tv HHS Nominee Representative Tom Price Testifies on Capitol Hill CSPAN January 19, 2017 3:37am-5:38am EST
a great moments. thanks. watch the 58 presidential inauguration live on friday. listen on the free c-span programming cap. the choice for health and human services secretary, commerce and -- tom price took questions from a panel. the georgia republican with a medical did degree was asked about the it before it will care act, his stock holdings, and the cost of prescription drugs. health education labor and pensions committee is chaired by senator lamar alexander alexander of tennessee.
[indistinct chatter] [gavel] >> the hearing will come to order. the committee on health, education, labor, and pensions will come to order. today, we are reviewing the nomination of dr. tom price to be the secretary of health and human services. dr. price, we welcome you and congratulations on your nomination. welcome, to you and your wife, betty, who is here with you. i enjoyed having the opportunity to visit with you in my office and learn about your plans. dr. price will be introduced today and a few minutes by a member of this committee and dr. price plus his home state senator. before senator isakson introduces the nominee, senator murray and i will make a few introductory remarks.
after the nominee makes his statement, we will have a usual round of questions. let me say something about that round of questions. last night, we had a hearing of 3.1 hours. i tried as chairman to be fair by following the same precedent we had with president obama's two education nominees by having one round of five questions followed by senator murray and me asking questions and wrapping up. i do not want to argue that again because we spent a lot of the 3.5 hours arguing about the 3.5 hours. i have listened carefully to what my colleagues have said and i look back for the health of human services secretary, when that person came before our committee. secretary burwell has one round of questions. one round, asking a question.
six members ask questions in the second round. six members ask a second round. what i decided to do in an effort to treat president-elect trump's nominee the same as we treat other nominees is to have a single round of seven minute questions, with secretary thompson, and that seems to me to give everyone in the senate more time to ask questions with the secretary. this is a courtesy hearing. dr. price will be before the finance committee on next tuesday. a number of members of this committee are also members of the finance committee.
they vote on his nomination and we will be the ones who reported to the floor if that is their decision. we have the hearing because we have some of the health care jurisdiction, important parts of it. we would like to talk to him about especially those issues. he has all of his paperwork in place before the finance committee, including the letter of agreement with the office of government ethics, available to this committee as well as others. the hope for the seven minute of questions is -- department of health and human services rather than have a continuing discussion about the number of minutes.
there will be an opportunity following the hearing to ask written questions of dr. price as well. if you are confirmed, to lead the department of health and human services, you will run an organization that spends $1.1 trillion a year. that has always troubled me, that you will be in charge of spending more than congress actually appropriates every year. by that, i mean the part of the budget we re-appropriate which is under good control, the part that has national defense, national institutes of health, national laboratories, over the last several years, that part is rising at about the rate of inflation. it is not adding to the budget.
it is about one third of the total government spending. it is a little less than the amount in your department every year. most of which is mandatory spending, which is going up at a rate like that while the rest of the budget is going like this. you will be overseeing medicare and medicaid. substance abuse programs. we enacted in december of last year and the president signed the most important of that -- the fda, we made important changes, giving them new authority to hire and pay the experts they need to move devices through the fda at a rapid rate getting those into the medicine cabinets of the doctor's office.
that was the doctor passes number one priority for we passed that into law in december. then the implementation of obama care and various proposals to replace it with concrete, practical alternatives. dr. price, i believe you are an excellent nominee for the job. you were a practicing orthopedic surgeon for more than a decade. i read about the resident doctors in training who you taught. you served as medical director of the orthopedic clinic at the memorial hospital.
you were chairman of the budget committee and have been a leader in deliberations over the future of our health care system. you know our subject very well. one of the first responsibilities you will have is give us your advice about how to repair the damage the affordable care act has caused so many americans and how to replace it or to replace parts of it, concrete practical alternatives that give americans more choices of lower cost insurance. let me give my view about how we might proceed and during the question-and-answer session, i will ask you more about your view. following the presidential election, president-elect trump said on 60 minutes that replacement and repeal of obamacare would be done simultaneously. to me, that means at the same time. recently, speaker of the house paul ryan said the repeal and replace of obamacare would be done concurrently. senator mcconnell said last week that we need to do this probably but in manageable pieces.
i am trying to interpret what the words mean. to me, that means obamacare should be finally repealed only to me, that means obamacare should be finally repealed only when there are concrete tactical reforms in place to give americans access to affordable health care. the american people deserve health care reform done in the right way, for the right reasons. in the right amount of time. it is not about developing a quick fix. it is about working toward long-term solutions that work for everyone. one way to think about what simultaneously and concurrently mean is to think about obamacare the same way you think about a collapsing bridge in your hometown. that is just what is happening with obamacare in my home state and in many other states. according to the insurance commissioner, the obamacare insurance market in our state is very near collapse. across the country, premiums and co-pays are up and employers have cut jobs in order to afford the mandates of obamacare. medicaid mandates are consuming
state budget spirit one third of american counties, citizens of federal subsidies have only a single choice of company to buy insurance from on the obamacare exchanges. without quick action next year, there may be zero choices on those exchanges. there subsidies may be worth as much as as a bus ticket in a town were no buses run. in georgia or in tennessee, very near collapse, the first thing we would do is send in a rescue crew to repair the bridge temporarily so no one else is hurt. then we would build a better bridge or more accurately in the case of health care, many bridges to replace the old bridge. finally, when the new bridges are finished, you would close the old bridge. that is how i suggest we
proceed. rescue those trapped in a collapsing system. replace the system with functional markets. as states develop their own plans for providing access to truly affordable health care. then repeal obama care for good. we should offer rescue plans so 11 million americans who buy individual insurance now, can continue to do so while we build a better set of concrete, practical alternatives. second, we should build better systems, providing americans with more choices of insurance that cost less. note that i say systems. not one system. if anyone is expected senator mcconnell to roll a wheelbarrow and to the second floor with a 4000 page copper has a republican health care plan, they will be waiting a long time because we do not believe in that we do not want to replace a failed washington, d.c. health care system with another failed washington, d.c., health care system.
so we will provide america with more choices of insurances that cost less and we will do this by moving more health care decisions out of washington dc into the hands of states and patients there -- thereby reducing taxes. we will do this carefully and step-by-step so it is effective. we should then repeal what remains of the law that did the damage and created all of this. i know the president-elect has said that after you are confirmed, which i hope is early in february, that he will propose a plan in congress. i look forward to that. i know you cannot tell us what the plan is today. i look forward to hearing from you how you suggest we approach this. we want to do it right and do this carefully and adequately so americans have concrete
practical alternatives in place of what is there today. we want to make sure that the parts of obamacare that are repealed are replaced before the repeal becomes effective. senator murray. sen. murray: thank you very much, chairman alexander, and all of our colleagues joining us today. congressman price, congratulations on your nomination. thank you. before i speak about this nominee, i want to say that we remain deeply disappointed in last night, where democrats were blocked from asking more than one round of questions. the nominee for secretary of education. disappointed that we are rushing this hearing as well. mr. chairman, you said seven minutes but i will just say, i do not think any of us in prior
nominees that you keep 22, ever thought, if i don't ask for another question, i have just set a precedent. i think there is no example of any senator asking to do a question before and being turned down. the nominees, a new administration, deserve to be asking questions, scrutinized in public before we have a choice to make on the floor of the senate on both sides of the aisle in terms of whether we vote yes or no. that is why we take it is important we are allowed the opportunity to ask second rounds of questions after we have heard all of the questions. today, we have three or four committee hearings going on at the same time. it is extremely challenging, in a subject that we care deeply about. i would like to point out again that several nominees that have come before, we will talk about secretary leavitt, church of you bush posse second secretary, five bipartisan senators
participated in a second round. the president nominee's obama's first secretary. again, it is unprecedented for a chairman to turn down a member who has a question to ask. for the record, i would like to ask consent to put parts of the record of the nominees of michael leavitt, and tom daschle into the record of the hearing. and again, our members have questions because this nominee is going to have jurisdiction over the health care and lives of millions of americans and we want to know where he stands before we make a decision, yes or no, for him to be there. that is why it is so important
to members of our community. having said that, i want to say the health of our families and communities could not the more important. when a young child goes to school healthy and ready to learn, she is better prepared. when women are empowered to pursue all of the dreams, our community benefits. when workers asked for quality health care that they can afford, our economy grows. when seniors are able to trust that the guarantee of programs they have paid into, medicare and social security will be there when needed, we live up to some of our most vital responsibilities. the department of health and human services has a critical role to play in ongoing work to meet each of these goals and many more. that is why evaluating a nominee for secretary of health and human services, i consider whether the nominee has a record
of putting people first and not politics or partisanship or those at the top, whether they will put science first and not ideology, and whether their vision for the health care in our country would help more parents get quality health care or take us backward. congressman price, i have serious concerns about your qualifications and plans for the department you hope to lead. i look forward to hearing from you today on a number of topics. i start by laying out issues of what your record suggests about your approach to our nation passes health care system. just last week, you voted to begin the process of ripping apart our health care system without any plan to replace it despite independent studies showing that nearly 30 million people would lose health care coverage and even though more and more members of your own party are expressing serious doubt about the ability to unify the plan and knowing in a matter of weeks, you could be leading the department whose core
responsibility is to enhance america's health and well-being. my constituents are coming up to me with tears in their eyes wondering what the future holds for their health care given the chaos republican efforts could cause. president-elect trump and republican leaders have promised the american people that their plans would somehow do no harm and would not cause anyone to lose coverage. just days ago, president-elect trump promised insurance for everybody. your own proposals would cause millions of people to lose coverage and force many people to pay more for their care and leave people with pre-existing conditions phone or both to insurance companies rejecting them or charging them more. i would be interested in hearing your explanation of how you have your plans for how we can keep the promises your party has made to the american people about their health care.
