If you believe that, in a country as big and messy as the United States, the government has a significant role to play in keeping people healthy and regulating medicine, there are plenty of reasons to be worried about Tom Price, President-elect Donald Trump’s choice for secretary of Health and Human Services.
On the one hand, since Trump explicitly ran on a promise to “repeal and replace Obamacare,” it’s not surprising that his pick for HHS would reflect this preference. Price, an orthopedic surgeon and U.S. congressman from Georgia, is indeed a hardened Obamacare foe. But this is just the tip of what is a hardline drown-government-in-a-bathtub philosophy: as the New York Times’ editorial board pointed out yesterday, Price, a supporter of plans to severely curtail Medicaid and Medicare and an ardent opponent of reproductive rights, seems “intent on systematically weakening, if not demolishing, the nation’s health care safety net.”
And the bright-red warning flags go beyond Price’s policy stances. The congressman also belongs to a truly radical medical organization known as the Association of American Physicians and Surgeons. And when you look into the specifics of what that group espouses it’s hard not to shudder a little bit extra hard.
Science Blogs managing editor David Gorski, himself a surgeon, summed up what he knows about the AAPS in a helpful blog post. The short version is that the organization stands at direct odds, in myriad ways, with some of very foundational beliefs of evidence-based modern public-health research. As Gorski explains, the organization takes what is basically an Ayn Rand–ian view of the medical world in which doctors are brilliant superheroes constantly undermined by government meddling in the forms of demands for evidence and accountability and things like that. Gorski describes the organization’s m.o. thusly: “The fetishization above all else of the individual doctor’s judgment and hostility to any restriction on physician autonomy, or, as I like to characterize it, anything that smacks of ‘telling doctors what to do.’”
The AAPS seems to filter the entire world through this reactionary prism, and that has taken it some, well, unhealthy places. Gorski excerpts a 2009 Mother Jones piece by Stephanie Mencimer laying out the organization’s positions:
[D]espite the lab coats and the official-sounding name, the docs of the AAPS are hardly part of mainstream medical society. Think Glenn Beck with an MD. The group (which did not return calls for comment for this story) has been around since 1943. Some of its former leaders were John Birchers, and its political philosophy comes straight out of Ayn Rand. Its general counsel is Andrew Schlafly, son of the legendary conservative activist Phyllis. The AAPS statement of principles declares that it is “evil” and “immoral” for physicians to participate in Medicare and Medicaid, and its journal is a repository for quackery. Its website features claims that tobacco taxes harm public health and electronic medical records are a form of “data control” like that employed by the East German secret police. An article on the AAPS website speculated that Barack Obama may have won the presidency by hypnotizing voters, especially cohorts known to be susceptible to “neurolinguistic programming”—that is, according to the writer, young people, educated people, and possibly Jews.
Setting aside the even more tinfoil-hatted stuff, the idea that it is “immoral” for doctors to participate in programs which pay for poor and/or elderly people’s health care is shockingly outside the bounds of mainstream public-health discourse; it’s the result of a hardened anti-government ideology. (Of course, if the organization were criticizing Medicaid on this or that grounds, that would be a different story.)
And it gets even worse, writes Gorski:
Perhaps [Price] was so attracted to the AAPS vision of doctors as special and “outside of the herd” to the point that he ignored its simultaneous promotion of dangerous medical quackery, such as antivaccine pseudoscience blaming vaccines for autism, including a view that is extreme even among antivaccine activists, namely that the “shaken baby syndrome” is a “misdiagnosis” for vaccine injury; its HIV/AIDS denialism; its blaming immigrants for crime and disease; its promotion of the pseudoscience claiming that abortion causes breast cancer using some of the most execrable “science” ever; its rejection of evidence-based guidelines as an unacceptable affront on the godlike autonomy of physicians; or the way the AAPS rejects even the concept of a scientific consensus about anything. Let’s just put it this way. The AAPS has featured publications by antivaccine mercury militia “scientists” Mark and David Geier. Even so, the very fact that Price was attracted enough to this organization and liked it enough to actually join it should raise a number of red flags. It certainly did with me, because I know the AAPS all too well.
How much of this stuff does Price himself belief? It’ll be a worthy topic of inquiry during his confirmation hearing. But either way, the AAPS isn’t the sort of group you join if you have any faith in government or belief that it can meaningfully help people; rather, it’s the sort of organization you join if you want to drag the world back to a time when individual patients were on their own, batted to and fro by indifferent markets, with effectively no recourse to fight against quackery, fraud, and other forms of medical malfeasance. If and when Price is handed the keys to HHS, things could get scary, fast.