Health secretary pick faces scrutiny
Trump’s pick for Health secretary has fought to limit safety net coverage in a state where need is great.
In Georgia, where many lack insurance, Rep. Tom Price has long battled assistance programs for the needy.
WASHINGTON — From the packed hallways of Atlanta’s massive county hospital to the thousands of patients who line up around the state every year to get Obamacare, yawning gaps in Georgia’s overburdened healthcare system aren’t hard to find.
“The need for care is just tremendous,” said Dr. Charles Moore, a Harvardtrained ear, nose and throat specialist who runs an Atlanta clinic for poor patients.
Georgia has some of the worst health outcomes in the U.S., with high rates of untreated illness and death from preventable diseases.
The state is also home to Dr. Tom Price, the Republican congressman President-elect Donald Trump has tapped to be the next Health and Human Services secretary. Trump has charged Price with repealing the Affordable Care Act and developing a replacement that Trump promised will protect millions of Americans who’ve gained coverage through the law.
He is an unorthodox choice for the task.
As a physician in Georgia and a lawmaker for 20 years, first in the state Legislature and then as a member of Georgia’s congressional delegation, Price has relentlessly fought to limit healthcare safety net programs, even as nearly 1 in 5 Georgians were locked out of health coverage.
His efforts to cut healthcare programs have stoked opposition to his nomination from Democrats.
Price’s critics are also eyeing his extensive trading in healthcare stocks, including revelations reported by CNN that he bought stock in a medical device maker just days before introducing legislation that would have benefited the company.
The Trump transition team disputes the report, saying the stock purchase was initiated by Price’s broker and the congressman was unaware of it. The issue is expected to feature prominently when Price appears Wednesday before the Senate Health Committee.
Price declined through a spokesman to be interviewed.
Throughout his political career, he has grounded his opposition to safety net programs in his medical experience. Price, 62, whose father and grandfather were doctors, is an orthopedic surgeon who came to Georgia more than 30 years ago from his native Michigan and later opened a solo practice outside Atlanta.
“Healthcare decisions should be made by patients and their doctors, not bureaucrats or insurance companies,” he said in 2007, explaining his votes against expanding the Children’s Health Insurance Program, which now provides coverage to more than 8 million low-income children.
Several of Price’s former medical colleagues say his view ref lects a long-standing frustration with limits that insurance programs such as Medicare and Medicaid put on doctors.
“He values physician autonomy and having the patient at the center of care,” said Dr. Steven Walsh, an anesthesiologist who began practicing alongside Price more than 30 years ago at North Fulton Hospital in Roswell, Ga., where Price still lives.
Many former colleagues, including Walsh, recalled Price’s extensive efforts to help doctors by limiting malpractice awards, requiring that they are promptly paid and restricting what medical services can be performed by nurses and others without a medical degree.
Many physicians are frustrated by the growing list of requirements from insurance programs, including that they report patient outcomes, track costs and use approved electronic record systems.
Price’s reaction has been to try to scale back the programs.
In the state Legislature, he was one of only four senators who opposed the creation in 1998 of PeachCare, Georgia’s version of the Children’s Health Insurance Program, a federal initiative to expand coverage for children from low- and moderate-income families. Price said such children could already get care. At the time, more than 300,000 Georgia children lacked coverage.
After being elected to Congress in 2004, Price continued his fight against the federal program, voting six times in 2007 and 2009 to oppose legislation to expand CHIP to reach more uninsured children, even as dozens of Republicans, including Georgia’s governor, backed the expansions.
Research has shown that CHIP and Medicaid improve children’s access to care, and there are even indications that poor kids who have coverage are healthier as adults.
Price also supported GOP budget blueprints developed by now-House Speaker Paul D. Ryan (RWis.) to scale back health protections for seniors by increasing the Medicare eligibility age from 65 to 67 and by shifting more costs to patients by converting Medicare into a voucher system.
And when Price took the helm of the House Budget Committee two years ago, he developed his own budget plans to slash trillions of dollars from federal healthcare programs.
Among the biggest targets was Medicaid, a state and federally funded program that today provides coverage to more than 70 million Americans, including poor children, seniors and the disabled. Medicaid is the largest payer for nursing home care in the country.
Price’s 2017 budget plan, if enacted, would have cut more than $2 trillion in Medicaid spending over the next decade, reducing federal aid to states by close to 40% and probably forcing many to place significant restrictions on who got coverage and which medical services they could get.
Price has argued the cuts are necessary to control skyrocketing federal healthcare spending and balance the budget. “For too many Americans, this world-class level of healthcare is beyond reach … because policies coming out of Washington are driving up the cost of care and preventing Americans from accessing the care they need,” he wrote in his 2017 plan.
Price’s top priority has always been patients, said Dr. William Clark, who has worked closely with Price at the Medical Assn. of Georgia. But in medical offices, clinics and hospitals that see Georgia’s neediest patients, there are few indications that limiting coverage helps patients’ health.
“The fact is, patients will avoid seeing the doctor if they can’t pay,” said Dr. Evan Weisman, a retired Atlanta cardiologist and longtime advocate for expanding health insurance.
Indeed, in 2013, 19% of Georgia adults reported skipping needed medical care because of cost, the highest rate in the nation.
At the same time, the gaps in coverage are putting a growing strain on many hospitals, particularly in rural parts of the state.
Georgia has begun to see improvements since Obamacare’s coverage expansion began. About half a million Georgians have gained health insurance in the last three years, but the talk of repealing the health law has many Georgians concerned, said Sheila Carter, who helps direct enrollment for the nonprofit InsureGA.
“People are very, very worried,” Carter said. “They need the insurance.”