medicare is another issue i would be interested in hearing about today. president-elect trump campaigned on promises to protect medicare and medicaid. you have said you plan to overhaul medicare in the first 6-8 months in this administration in a way that would end the guarantee of full coverage that so many people and people will with disabilities would rely on. you put forward policies that would shift one chilean dollars in medicaid costs to our state, squeezing their budgets and taking coverage away from struggling children and workers and families. while president-elect trump has said medicare should be able to negotiate jog prices for seniors, you have opposed efforts to do that and went so far as to call legislation on that issue a solution in search of a problem. i disagree. it is absolutely critical for families in my home state, and i
am eager to learn how you will reduce the cost of prescription drug costs in our community can it as a woman, mother, grandmother, and united states senator, i adeeply troubled by the ways you policies would impact women's access to health care and reproductive rights here and i have serious concerns about your understanding of women's need for basic health care like birth control, given your expressed doubts on the topic. your proposals to make women pay extra, out of pocket for birth control, and your repeated efforts to defund our nation passes largest provider of women's health care, planned parenthood. i am also very focused on the role of the department of health and human services in strengthening and protecting public health. i want to hear from you about whether and how you will uphold the gold standard of fda approval and, for example, how
would you approach important programs and rules intended to keep tobacco companies from luring children. finally as i discussed in the hearing yesterday, i believe firmly that especially as the president-elect tries to blur the president-elect tries to blur lines around conflict of interest, it is critical we not only do everything in our power to hold him to high standards but we do the same for cabinet nominees. that is why i was so appalled that with four of the president-elect's nominees currently serving in the house of representatives, house republicans attempted right out of the gate to get rid of the independent office of congressional ethics. muckler, they heard loud and clear from people across the country that it was not acceptable and they backed down. the office of congressional ethics has now been asked not only by democrats but by consumer advocacy group public citizen to investigate serious
concerns and questions about your medical stock trades during your time in the house. i and other democrats have repeatedly called for hearings for your nomination to be delayed until such an investigation is complete. it is disappointing to us that instead, republicans are moving forward with your nomination before we have all the facts. i hope you have come prepared to be fully transparent with us in your explanation. i have outlined a few of my questions and concerns about this nomination. i know in light of republican efforts, to take our health care system in a vastly different and harmful direction, that are shared by many to across the country who cannot be here today. it is crucial that the voice of the people who will be impacted every day by choices made under this administration are part of the process when it comes to the president-elect cabinet nominees. i want to say i am pleased that tomorrow, senator warren will
host a forum with witnesses who can speak to the impact of health care providers like land parenthood. the importance of the work done to expand access to mental health care and substance abuse treatment and the way in which full guarantee of medicare helps keep them financially and physically secure. there are stories across the country of lives saved and strengthened because of the progress we have made to expand quality affordable health care. i urge my republican colleagues to attend and prioritize what is best for women and men and families, not what is best for politics as they consider each of the decisions in the coming weeks. congressman price, as we begin this hearing, i would ask you to be as transparent and frank as possible about your views and your plans for the department and your -- urge you to provide us with additional information and answers, to any follow-up questions we have, in
a timely manner. i look forward to what i hope will be a rigorous and open discussion today and i hope the -- sen. alexander: thank you. would like to put into the record the information from the last six hearings, without going into detail, one round of questions, secretaries of billy one round with one member, a second round, one round us three, leavitt, six members asked a second round, thompson, one round of seven minutes ach. my decision is rather than give six of 23 members a second round, that it would be better to let every senator have seven minutes.
now, senator isakson. sen. isakson: thank you. i would like to ask consent of the remarks. the put into the record because will not read them. i have the unique honor and privilege to introduce a friend of mine for 30 years, someone i know to be a great politician, a great practicing legislator, a great family man and a great friend of mine and it is an honor to do so. i want to have each of you -- i think you will be impressed with what i hear -- with what you hear. i approach the introduction, if i am being asked what i would look for and somebody i want to trust with one truly -- $1 billion -- one troy dollars of my money, the quality of health care and the future of america quality of health care, i look for five things.
first, does this man understand the american family? not only does he, but his wife that he does. stand up. she will tell you he understands the family. his son, robert, is not here because he is singing country music and writing country music songs. he is a fine young man i enjoy working with. tom is a great family man. remember the debtor a member of the united methodist church, active in his community, doing what is right for his community, he is a man who understands family and the value of family and health care to every family. i want to know is he capable of handling $1 trillion? $1 trillion is a lot of money. it is a lot of money. more than we appropriated the value of health care to very family.
$1 trillion is a lot of money, pulling you get to $1.1 trillion, while wary? it is a lot of money. he has been sharing the budget committee. he's led probation for many years and has run one of the largest medical practices in he state of georgia. i have watched them over the last 30 years participate in activities. they contributed to the betterment of health care in our state, like the largest hospital trauma center we have in the state of georgia, saving ives every single day.
i would want to know they have some experience with the legislature. if you have a chairman and give them a budget and say talk to people and convince them what we need to do to change the law. that is a tall order. you want to find somebody who served in public office. tom was the first elected republican leader of the georgia state senate. he served in the congress of the united states. he improved the district remarkably when i left that he was elected to replace me. intellectual level went way up. he's done an swrout standing job being reelected six times to the united states house of representatives. serving as budget chairman, very active member of the congress of the united states of america. i want to know if he is an accountable person. he is one of the rare one of us -- i know this is true -- that reads all the bills.
i would mention a couple of things that have been set negative and i will address them because they are wrong. chuck schumer took this case of cymer and made it -- zimmer biomed, a stock that tom price asterisk manager -- tom price's manager managed for him. it is called desperate empires come or you take to the fact that are unrelated, put them together to indict someone for a wrong, when nothing was wrong. zimmer biomed, the stock purchase, took place without tom's knowledge. his knowledge was one month later and he did not know about it at the time it was made, so the allegations that were made yesterday on the floor of the senate are wrong by taking to the correct things put together to make incorrect. second, something has been said that i have working knowledge of, tom was accused of not being supportive of saving social security for seniors. i am 72 years old and i would not talk about someone disapproving of social security. tom price and i got a phone call eight months ago from aarp asking if we were traveling to townhall forums on saving social security. why would someone call tom price, a congressman, art johnny isakson, a senator, to do tom hall meetings -- townhall meetings about saving social security if they do not want to save social ecurity? lastly, one of the best votes i cast four years ago was for
sylvia burwell. when she came forward and the senate committee on the house, she is an articulate and intelligent lady. there was a lot of reason for me as a republican in the minority to vote against her because she is a democratic nominee, but i listened to her answers, studied her history, watched her actions, and i proudly voted for her. today, she is a professional friend of mine and we will miss her in the office, but there is no one better qualified to replace soviet burwell the tom price. i voted or soviet burwell of pride and know about the tom price of pride because i know he is the right man for the right job, at the right time, for america. he is my friend and i commend him and i urge you to vote for him in his confirmation. mr. chairman: thank you, senator isakson. much better than whatever was written for you to say. dr. price, welcome to the committee.
