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Trump’s nominee for the secretary of Human and Health Services is in favor of Paul Ryan’s plan, while the Republicans loos like they will implement a system that exacerbates the shortcomings of the Affordable Care Act, says physician Adam Gaffney

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SHARMINI PERIES: It’s The Real News Network. I’m Sharmini Peries, coming to you from Baltimore. Trump’s pick for Secretary of Human and Health Services, Tom Price, faced questions from both Republicans and Democrats on Wednesday. The hearings gave members of Congress an opportunity to ask their fellow Republican House Representative from Georgia about his policy positions on healthcare. The formal Confirmation Hearing will take place next Tuesday in front of the Senate Finance Committee. Joining us now to discuss Tom Price as a potential Health and Human Services Secretary is Adam Gaffney. Adam is an instructor in Medicine at Harvard Medical School. He writes about health care policy and politics and is a board member of Physicians for National Health Program. Thanks for joining us today, Adam. ADAM GAFFNEY: Thank you for having me. SHARMINI PERIES: So, Adam, Tom Price faced some tough questions from Vermont Senator Bernie Sanders during the hearing. Bernie Sanders asked Price about whether he would pursue efforts towards a truly universal health care system — this exchange is a bit lengthy, but let’s have a look. BERNIE SANDERS: Congressman Price, the United States of America is the only major country on Earth that does not guarantee health care to all people as a right. Canada does it. Every major country in Europe does it. Do you believe that health care is a right of all Americans, whether they’re rich or they’re poor? Should people, because they are Americans, be able to go to the doctor when they need to, be able to go into a hospital because they are Americans? TOM PRICE: Yes. We’re a compassionate society– BERNIE SANDERS: No, we’re not a compassionate society, in terms of our relationship to poor and working people, our record is worse than virtually any other country on Earth. We have the highest rate of childhood poverty of any other major country on Earth. And half of our senior, older workers have nothing set aside for retirement. So, I don’t think compared to other countries we are particularly compassionate. But my question is, in Canada, in other countries, all people have the right to get health care. Do you believe we should move in that direction? TOM PRICE: If you want to talk about other countries’ health care systems, there are consequences to the decisions that they’ve made, just as there are consequences to the decisions that we’ve made. I believe, and I look forward to working with you to make sure that every single American has access to the highest quality care and coverage that is possible. BERNIE SANDERS: “Has access to” does not mean that they are guaranteed healthcare. I have access to buying a $10-million home. I don’t have the money to do that. TOM PRICE: And that’s why we believe it’s appropriate to put in place a system that gives every person the financial feasibility to be able to purchase the coverage that they want for themselves and for their family, again, not what the government forces them to buy. BERNIE SANDERS: Yeah, but if they don’t have any… Well, it’s a longer story. Thank you very much. TOM PRICE: Thank you. SHARMINI PERIES: Adam, let me get your thoughts on that exchange. ADAM GAFFNEY: Well, I think that exchange says it all about the meaninglessness of the Republicans’ proposal for “universal access”. The New York Times report, I think it was last week, that Republican House was claiming that whatever they replaced the Affordable Care Act with would grant universal access. And that phrase means nothing as I think Senator Sanders asserts. We all have access to purchase anything. You know, you can go and buy a gourmet dinner, a house or Corvette. Having access to purchase something is not having it itself. So, you know, what we’re seeing is almost a linguistic game, I think, a rhetorical game, rather, in which the idea of universal health care, that language of universalism is being diluted to describe something that’s nothing like universal health care. SHARMINI PERIES: So, Adam, Sanders also asked whether Price would take on big pharma with the toughness suggested by Trump during his press conference last week. Here’s what Trump had to say. DONALD TRUMP: We have to get our drug industry coming back. Our drug industry has been disastrous. They’re leaving left and right. They supply our drugs but they don’t make them here, to a large extent. And the other thing we have to do is create new bidding procedures for the drug industry because they’re getting away with murder. Pharma has a lot of lobbies, a lot of lobbyists and a lot of power. And there’s very little bidding on drugs. We’re the largest buyer of