Nagel says choosing principles over party got him booted from health committee

CONCORD — State Speaker of the House Sherman Packard has removed a local representative from a committee to review bills relating to medical care, even though he was the only Republican on the committee who practices medicine.

Rep. David Nagel, a second-term Republican legislator who represents Gilford, Gilmanton and Laconia’s Ward 2 in Concord, said he was removed from the Health, Human Services and Elderly Affairs Committee last week. While he wasn’t given an explanation, he suspects his removal was due to opposition to several bills he saw as harmful to the public, even though they were supported by his party’s leadership.

“I’m a doctor. I took a Hippocratic oath. I have to care for my patients and put the needs of my patients above everyone else, including the Republican Party. These bills are inherently harmful,” Nagel said in an interview on Wednesday. “I never took an oath to the Republican Party, nor did any other Republican.”

While he received no explanation, he said the timeline of his removal left him with a clear reason for why Packard removed him from the committee.

Packard did not return a call for comment, nor did Rep. Wayne MacDonald, who chairs the Health, Human Services and Elderly Affairs Committee.

“A week ago last Thursday, after the House session, one of the members of the House said he wanted to have a word with me. He then walked me upstairs to the speaker’s office, they closed me in the room with the speaker and one other individual. They were concerned I wasn’t supporting the party.”

Nagel said he opposed the bills because he felt they would harm people seeking medical care in New Hampshire. “When the meeting was done they said, ‘OK, I think we’ve heard enough.’ The following Tuesday I got an email saying I was removed from the committee.”

Nagel said there were four bills he figures were the “deal-breakers.” Two of them seek to treat the medical industry as more of a free market, which Nagel said runs against real-world examples. Examples which show models that provide the best care at the lowest cost are those that treat medicine as a public good.

“The idea of moving in a free market direction is a really bad idea,” Nagel said. “There was no way in good conscience I could support them.”

Then there were two other bills he suspected sealed his fate. Those were HB 392, which seeks to dissolve the state Department of Health and Human Service's Office of Health Equity, among other things, and HB 524, which would repeal the New Hampshire Vaccine Association.

Speaking to HB 392, sponsored by Rep. Mike Belcher (R-Wakefield), Nagel said only the bill’s sponsor testified in its favor, while about 20 testified in person against it, and many more sent in comments critical of the legislation.

“The Office of Health Equity does a lot of amazing things for people with disabilities, legal refugees. They basically distribute $50 to $70 million in federal grants to organizations that help these people,” Nagel said. He said the bill’s sponsor couldn’t answer how those services would be delivered if the bill passed.

HB 524 would repeal the state vaccine association, established by statute more than 20 years ago. Nagel said the association ensures a supply of vaccines for Granite State children at no cost to their families and is funded by commercial insurers. Nagel called it a “win-win-win-win,” because taxpayers, insurers, patients and society at large all benefit.

The bill’s proponents argue the private sector could more efficiently supply the state with vaccines, but Nagel wasn’t convinced.

“It costs the taxpayers nothing and children get vaccinated for free,” Nagel said. “It’s the anti-vaxx people I think are behind this.”

Nagel cited outbreaks of measles and pertussis, both of which can be deadly to children, as well as a return of polio, all of which he said are occurring as a result of vaccine hesitancy.

“These are diseases that were gone in the United States. And we’re seeing them come back because of all the people who are unvaccinated.”

Nagel quoted a more experienced legislator who called HB 524 “the worst bill she’d ever seen,” and he was inclined to agree.

“The party decided to take those two bills and priority bills, and I am at a total loss as to why,” Nagel said.

His experience has left him disappointed with the partisanship he’s seen ruling the state Legislature. While there are medical professionals on the Democratic side of the committee, none of the remaining Republicans know what it’s like to care for a patient.

“There’s a loss of independent thought. Without me being there, there’s no one to give them a reality check. I don’t think it’s smart to remove the one person who’s actually knowledgeable from your side of the aisle.”

Despite his ouster, Nagel said he plans to continue to caucus as a Republican, and promote legislation he feels will improve medical outcomes for New Hampshire residents. He is sponsoring bills regarding integrative care, electronic records reform and prior authorization reform. “Those are all really important,” he said.

And while he’s disappointed by his removal from the panel, he said he’s “excited” about the support he’s received since. That support has validated his decision to make a principled stand despite the consequences, and has given him hope that partisanship in Concord might be a passing trend.

“Maybe something good will come out of this. That’s my hope, that we as legislators start to work together rather than apart,” Nagel said. “I think we have the potential to do that. I’m not holding my breath, but there’s a lot of good people there.”