dr. price: thank you, mr. chairman. all members of the committee, i want to thank you for the opportunity to speak with you today and engage and as the ranking member said about the discussion about the road ahead for our great nation, i want to thank senator isakson for his great introduction. am grateful for his friendship, kindness, and our state is blessed to have had his service and his leadership. i also wish to think my wife, ready, 33 years -- my wife betty, for 33 years, and her love means more to me than i ould ever say. over the past few weeks, i met with many of you individually and have gained a real appreciation for the passion you have for the department of health and human services. please, no that i share that passion play that is what i'm here today and honored to be the nominee for secretary of
health and human services. we all come to public service in our own unique ways that in form who we are and why we serve. i first professional calling was to care for patients. that experience as a position and later as a legislator has provided a holistic view of the complex interactions that take place every day across our communities. today, i hope to share with you, experience has helped shift me and my understanding and appreciation for the work of the department of health and human services. from an early age, had an interest in medicine. my earliest memories or of going up on a farm in the state of michigan. we lived on a farm in michigan before he moved to suburban detroit when i was fighters old. i spent most of my formative years being raised by a single mom, and some of my fondest memories are spending time with my grandfather, a position. -- a physician. when i was young, we would spend weekends with him and we would go on rounds, which at that time meant house calls, so
we would drive up to houses and i was -- the memories i have of individuals opening the door and welcoming him graciously are cemented in my mind. after graduating from medical school from the university of michigan, i moved to atlanta, which i called home for 40 years. that is where i met my wife, we raised our son, and i did a residency at emory university and grady memorial hospital, returned to serve as the medical director of the orthopedic clinic. throughout my career, i treated patients in all walks of life, including so many children. anyone who has treated a child knows the joy you have when you are able to tell the mom and dad that we have helped saved their child or helped their child back to helpfulness. my memories at grady are full of the gracious comments of patients and parents with a team of health care specialist had the privilege of working.
after 25 years of school and training, i started a work practice. the practice group, as senator isakson mentioned, and became one of the largest nonacademic orthopedic groups in the country, for which i would serve as chairman of the board. during 20 years as a practicing physician, i learned a good about not just treating patients with about the broader health care system and where it intersects with government. the couple of vivid memories stand out. one, many of my patients were never more irritated or angry when they recognized that there was somebody else in the exam room, not physically, but figuratively, who is getting between the doctor and the patient and making decisions, whether the insurance company or government. and then there was the day that i noticed my office, the mid 1990's, when i realized there were more individuals behind the door where the clinical work was going on seeing patients than in front of the door, and those folks were filling out forms and making certain that we were checking all the boxes and either
challenging are arguing with insurance companies or the government about what was in the best interest of the patient. it became clear to me that our health-care system was losing focus on its number one priority, and that is the patient. as a result, i felt compelled to broaden my role in public service and help solve the issues harming the delivery of medicine comes iran for the georgia state senate. i found the state senate in georgia to be remarkably bipartisan and collegial relationships were the norm. this is the environment i learned to legislate, reaching across the aisle to get work done. in congress, i was fortunate to be part of the collaboration that broke through party lines to solve problems. this past congress, there was a bipartisan effort that succeeded in reading medicare of a broken physician payment system and has begun the creation of a new system that if implemented properly, will help ensure that seniors have better access to higher quality care.
if confirmed, my obligation would be to carry to the department of health and human services both been appreciation for bipartisan team driven policymaking in what has been a lifetime commitment to improving the health and well-being of the american people. that is for the six principles of health care, affordability, accessibility, quality, responsiveness, innovation, and choices.
the health and human services is more than health care. their real heroes of the department doing incredible work to keep records safe, develop new drugs and treatment options, driven by scientists, conducting remarkable research. they are heroes among the talented dedicated men and women working to provide critical social services, helping families and children have a higher quality of living and the opportunity to rise up and achieve their american dream. the role of health and human services and improving lives means they must carry up responsibilities with compassion, efficient and effective and accountable. as well as willing to work with those in communities already doing incredible work on behalf of their citizens. the cross the spectrum of issues and services that the department handles, there endures a promise that has been made to the american people. we must strengthen our resolve to keep the promises our society has made to a senior citizens, and to those most in need of care and support, and that means saving and strengthening and securing medicare for today's beneficiaries and future generations. it means ensuring our nation's medicaid population has access to the highest quality care, maintaining and expanding america's leading role in american medical innovation and treatment of radical disease. i show your passion for these issues, having spent my life in service to them. there's no doubt we do not all agree or share the same point of view when it comes to addressing every one of these issues. our purchase the may differ but surely, there exists a common
commitment to public service and compassion. we all hope that we can help improve the lives of the american people to help heal individuals and whole communities, so with a healthy dose of humility and an appreciation for the scope of the challenges before us, with their assistance and what god's will, we can make it happen, and i look forward to working with you to do just that. mr. chairman, thank you mr. chairman: for the opportunity to be with you today. two ui, dr. price. we will begin a round of seven minute questions and i begin questioning -- let's have about the affordable care act and health-care system. my belief is that the historic mistake in passage of the affordable care act was it sought to expand the system that already cost too much. what is our goal here of those who want to repair the damage of obamacare and replace parts
of it? is it to lower the cost of insurance for americans? it is to give them more choices of that lower-cost insurance? and is it to put more decisions in the hands of states and into the hands of patients? dr. price: thank you, mr. chairman. the issues you raise with the choices and access and cost are at the heart and center of where we ought to be putting our attention. as i mentioned in the six principles i have for health care, affordability is incredibly important. it is no good if you cannot afford health coverage and acceptability is imperative. today, many folks have coverage but is they don't have access to the positions they would like to see. choices are vital. mr. chairman: isn't one of the primary means for achieving those choices moving more health care decisions out of washington and putting them back in the hands of states and
patient consumers? dr. price: in many instances, the closer you can have those decisions to the patient, keeping the focus on the patient, the better. mr. chairman: if responsibilities are headed toward the states, would that not necessarily involve a fair amount of extensive consultation with governors and state insurance departments about how to do that and what implementation schedule ought to be? dr. price: absolutely. folks at the state level know their populations better than we can know them. mr. chairman: senator mcconnell said obamacare would be replaced and appealed and manageable pieces. i want to suggest pieces on a chart back here. looks to me there are four major areas where americans get ur health care insurance and hen this medicare.
18% of americans. one is employer insurance, 60 1% of americans get their insurance on the job. one is medicaid, and -- which is 22%, and one is the individual market, only 6%, and the exchanges we hear about are only 4% of that 6% but that is where so much of the turmoil is. let me ask, is this the bill to reform medicare? dr. price: absolutely not rated -- absolutely not. mr. chairman: so we would focus on medicare, medicaid and individual -- are those accurate categories or would you categorize them in a different way? dr. price:-groep to address if they are in the individual or medicaid market. mr. chairman: is it possible to work on one of those areas at the time rather than in the conference of -- or let me put it this week, don't expect senator mcconnell to wheel and a wheelbarrow with a big, conference of republican health care plan and that is because in my opinion, we don't believe in are placing the washington, d.c. health care plan with their own failed plan.
