Arriif asaf in ar crllpe ouatc m doue only 6 in the exchanges we hear so much about, for prevent that is where so much of the turmoil is. Is this the bill to reform medicare . Absolutely not. We would be focused on insurance. Are those accurate categories . To challenge we have to address immediately are those in the medicaid market as you identified. Ones it possible to work on of those areas at a time . Rather than in a comprehensive i said dont expect senator mcconnell to wield in a well barrow with a comprehensive health care plan. We dont believe in that. Failedt believe in a plan with our own failed plan. We want to work on it step by step. How you respond to that . I think thats fair. For individuals, people need to know we want to go from a Democrat Health care system to a republican Health Care System. An goal would be to go from american Health Care System that recognizes the needs of all. I know your plan wont he is in until after your confirmed the president elect and said lets do repeal and replace simultaneously. Mean any repeal of parts of obamacare wouldnt take effect until after some alternative were in place for americans. Is that accurate . Do you know what the sequencing might he as we move through this process . I think thats fair. Nobody wants to pull the rug out from under anybody. We believe its imperative people be able to keep health to greaterd move choices and opportunity. There has been a lot of talk about individuals losing health coverage. That is not our goal. Let me ask you how long it might take. Working on these three big areas. Is weve been working on this so long, we ought to be able to make our votes in the next few months be about what to do with the implementation will be going as some of it act to the states the department you hope to lead. That may take several years. Is there a difference in the votes we might take in a longer time for a limitation of all we decide to do . Dr. Price thats fair. Our Health Care System is continually evolving. We ought to be always looking at how its working, whether its working for patients, whether its working for the individuals who are providing care for people. When it isnt, its incumbent upon policymakers that we do the kinds of things to adjust that policy so it can work for patients. Alexander the Obamacare Exchanges are about 4 of all of us who have insurance. Commissioner says the market is collapsing. I am told by many people that we need to basically have a rescue plan or reform plan for the individual market in place by march 1. Insurance companies who make their decisions about the year 2018 can make those plans so people who have insurance can buy. Is the market collapsing . Is march 1 and important approximate date for a decision . Price we see things that are adverse to the patients. Something is going aptly wrong out there. Its imperative for us to recognize that and put in place the kind of solutions we believe to be most appropriate. Alexander it will include recommendations on how to do that . We look forward to working with congress to come forward with that plan. I also have a petition signed by 500,000 people from across the country opposing the nomination. Recent press reports about your investments in the australian Biotech Company raises some serious questions about your judgment. In a Company Stock developing new drugs on four separate occasions. The choice. Dr. Price that was a decision i made. Senator murray you were given an opportunity to buy at a lower price than was available to public. Marketce it was at the price. It was at a price available to individuals in a private placement offering. It was the same price everybody paid. He is an investor and a board member of the company. He was reportedly overheard he had made people millionaires from the stock tip area inform you made these purchases based on conversations with representative collins area is that correct . Price i learned of the company from congressman collins. That is what i remember you saying in my office. Conversation, did he tell you anything that could be considered a stock tip . Dr. Price i dont believe so. You bought those shares it that not a stock tip . Dr. Price he talked about the company. That it had some significant merit and promise. Senator murray let me go on your purchases. Several provisions we wereld impact them notified to prepare for a final vote of the bill. Do you believe is appropriate for a Senior Member of congress actively involved in policymaking in the Health Sector to invest in a drug company that could benefit from those actions . Dr. Price thats not what happened. Itsor murray i think inappropriate and we need answers to this weather you used your access to nonpublic information when you bought at prices that were unavailable to the public. Price i had no access to nonpublic information. Week, yourray last voted to begin ripping apart our Health Care System which would cause nearly 30 Million People to lose their coverage and raise Health Care Costs without telling the American People specifically what you plan to do instead. Andidentelect trump republicans will deliver a plan that prevents anyone from losing coverage and leaves no one were soft. Days ago, present like trump said he would have insurance for everybody. Do you share those goals . A. Price we need to have system in place of has patients at the center and allows for every single american to gain access. Share hisrray you goal of insurance for everybody . Dr. Price it is my stated goal. If it was signed into law, and you consider these commitments to ensure all of americans and leave nobody where soft be met . Price my role in congress was to always make sure they had the opportunity again accents to it they had the feasibility to do so. Thats whats different about the plan we put forward. Bill onlyrray your allows people with preexisting conditions to an kaine Health Insurance if they have continuous insurance for 18 months