Recently, president-elect Donald Trump nominated Georgia congressman Tom Price to be Secretary for Health and Human Services (HHS). Price is a medical doctor whose impact on politics has been almost exclusively based on his unwavering opposition to the Affordable Care Act, known as Obamacare.
Once Trump was elected, along with a Republican Senate and House, most of us in healthcare knew that Obamacare was probably doomed. I don’t think it will be easy for the Republicans, now that they’re in power, to actually dismantle Obamacare, especially some of the more popular provisions such as elimination of the pre-existing conditions as a disqualification for receiving health insurance.
Also, there are over 20 million Americans who have taken advantage of health insurance from Obamacare, and I think it would be almost impossible for the Republicans to cut them off. But I may be delusional about the limits of Republican dislike of poorer Americans.
Setting aside healthcare insurance, what else may be impacted by Tom Price? Well, the Department of Health and Human Services is responsible for many of the important health care institutions that matter to me and my readers. Some of the major institutions under the HHS umbrella are:
- The National Institutes of Health (NIH) – the nucleus of biomedical and health-related research in the USA. Much of the research at NIH, which has an impressive world-wide reputation, serves as the foundation of much of what we know about human health and disease.
- The Centers for Disease Control and Prevention (CDC) – if you are a reader of this website and blog for the past 5 years, you know I, and many others, have tremendous respect for the CDC. It functions as the frontline, first responders if you will, for any disease that appears in the world. It is made up of some of the leading scientists, public health specialists, and thought leaders in healthcare, who give their careers to help humanity. And, of course, they set vaccine policy for this country. The CDC has tremendous influence on public health across the globe.
- The Food and Drug Administration (FDA) – the primary regulator of pharmaceuticals, medical devices, food, diagnostics, supplements, and many other areas, it is one of the most powerful agencies in the world for protecting the health of consumers.
- The Centers for Medicare and Medicaid Services (CMS) – the federal agency that administers the Medicare program along with advising the states on Medicaid and other public health care programs.
Tom Price will have significant influence on much of the science of medicine, let alone the financing of health care in the USA. There is one thing in Price’s background that give us some significant insight as to how he’ll run his department – let’s just say, it’s not good. Yeah, none of us of would have predicted this.
Tom Price and the AAPS
Dr. Tom Price belongs to a radical, right wing physician’s group called the Association of American Physicians and Surgeons (AAPS). If you’ve never heard of AAPS, they are a politically conservative non-profit association founded in 1943 to “fight socialized medicine and to fight the government takeover of medicine.”
I’ve written about this group before with regards to their ridiculous attacks on the medical fitness of Hillary Clinton.
The AAPS is generally recognized as politically conservative or ultra-conservative. According to David Gorski, “it is not an exaggeration to say that the AAPS, through its journal JPANDS, is waging a war on science- and evidence-based medicine in the name of its politics.”
The AAPS has a longstanding opposition to any sort of effort at any type of healthcare reform. And they stand against providing medicare based on need alone. They opposed the establishment of Medicare and Medicaid, claiming that “the effect of the law is evil and participation in carrying out its provisions is, in our opinion, immoral.” The organization is opposed to its members accepting payments from Medicare or Medicaid, and in fact, many only accept direct payments from patients. They want patients to purchase medical care directly from physicians. They also believe that there is no inherent right to medical care.
But it gets worse. AAPS requires its members to sign a “declaration of independence” pledging that they will not work with Medicare, Medicaid, or even private insurance companies. According to AAPS Principles of Medical Ethics, it is moral and ethical to refuse to treat patients who have Medicare or Medicaid.
Think about this principle – a physician, who takes an oath to “apply, for the benefit of the sick, all measures which are required.” It doesn’t say “unless you have Medicare or Medicaid.”
Despite its name, AAPS sits far outside what we consider to be the standards that we expect of our physicians. These people seem to think that their political beliefs preempt proper medical care.