we want to work on it step by step, large piece by piece. how do you respond to that? dr. price: i think that is fair. for individuals -- the american people need to appreciate that the last thing we want to do is go from a democrat health care system to a republican health care system. our goal is to go from what we see as a democrat health care system to an american health care system that recognizes the needs of all. mr. chairman: i know your plan will not be presented until after you confirmed, but the president-elect has said let's do a repeal and replace simultaneously. to me, that must mean that any repeal of parts of obamacare would not take effect until after some concrete, practical alternative for in place for americans to choose. is that accurate or do have a different idea of what
simultaneous might mean or what the sequencing might be as we move through this process? dr. price: i think it is fair. one of the important things we need to convey to the american people is that nobody is interested in pulling the rug out from under anybody. we believe that it is imperative that individuals who have health coverage be able to keep health coverage and hopefully move to greater choices and opportunities for them to gain the coverage they want for themselves and families. i think there has been a lot of talk about individuals losing health coverage and that is not our goal nor our desire or plan. mr. chairman: let me ask you about how long it will take, repairing the damage, working on these three big areas, individual market, medicaid and employer. i sense is we have been working on this so long, although we have different opinions about this, we ought to make most of our votes in the next months about what to do but that the implementation of whatever we decide, especially since it will be going some of it back to the states, the department you hope to lead, my take
several years, is there a difference between the boats and a longer time of implementation of what we do? dr. price:dr. price: i think it is fair. i would point out that our health care system is continually evolving and shade. we ought to be always looking at how it is working, whether it is working for patients, and whether it is working for individuals who are working to provide the highest quality care for books. when it is, that is fine. when it isn't, that is incumbent on policymakers to make sure to do the kinds of things to adjust that policy so it can work, especially for patients. mr. chairman: my last question is about the 6% individual market, obamacare exchanges are about 4% of all of us who have insurance. our insurance commissioner in tennessee says the market is virtually collapsing. i am told by many people that we need to basically have a rescue plan, a reform plan for the individual market in place
by march 1. so that insurance companies who make their decisions by the year 2018 can make those plans so that people have insurance to buy in knowledge the states. do you agree that the market is collapsing and we need a rescue plan and that march 1 is an important approximate date for decision of action? dr. price: we are seeing changes in individual and small group work its adverse to the patient, whether it is decreasing access to coverage, increasing premiums, higher deductibles, something is going badly wrong out there, and it is imperative for us to recognize that and put in place the kinds of solutions that we believe to be most appropriate. mr. chairman: and your plan that we are likely to see in february will include recommendations for how to do that? dr. price: should i be given the honor of meeting with the human and help services, we look forward to working with congress to come forward with the plan. mr. chairman: thank you, dr. price. senator murray? senator murray: i would like to
put a letter from chairman alexander on the importance of a second round of questions on this nominee, and ask the consent to for the record, 25 lenders signed by organizations opposing congressman price's nomination to lead the department of health and human services, and have a petition signed by 500,000 people from across the country opposing this nomination and i asked to put it in record. mr. chairman: it will be. senator murray: recent reports about your investments in the australian biotech company raises some serious questions about your judgment, and i want to review the facts. you purchased stock in a therapeutic company working to develop new drugs on four separate -- occasions between january 2015 in august 2016 and you made the decision to purchase an opera, yes or
no? dr. price: that was a decision i make, yes. senator murray: you are offered the opportunity to purchase stock at a lower price than the general public, yes or no? dr. price: the initial purchase and generates many 15 was at the market price. the secondary purchase in june through august, september of i-16 was at a price available to individuals participating in a private basement offering. senator murray: lower than available to the general public, correct? dr. price: i do not know that it was, it was the same price that they had for the private place offering. senator murray: he is an investor and board member of the company, and he was reportedly overheard just last week on the house floor bragging about how he had made people millionaires from a stock tip. congressman price, in our meeting, you informed me you made the purchases based on
conversations with representative collins, is that correct? dr. price: no. matt schlapp that is -- senator murray: that is what you said to me in my office. dr. price: what i believed i said to us that is what i want from representative collins. senator murray: i recall you had a conversation with collins and then decided to purchase the stock. dr. price: that is not correct. senator murray: that is what i remember you say in my office. in that conversation, did representative comments tell you anything that could be considered "a stock tip," yes or no? i do not believe so, no. dr. price: senator murray: if you are telling me he gave -- dr. price: i do not believe so, no. senator murray: if you're telling me that you bought those shares, is that not a stock tip? dr. price: that is not one happened. he talked about the company and the work they were doing and tried to solve the problem of secondary scoliosis, a debilitating disease and when i had the opportunity to treat
patients -- senator murray: i am aware of that. dr. price: and it has a significant merit and promise and purchased the initial shares on the stock exchange. senator murray: congressman price, i have limited time. your purchases occurred while the 21st century cures act, which had several provisions that could impact drug developers like inmates immunotherapy therapeutics and days before you notify to have a final vote on the bill. do believe it is appropriate for a senior member of congress actively involved in policymaking in the health sector to repeatedly, personally invest in a drug company that could benefit from those actions, yes or no? dr. price: that is not what happened.
senator murray: let me say i believe it is inappropriate and we need answers to this regarding whether you and congressman collins used your access to nonpublic information when you bought prices -- but at prices and available to the public. dr. price: i had no access to nonpublic information. senator murray: well, we were gone. congressman price, lastly, you and republicans in congress voted to begin ripping apart our health care system, which would cause nearly 30 million people to lose their coverage and recess care -- and raise health care costs for families, without time the record before you plan to do instead. president-elect trump and republicans in congress have promised to deliver a plan that prevents anyone from losing coverage and leaves no one wears off. days ago, president-elect trump said his plan would provide insurance for everybody. do you share those goals? dr. price: i think it is imperative we have a system in place that has patients at the center and allows for every single american to have the opportunity to gain access for the coverage they want. senator murray: you share his goal of insurance for everybody? dr. price:dr. price: that has always been my stated goal to what i worked on my entire public career.
senator murray: if you repeal plan was signed into law, would you consider these commitments to ensure all americans live no one worse off? dr. price: the goal of the bills that i have worked on in congress and understanding the role that and give -- senator murray: i asking -- dr. price: my role in congress was to make certain individuals had the opportunity to gain access to the kind of coverage that they desired and that they had the financial feasibility to do so. that is what is different about the plans are put forward. senator murray: i think it is important we have clear answers, so your bill only allows people at the existing conditions to obtain health insurance if they maintained continuous insurance for 18 months prior. millions of americans at the existing health conditions lacked health insurance and under your plan, they could deny those americans coverage for pre-existing conditions, yes or no, under your bill? dr. price: it is a broader question because we would put
in high-risk pools and individual post that would allow every individual in the small group individual market and those challenge of facing on this to gain access to the coverage they want, so he believed through the plan that every single person would have the opportunity and financial feasibility to get the coverage that they want. senator murray: we disagree on the consequences of that. here bill would repeal -- your bill would repeal coverage available to adults up to age 26, correct? dr. price: the bill i authored did not include coverage of to age 26, the insurance companies said they were working that and including that in their plans going forward, so we felt it was covered. senator murray: your bill takes only current benefits, which include prescription drugs, mental health, substance abuse disorder, benefits and trinity coverage, among others, correct? dr. price: it is different in the legislative arena than administrative, but we would put factors in place that would measure individuals have the
care and coverage needed. senator murray: i disagree with the consequences but your bill to not cover that. your builder appeals the lifetime limits on coverage that helps a lot of people who are sick and have high medical expenses like a person with cancer, yes or no? dr. price: again, a larger question because we would put a different construct in place that would allow every single person to gain access to the coverage they want and have nobody fall through the cracks. senator murray: just with these questions, i'm concerned your vision for a health care system is very different and when i think millions of americans are accounting on. mr. chairman: thank you. senator enzi? senator enzi: thank you, mr. chairman and dr. price for being willing to serve and go through this process. i call this gotcha management. nothing is barred and the idea
is to get you to take questions on short notice, and public, that you would not have done what you normally do. i work to do for the last two years, immediately do at least once a week. every week we have been in session, so i know how you operate and i appreciate how you operate, and the care and the focus and the concern and how comprehensively you think bout the medical things. one of my concerns is the rural areas because wyoming is the most rural state in the nation. i hate to do that -- i hesitate to do that because last night t the education hearing, i got to hear from mrs. devos, who remembered a conversation from a month before that i had on
the rural problem, which dealt with grizzly bears by the property school in wyoming and that became a major topic around here. i am glad everybody recognizes that need and concern. part of the story was that that is the grade school that former senator craig thomas went to, and when he was there, they did not need that fence because he was tough. but there are different kinds of problems in different places in the health care area. there are different kinds of problems in different kinds of places in the health care area. i have a county the size of delaware that has one community with 2500 people. it does have a hospital, but when you have a rural community, a rural county that big with that small of a town, it is difficult to keep a doctor without at least a pa, the hospital has to close. if that hospital closes, emergency care is 80 miles away. not a likely story and most of
the places and we need to make sure those things are covered. i've appreciated getting to share those with you over the period of time. i was always curious as to why you had left a very successful practice and were willing to come back here to try to make a difference and i want to congratulate you on the difference you have made. now, one of the questions i would ask you is why are you willing to leave a place with so much responsibility and background and capability to be willing to be the secretary of health and human services? rep. price: thank you, senator. when i think about the mission of the department of health and human services to improve the health, safety, and well-being of the american people, it's what i've literally spent my
life trying to do, so to have the opportunity to participate, if confirmed, to service the secretary of health and human services and try to guide that organization in a direction that would further fulfill that mission, i can't think of anything more fulfilling or exciting. senator enzi: i think you have the background for doing that, given your background in the wide range of hospitals and practices and then coming here and going through a number of different committee situations. what you are about to go through is a rather intense and that is followed by the most productive part, if senators happened to read the answers, and that is when we get to do written questions, which we hope you will provide a rapid response on. those are not nearly as much fun for the panelists because they are not in public.
i will move to some questions that are a little bit more related here. we begin the serious and challenging task of restoring the health insurance markets, which are teetering on the brink. some counties, you can't get coverage. in wyoming, there is only one provider and it is my understanding that the incoming administration may have the ability to make key policy changes, some of the most critical changes for short-term stabilization might include reducing the number of special enrollment periods and requiring upfront verification or aligning grace periods with state law. my understanding from those in the insurance business is it is targeted actions by health and human services may provide meaningful changes that could impact premiums for the next year. of those options you might consider?
