate a vice presidential candidate who would waver on the issue — especially in a debate against Indiana Governor Mike Pence, the Republican vice presidential nominee who signed one of the most restrictive anti-abortion laws in the country.
But there, too, Kaine’s approach has always focused on supporting education and access to contraception as a means of preventing the need for abortions, said Tavenner, who added that he fought against attempts by the Virginia legislature to restrict abortions by imposing strict facility standards.
“He was strongly committed to protecting a woman’s right to choose, but he was also committed to prevention and education so that they don’t have to make that choice,” he said.
Kaine did express reservations about one preventive health initiative as governor. In 2007, he signed legislation requiring all sixth grade girls in Virginia to get the human papillomavirus vaccine, which can prevent cervical cancer. But he initially said he had “some qualms” about the mandate, and wanted a stronger provision to allow parents to refuse to let their daughters get it if they had religious or other objections.
Eventually, however, he decided the language was already good enough to give some discretion to parents. At the time, Virginia was only the second state in the country to require the vaccine.
On other health care issues, Kaine tends to stick to the standard Democratic line. Like Clinton, he has called for Medicare to negotiate prescription drug prices, a proposal he began making in his 2012 race for the Senate, when he used it as a campaign issue against Republican George Allen.
He has also shared other Democrats’ outrage against drug price hikes, like Martin Shkreli’s decision to increase the price of Daraprim, a drug manufactured by Turing Pharmaceuticals and used to treat people with AIDS, by more than 5,000 percent.
“It’s basically a profit opportunity. It is the patient as a hostage, the patient as a profit center,” Kaine said at a Senate Aging Committee hearing in April on the price increase.
The health care industry has been a consistent contributor to Kaine’s campaigns, but has become more prominent in this election cycle. Since 2015, health care political action committees — which include pharmaceutical companies, physicians, and health care services — have donated $63,500 to Kaine, making them his most important source of PAC funds, according to Political Moneyline.
Among the largest donors in this cycle were $9,000 from 21st Century Oncology Inc., a Florida-based company that has affiliated doctors around the world; $5,000 from Centene Corporation, which provides services for uninsured and uninsured people; $5,000 from Fresenius Medical Care North America, which focuses on patients with kidney failure and other chronic diseases; and $3,000 from Novo Nordisk Inc., a pharmaceutical company that specializes in diabetes medications.
Dylan Scott and Sheila Kaplan contributed reporting.