How the NRA Used One Tweet to Derail an Obama Nominee

Republicans called guns a public-health issue before that was considered a political death sentence.

The NRA spends its days defending deadly weapons, but it only needed a single tweet to kill a top Obama official.

If you've been following the news cycle, you probably saw Rand Paul and the gun lobby pitch a fit over the nomination of Vivek Murthy, the Harvard- and Yale-educated physician Obama picked to serve as the nation's top doctor. Murthy's biggest crime, beyond some concerns that he would "propagandize" on behalf of the Affordable Care Act, was simply that he described gun violence as a public-health issue. Once. In a tweet. In 2012. For the uninitiated, Murthy's offending statement is this: "Tired of politicians playing politics w/ guns, putting lives at risk b/c they're scared of NRA. Guns are a health care issue."

Since then he has earned the undying ire of the NRA, which went public in its opposition to Murthy, threatening to "score" — track how lawmakers vote — any vote taken against him. Such measures might make sense if the surgeon general were in a position to regulate guns, but the post is a largely ceremonial seat used to highlight pressing health concerns.

Murthy's claim is not particularly novel, even among Republicans holding the exact same position. "I doubt there's been a surgeon general dating back to the days of Lyndon Johnson that would pass the NRA litmus test," Jim Kessler with the centrist Democratic group Third Way told The Daily Beast.

Until now, they never had to.

C. Everett Koop, President Reagan's surgeon general, made precisely Murthy's point. Writing in the Journal of the American Medical Association in 1992, he called gun violence "a public-health emergency" and proposed that owning and operating a firearm carry with it the same restrictions as owning and operating a car. Koop did eventually alienate himself from conservatives, but his stance on gun violence wasn't the reason; it was primarily his aggressive advocacy on AIDs. That conservatives didn't flare up over his position on gun voilence shows how things have changed.

Such rhetoric hasn't merely been the province of surgeons general. Announcing an initiative to fight gun violence at the Pennsylvania Convention Center in 2001, President Bush noted three out of four murder victims in Philadelphia were shot to death with handguns, adding that the figure rises to nine out of 10 among youth. "In America today, a teenager is more likely to die from a gunshot than from all natural causes of death combined," he told the gathered audience. The NRA heartily endorsed him in 2004.

Louis W. Sullivan, President George H.W. Bush's Health and Human Services secretary, spoke even more directly to the point, calling gun-related violence "a public-health problem in addition to being a criminal-justice problem." He was particularly concerned about gun violence's impact in the black community, where violence was cited as the primary cause of death for males ages 15-25, with 80 percent of the cases involving handguns. Sullivan wasn't some freakish outlier: He was confirmed 98-1, with Republican Sens. Dan Coats, Thad Cochran, Chuck Grassley, John McCain, Mitch McConnell, and Richard Shelby voting "yes."

The gun lobby's current offensive smacks of a time in the 1990s when NRA-backed politicians went after researchers for publishing firearm data. They also attacked the Centers for Disease Control and Prevention for funding the research, and won. Now it appears they've moved from information suppression to rhetoric policing.

The larger irony is that when Murthy states gun violence is a health issue, he is merely stating the obvious. Whatever your notions about guns being symbolic of liberty, freedom, and America, when a bullet enters the human body, the situation falls very quickly and squarely into the arena of public health. The CDC reminds us firearms were among the leading mechanisms of injury in the U.S. in 2010, along with motor-vehicle and fall-related injuries. In 2009, they were the cause of 31,347 deaths; the number of deaths attributed to car accidents was 36,216.