rep. price: absolutely. the insurers are deciding right now as they come forward in march and april with the premium levels will be for 2018. what they need to hear from all of us is a level of support and stability in the market, the kinds of things that are able to provide stability. there are counties in the state where there are only one provider. we must, as policymakers, ask what is going on. where are the problems out there? that may work for the insurers in certain instances, but it does not work for patients. if we keep the patients at the center, we will get to the right answer.
senator enzi: i appreciate that. i got to work with senator kenzie for many years desk kennedy for many years -- senator kennedy for many years n biologics. the fda has issued guidance documents since the law assed. i was concerned that in 2017, having gone near death through nearly two president -- having gone through nearly two presidential terms, we finally got a draft. i will ask that question in writing. rep. price: thank you very much. senator sanders: thank you, mr. chairman to read congressman price, think you for the conversation we had the other day. congressman, on may 7, 2015,
let me begin by saying all of us know that we have come through a very unusual election process -- president-elect trump received almost 3 million votes less than secretary clinton, but he won the electoral college, he will be inaugurated this week. he won a number of states by rather slim margins. during the course of his campaign, mr. trump said over and over again that he would not cut social security, not cut medicare, not cut medicaid. let me read some quotes. on may 7, 2015, he tweeted, "i was the first and only potential gop candidate to state there would be no cuts to social security, medicare, and medicaid go on april 18, he said "every republican wants to do a big number on social security, they want to do it on medicare, they
want to do it on medicaid, and we can't do that and it is not fair to the people who have been paying in four years." august 10, "i will save medicare, medicaid, and social security without cuts -- we have to do it, people have been paying in four years and many of these candidates want to cut it." march 20 9, 2016, "paul ryan wants to knock out social security, knock it down, way down, he wants to knock medicare down, way down, number one, you were going to lose the election if you are going to do that, i'm not going to cut it, i'm not going to raise ages, i'm not going to do all of the things they want to do, they want to cut it very substantially, i'm not going to do that." point being, this is not something he said in passing. i think it is likely he won the
election because millions of working class people and senior citizens heard him say he would not cut social security, medicare, and medicaid. a simple question. is the president-elect going to keep his word to the american people and not cut social security, medicare, and medicaid or did he lie to the american people? rep. price: i have not had extensive discussions with them about the comments he made, but i have no reason to believe that he has changed his position. senator sanders: to the best of your knowledge, you are telling us, mr. trump will not cut social security, medicare, and medicaid. rep. price: i have no reason to believe that that position has changed. senator sanders: wrote -- quoting mr. drum or at least paraphrasing, last week, he said, pharma is getting away with murder. you recall that tweet? rep. price: i do. congress -- senator sanders: there are many of us on our
side of the aisle that are working on legislation to end the absurdity of the american people being ripped off by the pharmaceutical industry, who two years ago made $50 billion in profits, while one out of five americans can't afford to fill their prescriptions that doctors right. will you and will the president-elect join us in legislation we are working on, which would allow medicare to negotiate prices with the drug companies and lower prices and allow the american people to bring in less expensive medicine from canada and other countries? is that something you will work with us on? rep. price: issue of drug pricing and drug cost is one of great concern to all americans. i think it is important to appreciate the areas where we have had significant success. whether it is the generic areas --
senator sanders: you are aware that we are paying by far the highest prices for restriction drugs. you don't disagree with that, do you? do you disagree with that? rep. price: i think that is the case. senator sanders: it is. rep. price: if we get to the root cause, i think we can solid bipartisan lee. senator sanders: one of the root causes is that every other major country honors negotiates drug prices with the pharmaceutical entry. in our country, they can raise the prices, they could double the price is today, there is no law to prevent them from doing that. will you work with us so that medicare negotiates prices with the pharmaceutical industry? rep. price: you have my commitment to work with you and others to make certain that the drug pricing is reasonable and that individuals across this land have access to the medications that they need. senator sanders: was not quite the answer to the question that i asked. congressman price, the united states of america is the only
major country on earth that does not guarantee health care to all people as a right. canada does it, every major country in europe does it. you believe that health care is a right of all americans, whether they are rich or poor? should people, because they are americans, be able to go to the doctor when they need to, be able to go into a hospital because they are americans? rep. price: if we are a compassionate society -- senator sanders: no, we are not a compassionate society. our record is worse than any country on earth in relation to poor and working people. half of our older workers have nothing set aside for retirement. compared to other countries, we are not particularly compassionate. i question is, in canada and other countries, all people have the right to get health care. do you believe we should move in that direction? rep. price: if you want to talk about other countries' health
care systems, there are consequences to the decisions they have made, just like there are consequences to the decisions we make. i look forward to making sure every single american has access to the highest quality care and coverage possible. senator sanders: access to does not mean they are guaranteed health care. i have access to buy a $10 million home, i don't have the money to do that. rep. price: that is why we believe it is appropriate to put in place a system to give every person the financial feasibility to purchase the coverage they want for themselves and their family, not with the government forces them to buy. senator sanders: that is a longer story. thank you very much. rep. price: thank you. senator hatch: welcome to the committee. we have worked with you over the years. i have found you to always be very knowledgeable, very up front, very straightforward, very honest, and somebody who really understands health care in this country.
you are just perfectly situated to be able to help turn it around and get us to a place that it works. we hear a lot from the other side about how bad the system is and so forth. i do think it is very good myself. we've got to work on it and get it done right, but i sure would like to have you hoping to get it done. you are one of the really premier people in the sole congress and in the world, as a matter of fact, understanding what needs to be done and recognize in the problems of getting it done. dr. price, some of my colleagues have criticized you for your health related stock holdings while serving in the house. not only do house rules not prohibit members from trading stocks, but it is not an uncommon practice for members of congress, in fact, there were members on this committee, who have traded individual health stocks, while serving on this committee. this appears to be nothing more than a hypocritical attack on your good character.
i personally resent it. you have always disclosed -- let me just say this, can you confirm that you have always followed the law relating to trading in stocks while serving as a member of congress? rep. price: thank you, sir. everything that we have done has been aboveboard, transparent, legal, and his you know, there is an organization called the office of government ethics that looks that all of, for every cabinet nominee, looks at all of the possessions come all of the holdings, and the like, and makes a recommendation as to what the cabinet member must do to make sure there is no conflict of interest. the office of government ethics has looked at the holdings and given advice about what we need to be done in terms of divesting from stock holdings to make sure there is no conflict of interest. we have read those and agreed to those, signed those, that document is online for everybody to see so that everybody is absolutely certain
that there will be no conflict of interest whatsoever. senator hatch: and you follow their advice? rep. price: absolutely. senator hatch: collects of obamacare -- the collapse of obamacare has dissolved our effectiveness. despite failed reforms, i don't think we can lose sight of the broader health system at risk. rare disease patients do not have access to life-saving treatments because policies that stem from obamacare prevent investments and innovative therapies that can cure and save lives. this is an issue i'm deeply passionate about. what steps do you believe will increase the pipeline for disease therapies to bring treatments and cures to patients in desperate need of hope? rep. price: the act which past 30 years ago, it really has
revolutionized the ability to treat rare diseases. it made the united states and the leader in coming forward with treatments for rare diseases. i think there are things we can do in terms of patent protection, liability, in terms of incentive is asian of resourceiz -- incentiveation -- incentivization of resources. senator hatch: we have some more drugs coming through because of that bill. all of a sudden, there is an explosion for populations of less than 200,000 people. it is a pretty important little bill. it was a republican bill. rep. price: one of the success stories for public policy in the country. senator hatch: one of the essential duties of the hhs
secretary is to be diligent and thoughtful when considering if federal regulation is necessary and assessing whether the regulations impede research, development, and innovation. over the years, the regulations about dietary supplements has changed dramatically. do you recognize dietary supplements in helping reach and maintain healthy lifestyles? rep. price: absolutely. senator hatch: will you commit to me and the members to protect public health while assuring that consumers continue to access to safe products? rep. price: this is one of those areas where it is incredibly important to gain the information you referred to, to gather the individuals who know the most about this area. whether it is consumers, whether it is those providing the products to market, make sure that there are protections for products, but it is absolutely vital to get this
right. : senator hatch i will tell you this. i have to commend donald trump for picking you. you are clearly one of the premier people in all of congress who understands the problems with health care. you have the professional background that i don't think any other member of congress can match to help solve the problems that we have. we have a real messy situation. obamacare has not really helped. do you think obamacare has helped? rep. price: i think some of the things that have occurred with the passage of the aca have improved certain areas. the coverage has certainly improved. the consequences of that, that many people have coverage, but they don't have care, but there are so many things about the decision-making process, who decides about our health care, should it be the federal government or patients and families and doctors and we certainly believe the latter as opposed to the former.
