It aligns Bush Republicans, like Chao and McConnell, with the man who used to ridicule the Bushes and their allies as “lightweights.” Nothing unites today’s Republican Party like using the federal government to reward multinational corporations and billionaire campaign donors. This is, in fact, Elaine Chao’s specialty. She knows exactly what her responsibility will be at the Department of Transportation. The “most anti-labor labor secretary [labor leaders] had ever seen” is more than ready to become the most anti-public infrastructure transportation secretary America has ever seen. She is already arguing that Trump’s plan is the only option. “The government does not have the resources to address all the infrastructure needs within our country,” Chao told senators. But, she gleefully reported that there was a lot that could be done with “innovative financing tools, such as public-private partnerships.”
That doesn’t sound so awful. Unfortunately, says Ronald Klain, who oversaw the team implementing President Obama’s American Recovery and Renewal Act, “it’s a trap.”
“Trump’s plan is not really an infrastructure plan,” Klain explains. “It’s a tax-cut plan for utility-industry and construction-sector investors, and a massive corporate welfare plan for contractors. The Trump plan doesn’t directly fund new roads, bridges, water systems or airports, as did Hillary Clinton’s 2016 infrastructure proposal. Instead, Trump’s plan provides tax breaks to private-sector investors who back profitable construction projects. These projects (such as electrical grid modernization or energy pipeline expansion) might already be planned or even under way. There’s no requirement that the tax breaks be used for incremental or otherwise expanded construction efforts; they could all go just to fatten the pockets of investors in previously planned projects.”
Corporate welfare? Check.
Fattening the accounts of investors? Check.
Bait-and-switching taxpayers with tax-cut schemes disguised as job plans? Check.
Using the good name of “infrastructure investment” to enrich private-sector profiteers? Check.
Chao swears an oath to “well and faithfully discharge the duties of the office” whenever she assumes a public position. But she has never left any doubt that her highest duty is to the private profiteers who are invariably the beneficiaries of her “service.” It was slim pickings at the Department of Labor. At the Department of Transportation, Chao’s ability to issue letters of marque to modern privateers is magnified a thousandfold.
— 30 —
THE KINGFISH OF THE QUAGMIRE
Tom Price
Secretary of Health and Human Services
The greatest secretary of what is now known as the Department of Health and Human Services in the almost seventy-year history of the agency’s modern incarnation was the social and civic reformer John Gardner, who Lyndon Johnson charged with creating a “Great Society.” Capitalizing on a landslide mandate from the people in the 1964 election and a supportive Congress, Johnson wanted to address the basic human needs of a prosperous nation that still knew poverty, of an innovative nation that was leading the way in curing diseases but still allowed the sick to perish for lack of care, of a technologically advanced nation that had not shared the benefits of technological progress with the whole of its population. Gardner put the emphasis on society in that “Great Society” equation, arguing for an interpretation of the American experiment that begins with the “simple, easily forgotten truth that we need one another.”
“I sometimes think that history might easily say about this nation: ‘It was a great nation full of talented people with enormous energy who forgot that they needed one another,’” warned Gardner, who after breaking with the Johnson administration over the Vietnam War went on to form the group Common Cause. Gardner would go on to become the great champion of civic engagement, and the great fretter about how the influence of money on our politics stifles progress. Late in life, he counseled that “we must end the indiscriminate trashing of government. Carefully targeted criticism is immensely important, but mindless trashing has made able civil servants—who constitute the majority—feel like members of a battered profession. If we want to make government better, that is not the way to do it. Rather we must target our efforts. We must insist, for example, that government make itself worthy of respect by eliminating the many ways in which moneyed interests coerce legislators. In a land where the Founders committed themselves to the consent of the governed, the fact that money can buy political outcomes is an obscenity. The simple rule is, ‘Hold power accountable.’ We can no longer tolerate any government—federal, state or local—that has created such an impenetrable web of power, money and special interest that it is no longer controllable by the electorate.”