prior. Millions of americans lack insurance for short amounts of time. Insurance companies could deny for preexisting conditions. Dr. Price we would put in high risk tools that would allow gain access person to the coverage they want. We think every Single Person should have the financial feasibility to get the coverage they want. we disagree on the consequences of that. It did not have coverage up to age 26. They will work that. They were concluding that in their plans going forward. Your bill takes away current benefits which includes Substance Use disorder and a maternity coverage among others. That is correct. Dr. Price there are other things we would put in place to make sure they had the care and coverage they needed. Your bill repeals the lifetime that helps people who have high medical expenses like a person with cancer. Dr. Price its a larger question. We would put a construct in place that allow for any person to get access to what they want. Senator murray with these questions, i am concerned that your vision for a Health Care System is different than one i think millions of americans are counting on. Senator enzi thank you for being willing to serve and to go through this process. Nothing is barred and the ideas to get you to take questions on short notice in public that you wouldnt have done what you normally do. Have worked with you the last two years. I know how you operate. Focus of how comprehensively you think about particularly the medical things. Concerns is the rural areas. Wyoming is the most rural state in the nation. In the education hearing, i got to hear from mrs. Devos who remembered a conversation from a month for that i had on a rural problem which dealt with grizzly bears by the school and wyoming. That became a major topic around here. Recognizeserybody that needed concern. Thats the grade school craig thomas went to. When he was there, they didnt need that fence because he was tough. There are different kinds of goblins and different places. I have accounting thats the size of delaware that has 2500 people. It does have a hospital. When you have a rural county that big with that small the town, its difficult to keep a doctor. The hospital has to close. Thats not a likely story in most places. We to make sure that those things are covered. I appreciate getting to share those with you. To whylways curious as you left a successful practice and willing to come here and make a difference. I want to congratulate you on the difference you have made. Leave ayou willing to place with so much responsibility and background and capability to be willing to be the secretary of health and Human Services. Price when i think about the mission of the part of Human Department of health and Human Services, its what ive spent my life trying to do. To have the opportunity to confirmed, to serve as the secretary of health and Human Services and try to guide in an organization that will further fulfill that mission, i cant think of anything more fulfilling or exciting. Think you have the background for doing that. Going through a number of committee situations, what you are about to go through is intense and thats followed by probably the most productive part if senators read the answers. We get to do written questions as well. We hope you will provide a Rapid Response on. Those arent as much fun for the panelists. They are not in public. I will move to some questions that are more related. We begin seriously challenging tasks every story in these markets which are teetering on the brink. Some are collapsing. Some counties who cant get coverage. In wyoming there is only one provider. Its my understanding that the Incoming Administration may be able to make some key policy changes immediately. Include reducing the number of special enrollment upfrontd having verification. My understanding is from those in the Insurance Business its targeted. It made provide meaningful changes that could impact premiums for the next year. Are those some options you might consider. Price as they come forward in march and april, the premium levels will be for calendar year 2018. They need to hear from all of us a level of support and stability in the market. The kinds of things that make it so they are able to provide product to the patients out there. You mentioned there are counties in your state where there is only one provider. One third the counties in this country only have one insurance provider. Policymakers and people administering the programs, whats going on . Where are the problems out there . Insurers, it doesnt work for patients. If we keep the patients at the center of this, we will get to the right answer. Senator i got to work with senator kennedy on dialogics. For thehe requirements fda has issued guidance documents. They havent set policy. In 2017ncerned that yesterday we had a draft of the interchangeability policy. Thank you. Senator sanders senator sanders thanks for being here. Thanks for the conversation we had the other day. Congressman, on may 7,thsnhr ste tsur cs to social a our record is worse than any other country on earth. We have the highest rate of childhood poverty and half of our Senior Citizens have nothing set aside for retirement. I dont think we are particular compassionate. My question is in canada, do you , believe that we should move in that direction . Price if you want to talk about other Health Care Systems, there are consequences and i believe that every single american has access to the highest quality care and coverage possible. Toator sanders has access does not mean they are guaranteed health care. I have access to buying a home and do not have the money to do it. Dr. Price we believe it is appropriate to give people a system that gives them financial feasibility to purchase cover and not what the Government Forces them to buy. Senator sanders thats a longer story. Thank you very much. Hatch welcome to the committee. I have found you to always be