senator hatch: i take it you believe getting health care closer to the people is a far better thing than everybody pontificating from washington dc. rep. price: i think the more involvement patients and doctors can have will result in higher quality care. senator hatch: i defended doctors, hospitals, health care providers, etc. in another ife. what do you think we should do about medical liability? rep. price: this is a really difficult challenge because it is not just the malpractice rates that doctors or hospitals pray, but it is the practice of defensive medicine, the things that physicians do, but there are tests and procedures that are not necessarily needed to make a diagnosis -- senator hatch: that shows up in their history. rep. price: so if they are called up into the court of law, so they say, i don't know what you wanted me to do, i did verything.
if we look at it in that light and try to decrease the practice of defensive medicine to the benefit of patients, i think we can get to the right answer. there are exciting opportunities that have been bipartisan in the past. senator hatch: thank you, sir. senator casey: thank you mr. chairman and representative price. thanks for the visit to our office. i wanted to highlight something we probably don't spend enough time highlighting or talking about and that is the full protections of what was known as the original bill. we have a lot of short-term and -- shorthand terminology. i know you and i have a basic disagreement. what a lot of people have orgotten about and the chairmen had a chart earlier that outlined the categories of
americans that have health insurance by virtue of various programs. the number he had on the poster about the number of americans in the employer-sponsored coverage category and it was 178 million people. that is a lot of folks with coverage, who had coverage before, most of them had coverage before the legislation, and after, but they did not have protections. that only came with the passage of the legislation. we know that people have purchased health insurance to the individual marketplace. i wanted to ask you a couple questions about those basic protections that are no law that were not law before. i think you would agree with me that you meet remarkably inspiring people in your work and once in a while in the
senate, we do and we don't take enough time to have those opportunities, but one of the people i met in the lead up to the legislation passing was stacy ritter from manheim, pennsylvania. she did not have a personal challenge, it was the challenge aced by her two daughters. they were four years old, matalin and hannah. as stacy said about her daughters, she said that they would, at that time, would be punished and rejected because they had the misfortune of developing cancer as a child. her basic problem was the caps on treatment. the first question i would ask you in terms of your work as secretary of health and human services should you be confirmed, will you commit to maintaining the protections that ensure that no child, no hild is denied insurance
coverage because of pre-existing conditions? rep. price: i think that pediatric cancer is one of those things that is remarkably challenging. i remember when i was in my residency and i did a rotation on the pediatric orthopedic ward and so many of those children had can't -- cancer and before i began that rotation, i'll most dreaded going through that month because i was worried about just the severity of the challenges i would meet. it was one of the most uplifting months i spent a medical school and that was because the children were so uplifting. absolutely, we need to make certain that every single child has access to the kind of coverage that they need and the care that they need and there are a number of ways to do that and i look forward to working with you to make that happen. senator casey: i heard the word yes there. secondly, it is really hard to believe that we even have to ask a question about this next topic, which is victims of
domestic violence. it was the stated law prior to the passage of the legislation that victims of domestic violence were considered americans without a pre-existing condition. it is still the law in some states that they are not protected. will you commit to maintaining the protections that ensure that victims of domestic violence will not be discriminated against when purchasing health insurance? rep. price: i think it is absolutely vital that victims of domestic violence and others, anybody, we need to have a system in place that ensures that individuals are not priced out of the market because they get a bad diagnosis, are not eligible or able to purchase coverage that works for them -- senator casey: i don't want to get hung up on priced out of the market. what i'm asking for is an
ironclad guarantee that that circumstance, that horrific circumstance will never be a bar to coverage, treatment, or care? rep. price: it certainly should not be. if i'm fortunate to be confirmed, that is an administrative role and a policy decision that the legislators -- senator casey: i think we can agree on that. number three, will you maintain to committing the protection that prohibits the discrimination based on health status or disability? yes or no? rep. price: again, i think it is absolutely imperative that we have a system in place that works for patients and anybody not being able to gain access to the coverage that they want or need is not a system that works for patients. senator casey: what i'm getting at here is that we had a state of the lobby for passage of the aca where individuals like hat, whether a child had a pre-existing condition, even if the parents were paying
premiums for years, an insurance company could literally say, sorry, you have a pre-existing condition, you can't get coverage. women were discriminated against because they were women. just a remarkable stain on america that we allow that to happen. my concern now is not just a series of concerns about what you has proposed about a member of the house and what you could do a secretary, but i just heard earlier the three areas that will be a focus in whatever replacement plan there is and i'm anxious to see it would be and i wrote them down - chairman alexander wanted to take off the table and that is a good thing, medicare, but i heard that there would be three targets -- my word, of course -- the individual market, medicaid, and employer-sponsored coverage. i hope that if
employer-sponsored coverage is a subject of change that will ensure all of those protections that are in place right now. that is why i'm asking those questions. i will follow up more in writing or if we get another round, mr. chairman put me on record as incorporating it everything ranking member marie said about questions and additional rounds. thank you. >> duly noted and i appreciate your using your seven minutes o ask questions. >> sen. isakson:'s deferred to senator paul. senator paul: as a fellow physician and a fellow physician who did some of my training at grady, congratulations and it was everybody at the commission could come to grady and see what it is like to work in one of our nation's biggest charity hospitals often doing work that is just incredible, gunshot wounds, contract -- compact fractures to the femur, you
name it. i remember being there is a student as an intern, we used to calculate how many hours and divide by our income and say, we wish we could get minimum wage. i think it is critical to get someone with clear reasoning and critical skills to be in harge of our government. i think what i regret about this kind of hearing and what a ot of people in america regret about it is the vitriol and the rancor and the partisanship that -- we kind of all want the same things. to question your motives is insulting. to question whether you are honest is insulting. the whole question of -- did you go into public service to enrich yourself or for public service? rep. price: i have a passion for public service and a passion for people and that is
hat guided our decision. some i think it was a foolish decision for both of us. senator paul: did you take a pay cut? rep. price: i did not consider the remuneration. senator paul: right, but i'm guessing it was a pay cut. i think we all want the most amount of for people at the least amount of cost, we want people to get access to health are. what are your motives? what are your goals? do you want more people to be insured? do you want more people to have health care? do we disagree on just how we do it and not necessarily just the motives? rep. price: as it tried to lay out earlier and i know time is short for everybody, the principles that i think are absolutely imperative for a health care system is one that is affordable for everybody, one that provides access to health care and coverage, one that is of the highest coverage, that is responsive to
patients. the system is not any good if it is not responding to patients to read one that incentivizes innovation because it is the innovation that drives high-quality health care. one that ensures choices are made and preserved by patients. patients should be choosing who is treating them. senator paul: republicans have been accused of having no replacement ideas. approximately how many bills to you have that would be, could be regarded as replacement bills are ways to improve the health insurance system in our health care? >> we have had bun large-it remember bill since march or arly 2009 and beacombrond that -- beyond that tens of hundreds. >> it's been considered america, this horrible rotten place that we don't have compassion and physicians. but you worked as a emergency
room or physician did you always agree with the hospital and treat all comers regardless of whether they had the ability to pay? >> that is one thing we pride ourselves on. everybody was provided care not only in our residency but in our private orthopedic practice as well. >> those who say we have no compassion extoll the virtue obvious socialism and look at a country like venezuela like great resources and? utter disaster where people can't eat evolving into violence. i think it is important that we do have a debate between socialism and communism and america and capitalism. one of the things that's extraordinary about our country is two years ago in 2014 we gave away $ho 400 billion, privately, individually to churches and charities. we're an incredibly compassionate society. i think often this was misplaced in sort of the wonky numbers of this number and that
number within health care. how much we do help each other. not only do we help each other in our country. i will bet you half the physicians in my community have gone on international trips and done international charity work. all that is lost in saying we're this heartless terrible country. i would just argue the opposite. i think the greatness of our country and the greatness and compassion of our country, we give away more than the gross domestic product than socialized countries around the world. with regard to replacement, there are some big broad ideas that would ensure more people. one is the idea of legalizing the sale of all types of insurance. under obamacare we made it illegal to sell certain types of inexpensive insurance. do you think we could insure more people and help some people who don't get insurance under obamacare if we would legalize the sale of more types of insurance? >> i think choice is absolutely
