Washington, DC–(ENEWSPF)–December 23, 2016
Tom Price M.D. is Donald Trump’s pick for Secretary of Health and Human Services. He would only be the third physician to hold that post. Traditionally, the HHS secretary focused their efforts on improving health care for the poor, the sick and the vulnerable. They tended to champion causes such as decreasing tobacco use, improving Medicare and fighting the HIV-AIDS crisis. In a new editorial in the New England Journal of Medicine, (NEJM) based on his history in politics, Tom Price looks to go in a different direction.
Ostensibly, he emphasizes the importance of making our health care system “more responsive and affordable to meet the needs of America’s patients and those who care for them.” But as compared with his predecessors’ actions, Price’s record demonstrates less concern for the sick, the poor, and the health of the public and much greater concern for the economic well-being of their physician caregivers.
The NEJM gives a long list of health care positions that Tom Price has supported. In the past, he has come out against regulating tobacco as a drug, he opposed laws against armor piercing bullets and has fought expanding the Child Health Insurance Program (CHIP). For some reason, he’s especially opposed to VP Joe Biden’s “Cancer Moonshot”. According to a Dec 20th interview with MedPage Today, he plans to focus on ACA repeal, cutting hassles for doctors and defunding Planned parenthood. Ironically, he calls his ACA replacement plan “Empowering Patients First Act” while it does just the opposite.
His proposal for replacing the ACA is H.R. 2300, the Empowering Patients First Act,5 which would eliminate the ACA’s Medicaid expansion and replace its subsidies with flat tax credits based on age, not income ($1,200 per year for someone 18 to 35 years of age; $3,000 for someone 50 or older, with an additional one-time credit of $1,000 toward a health savings account). Price’s plan is regressive: it offers much greater subsidies relative to income for purchasers with high incomes and much more meager subsidies for those with low incomes.
In short, his plan will make it easier for well-off and healthy families to afford care while penalizing the poor and the sick. It would also deregulate the insurance business, allowing a race to bottom in terms of coverage and an increase in cost sharing. Insurance companies will see a windfall under his plan but they aren’t the only beneficiaries of his plan.
Whereas Price’s actions to date have not reflected the tradition of the physician as advocate for the poor and vulnerable, they do harken back to an earlier tradition in American medicine: the physician advocate as protector of the guild.
Physicians will be empowered to negotiate higher rates with insurers, increasing their income at the expense of patients, since these costs will be passed on directly to them. Patients will receive less care for more money and those with pre-existing conditions will probably not be able to afford care unless they are wealthy. I find this sickening, especially in light of Trump’s promises to improve health care in America. It looks like he wants to improve health care for insurers and physicians while taking away health care from the patients who need it. This won’t surprise DailyKos readers, but America, you’ve been sold a bill of goods. Trump looks to dismantle HHS and Tom Price is his guy to do it.
The HHS Department oversees a broad set of health programs that touch about half of all Americans. Over five decades and the administrations of nine presidents, both Democratic and Republican secretaries have used these programs to protect the most vulnerable Americans. The proposed nomination of Tom Price to HHS highlights a sharp contrast between this tradition of compassionate leadership and the priorities of the incoming administration.
I’m a physician and my top priority is helping my patients. I swore an oath to do no harm. Tom Price will do harm to patients. I don’t know if he crossed his fingers when he swore the oath but he’s certainly an oath-breaker. Yes, there are issues in the medical community in terms of burnout and student loan burdens but the government is supposed to be the guardian of the little guy, the average American, not physicians and insurance companies. This is clearly not the way the Trump administration sees the role of government and I hope the Democrats take a strong stand against this nomination.
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