W

ASHINGTON — It’s called a “courtesy hearing,” but Representative Tom Price, President-elect Donald Trump’s nominee for secretary of health and human services, can expect some of his Senate interrogators to get a little rough.

Price, an orthopedic surgeon and six-term GOP congressman from Georgia, will appear before the Senate Committee on Health, Education, Labor, and Pensions to answer questions on Wednesday. It’s a courtesy hearing because a separate panel, the Senate Finance Committee, will actually vote on his nomination.

Still, there will be a lot to discuss.

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Price is widely known for his crusade to repeal the Affordable Care Act — an issue he took on well before Trump made it a cornerstone of his campaign. But even as Congress moves to abolish the law, some GOP lawmakers remain worried about the prospect of leaving consumers without a viable replacement. And Democrats continue to fight against repeal.

As HHS secretary, Price would not have the power to enact a new health law. But he will set the pace for how the agency implements the current one, and, while Congress debates its replacement, he can change the rules to discourage insurers from participating.

Price is also appearing before lawmakers at a time of growing scrutiny over his investments in health care and tobacco companies. Last week, he pledged to divest his financial interests from 43 companies. But questions remain about whether Price, whose shares in Innate Immunotherapeutics boomed shortly after his purchase last fall, secured a deal that was not available to the general public.

Here are some questions we would like to see answered.

You have proposed major changes to Medicare. How can you do so without leaving Americans vulnerable?

Trump has promised not to gut Medicare, the federal health insurance program for people age 65 and older, some younger people with disabilities, and those with permanent kidney failure.

But Price, and much of the Republican leadership, believes changes are necessary to avoid bankruptcy. There is likely to be strong opposition, even among those who support repeal of the Affordable Care Act.

The National Physicians Alliance, one of the doctors groups that opposes Price’s nomination, has said his interest in moving to “privatize Medicare would end the healthcare guarantee for our nation’s 57 million seniors and drastically hurt our most elderly and vulnerable patients.”

We’d like to know how Price plans to alter the Medicare Advantage and Part D programs, which can be changed without ACA repeal. And how will he protect the low-income elderly, if his plan to provide them with vouchers is adopted? Lastly, will Price continue to oppose allowing Medicare to negotiate with drug companies — a bid to lower drug prices —even though Trump has said he would support the idea?

How will your anti-abortion views impact your work with the Food and Drug Administration and the National Institutes of Health?

The FDA is an independent agency, but falls under the umbrella of HHS, which would put Price at the center of debates involving reproductive health, as well as fetal tissue and embryonic stem cell research.

He is strongly opposed to abortion. As a congressman, he had a 0 percent rating from Planned Parenthood and a 100 percent rating from the National Right to Life. He has also supported defining personhood as beginning from the moment of conception and therefore providing constitutional protections to unborn persons.

How will these views affect his decisions at HHS and the work conducted at the FDA and NIH?

A recent report suggested you got a ‘sweetheart deal’ on shares in a foreign biotech, even though it wasn’t issuing stock on the open market. How did you come to buy the shares in Innate Immunotherapeutics? And how did you handle your other trades?

Members of Congress are permitted to buy and sell stock, and biomedical and health care stocks remain popular.

It’s all perfectly legal. There’s one exception: Lawmakers are not permitted to use their positions to gain special access to investments. In this case, Price must explain how he got in.

As Kaiser Health News reported last week, Innate Immuno has hinged its business strategy on winning approval for its new multiple sclerosis drug from the FDA. Price’s profiting off of that stock could present a conflict of interest.

We’re also curious to learn why Price, a physician, invested in tobacco company Altria.

How do you propose doctors be protected from malpractice claims while also ensuring patients can seek redress?

One of Price’s main interests since being elected to public office has been trying to limit doctors’ vulnerability to patients who sue them for malpractice.

He has said that “there is too much money on the table” in medical malpractice cases, which, he contends, drives up the cost of malpractice insurance premiums and health care overall.

But how does Price square his interest in tort reform with an interest in protecting patients?

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Do you share the president-elect’s concerns about the safety of US vaccines?

Trump has made a number of remarks indicating that he is concerned about vaccine safety, seemingly lending credence to debunked theories suggesting vaccines can cause autism. He also met recently with Robert F. Kennedy Jr., an outspoken anti-vaccine figure, who later said he had been asked to lead a committee on vaccine safety. (Trump’s transition team did not confirm he had been asked to do so.)

As the head of the nation’s top health agency, Price would be in a position to, at the very least, set the administration’s tone on vaccines.

How will you regulate the cigar industry?

As a congressman, Price tried to exempt the cigar industry from the new FDA rules that require premium, hand-rolled cigars to comply with the same testing and labeling requirements that smokeless tobacco and flavored must follow.

The industry opposes these rules for several reasons. It is also opposed to a provision that requires manufacturers to put health warning labels on the boxes, which are now often covered with intricate artwork.

As HHS secretary, and a cigar smoker, Price could block implementation of that rule. But would he?