vital. i know if we have as a principle and goal having patients have those choices then i believe that patients will select the kind of coverage they want. the choices that ought to be available to them are a full array of opportunities. >> do you think health savings accounts will help also some people that are not helped currently? >> i think health savings accounts and high deductible catastrophic coverage make a whole lot of sense for many individuals. we ought not force anybody to do anything. it ought to be a voluntary choice. but they ought to have the choice to be able to select them. >> one of the things you've had different legislation on and i'm a big supporter is allowing individuals to join together in groups to buy insurance. do you think this has ra possibility of what senator alexander talked about the millions of people on an vinlt market? i have great sympathy for that. i was a small physician with four employees. if one were to get sick could be devastating not only to them but also to the economics of keeping them employed. but letting us join together
and to pools where instead of me buying insurance as one of four people i could buy it in a big group maybe 100,000, maybe 1 million people. currently the law prevents that. but you have a bill expanding that. could you mention some of the plans and how that might help some people get insurance? >> thank you. association health plans are one of those that would allow individuals who are economically aligned to purchase coverage together even though they don't necessarily work together. individual health pools which is one of the secrets to solve the conundrum we find ourselves in would allow anybody to pool with anybody else solely for the purpose of purchasing coverage. the mod sl the blue shield plan that exists decades ago that allowed people to pool their resources together for major medical coverage for hospitalization. that makes a lot of sense. it allows insurance to work the
way it's supposed to work to spread the risk. then anybody's adverse health status doesn't drive up the cost because the pool is large enough. >> senator franken. >> i'll tell you how we get really big risk pool. be called medicare for everyone. that would be the biggest risk pool. dr. price it was nice meeting you the other day. did you enjoy meeting me? >> thank you. i did. i did. i enjoyed our discussion about our gray hair. >> dr. price, what is the leading cause of preventable death in the united states? >> i'll defer to you. you've obviously got it on the page in front of you. >> i actually knew this before i put it on the page. it's smoking. >> that hits home. i lost my dad to who was a lucky strikes smoker from world war ii to emif a seementa and
he prided himself on the fact that he never smoked a cigarette with a filter for years and years. and it was incredible tragedy. >> i lost my dad, too. as a physician, you may know -- i guess you didn't -- that smoking kills approximately 480,000 americans each year and totals $170 billion each year in health care costs. and yet between 1993 and 2012 you were a shareholder of tobacco, big tobacco companies. meaning that you personally benefited from tobacco sales. meanwhile, you voted against lark legislation in 2009 that gave the f.d.a. the authority to regulate tobacco. congressman price, you are a physician which means you took
the hip cratic oath, a pledge to do no harm. how do you square reeping personal financial gain from the sales of an addictive product that kills millions of americans every decade with also voting against measures to reduce the death toll inflicted by tobacco. >> it's an interesting question, senator and it's a curious observation. i have no idea what stocks i held in the 90s or the 2000s or even now. all of these decisions for all of us i suspect through mutt tull funds and through mention plans. i would bet -- and i don't want to -- well, i won't bet here. i would suspect that in your pension plan that there are components of that that are held that may have something to do sometime in your history with tobacco. >> i find it very hard to believe that you did not know that you had tobacco stocks.
i find it a little hard to believe that in the questions about your stock portfolio you've said you didn't know things. just over the last four years you traded more than $300,000 in health related stocks while at the same time sponsoring advocating legislation that could affect the perform bs of those stocks. now, and we talked a little bit about the zimmer biomed. your broker you say -- you didn't know this -- bought it on march 17, 2006. you did introduce a bill later -- a week later on march 23, 2016 -- you say that you did not know then that you had this stock. it was a rule -- to delay a federal rule that would reduce the probability of the company's joint -- to delay a
rule that would hurt the company. what i don't understand is once you found out that your broker bought it, you kept the stock. ou purchased this $50,000 to $100,000 worth of stock in a biomedical company. we talked a little bit. the single largest purchase in the past three years. in a private deal that was not made available to the public. and i find it absolutely amazing that you responded that you did not know that you got a discounted price. that is absolutely amazing because we discussed this. >> by definition i believe that's the nature of a private placement offering. what i said to you and what i've said to others is i paid exactly the same price as everybody else, i disclosed it. >> it was a private offering
that went to 20 people including representative your colleague chris collins, his chief of staff, and a prominent d.c. lobbyist. and you reported 50-100,000 in profits on this purchase. it really begs credibility sir when you say you did not know that you got a discount on this. this was a private offering to a very small number when you have the committee chairman of the budget committee, when you have a congressman as chief of staff, these sound like sweetheart deals and i think that our job in this body and in congress and in government is to avoid the appearance of conflict. and, boy, you have not done this. i want to talk just about your
latest plan empowering patients first act. some of it is detailed in this article from the new england journal of medicine. it is called care for the vulnerable versus cash for the powerful. trump's pick for hhs. i will just read a random paragraph. price's record demonstrates less concern for the stick, the poor, and the health of the public and much greater concern for the economic well-being of their physician care givers. and i would commend this to every member of the committee because what your plan does is one of the things it gives a tax credit to americans to buy health insurance. it is no difference fror someone who is poor, someone
who makes 20,000, and to bill gates. it is an incredibly regressive system. you have talked about the ending -- you want to end the expansion of medicaid. that has people in minnesota scared out of their minds. look, i have heard a lot -- obamacare has been a disaster. first of all, you have to admit that it has met the cost curve. that the cost of health care in this country has grown less than it did in the previous ten years. it is also covered 20 million more people. but forget them. in 2008 i would go around the state of minnesota in every vfw hall, in every cafe, i would see a bulleten board where it would have a burger bash or
spaghetti dinner for someone who had gone bankrupt because they had gone through their annual cap or their lifetime cap. i am very frightened about what you are going to do. and so are millions of americans. frankly, i know that you do things that help that physician roups, you've put in provisions that would prevent these findings by -- efficiency and innovation boards. that would have to be cleared by physician groups. i see you as someone who is there for the doctor and that this is a cover for -- this is
not going to create access for all americans what you've talked about, the empowering patients first act. this is going to unravel something that has given a lot of americans peace of mind knowing that their kids can stay on their health care until they are 26. knowing that they have -- if they have a preexisting condition, that won't stop them from getting care. that is what this hearing should be about. man.ou are a smart >> senator we're a minute over. >> ok. and my second round i will be a minute short. >> sure. >> thanks. >> you may be here by yourself. >> i'll be here with him. > you know, the -- the
hearings was 11 hours. that's a long time. >> thank you, senator franken. senator ikesen. >> senator price with that question ended without having any time, if you have any response? this ould just say that is one of the things that makes it difficult to reach a solution here in washington. the concerns that were expressed by the senator are valid concerns. the conclusions that he drew on the policies that i've promoted and will continue to proment are absolutely incorrect. we all share a concern for the american people and how we best make certain that they have access to the highest quality care that the world knows. and so i hope -- and i understand why he's doing it. it's a political activity. i understand that. but i hope that we're able to work together if i'm given the privilege of leading and serving as the secretary of
health and human services to truly solve these difficult challenges that we have in our nation. >> isn't it true that by the date of may 15 of every year since you served in congress you have had to make full disclosure of everything you own, everything your wife owns, what it's worth, when it was acquired and what it was sold for? >> every single year and the house requires a monthly transaction form that updates that. >> isn't it true that every transaction that's been referred to were available in public? >> absolutely. and they remain so today. >> these are not discovered things that were hidden. these are facts that we require you to disclose? >> there isn't a single bit of information out here that i didn't reveal to the public. >> isn't it true that transparency is the antiseptic that creates the environment where there is no corruption? >> sunshine cures disease. >> isn't it correct you've worked throughout your career
in the georgia senate, united states congress, and i'm sure you will as h.h.s. to be sure there's transparency? >> it's a hallmark and key especially in health care and the service that is h.h.s. provides. >> do you not love your country, your job, and if you have the opportunity to be secretary of h h.h.s. to disclose everything so there's not an appearance of any conflict of interest? >> absolutely and the work they do to look at everybody's holdings and assets who are scheduled to potentially serve in the cabinet. and then they make a recommendation, a very specific recommendation that's also available to be seen on line. and we have agreed to every single recommendation that they whatever ve vest of holdings we have that might even give the appearance of a possible conflict. >> mr. president, i yield back the balance whatever holdings we have of my time. >> senator bennett.
