Rep. Tom Price (R-GA), tapped to be secretary of health and human services under Trump, is a physician, an orthopedic surgeon to be precise. And a tea partier. And an avowed enemy of Obamacare. You'd think a physician might have some compassion for the uninsured, but in Price's case, think again.
The former orthopedic surgeon has long complained that doctors face, as the AMA put it, "excessive regulatory burdens," and his proposals would lead to increased pay for doctors. But they would also reverse reforms that have kept health care spending in check during Barack Obama's presidency and could send costs skyrocketing once again.
For all of the controversy over health care under Obama, there has been general agreement on one area of success: Growth in health care spending has slowed. The Affordable Care Act, popularly known as Obamacare, created new schemes for paying doctors and hospitals that helped sharply reduce the annual increase in national health care spending and keep it below pre-recession levels. Both Republicans and Democrats have supported these provisions, which have centered on charging for the overall quality of care rather than for each service performed. But now Price, a longtime booster of freeing doctors from government restrictions, appears eager and able to undo them.
Even without Congress repealing Obamacare, Price would be in a position at HHS to undo many of the elements of the law by refusing to enforce its regulations. Like those that govern payments to providers. One of the things that Obamacare has done is to slowly begin to unwind the fee-for-service structure that has made so many doctors—particularly specialists like Price—wealthy. It's built-in quality measures that reward physicians for providing better care, not more care. That's worked, really well, to achieve the first slow-down in the increase in healthcare costs in decades. It also made Obamacare a bargain—it cost $2.6 trillion lower over five years than it was originally estimated to.
But that doesn't matter to Price, who wants to take the government out of health care to the greatest extent he can, except for in funneling taxpayer dollars to providers, including privatizing Medicare. His big proposal for it is "private contracting"—allowing Medicare patients to use it, along with a big additional fee, to see doctors who don't accept Medicare patients because of its lower fee payments. That would inevitably move doctors out of the low-paying, strict Medicare market because they could make more under the private contracting scheme. And that would increase costs for the government by reducing its bargaining power in negotiating prices. He's going to kill Medicare through whatever means possible. As long as it means more money in the pockets of doctors.
It's not just sticking up for his former profession that's motivating Price, however. He's also a tea party Republican who sees no value in government and wants to minimize its role in every aspect of life. Including health—you know, actual life and death. Now he's going to be in charge of it.