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ACP raises concerns with incoming administration on health care
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With 8 days until President-elect Donald J. Trump is inaugurated, his approach to health care policy appears to be in conflict with the goals of the ACP.
The association released statements criticizing the Senate’s vote to begin repealing the Affordable Care Act — a position strongly advocated by Trump in a press conference on Jan. 11 — and supporting the current immunization schedule recommended by the CDC. Earlier this week, Trump met with Robert Kennedy, Jr, who has criticized immunization policies, which troubled infectious disease experts.
Repealing and replacing the ACA
After the Senate’s late-night vote to clear procedural hurdles that would allow for repeal of the ACA, the ACP condemned the decision in a statement.
“ACP has warned Congress that repealing the ACA will lead to massive losses of coverage and consumer protections for people enrolled in commercial insurance markets and in the Medicaid program, slow the movement to value-based payment reforms, force seniors to pay more for their prescription drugs, and undermine initiatives to prevent illnesses and promote public health,” Nitin S. Damle, MD, MS, MACP, president of ACP, said. “If the ACA is repealed, every state in the country will experience big increases in the uninsured rate, uncompensated care, and potential loss of coverage for people with pre-existing conditions.”
This Friday, the House is expected to take its first step in repealing the ACA by voting on the issue. ACP will continue its assertions to “first, do no harm” by urging Congress to keep protections established by the ACA and evaluate proposed changes to ensure that they will result in improvements in coverage, access and protections for patients.
At his press conference yesterday, Trump announced that he supported efforts to repeal and replace the ACA.
“You’re going to be very proud of what we put forth having to do with health care,” he said. “Obamacare is a complete and total disaster. They can say what they want, they can guide you any way they want to guide you. In some cases, they guide you incorrectly. In most cases, you realize what’s happened. It’s imploding as we sit.”
Trump asserted that keeping the ACA in place would be “catastrophic.”
Trump also said that shortly after his nominee for HHS secretary, Tom Price, MD, (R-Ga.), is confirmed by the Senate he will announce an anticipated replacement plan, although he offered no details on what that plan would include.
“We don’t want to own it politically,” he said. “They [the Democrats] own it right now. The easiest thing would be to let it implode in 2017 and, believe me, we’d get whatever we wanted, but it would take a long time. We’re going to be submitting, as soon as our secretary is approved, almost simultaneously or shortly thereafter, a plan. It will be repeal and replace... We’re going to get a health bill passed and health care taken care of in this country.”
“We’re going to have a health care that’s far less expensive and far better,” he said.
Incoming vaccine safety administration
On Tuesday, Trump met with Robert F. Kennedy Jr., who supports scientifically discredited claims about the safety of vaccines, including the disproven theory that the use of the mercury-containing preservative thimerosal in certain vaccines is associated with neurological disorders in children such as autism. Kennedy said he was asked to chair a commission on vaccine safety during the meeting, causing concerns among infectious disease experts and the ACP.
Kennedy told reporters, “President-elect Trump has some doubts about the current vaccine policies and he has questions about it. He says his opinion doesn’t matter but the science does matter, and we ought to be reading the science, and we ought to be debating the science, and everybody ought to be assured that the vaccines that we have — he’s very pro-vaccine, as am I — are as safe as they possibly can be.”
According to the ACP, the announcement of a commission to study vaccine safety and scientific integrity will cause unnecessary skepticism and confusion on the importance of vaccinations.
“Vaccines are a safe, effective, and easy way for children and adults to protect themselves, their families and friends, and their communities from life-threatening diseases,” Damle said in a statement.
“Immunization is considered one of the great public health victories in the last 100 years, when rates of a host of dreaded diseases were slashed dramatically as safe, effective vaccines were introduced,” Damle added. “Once-feared diseases like polio, rubella, and pertussis became virtually unknown as routine vaccination cut rates to almost zero.”
In an interview with Healio, Dean A. Blumberg, MD, chief of pediatric infectious diseases at the University of California, Davis, Medical Center, claimed that Kennedy’s beliefs and past statements show that he lacks an understanding of mainstream science.
“Anything that elevates the profile of fringe beliefs can make it more confusing for [infectious disease doctors] in the mainstream scientific community to convince parents — and even other health care providers — what the mainstream science is saying about the safety and effectiveness of vaccines,” Blumberg added.
If this reduces the ability of children to receive vaccines or negatively affects the public’s perception of vaccine safety, harm has been done, Paul A. Offit, MD, director of the Vaccine Education Center and professor of pediatrics in the division of infectious diseases at The Children’s Hospital of Philadelphia, told Healio.
The Trump transition team denied that a request for Kennedy to chair a vaccine safety commission had been made in a statement to reporters, saying that Trump “is exploring the possibility of forming a committee on autism.” – by Alaina Tedesco
For more information:
https://www.acponline.org/acp-newsroom/internists-disappointed-and-dismayed-at-senate-vote
Disclosures: Blumberg reports being on speakers bureau for Merck and Sanofi Pasteur, earning honorariums that are given to the university. Offit reports no relevant financial disclosures.