drugs in the world and yet we don’t bid properly, and we’re going to start bidding and we’re going to save billions of dollars over a period of time. SHARMINI PERIES: I guess the question is whether his nominee for Health and Human Services and, of course, his potential pick for the FDA will take any steps towards lowering the prescription drug prices? What do you think, Adam? ADAM GAFFNEY: Well, I’m skeptical that the Trump administration is going to follow through with its claim to take on big pharma. I’ll be happy if I’m proved wrong on that but I’m skeptical. If you look at their overall orientation, it’s extremely pro-corporate. It’s extremely pro-rich. I am skeptical that they are going to be as aggressive about … prices as they claim. If they wanted to do what they’re talking about, they’re going to need to pass legislation that would allow Medicare to directly negotiate drug prices in order to undo the 2003 Medicare Modernization Act provision that prevents them from doing so. I’ll be happy if I’m wrong about the Trump administration on this point, but I’m skeptical he’s going to be this, you know, thorn in the side of big pharma like he claims to be. And certainly nothing that Price said in the hearings today suggested that he was particularly keen on taking on big pharma either. SHARMINI PERIES: Adam, the issue of cost control or how much this current policy, the Affordable Care Act, is costing people seems to be a concern, even for the Republicans. In fact, Republican Rand Paul at the hearing included a question about high-risk pools and associated costs related to it. What are these proposals? What does it entail in terms of what the Republicans are thinking at this time? ADAM GAFFNEY: Well, I think the Republicans are realizing that, politically, it’s going to be very difficult to simply repeal the Affordable Care Act and put nothing in its place. In fact, there was a lot of, you know… The Chairman who was questioning Price, you know, asserted several times that the Republicans needed to both repeal and replace. So, what are they going to replace it with, is the big question. And so, they’re realizing it’s not so easy to do and so they’re coming up with a number of stop-gap measures that could potentially help certain individuals. You know, what I think we’re going to see is some sort of replacement plan at some point. It’s probably going to resemble, you know, Paul Ryan’s GOP plan that they put forth in June, which Price has actually signed on for. And it might incorporate such things as replacing the Affordable Care Act subsidies with tax credits, high-risk pools for people who are pushed out of the insurance market, watered-down protections for pre-existing conditions. So, I think we’re going to see an overall deterioration of some of the protections of the Affordable Care Act, maybe not their outright elimination, as well as, an overall shift towards more aggressive ways of financing the health care system. SHARMINI PERIES: Tom Price’s history is also very relevant. He seems to have some insurance industries and pharma in his history, in terms of his business relationships. Can you highlight some of those conflicts that he faces now? ADAM GAFFNEY: This is going to be a serious issue for him going forward, I think. Last month, the Wall Street Journal reported that he had traded over $300,000 in stock for pharma, insurance companies, health care industry stock, over 40 years. During that period, he was very much involved in passing legislation that would affect those very same industries. And, at the same time, he was receiving corporate money from those for his campaign, as do many politicians. But the plot is thickening a little bit. One of the things that came up in the hearing was a particularly problematic purchase he made of stock off of the open market. This was originally reported by Kaiser Health News. They found that he had purchased an Australian pharmaceutical company called Immunogenetics [sic] that, you know, may have potentially been on a tip from Chris Collins, who’s on the board of the company and who is also in Congress. So, we’re seeing a number of potential ethical issues pertaining to sort of his position at the boundaries of the medical-industrial complex, as it’s sometimes called. SHARMINI PERIES: Adam, you’ve been four hours watching the hearings today. Did this issue come up at all? ADAM GAFFNEY: Repeatedly, in fact. It was a repeated issue brought up by multiple senators, including especially, Senator Murray, who pointedly asked him about the Australian pharmaceutical company that I mentioned. There was another issue that came up. Price had purchased a stock for a medical device company. Within a week, this was last year, he had introduced legislation that would actually help that company. And, actually, later on — and this was initially reported by CNN, I should add — that company actually gave to his campaign. That issue, he defended it on the basis of saying that