New Trump appointment bodes better for future of healthcare

President-elect Donald Trump has named Rep. Tom Price (R-GA) to head the U.S. Department of Health and Human Services in the new administration in Washington, D.C.

A physician who practiced medicine and surgery for 20 years, Dr. Price has served for the last 12 years in Congress where he has risen to Chair of the House Committee on the Budget (replacing Paul Ryan when he became Speaker of the House). Dr. Price rigorously opposed the Affordable Care Act (ACA) and has consistently sought a smaller federal government in all aspects of American life.

When confirmed by the Senate early next year, he will be the first physician to head the DHHS since Lewis Sullivan, M.D., during George H. W. Bush’s administration.

(I met with Dr. Sullivan several times in Washington between 1989 and 1992, and once had the pleasure of attending a picnic with him and his family. He was committed to continuing the public health education programs I had started with U.S. Surgeon General C. Everett Koop in the prior Reagan Administration.)

All signs point to repealing and replacing the ACA

As promised on the campaign trail, President-elect Trump is now poised to repeal and replace the ACA. And Dr. Price is just the right person to help get it done.

In 2009, Dr. Price sponsored the Empowering Patients First Act (EPFA), a full-fledged alternative to the purely partisan ACA, which had ultimately prevailed by one (bought) vote in Congress.

Unlike the Obama administration’s repeated claims that Republicans had no alternative plan, Dr. Price’s EPFA was, in fact, a complete overhaul of healthcare. His plan would have empowered patients first and healthcare providers second. Instead of empowering government and health insurance bureaucrats, as under the ACA.

Then, following more well-publicized failures of the ACA in 2015, Price introduced an expanded version of his EPFA bill to provide vouchers allowing all citizens to opt out of government-mandated programs, including Medicare, Medicaid, TriCare (for active duty and retired military and their families), and VA (for former active duty military but not having retired following a full military career).

That option would be a real “pro-choice” government health program. It would also allow insurance companies to compete nationally, across state lines. Also, it would establish insurance risk-pools to allow real, sustainable business solutions to health insurance, instead of unsustainable and all-around costly and cumbersome government mandates and subsidies.

Dr. Price also led a group in Congress to oppose a Veterans Administration proposal to allow nurse practitioners to practice independently without supervision from a licensed physician. You may be in one of the U.S. states that currently allows nurse practitioners to provide care without physician supervision.

It is not always a pretty picture. The practice generally imparts lower standards, lower medical knowledge, and lower quality of medical care.

Dr. Price argued that by imposing nurse practitioners into the primary practice of medicine nationally in VA facilities across the country, it would lower standards of care. He said it would also conflict with state licensure authorities, which do not permit such practice in most states. Last, it would also provide yet another example of the federal government steamrolling over local government and community standards.

Future of healthcare finally looks more promising

Donald Trump has found in Dr. Price another administration official who actually understands and respects the U.S. Constitution, and who wishes to see less federal oversight into the rights of citizens, and state and local governments.

Dr. Price will have a hefty responsibility. The DHHS has the biggest budget in the bloated federal government, largely with federal disbursement programs under Social Security, Medicare, and Medicaid, as well as the big, cumbersome, ineffective bureaucracies at the alphabet soup of agencies CDC, FDA, NIH and others.

Thankfully, after many years, there will finally be an honest broker who knows the subject matter and the stakes. I wish him well.


“Trump Picks Rep. Tom Price, MD, to Lead HHS,” Medscape ( 11/28/2016