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  • Malpractice lawsuits drain many millions of dollars which could otherwise be spent caring for patients. The threat of malpractice strongly encourages “defensive medicine” , meaning over diagnosis and excess worrying beyond evidence based care. The annual (!) cost to the healthcare system is estimated to be 50-200 Billion (yes, billion) dollars. Unfortunately, only 8% of patients harmed in the process of medical care are compensated. This is the reason why the present system is inadequate and need to be replaced.
    In my opinion, medicine should follow the example of the manufacturing industry, who long ago created the effective and efficient “Workman’s Comp”. We should create “Patient’s Comp”, a administrative process where patients harmed in the process of medical care are examined, and treated and compensated according to a set fee schedule. This is a rational, less expensive system which encourages reporting of errors and therefore learning from errors and fosters future prevention of errors.
    The only people opposed to such a rational system are lawyers who presently reap tremendous rewards from people’s suffering and get 40% of the awards given to patients. That has to stop. A reasonable, effective system such as “Patient’s Comp” is long overdue

  • The HHS runs the department that surveys and reviews long term care facilities. We continue to see failing nursing facilities 30 years after the implementation of the Nursing Home Reform Act otherwise known as OBRA. Nursing home owners tend to vote Republican because they want these federal regulations reduced. I wish they would ask how Dr. Price is going to address this healthcare crisis in this forgotten population.

  • How can there by any honest, useful debate on any issue when one side begins the debate with all the falsehoods built into just this article’s section on Medicare? The author writes (asking Dr. Price):

    “You have proposed major changes to Medicare. How can you do so without leaving Americans vulnerable? Trump has promised not to gut Medicare, the federal health insurance program for people age 65 and older, some younger people with disabilities, and those with permanent kidney failure. But Price, and much of the Republican leadership, believes changes are necessary to avoid bankruptcy. There is likely to be strong opposition, even among those who support repeal of the Affordable Care Act. The National Physicians Alliance, one of the doctors groups that opposes Price’s nomination, has said his interest in moving to “privatize Medicare would end the healthcare guarantee for our nation’s 57 million seniors and drastically hurt our most elderly and vulnerable patients.”

    “We’d like to know how Price plans to alter the Medicare Advantage and Part D programs, which can be changed without ACA repeal. And how will he protect the low-income elderly, if his plan to provide them with vouchers is adopted? Lastly, will Price continue to oppose allowing Medicare to negotiate with drug companies — a bid to lower drug prices —even though Trump has said he would support the idea?”

    In those two paragraphs, there are eight outright lies or statements so misleading that they can be considered lies:

    1. There is absolutely no basis for the statement that “proposed major changes to Medicare (would be) leaving Americans vulnerable.” Major changes to 1965 Medicare were made in 1972, 1985, 1997, 2003, 2010 and 2015. To write those outrageously inflammatory words about future changes is pure propaganda Mediscare. (As an aside, everyone of reason on all political sides agrees that Americans under 50 will be totally vulnerable in their senior years if no reform is made.)
    2. It is jingoistic to write that people think “changes are necessary to avoid bankruptcy.” The reality is that doing nothing, keeping current Medicare law just as it is, results in the following:
    — Part B premiums will shortly (under 5 years) exceed $200 a month for people newly entering the Medicare program (and those not on Social Security and a few other groups)
    — Part C premiums will rise as premium support falls, making what has been primarily a program for the lower middle class a program only for the middle and upper middle class (rich people get private supplemental insurance). This will drive some people back into traditional Medicare (where they cost more per capita than on Part C) or drive them into becoming dual-eligible Medicare/Medicaid beneficiaries (which costs the government in total much more per person)
    — Doctors will receive no raises after 2024, forcing more and more to drop out
    — Hospitals will have their already low rates cut by 13% in 2028 with larger cuts to follow year after year as the HI Trust Fund can spend only what it takes in in payroll taxes (Medicare actuaries estimate that this will lead to the closure of many hospitals, harming everyone in addition to those on Medicare)
    3. There is no proposal to “privatize Medicare;” politicians and others like the author of this article who make that statement either do not even know what the word “privatize” means (no investor would be interested in taking Medicare — with its $50 Trillion unfunded liability — private) or just engaging in more jingoistic Mediscare
    4. There is no Medicare reform proposal anywhere that “would end the healthcare guarantee for our nation’s 57 million seniors.” That is a lie two different ways. Nothing changes the Medicare guarantee. There are not 57,000,000 seniors today (if the author means sometime in the future, there are many more than 57,000,000).
    5. There is nothing proposed that would “drastically hurt our most elderly and vulnerable patients.” This is just the same nonsense deceitful propaganda as discussed in lie number 1 above. And the major change proposed by Dr. Price and dozens of others for the last 22 years, when two Democrats came up with the idea in the Medicare context (100% Medicare premium support in 2024 replacing the 45% Medicare premium support that will be in force in 2024 under current law) would not affect anyone currently on Medicare that does not want premium support
    6. As to how Dr. Price will “protect the low-income elderly,” there is no proposal to change anything in Social Security Extra Help/LIS or the Medicare Savings Program (and we don’t like being called “elderly,” you senior hater)
    7. This is the biggest and most deceitful lie of all. There is no “plan to provide (people on Medicare) with vouchers.” There has been no such plan by anyone related to Medicare since one by Democrat Richard Gephardt in 1981
    8. It would be interesting to know if Dr. Price (always rudely called just Price by this hateful author) will “continue to oppose allowing Medicare to negotiate with drug companies.” Because to do so would mean totally changing the way public Medicare drug coverage works today. Today Medicare does not negotiate because Medicare does not buy drugs. If I am forced to have the $1200-toilet-seat guys in Washington negotiate my drug prices and forced to buy my drugs from them (as opposed to the much better negotiators with much more buying power that I have now), I must be allowed to drop out of Part D without the current penalty that would be imposed.

    With eight outright lies or statements so misleading that they can be considered lies in just the two paragraphs on Medicare, imagine how bad the rest of this article is.

  • Here’s a question that should be added: What will you do to improve medical device safety at FDA, such as prescreening patients for reactivity to dental and medical devices to ensure they are “right for you” before they are installed?

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