Many are describing President-elect’s choice of Representative Tom Price as the secretary of health and human services as “scary” and a “radical choice.”
To understand why, you should both understand what he believes and what his job will be.
The HHS Secretary
Surprisingly, few people probably know the name of the current HHS secretary – Sylvia Mathews Burwell.
She succeeded Kathleen Sebelius, who resigned in 2014, mostly over problems with the healthcare.gov website and roll-out of the Affordable Care Act.
What does the HHS Secretary do?
As head of the United States Department of Health and Human Services, the HHS Secretary is a member of the President’s Cabinet and overseas the:
- Administration for Children and Families (ACF)
- Administration for Community Living (ACL)
- Agency for Healthcare Research and Quality (AHRQ)
- Agency for Toxic Substances and Disease Registry (ATSDR)
- Centers for Disease Control and Prevention (CDC)
- Centers for Medicare & Medicaid Services (CMS)
- Food and Drug Administration (FDA)
- Health Resources and Services Administration (HRSA)
- Indian Health Service (IHS)
- National Institutes of Health (NIH)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
As you probably recognize at least a few of those names, like the FDA, CDC, and NIH, you likely know that these agencies “administer a wide variety of health and human services and conduct life-saving research for the nation, protecting and serving all Americans.”
That work can be seen in the current strategic plan of the HHS:
- To Strengthen Health Care
- To Advance Scientific Knowledge and Innovation
- To Advance the Health, Safety, and Well-Being of the American People
- To Ensure Efficiency, Transparency, Accountability, and Effectiveness of HHS Programs
And it can be seen in many of the current problems they are tackling, such as combating the opioid epidemic, lead poisoning hazards, the Zika virus, and continuing to get more people insurance coverage, etc.
Problems with Tom Price as HHS Secretary
So what might be the problem with Rep. Tom Price as HHS Secretary, after all, he is a doctor and has been endorsed by the AMA?
“The Association of American Physicians and Surgeons recommends a policy of Non-Participation to all physicians as the only legal, moral, and ethical means of concretely expressing their complete disapproval of the spirit and philosophy behind these amendments.”
THE PRINCIPLES OF MEDICAL ETHICS OF THE ASSOCIATION OF AMERICAN PHYSICIANS AND SURGEONS
Tom Price is a member of the Association of American Physicians and Surgeons (AAPS), an organization of doctors that was opposed to the establishment of Medicare and Medicaid and which tells its members that it is “legal, moral, and ethical” to not treat patients on Medicare and Medicaid.
The AAPS is also against birth control and pushes a lot of anti-vaccine misinformation that can scare parents away from getting their kids vaccinated and protected against vaccine-preventable diseases!
A Radical Choice
In describing Tom Price as a “radical choice” for HHS Secretary, the New York Times stated that he is “a man intent on systematically weakening, if not demolishing, the nation’s health care safety net.”
In addition to supporting the repeal of Obamacare, Tom Price is a climate change denier, and has been in favor of:
- block granting Medicaid
- turning Medicare into a voucher program, which many think is a step towards privatization
- barring all federal funds for Planned Parenthood, even though the very great majority of their activities have nothing to do with abortion
- limiting participation in Children’s Health Insurance Program (CHIP) and voting against expanding CHIP several times
- cutting billions of dollars from the Supplemental Nutrition Assistance Program (SNAP or food stamps) as it was converted to a State Flexibility Fund in the 2015 GOP proposed budget
- continuing to ban research on gun violence at the CDC as he did not sign a letter with a bipartisan group of 146 other members of Congress, led by Congressman David Price, calling for a lift of the de-facto ban on federal gun violence research
And although his nomination was supported by the AMA, the American Academy of Family Physicians (AAFP), and the Association of American Medical Colleges (AAMC), there are many doctors and medical students who think that “Price’s stances are incompatible with the values of the medical profession and with the stated missions of the above organizations.”
The AAP on the Nomination of Tom Price
What has the American Academy of Pediatrics said about Tom Price’s nomination?
“Above all, HHS should strive to implement an agenda with children at the core and ensure that all children have access to high-quality, affordable health care so they can thrive throughout their lifetimes. All children, regardless of their immigration status, should have affordable health care coverage, insurance with pediatric-appropriate benefits, access to timely and affordable primary and subspecialty pediatric care and mental health services, and receive comprehensive, family-centered care in a medical home.”
AAP’s Blueprint for Children
As is their style, they have not issued a statement, but reviewing the AAP’s Blueprint for Children, it isn’t too hard to figure out what they would say.
The Blueprint, which “presents specific policy recommendations for the federal government to align its activities to promote healthy children, support secure families, build strong communities, and ensure that the United States is a leading nation for children,” states that they:
- oppose block grants for Medicaid and other entitlement programs
- support renewing and strengthening CHIP
- support maternal and reproductive health programs
- want to improve access to Medicaid services
- support protecting and strengthening federal nutrition programs for children and families, including SNAP and WIC
- support federally funded research to build the evidence base for a public health response to violence, including research on gun violence coordinated by the Centers for Disease Control and Prevention (CDC)
- want the administration to aggressively addresses climate change
- support the enactment of comprehensive immigration reform that prioritizes the health, well-being, and safety of children
- want the administration to address factors that make some children more vulnerable than others, such as race, ethnicity, religion, sexual orientation or gender identity, and disability
And perhaps the thing that is most apparently in conflict with Tom Price’s nomination, the AAP states that they want the HHS secretary and Congress to:
“Support and improve the ACA. The ACA has made important progress for children. Congress should improve upon this progress and enhance pediatric benefits in the marketplaces, allow families that are not eligible for CHIP to purchase CHIP plans in the health insurance marketplaces, improve affordability of plans for families (especially those with children with special health care needs), and strengthen rules to ensure that adequate pediatric networks exist in marketplace plans.”
Tom Price is not going to support and improve the ACA (Obamacare), strengthen CHIP, or improve access to Medicaid services. He is basically against just about everything the American Academy of Pediatrics supports and has been working for.
We don’t need a statement from the AAP to know what that means.
Last Updated on December 7, 2016 by Vincent Iannelli, MD
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