Newly minted Health and Human Services Secretary Price has wasted no time issuing press releases to promote the much aligned Trumpcare alternative to Obamacare. As soon as the American Health Care Act (AHCA) was introduced HHS started touting Trumpcare as it has been dubbed. While most HHS news releases try to be upbeat, positive, and fact-based, Secretary Price has begun issuing HHS press releases to counter negative coverage Trumpcare has been getting.
Trumpcare Doctors Care More
On March 14, HHS issued a news release touting how Trumpcare will restore the doctor-patient relationship. Unfortunately, Secretary Price has based his assessment of Trumpcare strengthening the doctor-patient relationship upon biased anecdotes he heard. Read the full HHS news release at the end of the post.
The doctor-patient relationship is the most sacred part of our entire healthcare system. The personal stories we heard today are further evidence that under the current healthcare law, that relationship is being undermined.
Similar to President Trump, Secretary Price does not provide any other evidence to support his argument that under the current Affordable Care Act patients are not engaging with their doctors. At least under the ACA, many people of low and moderate incomes can actually affordable to visit a doctor to have a relationship with. Secretary Price states further,
The Affordable Care Act has given Washington more power and authority over healthcare, leaving patients and providers with less freedom over medical decisions. Whenever the federal government thinks it knows better than a patient and their doctor about what they need, quality of care is compromised.
The ACA Doesn’t Dictate Health Care Networks
The ACA doesn’t dictate health care, it addresses health insurance. The whole doctor-patient relationship argument is a red-herring to divert the attention of Americans from how many people will lose health insurance under Trumpcare. The health insurance companies develop health plans to meet the requirements set down by each state they offer insurance in. Each state usually has minimum requirements for the network of providers that must be included. Many ACA individual and family plans do have narrow networks. Many popular and more expensive doctors and medical groups may not be in the ACA plans. But the federal government has not dictated the doctors that should be in-network. Trumpcare has no provision that I have read that will mandate wider networks either.
Of course, the height of hypocrisy for Tom Price is promoting Trumpcare as protecting the doctor-patient relationship when the AHCA explicitly defunds Planned Parenthood. Thousands of women who see a Planned Parenthood doctor or nurse practitioner will have their provider relationship blown up by Trumpcare. This destruction is not just Medicaid, the prohibition against Planned Parenthood extends to private insurance as well. This is the government over-reach that Republicans accused Obamacare of. Only this time, the GOP plan is telling private health insurance companies that they can not contract with Planned Parenthood and still have the health plans eligible for the tax credits.
Trumpcare Pushes High Deductible Health Plans
Secretary Price also bemoans high deductibles as a hurdle to patient care. This is true, but Trumpcare is pushing Health Savings Accounts which are High Deductible Health Plans. He states that Trumpcare wants market forces to lower the cost of care, and bring down premiums and deductibles. But there is no mechanism within Trumpcare to limit or bring down health care costs. Health plan premiums are a direct reflection of the deductible. If price is paramount, people will enroll in high deductible health plans for the lowest rate, regardless of whether it is through Trumpcare or Obamacare.
Secretary Price is not content to make unsubstantiated claims about Trumpcare, he has decided to go to war with the non-partisan Congressional Budget Office (CBO).
Health and Human Services Secretary Tom Price, M.D., released the following statement today on the Congressional Budget Office (CBO) report on the American Health Care Act:
“The CBO report’s coverage numbers defy logic. They project that zeroing out the individual mandate – allowing Americans to choose whether to have insurance – will result in 14 million Americans opting out of coverage in one year. For there to be the reductions in coverage they project in just the first year, they assume five million Americans on Medicaid will drop off of health insurance for which they pay very little, and another nine million will stop participating in the individual and employer markets. These types of assumptions do not translate to the real world, and they do not accurately estimate the effects of this bill.
“The CBO report also does not incorporate two-thirds of the healthcare reform plan President Trump has called for – specifically the regulatory relief HHS can provide and the additional legislative reforms Congress is and will be pursuing. Our three-pronged approach will free patients to purchase coverage that works best for them at a price they can afford. Doctors and patients understand that, especially under current law, having coverage is not the same thing as having access to the care one wants or needs. Our approach will provide Americans with relief from the collapsing healthcare law, which never delivered on the benefits projected by the Congressional Budget Office in the first place.”
