Donald Trump’s decision to appoint Robert F. Kennedy Jr. to lead the Health and Human Services Department is an alarming choice, given Kennedy’s fringe medical views and history of making misleading and often incorrect statements about health matters. Making things worse, the president-elect has opted to surround RFK Jr. with a series of conspiracy theorists and equally unqualified individuals.
Yet, one bit of news about Kennedy’s plans as HHS secretary is giving liberal wonks a glimmer of hope. Reports indicate Kennedy is considering an effort to overhaul Medicare’s payment formula. Right now, Medicare’s coding system favors surgeries and specialty care over primary care and prevention. Private insurers often base compensation levels off this formula, too.
As Dean Baker, senior economist at the Center for Economic and Policy Research, notes, “This is a big part of the story of why we pay our doctors so much more than doctors in other wealthy countries.”
Calley Means, a top adviser to Kennedy, recently posted on X that the Medicare payment codes “embed a system that waits for Americans to get sick and profits.” Kennedy’s Make America Healthy Again (MAHA) Super PAC, which wants to drive his agenda, says it intends to support “policies that promote preventative health care.”
The U.S. health care system is littered with policy quirks that jack up costs for patients and taxpayers, generate outsized profits for corporate interests or a select lucky few, and produce exceedingly poor health outcomes. There are many such scams that HHS, and the agencies it oversees, could target — if Republican policy hands don’t get their way, and if Trump’s health care regulators, including RFK Jr., aren’t distracted by pseudoscientific nonsense.
To this point, conservative think tanks and Trump allies have telegraphed plans to further enrich private health care interests.
In recent years, conservatives developed two competing policy agenda programs. One was the notorious Project 2025, led by the Heritage Foundation. The other was at the America First Policy Institute, a think tank helmed by top Trump allies like Linda McMahon and Brooke Rollins, both of whom have been tapped to serve in the president-elect’s Cabinet.
Both the Project 2025 and AFPI policy agendas propose totally privatizing Medicare, the government health insurance program for seniors and people with disabilities, and doing so rapidly. Project 2025 includes a plan to “make Medicare Advantage the default enrollment option” for newly eligible beneficiaries. AFPI says it would “allow Medicare to auto-enroll new beneficiaries in Medicare Advantage instead of traditional Medicare, with clear information on both options for all new enrollees.”
A majority of Americans eligible for Medicare are already on privatized Medicare Advantage plans — a shift that was sped up by Trump’s first administration — but the Project 2025 and AFPI agendas would spell a quick end to the traditional Medicare program, and its central premise: that seniors can go to any doctor or provider they choose.
Their proposals would be an incredible boon for private health insurers — which generate huge profits and growing portions of their revenues from the Medicare Advantage program — and further consolidate corporate control over America’s health care system.
Health insurers and their lobbyists are publicly expressing excitement about the incoming Trump administration. Following Trump’s win last month, the Better Medicare Alliance, an advocacy group for Medicare Advantage plans, said in a statement: “President-elect Donald Trump and Vice President-elect JD Vance understand that protecting Medicare is a top priority for seniors, including Medicare Advantage.”
And insurers are even more excited about Trump’s selection of TV doctor Mehmet Oz to lead the Centers for Medicare and Medicaid Services, an agency overseen by HHS. Oz previously proposed putting “every American who is not on Medicaid” on private Medicare Advantage plans — an idea he framed as “Medicare Advantage for All.” Oz has also pitched Medicare Advantage plans on his show, the Dr. Oz Show.
The Better Medicare Alliance said that Oz “recognizes the value of Medicare Advantage,” adding: “we look forward to working with Dr. Oz to protect and strengthen this vital program for seniors.”
Republicans are also pushing to end the Biden administration’s pilot program to have Medicare pay negotiated prices on some drugs for the first time. Project 2025 says the Biden administration’s “government price controls will limit access to medications and reduce patient access to new medication,” adding: “This ‘negotiation’ program should be repealed.”
A majority of House Republican lawmakers signed onto a budget plan this year that similarly pledges to repeal Democrats’ Medicare drug negotiation program, characterizing it as “socialist price controls that will limit access to life-saving drugs.”
Virtually all other countries negotiate drug prices. Congress’ decision to bar Medicare from negotiating drug prices two decades ago is a major reason why Americans pay far more for the same treatments than people in other wealthy countries, even though the U.S. government subsidizes research and development on virtually all drugs that are approved for sale.
When he first ran for president, Trump pledged to negotiate drug prices “like crazy,” but failed to follow through on it.
In September, after endorsing Trump, Kennedy specifically urged him to “level the playing field for Americans internationally on drug costs.”
“Today in Germany, Ozempic costs less than a tenth of what it does in the U.S. because while Berlin negotiates prices on behalf of all Germans, Washington can’t do the same,” Kennedy wrote in an op-ed. “Legislators should cap drug prices so that companies can’t charge Americans substantially more than Europeans pay.”
There, Kennedy recognizes a basic reality that most Republican politicians and policymakers deny.
On the other hand, he and several other incoming Trump health regulators have routinely spread junk science about pharmaceutical products. It’s easy to see Kennedy and co. wasting time and political capital waging battles that do not matter — or that could, alternatively, endanger the public.
Kennedy has wrongly claimed that vaccines could be linked to autism and suggested that antidepressants could be to blame for mass shootings. He called Covid-19 vaccines the “deadliest vaccine ever made,” and claimed they could be used to insert microchips into people to track them.
There’s no evidence for such claims. In truth, the Covid vaccines — which rely on government-financed technology, and benefited from support from Trump’s Operation Warp Speed — were an overwhelming success.
And yet, despite the U.S. government’s massive investments in Covid vaccines, America ultimately ended up paying far more for these products than other countries. The uninsured can pay over $200 for the jab.
This is the real pharma scam. It’s one the next government could end, if Trump and RFK Jr. want to.
Will they pick that important fight — or fake ones, instead?
Daniel D`Amico for SANREMO.FM