>> thank you, mr. chairman and thank you for the 7 minutes as well. i should tell you that i've never shown my knee before dr. price came to my office but he gave me some free medical advice. >> how are you doing? >> i'm curious whether you got the mri. >> today. i'll let you know. congressman, i enjoyed our conversation and it is good to see you here. i know you have been chair of the house budget committee. i know you're a member of the tea party. a strong advocate of balancing the budget, introducing a balanced budget for a stronger america called. what i've noticed is that after gaining control of the house, senate, white house the first order of business for the republican majority here has been to pass a budget esolution repealing the aca. this specifically authorizes $9
trillion in additional debt. it rigs the bill in secret to block any point of order to the bill because that will increase the deficit. senator paul. om he said, the more things change the more they seem to stay the same. republicans won the white house, republicans control the senate, republicans control the house. and what will be the first ordore of business for the new republican majority? to pass a budget that never balances. to pass a budget that will add $9.7 trillion of new debt over 10 years. this is a facksimly. is that really he asks what we campaigned on? the quote goes on. why would we vote on a budget that adds $9.7 trillion to the debt?
because we're in a hurry. we can't be bothered. it's just numbers. i was told again and again swallow it, take it, they're just numbers. don't worry. it's not really a budge. and yet the legislation says it's a budget. so this is what republicans are for. this is the blueprint that the republican party says they are for. $10 trillion worth of new debt. i'm not for it. said that honest man. rand paul is right. the repeal law overrides two separate budget provisions already passed by the senate to prevent increasing the deficit by more than $10 billion, given your inthe deficit in more than $5 billion. are you aware that behind closed doors republican leadership wrote into this bill that any replacement to the affordable care act would be exempt from senate rules that prohibit large increases to the deficit? >> as you may know, senator, i
stepped aside as chairman of the budget committee at the beginning of this year so i wasn't involved in the writing -- >> you have been the budget committee chairman during the rise of the tea party. you are a member of the tea party caucus. you have said over and over again as other people have that the reason you've come to washington is to reduce our deficit and reduce our debt. i assume you are very well aware of the vehicle that is being used to repeal the affordable care act. this is not some small piece of legislation. this is the republican budget. >> i'm aware of the bill. >> do you support the budget that increases the debt by $10 trillion. >> what i support is an opportunity to use the reconciliation to address the real challenges in the affordable care act and to make certain that we put in place at the same time a provision that allows us to move the health care system in a much better direction. >> do you support the budget that was passed by the senate
republicans to repeal the affordable care act that adds $10 trillion to the budget? >> the reconciliation bill is yet to come. i support the process that allows for and provides for the fiscal year 2017 reconciliation bill to come forward. >> will you commit today that any replacement plan for the affordable care act will not in any way contribute toward our deficit or our debt? >> i commit to working with you to make certain that that happens. >> will you commit as a member of the tea party that no replacement for this dreadful obamacare that allegedly created this deficit and debt will add to the deficit and debt? can you tell us the tea party you are not going to increase the deficit by repealing the affordable care act? >> there are a lot of contributions to the debt and deficit as you know, senator. >> that's true and we talked about it. are you going to allow the repeal of the health care bill to be be one of those contributors to our deficit and to our debt?
the cbo has said that repeal of the health care law could increase our deficit by up to $353 billion. that's what they've said. senator paul, an honest man, has gone to the floor and said the first thing we're doing is passing a budget that increases it by $10 billion. what do you say to the tea party? >> what i say -- >> more important, the people that live in colorado. >> what i say to folks in colorado and across this land that the congressional budget office and the conclusions they reached are in a silo. looking at it as if nothing else happened following the repeal. if you look at the whole constellation of thing that is will occur i believe and working with every member of congress should i be given the privilege of serving as the secretary, we will make certain that it addresses the health care challenges that are very real and we look forward to working with you and commiting to work with you on being as
fiscally responsible as we can possibly be because the debt and the deficit is a real challenge. >> with respect, and i have a lot for you. with respect, that's what every politician says about the cbo. then we just run up the debt and run up the debt. and the theory of the case here i think from the republican party on this subject has been that the health care law has increased costs, that the health care law has increased our deficit, increased our debt. and i would hope that you could take a pledge today that would say that nothing you would advocate for would pass or have the president sign into law would add $1 to our deficit and debt. >> i hope that's the case and look forward to working with you to ensure that it is. >> i yield back my time. >> senator collins. >> thank you, mr. president. dr. price, welcome. i too very much enjoyed our
discussion on a wide range of health care issues in my office. many of us have expressed concern about what would happen to the millions of americans who are in the individual market of the aca on the exchanges. but there has been remarkably little debate on what would happen if congress took no action with regard to the individual market. ould you give us your answer as far as what you would see happening to the individual market if we do nothing. >> i appreciate that. and i appreciate the opportunity to come visit you. we had a wonderful conversation about many, many different areas. the american people know this. they appreciate that the individual small group market where many of the millions as
the chairman pointed out gain their coverage is breaking in many, many ways. we're in a downward spiral on being able to provide individuals the opportunity -- any opportunity at all. so one third of the counties in this nation have just one insurance provider. there are five states that have only one insurance provider. the premiums are going up for folks, the deductibles. i get calls almost weekly from my former fellow physicians who tell me that their patients are making decisions about not getting the kind of care that they need because they can't afford the deductible. if you are an individual out there making 30, 40, 50,000 a year and your deductible is now 6,000 or 12,000 for a family -- which is not unusual on the exchange -- you may have an insurance card. it may have a wonderful name. but you don't have any care because you can't afford the deductible. so people are denying themselves the kind of care that they need and those are
the things that we ought to be addressing. again, i hope in a bipartisan way we'll be able to do that. >> thank you. i think that's very important to clarify. that in the individual market we're seeing double digit increases in premiums, higher deductibles, larger copays, and we're also seeing far fewer choices as more and more insurers gives up and flee the market. the coops have failed dramatically. all 23 of them are in financial trouble. only five are still operating. so for us to say that everything is going well with obamacare is just not accurate. and that's why i feel that we do need to fix the floods of what is a well-intentioned but deeply problematic law. i want to clarify another issue
on the aca. there's been much debate on whether we should repeal the law with no replacement. i think most people reject that idea. as you said, we don't want to pull the rug out from under people who are relying on the insurance that has been provided through the aca. another group has advocated repeal with a two or three year delay. i think that approach also doesn't work because it creates great anxiety for consumers and insurers would be unable to price their policies if they don't know what the rules are going to be. it's my understanding that your goal is to quickly pass a reform package that would provide access to affordable health insurance for all americans with more choices that we have now. is that accurate?
>> absolutely. it is vital. we often times don't talk about the 20 million folks that still don't have coverage. there are a lot of people that don't. if we're responsible policy makers and administrators of policy, it's incumbent upon us to step back and say why is that? what's going on for making that happen to the 20 million who don't have coverage inspite of the grand things that were done? i would suggest because of the structure makes it virtually impossible for many individuals to gain that kind of coverage. we on the other hand i believe it's important that we work together to put forward a system that actually allows again every single american to have the opportunity to purchase the kind of coverage that they think is best for themselves and their families. >> so your goal is actually to have more people covered by insurance. >> yes. >> i have been baffled over the years by what cms reimbursing for and what it fails to
reimburse for. senator jean shaheen and i finally scored a victory of tting cms to cover continues glucose monitors for individuals with diabetes that had been covered by the vast majority of private insurers. but when those individuals aged into medicare they lost that coverage, made no sense whatsoever. what i'm finding now is that cms frequently does not pay for services that helps to keep people well. there is a large practice in my state that has a nurse or a medical assistant call individuals with diabetes once a week and check on their blood sugar levels, their adherence to their diets and exercise regimes. and it's had really positive results. well, the irony is that if diabetes gets out of control
and those individuals end up having to have amputations or go blind, cms, medicare will pay for that but it won't pay for that phone call to check on the individual that's helping to control their diabetes and keep them well. will you pledge to take a look at those kinds of policies and reevaluate what we do pay for? >> absolutely. it's imperative that we are constantly looking and determining whether or not we're getting the outcomes that we want, and the processes are helping or obstructing those outcomes. >> finally, i want to touch on biomedical research, which is a passion of mine. i found it -- founded both the diabetes caucus in 1997 and i also am the founder of the always mer's task force in the senate. senator warper is the
cochair. alzheimer's' has become the most expensive disease. it costs $263 billion a year, 150 billion comes from medicare and medicaid. it's going to bankrupt those programs. it's devastating to families and the victims. diabetes consumes one out of three medicare dollars. if we invest in biomedical research, we have the possibility of not only improving lives for americans and curing or coming up with effective treatments for devastating diseases but also actually lowering health care costs. do you support the increases for nih that we have passed in the last year and are on track to pass this year as well? >> nih is a treasure for our
country and the kinds of things that we should be doing to find cures for those diseases. one of the core avenues to be able to make that happen is through nih and i supported the increase. >> thank you. that goes along with your principle of innovation. >> absolutely. >> thank you. >> >> we've been at this for about two hours. i'm going to suspend the operation for about five minutes and then we'll go to senator white house. just so we can take a little break. the committee is recessed for ive minutes. >> confirmation hearings ontinue today.