If Secretary Price, who I assume is a really smart guy, has other actuarial evidence and statistics to back up his claim the CBO assumptions are incorrect, let him provide it. He has the entire HHS agency at his finger-tips to crunch numbers. There is no greater cruncher-of-numbers than the Centers for Medicare and Medicaid Services. CMS pumps out volumes of statistical and actuarial data used for determining reimbursements for Medicare and Medicaid services.
Secretary Price is quick to discount the CBO report on the effects of Trumpcare because they have not considered future legislative reforms. This is one of those WTF moments. The CBO is tasked with evaluating bills approved in committee or upon special request.
…CBO is required by law to produce a formal cost estimate for nearly every bill that is approved by a full committee of either the House or the Senate; the only exceptions are appropriation bills, which do not receive formal written cost estimates but whose budgetary effects CBO estimates for the Appropriations Committees. CBO also produces formal cost estimates at other stages of the legislative process if requested to do so by a relevant committee or by the Congressional leadership.
Secretary Price, who was a member of congress, knows how the CBO works but has decided to ignore it. The CBO cannot consider every possible amendment or new legislation that has not been approved. I’m sure if the CBO had delivered a positive assessment of Trumpcare, Secretary Price would hold up the report as a gold standard of statistical analysis.
It is unfortunately the Secretary Price is using his position to make assertions about Trumpcare that are not based in fact or reality. All cabinet secretaries are political appointees and news releases supporting new initiatives, regulations, or laws are to be expected. What is not expected are statements from a Secretary that are misleading and adversarial in tone. If you want to watch the new Trumpcare TV channel, you can sign-up for the latest broadcasts of Secretary Price at https://www.hhs.gov/about/news/index.html .
CBO Trumpcare Costs
|Date:||March 14, 2017|
American Health Care Act Will Restore, Protect, and Preserve the Doctor-Patient Relationship
March 14, 2017
Yesterday, Health and Human Services Secretary Tom Price, M.D., joined President Trump and Vice President Pence at the White House for a listening session on healthcare. The participants included doctors, patients, and small business owners who discussed Obamacare and how the current law is failing them.
After listening to their stories, the Secretary released the following statement in support of the American Health Care Act (AHCA), specifically its provisions to restore, protect, and preserve the doctor-patient relationship.
“The doctor-patient relationship is the most sacred part of our entire healthcare system. The personal stories we heard today are further evidence that under the current healthcare law, that relationship is being undermined. The Affordable Care Act has given Washington more power and authority over healthcare, leaving patients and providers with less freedom over medical decisions. Whenever the federal government thinks it knows better than a patient and their doctor about what they need, quality of care is compromised.
“The American Health Care Act will restore, protect and preserve the doctor-patient relationship — the trusting partnership that is fundamental to quality healthcare. Our reform effort will ensure patients and physicians are the ones making medical decisions, not Washington, and provide relief to those being harmed by the current healthcare system.”
How the American Health Care Act Protects the Doctor-Patient Relationship
- Empowering Patients with Access to Healthcare Dollars. The American Health Care Act expands the usefulness of Health Savings Accounts, adding flexibility and increasing contribution limits so that Americans can build savings for when healthcare needs arise.
- Expanding Patient Choice to See the Doctor of Their Choice. Every American should be able to choose the plan that fits their needs and allows them to see the doctor that they want. We will end the ‘Washington knows best’ mentality of picking winners and losers among patients. Instead, patients will have the freedom to choose the coverage that is right for them. That could be a comprehensive plan with a broad network, an HMO plan, or a catastrophic plan that allows the patient to shop around to get the best deal on routine medical expenses – it’s up to you, not Washington, DC.
- Encouraging Innovation to Protect Patients. The AHCA’s Patient and State Stability Fund will allow states to ensure meaningful access to care for patients through a variety of innovation options to drive down costs, improve access to coverage options, and provide further financial assistance to lower premiums, deductibles, and out-of-pocket costs.
- Providing Patients with Meaningful Access to Care. When a doctor recommends a procedure, but a patient has a $6,000 or $10,000 deductible, they may have “coverage,” but they don’t have care. They cannot afford the procedure that their doctor is recommending they have. This is a classic example of Washington inserting itself into the hospital examination room. We’re working to let market forces lower the cost of care and bring down premiums and deductibles, so that patients not only have coverage, but meaningful access to the procedures they need and that their doctor recommends.