The head of AAPS is Dr. Jane Orient, is also the managing editor of the Journal of American Physicians and Surgeons (JAPANDS), published by AAPS. The journal does not have an impact factor, and does not appear to be indexed in PubMed. According to an article by Stephanie Mencimer, The Tea Party’s Favorite Doctors,
…(their) journal is a repository for quackery. Its website features claims that tobacco taxes harm public health and electronic medical records are a form of “data control” like that employed by the East German secret police. An article on the AAPS website speculated that Barack Obama may have won the presidency by hypnotizing voters, especially cohorts known to be susceptible to “neurolinguistic programming”—that is, according to the writer, young people, educated people, and possibly Jews.
No wonder it’s not on PubMed. It’s not science. Or possibly since PubMed is a government run database, it’s evil. Who knows?
And now, we have Tom Price, a card carrying member of AAPS, preparing to run our health care system. He is directly responsible for Medicare, probably the most successful health care plan in the nation (if not the world), and he thinks that any type of public health insurance is not a right of citizens. This is a nightmare for millions of seniors and disabled who rely upon Medicare for all of their medical needs.
I cannot imagine want the future holds for our citizens.
But there’s more
The AAPS has right wing beliefs that is far outside of what we consider good medicine. The AAPS is also opposed to abortion, organ donations, and just about anything a moderately science-based physician would accept.
Organ donations? Part of their issue is that the system that controls donations is a bureaucracy that decides who gets and doesn’t get an organ. Or maybe it’s racism. Or maybe it’s just some random belief that anything reasonably scientific is bad.
The AAPS is also anti-vaccine at many levels. They are opposed to “mandatory vaccinations” as a requirement for attending public schools. They buy into the myth that shaken baby syndrome is related to vaccines! They buy into just about every anti-vaccine myth and oppose the use of Gardasil. They think that vaccines cause autism (it doesn’t). It’s like they accept the holy checklist of the anti-vaccine cult as a fundamental “scientific” belief of their organization
Let’s remember that vaccines are considered one of the great achievements of medicine over the past century. Millions of lives have been saved by vaccines just over the past couple of decades.
dangerous medical quackery, such as antivaccine pseudoscience blaming vaccines for autism, including a view that is extreme even among antivaccine activists, namely that the “shaken baby syndrome” is a “misdiagnosis” for vaccine injury; its HIV/AIDS denialism; its blaming immigrants for crime and disease; its promotion of the pseudoscience claiming that abortion causes breast cancer using some of the most execrable “science” ever; its rejection of evidence-based guidelines as an unacceptable affront on the godlike autonomy of physicians; or the way the AAPS rejects even the concept of a scientific consensus about anything.
Let’s just put it this way. The AAPS has featured publications by antivaccine mercury militia “scientists” Mark and David Geier. Even so, the very fact that Price was attracted enough to this organization and liked it enough to actually join it should raise a number of red flags. It certainly did with me, because I know the AAPS all too well.
Andrew Wakefield must be cheering loudly.
Maybe Dr. Tom Price doesn’t accept all of the tenets of the AAPS. However, there is a lot of information out there that seems to indicate that he is in line with many of the precepts of the AAPS. According to an article in Scientific American, Dr. Price wants limits on medical research with spending limits (or cuts to other programs to fund it). He is also opposed to embryonic stem cell research, one of the most important tools for medical research.
With respect to vaccines, it’s hard to tell whether he’s in line with the AAPS or not. One of the central core beliefs of Price is opposition to lawsuits against companies and physicians. In one law proposed by him while a congressman (see section 405, pdf), he seems to support the continuation of the current system of vaccine manufacturer liability, the National Vaccine Injury Compensation Program. But wanting to limit liability is a long way from being pro-vaccine.
The information we have is that Tom Price accepts a lot of the basic AAPS beliefs, including their Ayn Rand styled hatred of public health care and their pseudoscience. And that’s scary. As the person in charge of a boatload of our research, science, and healthcare policy, it is difficult for me to be happy about this pick, but I haven’t been happy about anything coming from president elect Trump.