Surely, among the twenty-three secretaries of an agency that is responsible for putting a trillion-dollar budget and roughly eighty thousand employees to work on behalf of “improving the health, safety, and well-being of America,” none has been so at odds with John Gardner’s vision as Tom Price.
Donald Trump’s secretary of health and human services is a pure reflection of the politics of special-interest influence, and self-interested denial of the public good, that Gardner decried.
A seven-term congressman from Georgia who freely admits that, as a millionaire physician, he got into politics to make sure that the views of millionaire physicians were well represented when health care policies are debated, Price has often been linked with the Association of American Physicians and Surgeons (AAPS), a group founded in the 1940s to oppose social welfare proposals in the era when Franklin Delano Roosevelt was arguing for a “Second Bill of Rights” that included “the right to adequate medical care and the opportunity to achieve and enjoy good health” and “the right to adequate protection from the economic fears of old age, sickness, accident, and unemployment.” Fiercely right-wing, the AAPS says its mission is to “fight socialized medicine and to fight the government takeover of medicine.” And it takes that fight to extremes, Mother Jones magazine noted in a 2009 piece. “As tea partiers have become the leading opposition to [President Barack Obama’s Affordable Care Act], AAPS has lent credibility to their criticism of the emerging health care legislation. Before the big 9/12 rally in Washington, AAPS cosponsored a protest on Capitol Hill with the Tea Party Patriots that AAPS says attracted 1,000 physicians. The organization’s president, Mark Kellen, appeared with Georgia representatives Tom Price and Phil Gingrey—GOP members of the congressional doctors’ caucus—to slam the bill,” explained writer Stephanie Mencimer, one of the ablest chroniclers of the Tea Party movement and its political fallout.
Mencimer detailed the deep engagement of “AAPS docs” in the anti-reform drive, noting that, on Fox News and talk radio programs, “AAPS docs often appear to offer an expert medical opinion against reform.”
“Yet despite the lab coats and the official-sounding name,” she continued, “the docs of the AAPS are hardly part of mainstream medical society. Think Glenn Beck with an MD. The group (which did not return calls for comment for this story) has been around since 1943. Some of its former leaders were John Birchers, and its political philosophy comes straight out of Ayn Rand. Its general counsel is Andrew Schlafly, son of the legendary conservative activist Phyllis. The AAPS statement of principles declares that it is ‘evil’ and ‘immoral’ for physicians to participate in Medicare and Medicaid, and its 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.”
Price comes across as a considerably more reasonable man than the most whacked-out of the “AAPS docs.” He is a frequently genial southern-gentleman type who only occasionally goe
s off the rails with a speech like the 2010 Conservative Political Action Conference address in which he declared: “We must take our country back—take it back from a vile liberal agenda that is threatening everything we hold dear as Americans.” But when it comes to policy, he’s not just way out on the right wing (as an ardent if often factually challenged foe of abortion rights, gun control and gay rights), he’s way in the pocket of the special interests that use their campaign money and lobbying power to warp debates about things like “improving the health, safety, and well-being of America.” (In 2009, he was one of just ninety-seven House members to oppose the bipartisan Family Smoking Prevention and Tobacco Control Act, groundbreaking legislation that gave the Food and Drug Administration regulatory jurisdiction over tobacco products and the authority to regulate tobacco as the drug that it is.)
In a Washington swamp that is overpopulated with self-serving politicians, Price is the kingfish of the quagmire.
“Tom Price Is the Walking Definition of an Appearance of Corruption,” explains Slate’s Jordan Weissmann. “First,” Weissmann wrote when Price joined the Trump team, “the congressman has a habit of trading stocks in medical companies while also writing legislation that could sway those firms’ fortunes. The Wall Street Journal recently found that Price had ‘bought and sold stock in about 40 health-care, pharmaceutical and biomedical companies since 2012, including a dozen in the current congressional session.’ In total, he traded shares worth $300,000. Price, a former orthopedic surgeon who now chairs the extremely powerful House Budget Committee, regularly introduces bills on health care policy and sits on the House subcommittee that oversees Medicare.”
