Tuesday, December 27, 2016

Trump’s Health Secretary Pick Leaves Nation’s Doctors Divided - The New York Times


When President-elect Donald J. Trump chose Representative Tom Price of Georgia to be his health and human services secretary, the American Medical Association swiftly endorsed the selection of one of its own, an orthopedic surgeon who has championed the role of physicians throughout his legislative career.
Then the larger world of doctors and nurses weighed in on the beliefs and record of Mr. Price, a suburban Atlanta Republican — and the split among caregivers, especially doctors, quickly grew sharp.
The controversy began soon after Mr. Trump announced on Nov. 29 that he had chosen Mr. Price to head the Department of Health and Human Services, which controls Medicare, Medicaid, the Affordable Care Act’s federal health insurance exchange, the National Institutes of Health, the Food and Drug Administration and the Centers for Disease Control and Prevention.
Within hours, the A.M.A. — the nation’s largest medical advocacy group, which has nearly 235,000 members and calls itself “the voice of the medical profession” — issued a statement saying it “strongly supports” the selection.
It noted Mr. Price’s experience as a doctor, a state legislator and a member of Congress. It praised, in particular, his support for “patient choice and market-based solutions” and his efforts to reduce “excessive regulatory burdens” on doctors.
The enthusiasm was understandable at one level: Mr. Price has been a member of the A.M.A. house of delegates since 2005 and was an alternate delegate for a decade before that, according to the A.M.A. and the Medical Association of Georgia.
“For those who are attacking Dr. Price, I have to ask whom you would rather have at the helm of H.H.S. — a career bureaucrat? A former governor who views doctors as a cost center to be controlled?” said Dr. Robert E. Hertzka of San Diego, an anesthesiologist and former president of the California Medical Association. “Tom Price may turn out to be the best friend that physicians and patients have ever had in that role.”
Many doctors are not willing to take that chance. More than 750 people who identify themselves as members of the A.M.A. signed a letter to the association’s board objecting to the endorsement.


The “unqualified support” for Mr. Price is inappropriate, the letter says, because he has been “a strong opponent of so much of our clearly delineated A.M.A. policy” on issues like the Affordable Care Act, contraception and gay rights. Some doctors also said patients could be hurt by major changes in Medicare and Medicaid that Mr. Price, along with other House Republicans, has advocated.


Phillip J. Blando, a spokesman for the Trump transition team, said Mr. Price had been endorsed by many medical groups and was “uniquely prepared” for the job. “If confirmed,” he said, “Dr. Price will work to restore the patient-doctor relationship and clamp down on government overreach.”
Mr. Price has introduced legislation to repeal Mr. Obama’s health law, including its expansion of Medicaid and subsidies for the purchase of private insurance. He advocates tax credits to help people buy insurance, greater use of individual health savings accounts and state-run “high-risk pools” for people with pre-existing conditions who might otherwise have difficulty finding affordable coverage.
As a member of the House Budget Committee, and then its chairman, he has supported proposals to shift Medicare away from its open-ended commitment to pay for medical services and toward a fixed government contribution for each beneficiary, which could be used for either private insurance or traditional Medicare. Such proposals could increase costs for some beneficiaries or limit the amount of care they receive, health policy experts say.
Mr. Price has also backed turning Medicaid into block grants to state governments. Critics say that states would probably respond by restricting eligibility, cutting Medicaid benefits or reducing payments to health care providers.
In leading efforts to repeal the president’s health law, he is pursuing a goal in opposition to the policies of the A.M.A. In a 2010 letter to congressional leaders, Dr. J. James Rohack, who was then president of the A.M.A., said the law took “an important step toward improving the health of the American people,” by “extending coverage to the vast majority of the uninsured” and “improving competition and choice in the insurance marketplace.”
Dr. Samantha G. Harrington, a doctor at Cambridge Hospital in Massachusetts, said she had canceled her A.M.A. membership because she found its endorsement of Mr. Price “embarrassing and shameful.”
Dr. Thomas M. Gellhaus, president of the American Congress of Obstetricians and Gynecologists, said Mr. Price had “worked closely with us” on many issues. But, he said in a recent letter to the congressman, “some of the bills you supported in Congress would not serve women’s health well.”
Mr. Price has supported efforts to restrict abortion and cut off federal funds for Planned Parenthood clinics. If confirmed, Mr. Price would be only the third physician to serve as secretary in the 63-year history of the Health and Human Services Department and its predecessor, the Department of Health, Education and Welfare.

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Trump’s Health Secretary Pick Leaves Nation’s Doctors Divided - The New York Times

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