Just because the Senate voted to make Tom Price the nation’s top health care official doesn't mean that the debates that flared over his nomination should end.
This fight is just beginning.
The Senate confirmed Price as secretary of Health and Human Services in the middle of the night in a straight 52-47 vote along party lines. He was a deeply flawed nominee. Nancy Altman of Social Security Works, who is an attorney, reviewed his ethics and the legality of his actions in an post headlined, “Should Tom Price Be in Jail for Insider Trading?” PBS noted, somewhat more delicately, that Price has “shown little restraint in his personal stock trading.”
But Price is not just ethically challenged. He is also ideologically charged. His policy views place him on the extreme right of health care debates.
Medicare, Medicaid, Social Security and the ACA
Price is committed to privatizing Medicare and cutting spending on the federal health insurance program, which covers seniors and people with permanent disabilities. If he has his way, the 57 million people Medicare serves can count on drastic cuts in coverage. He wants to limit Medicaid spending, which will harm the health of lower-income Americans. He wants to end taxpayer funding for Planned Parenthood and opposes a woman's right to choose. He supports cutting Social Security payments through several mechanisms, including raising the retirement age.
However, Price opposes one of the best ways to cut health care costs. As I discussed earlier, Price also opposes having Medicare pay his fellow physicians (he is an orthopedic surgeon) based on outcomes or quality of care, despite the fact that the current system contains perverse incentives for over-treatment. He is a longtime ally of the American Medical Association, a group that opposed the creation of both Medicare and Social Security.
Opponents of Price's confirmation must now mobilize to fight the extremist policies he will pursue. But we should be mindful that the pre-Price status quo hasn’t worked for most Americans.
Take, for example, Price’s intention to dismantle the Affordable Care Act. A recent study concluded that repealing the ACA would lead to the deaths of 43,000 Americans per year. The ACA helped many people, but it would be unwise to ignore the fact that it fell far short of its intended goal.
A recent survey by the Commonwealth Fund found that the ACA improved Americans' ability to buy insurance on their own. But it wasn’t a cure-all. For example:
-Some 63 million Americans went without health care for medication they needed because of the cost in 2016. That’s an improvement over the 2012 figure of 82 million, but it’s nowhere near good enough.
-One in three (31 percent) Americans said it was difficult or impossible to find a health plan that met their needs in 2016. That was down from the 53 percent who said that in 2012, but, again, still too high.
-The number of people who said they couldn’t afford to see a doctor when they were sick fell from 29 percent in 2012 to 20 percent in 2016.
Health care affordability is still a critical problem. Even “good” employer-sponsored health care is unaffordable in many American households. Milliman, an actuarial firm, found that the average employee share of health care costs in 2016 reached $11,033 for a family of four with an employer-sponsored PPO plan.
Part of the problem is that, despite what conservatives believe, the private sector is not very good at providing health coverage. Both the ACA and employer insurance rely on the for-profit health insurance industry where, as the Center for Economic and Policy Research notes, overhead keeps rising. As CEPR’s Nick Buffie puts it,
The same cannot be said of public health insurance programs such as Medicare, Medicaid, the Children’s Health Insurance Program, and the Veteran’s Health Administration.
Contrary to what most Republicans (and many Democrats) would have us believe, there are some things government can do more efficiently and effectively than the private sector. Health care happens to be one of them.
Make the Case for Government Itself
The best way to fight Price and other right-wing ideologues is with clear-cut alternatives to their ideas — in this case, with proposals that build on a popular and cost-efficient program to give Americans quality, affordable health care.
That means Medicare for All — a single-payer, government-managed system that builds on the efficiencies of today's Medicare, carefully rolled out to avoid disruption.
In the meantime, let’s protect the Affordable Care Act. But the best way to do that is by doing what Democrats should have done all along: by making the case for a better system, and then fighting for it. That means making the case for government itself.
Tom Price believes that government can’t do anything right. He’s wrong. He believes government doesn’t need to care for the poor, people with disabilities and the elderly, or manage the economy, protect our health, or keep its covenant with working Americans when they retire.
Price doesn’t believe American families should have affordable child care, or that they should be guaranteed adequate vacation time, sick leave, or family leave. He believes in lowering taxes for the wealthy and leaving the rest of us to fend for ourselves.
We must resist that agenda. But let’s not forget: The status quo has failed most working Americans. The best way to challenge Tom Price, and his far-right ideology, is by laying out a vision for a better future — and defending government’s role in bringing it about.