Will Trump’s next FDA chief protect us?

Gottlieb helped consumers by regulating industries

Donald Trump’s deregulation presidency has been an aggressive assault on the protections Americans need in order to live healthier lives. He may have gotten a boost last week with the sudden resignation of his Food and Drug Administration Commissioner Scott Gottlieb — a conservative but serious-minded reformer who was willing to embrace regulations on vaping and tobacco companies and to publicly call out the pricing tricks of pharmaceutical companies.

The Trump administration’s view is that when it comes to our health, we don’t need more protections, we need fewer things getting in the way of allowing companies to do as they please. Fossil fuel companies have enjoyed not only the lowering of clean air and water standards, but former industry lobbyists have taken over writing the rules at the Environmental Protection Agency.

Likewise, the consumer protections in the Affordable Care Act, such as those put in place to protect the tens of millions of Americans with pre-existing conditions, have been undermined by new unregulated insurance, permitted and promoted by Trump. With these junk policies, insurance companies decide whom not to cover, what not to cover and how much to charge.

Trump likes to trumpet his deregulation push as liberating the economy from bureaucrats. But this is not red tape that small businesses are caught up in. These are consumer protections meant to ensure that massively profitable multibillion dollar companies meet minimum standards.

Trump doesn’t dislike all regulations. At the same time he is lifting regulations on fossil fuel and health companies, he is imposing new ones on individuals. To qualify for Medicaid, lowincome workers in seven states face new regulations requiring them to fill out forms logging their hours worked. In Arkansas alone, more than 18,000 people have already lost their coverage. And Trump wants similar regulations for families that receive food stamps.

Against this backdrop, Gottlieb’s surprise announcement is a setback for consumers. He was unusual in this administration for his repeated willingness to stand up for the American public against powerful pharmaceutical, tobacco and vaping companies, and was unafraid to push for new regulation as an important part of that effort.

As data mounted about dramatic increases in teenage nicotine addiction from vaping, Gottlieb saw the makings of what he called an “epidemic,” and he became something of an accidental activist regulator. He issued more than 1,300 warning letters and fines for those who sold e-cigarettes to minors and even publicly adjusted his prior views when faced with new information. He had begun the process of sharply curtailing the sale of flavored e-cigarettes targeting minors, had announced support for banning menthol cigarettes, and was on a path toward reducing nicotine levels in cigarettes.

Gottlieb was also beginning to take a harder line on dietary supplements and opioid prescribing limits, and was actively implementing food and calorielabeling laws passed during the Obama administration. And he was outspoken on the high cost of prescription drugs and called the industry to account for underhanded practices that delayed the availability of lower-cost generic medicines. He even publicly named names of those who in his words “game the system” and “exploit loopholes.”

When he announced his resignation, he was still very much in the middle of these efforts, and much remains to be decided. It’s unclear whether Gottlieb had enough administration support for some of his far-reaching reforms. If not, this will mark victories for the vaping and tobacco industries, and might have influenced his decision to leave.

Our system doesn’t work without regulators willing to take on companies that put their profits ahead of the public’s health. When our government agencies can’t or won’t write rules to rein them in, it’s another sign that we need a change in the Oval Office.

Andy Slavitt, a member of USA TODAY’s Board of Contributors, is a former health care industry executive who ran the Affordable Care Act and the Centers for Medicare and Medicaid Services from 2015 to 2017.