Weissmann went on to note that “his investments have included at least one very nice bargain. In 2015 Price bought discounted stock in a small Australian biotech firm, Innate Immuno, that was attempting to win Food and Drug Administration approval for a new multiple sclerosis drug. Price purchased the stock in a private offering marketed only to ‘sophisticated U.S. investors’ that Kaiser Health News referred to as a ‘sweetheart deal.’” As of January 2017, Price was enjoying a 400 percent gain on the investment.
These details, along with a January 17, 2017, CNN report that Price “purchased shares in a medical device manufacturer days before introducing legislation that would have directly benefited the company,” led Senate minority leader Chuck Schumer, D-New York, to announce that the Office of Congressional Ethics needed to “conduct an immediate and thorough investigation into these potential violations of the STOCK Act before Rep. Price’s nomination moves forward.”
The 2012 Stop Trading on Congressional Knowledge (STOCK) Act was enacted to combat insider trading by members of Congress, and Schumer said: “This new report makes clear that this isn’t just a couple of questionable trades, but rather a clear and troubling pattern of Congressman Price trading stock and using his office to benefit the companies in which he is investing.” (According to a ProPublica report published in mid-March 2017, former U.S. attorney Preet Bharara was overseeing an investigation into Price’s stock trades when he was ousted from his post by President Trump.)
“The President-elect claims he wants to drain the swamp, but Congressman Price has spent his career filling it up,” declared Schumer. Massachusetts senator Elizabeth Warren asked Price during his Senate Committee on Health, Education, Labor and Pensions confirmation hearing if the congressman had taken actions “to advance your plan to help the company that you now owned stock in.”
“I’m offended by that insinuation,” responded Price, with what keen observers will recognize as something less than a full-throated denial of any conflicts of interest.
Warren persisted. “I’m just asking: Did you buy the stock and then did you introduce a bill that would be helpful to the companies you just bought stock in?”
“The stock was bought by a broker who was making those decisions. I wasn’t making those decisions,” claimed Price.
Warren persisted. “Let’s just be clear,” said the Democrat from Massachusetts. “This is someone who buys stock at your direction. This is someone who buys and sells the stock you want them to buy and sell.”
“That’s not true, senator,” claimed Price.
Warren persisted. “Well, because you decide not to tell them? Wink wink, nod nod? And we’re all just supposed to believe that?”
Price and the Trump administration correctly assumed that the Republican majority in the Senate would accept the kingfish’s lame excuses as sufficient and put him in charge of a massive federal agency with responsibility for the Food and Drug Administration, the National Institutes of Health, the Indian Health Service, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Administration for Children and Families, the Administration for Community Living, the Agency for Healthcare Research and Quality, the Agency for Toxic Substances and Disease Registry, the Center for Faith-Based and Neighborhood Partnerships and the Office of the National Coordinator for Health Information Technology.
But Ohio senator Sherrod Brown grabbed every opportunity to highlight the cruel ironies of this particular nomination. “Buying and selling health care stocks as a member of Congress while you’re voting and helping those companies, that’s bad enough,” said Brown. “But what he wants to do to maybe the greatest program in American history, Medicare, is much, much worse.” And there was the matter of Price’s opposition not just to the Affordable Care Act but to the premise that Americans have a right to get the treatment they need when they are ailing.
National Nurses United executive director RoseAnn DeMoro echoed an observation by Vermont senator Bernie Sanders at Price’s Senate confirmation hearing. Price equated the notion that an American might have “access” to buying insurance with access to actual care. “‘Has access to’ does not mean that they are guaranteed health care,” said Sanders. “I have access to buying a $10 million home; I don’t have the money to do that.” “Unpack the evasions and you have the Ayn Rand–Tea Party philosophy in a nutshell,” DeMoro said of Price. “You only deserve the healthcare you can buy, from private insurance companies that have a history of price gouging with multiple restrictions on the care you can receive even after paying your premiums.”