he hadn’t actually picked that stock himself, that his stockbroker had picked it without his knowledge. But I think at the very least this shows a compromised judgement, a lapse in judgement and really loyalties that are unclear. And I think it’s going to be a serious issue for him. SHARMINI PERIES: Is it serious enough that his confirmation is in question? ADAM GAFFNEY: I think most of this is considered legal, or is legal, rather. The real question will be — and I don’t have the expertise to answer this — is whether the purchase of the Australian pharmaceutical company I mentioned, could potentially have been an instance of insider trading. And that we don’t know yet. And again, I’m not an expert on some of those areas of the law. That remains to be seen. But yes, I think if, in fact, that you know more is determined or more light is shed on that, that could potentially compromise him, I think. SHARMINI PERIES: Now, Republicans have regularly depicted Obamacare as the root of the health care crisis in the country. Meanwhile, Democrats such as Minnesota Senator Al Franken, for example, in today’s hearing argued that Obamacare — and let me quote him — “bent the cost curve” where he has the Affordable Care Act and our health care system as a stepping stone for a single-payer system. Do you agree with that? And do you think that the Democrats planned to make the overall Affordable Care Act, more affordable in the long run for everyone? ADAM GAFFNEY: I would agree with the case that Al Franken made that the biggest risk pool which he said today would be a Medicare for All program. And so, I think, you know, part of the problem here, and part of the reason why the Republicans are able to criticize the ACA so much, is that the ACA left many things undone. So, they’re able to make legitimate critiques. Tom Price brought up the fact that, you know, more than 20 million Americans are still uninsured. He talked a lot about high deductibles that are preventing Americans from purchasing health care. And he’s correct. Those are both problems — uninsurance and under-insurance. Now, his plan will make both of those problems worse, in my opinion, but it doesn’t detract from the fact that this makes for effective talking points. So, I don’t know what the Democrats will do. What I hope all politicians do is to realize that the Affordable Care Act was not enough. It left a lot undone. And also realize that the Republican replacement will actually just exacerbate its weaknesses while eliminating the parts that actually help people. And so I hope when that realization happens, that we do move forward with new legislation that would actually create, as Bernie Sanders put it, a right to health care in this country, which we still lack even today. SHARMINI PERIES: Earlier in that exchange that we showed between Bernie Sanders and Price, Price was saying that, you know, comparing our health care system to other countries, if you want to go there, he had a case to be made. Would you agree with that? I mean, Bernie Sanders was clearly saying, you know, so many developed countries in the world offer health care to their population but the U.S. doesn’t. Where do you think Price was going with that? ADAM GAFFNEY: I think that he was probably… I know where he was going. He was sort of darkly suggesting that we don’t want the scary socialized medicine that exists in places like Canada or the U.K. There are a lot of myths that are spread about the nature of those health care systems. You know, you hear this myth about Canadians flocking into the United States because they can’t get the health care they need there. That’s been shown to be a myth. So, I think he was sort of invoking the specter of socialized medicine as something that, you know, involves rationing, and other hard choices. And the reality is that those are myths. You know, we spend much more per capita than all these countries do, in many cases double as much. We don’t cover the entirety of our population. We actually don’t achieve better outcomes in terms of basic things like life expectancy or infant mortality, or even when we look at mortality that’s actually amenable to treatment, interestingly. So, you know, this is a long-standing tradition of, again, invoking this sort of fear of socialized medicine. When, in fact, we know that, call it socialized medicine if you want to, it actually out-performs our more market-based system by a longshot. SHARMINI PERIES: And let me endorse that here, having spent many, many, many years in Canada and having had three children there, I have never seen a medical bill or have waited in line for any services that was required and requested from my doctor. So, testimony here — it works. Thanks so much for joining us, Adam. ADAM GAFFNEY: A real pleasure to be on the show. Thank you for having me. SHARMINI PERIES: And thank you for joining us on The Real News Network. ————————- END

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