Decoding the Next Choice for US HHS Secretary: Public Health Watch

Department of Health and Human Services (HHS) secretary Tom Price became the latest official in the administration of President Trump to resign when he stepped down last week under a cloud of controversy concerning his use of a private plane for government travel.

In the days since, there has been a lot of chatter in and around Washington indicating that those who opposed Price’s appointment in the first place will use this as an opportunity to pressure the President into picking someone for the position who—among other things—has not long advocated for significant cutbacks to Medicare and Medicaid. Price, a former physician, pushed for significant reforms to these programs while serving as a congressman from Georgia.

However, on the surface at least, this seems like a lost cause politically, given that President Trump holds all the cards, what with a Republican-controlled Senate. Frankly, Democrats will be lucky if they can get the President to consider membership in a frequent-flyer program a prerequisite for the post.

In all seriousness, though, acting secretary Don Wright, MD, MPH—announced Friday as Price’s short-term successor in the immediate aftermath of his replacement—is not seen as a viable permanent candidate (we are not sure why), despite his extensive experience in medicine as well as in government. This is actually the second time he’s held the interim job, as he kept the seat warm until Price was confirmed by the Senate earlier this year.

Which may mean that a new face will take over—or not. An article published on September 30, 2017 in The New York Times suggests that current commissioner of the US Food and Drug Administration (FDA) Scott Gottlieb, MD, and current head of the Centers for Medicare and Medicaid Services (CMS) Seema Verma, MPH, are President Trump’s top 2 choices for the post. As the article notes, both have the advantage of having recently gone through the Senate confirmation process for their current jobs; however, as Contagion^® reported at the time of his appointment, Dr. Gottlieb has been accused of being too cozy with the pharmaceutical and biotech industries. Whether that will be enough to generate significant opposition in the GOP-controlled Senate against his being shifted to HHS is questionable, though.

That said, television and radio personality—oh, and physician—Mehmet Oz, MD, who is also under consideration for the HHS job, at least according to a report in The New York Daily News, may be an even more divisive potential pick. The former protégé of Oprah Winfrey has been at the center of numerous controversies surrounding his medical advice and accused of making recommendations that are not based on currently accepted scientific evidence.

So, there’s that.

Individual policy positions aside, though, what makes the President’s next pick for HHS so significant, of course, is its potential effect on the future of the Affordable Care Act (ACA), proposed replacements for which have so far died very public political deaths during his short time in office. In other words, the next HHS secretary will likely be tasked with working with both parties in Congress to come up with a compromise plan to reform how healthcare is delivered—and paid for—in the United States for years to come.

So, no pressure to get it right this time, folks.

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.