National Nurses United co-president Jean Ross, RN, noted that “during his first hearing before the Senate HELP Committee (Health, Education, Labor and Pensions), Representative Price failed to provide any reassurance that he will be an advocate for the public interest, rather than the narrow interest of the corporate healthcare industry and his most conservative backers who have long threatened our vital safety net protections.”
Before Price’s nomination was taken up by the full Senate, Ross said it was vitally important for Price “to end the evasion of how the Trump administration he will represent will meet the guarantees promised by President Trump that no one will lose health coverage while also lowering the high costs of healthcare premiums and other out of pocket costs.”
Senate Republicans opted against settling that issue, confirming Price on a 52–47 party-line vote on February 10, 2017. Less than a month later, Price advanced a plan to repeal and replace the Affordable Care Act that broke Trump’s campaign trail promises. Price’s claim that the new plan was “much better than what’s out there now” provoked laughter, and tears.
The nonpartisan Congressional Budget Office reviewed the plan and determined that, were it to be enacted, 14 million more Americans would be uninsured within a year and 24 million more Americans would be uninsured by 2026. Internal White House forecasts suggested the prospect that the uninsured numbers could be even higher. Even conservative Republicans said the plan was a travesty, as it cut programs for the vulnerable in order to fund tax breaks for the wealthiest Americans. Senator Susan Collins, R-Maine, said Price’s proposal “[didn’t] come close to achieving the goal of allowing low-income seniors to purchase health insurance.” Newspapers across the country ripped Price’s plan to scuttle success
ful and popular Medicaid expansion initiatives.
“Thousands of Americans will die if this legislation is passed,” said Senator Sanders, who decried Price’s plan for “throwing 24 million Americans off of health insurance, raising premiums for older low income Americans, while giving $285 billion in tax breaks to the top 2 percent” as “disgusting and immoral.”
Tom Price was undeterred. He defended massive new tax cuts for health insurance company CEOs and other benefits for wealthy people like, um, Tom Price. He blew off the concerns of ailing Americans. Brian Kline, a cancer survivor from Pennsylvania, told Price at a town hall gathering that “Medicaid expansion saved my life and saved me from medical bankruptcy.” “Why do you want to take away my Medicaid expansion?” asked the retail worker who makes $11.66 an hour. The answer Kline got from the secretary of health and human services, whose net worth is listed as $13,640,071, was a dismissive suggestion that the patient should be grateful to be getting any care at all. “It’s wonderful that you have received the care that you’ve received,” he said. “But that’s not necessarily true for everybody.”
Price’s callous response did nothing to advance the cause of a “repeal and replace” scheme that initially crashed and burned. But the secretary kept at it, as he had throughout the Obama years. By early May, the Republican-controlled House endorsed a Price-backed proposal that many critics saw as worse than the initial plan. Price said the House majority was doing “what’s right for the American people.” But Sister Simone Campbell, SSS, the executive director of NETWORK Lobby for Catholic Social Justice, said Price and his allies were “preferencing the millionaires and billionaires” over ailing Americans. “The passage of the American Health Care Act (AHCA) in the House is a dangerous and irresponsible step that threatens access to healthcare for at least 24 million Americans. It violates Christian and Catholic faith teaching and the values of our nation,” said Sister Simone. “The AHCA cuts $880 billion from Medicaid to give large tax cuts to the very wealthiest. This is far from the Gospel mandate to care for our most vulnerable sisters and brothers. It takes away access to healthcare for the most vulnerable and widens the gaps in inequality in our society. This vote was a vote against the millions of children, elderly, people living with disabilities, and people experiencing poverty who are supported by Medicaid.”