By Joyce Frieden
MedPage Today, November 14, 2017
Members of the organized medicine community had mixed reactions to President Trump’s nomination on Monday of Alex Azar, JD, to run the U.S. Department of Health and Human Services (HHS).
The American Medical Association (AMA) had a brief but positive response when asked for comment: “Alex Azar is a capable and proven administrator who has a deep understanding of the HHS portfolio based on his prior work as Deputy Secretary and General Counsel,” said AMA president David Barbe, MD, in a statement.
Azar, whose nomination must be confirmed by the Senate, would replace Tom Price, MD, who resigned in late September after he came under fire for his use of private charter jets as well as military aircraft for travel, sometimes to destinations as far flung as China, but also for trips as short as jaunts from Washington to Philadelphia.
Azar is the founder and chairman of Seraphim Strategies, a consulting firm in Indianapolis, according to his LinkedIn profile. He served as general counsel and then deputy secretary at HHS in the George W. Bush administration, and also was president of Eli Lilly’s U.S. business unit, Lilly USA, from 2012 to 2016. He received a bachelor’s degree in government and economics from Dartmouth University in Hanover, New Hampshire, and a law degree from Yale Law School in New Haven, Connecticut.
The Association of American Medical Colleges (AAMC) took a neutral approach. “We congratulate Alex Azar on his nomination as secretary of HHS,” AAMC president and CEO Darrell Kirch, MD, said in a statement Monday. “In this position, he will oversee many of the federal agencies that play a crucial role in how the nation’s medical schools and teaching hospitals are able to educate and train the next generation of doctors, care for the nation’s most vulnerable and complex patients, and conduct medical research that brings hope to countless Americans.
“Upon his confirmation, we look forward to working with Mr. Azar on improving the health of all through high-quality clinical care, groundbreaking medical research, and a robust, diverse physician workforce.”
The Medical Group Management Association (MGMA), which represents leaders of physician practices, also took a neutral stance. “MGMA is hopeful Azar will bring his business acumen to HHS and continue the department’s push to reduce the regulatory burden on physician practices,” Anders Gilberg, the group’s senior vice president for government affairs, said in a statement.
The Federation of American Hospitals (FAH) was both more lengthy and more positive. “We welcome and support the nomination of Alex Azar for HHS Secretary,” Chip Kahn, FAH’s president and CEO, said in a statement. “His years of experience in government service and the healthcare sector makes him uniquely qualified to confront the challenges facing patients, families and caregivers.”
“I have worked with Mr. Azar in the past and think he is the perfect pick for the times,” Kahn continued. “His steady hand of leadership will be critically important as the deliberations over health reform and the many healthcare quality and cost issues proceed. We encourage the Senate to confirm Mr. Azar quickly.”
Jeff Myers, president and CEO of Medicaid Health Plans of America, called Azar a “promising candidate” because of his previous work at HHS and the experience that it gives him. “Moreover, his experience in the pharmaceutical industry uniquely qualifies him to effectively tackle runaway drug prices, counterintuitive as it may seem, using market-based competition,” he said in a statement. “We’ll be following his nomination closely.”
On the other hand, several physician groups were unhappy with the nomination. “The National Physicians Alliance (NPA) opposes Alex Azar’s nomination to be the next Secretary of Health and Human Services (HHS) because we believe Mr. Azar’s deep ties to the pharmaceutical industry disqualify him from being an independent voice for our nation’s healthcare system,” the organization said in a statement. “Moreover, his previous work in industry and in the public sector show that he has no inclination to improve upon the gains we have made in the Affordable Care Act and continue to push toward real affordable, equitable and universal healthcare for all.”
NPA, which advocates for “high-quality and affordable healthcare for all“, “has prided itself on [representing] America’s ‘Unbranded Doctors’ by upholding the principle of patient-first, conflict-of-interest-free healthcare,” the statement continued. “Drug corporations already have undue influence over health policy in America, and to nominate a former drug company executive to lead the HHS further adds to our concerns that we will continue to have a lack of action on skyrocketing drug prices that are crippling our ability to provide the healthcare our patients need.”
Physicians for a National Health Program (PNHP), a group which supports single-payer healthcare, also wasn’t happy with Trump’s pick. “Trump talked really tough about taking on Big Pharma when he was on the campaign trail, but since his inauguration it’s clear that was all a sham,” Adam Gaffney, MD, PNHP’s secretary, said in a phone interview. “Azar is a previous Lilly executive and drug company lobbyist, so I don’t think there’s any reason to suggest he’s going to take on Big Pharma; I think we can expect that drug prices are going to continue to rise.”
In addition, “I’m very worried about the Trump agenda about healthcare in general — giving Medicaid waivers that might water down access, impose new requirements, and keep people out of Medicaid,” said Gaffney, who is also a pulmonary specialist at Cambridge Health Alliance and Harvard Medical School. “The fact that Azar is willing to take on this [job] is an indication that he’s willing to go with the Republican agenda, which is to get people off of Medicaid … There are already 28 million uninsured people in this country; we want to bring that number down.”
Several other physician organizations, including the American Congress of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the American College of Physicians, said they had no comment on the Azar nomination.