knowledgeable and upfront. Very straightforward and honest, somebody who understands the Health Care System of the country. You are perfectly situated to turn this around. You hear a lot from the other side about how bad the system is. I dont think it is great. We have to work on it to get it done right. I would like to have you right there helping to get it done. You are one of the premier people in this congress and the world to understand what needs to be done and you recognize the problems of getting it done. Some colleagues have criticized you for your healthrelated Stock Holdings while serving in the house will stop house rules do not prohibit in the house. House rules do not prohibit members from owning stocks. There are members on the committee who have traded individual stocks while serving on this committee and this appears to be a hypocritical attack on your character. I resented. Resent it. You have always disclosed. Can you confirm you follow the law regarding trading stocks while serving as a member of congress. Dr. Price everything i do is above board and legal. As you know there is an , Organization Called the office of government ethics that looks at every cabinet nominee and all of the possessions and holdings, making a recommendation about what the cabinet member must do to have no conflicts of interest. They have looked at our holdings and given advice about what would need to be done in terms of divesting. There is no conflict of interest. We have read those agreements and sign them. That is online for everybody to see. Everybody is certain that there will be no conflict of interest. Dr. Hatch you followed the advice. The collapse of obamacare has exacerbated problems. We have seen european idealism strangle functional insurance design with cost revenue measures. I dont think we can lose sight of the Broader Health system. Disease patients do not have access to lifesaving treatments because policies that stem from obamacare prevent investments and innovative therapies that can care and save lives. This is an issue i am deeply passionate about. What steps do you believe will improve the pipeline for rare disease therapies to bring treatments and cures to people in desperate need of hope. Price it was revolutionizing the ability to treat Rare Diseases and it made the United States a leader in coming forward with treatments for Rare Diseases. I think that there are things that we can do, in terms of patent attention, liability, resources, to encourage the discovery of cure. Senator hatch we have some blockbuster judge came from that. We put some incentives and effect and there is an explosion. It is important. It was a republican bill. Dr. Price it was a Success Story for homeopathy in the country. Senator hatch one of the central duties of the hhs secretary is to be diligent and thoughtful, when considering federal regulation is necessary. Over the years, the Regulatory Infrastructure on Dietary Supplements has changed. Do you recognize the importance of Dietary Supplements for Healthy Lifestyles . Dr. Price absolutely. senator hatch will you work to ensure appropriate regulations on Dietary Supplements to protect Public Health while ensuring that people have access to Safe Products . Dr. Price this is important. You need to gain the information and gather the individuals who know the most about this area, whether it is consumers, those providing the product to the market, making sure this is done right. Senator hatch i have to commend to donald trump you. You are clearly a premier person in all of congress to understand these problems of health care and you have a professional background. I dont know that any other member of congress can match that. We have a real messy situation here. Obamacare has not really helped. Do you think it has . Dr. Price some of the things in the passage of the Affordable Care act has improved some things. The coverage has improved. The consequences include people have a coverage but not health care. There are so me things about the decisionmaking process who , decides our health care . Should it be the government or families and patients. Senator hatch i take it you believe that Getting Health Care closer to the people is better than everybody pontificating from washington. Dr. Price the more decisions, the higher care we will have. What do you think about this . Hatch i was a defense lawyer. I defended doctors and hospitals. What do you think we should do about medical liability . Dr. Price its not just the malpractice rates that doctors or hospitals pay. Its defense of medicine that physicians do that dont hurt anybody. There are test not needed to make a diagnosis. It shows up in their history so if they are called into a court they can say to the judge and jury. I did everything it. Everything is rarely necessary. If we look at it in that light and try to decrease defense of medicine to the benefit of patients, we can get to the right answer. There are some exciting ideas out there. Senator casey we are grateful you are here and thanks for the visit to our office. Highlight something we probably dont spend enough time on. The full protections of what was known as the original bill. We have had a lot of shorthand terminology since then. I know we have a basic disagreement. I think its important to be candid about that. What a lot of people have forgotten about is and the chairmen had a chart earlier that outlined the categories of americans who have Health Insurance. Orvirtue of various programs the number he had on the poster about the americans in the wasoyer sponsored category 178 Million People. That is a lot of people with coverage who have had coverage before the legislation and they didnt have protections. Know that people have they have purchased to the individua price pediatric cancer is one of those things that is remarkably challenging. I did a rotation on the orthopedic ward and so many of those children have had cancer and i would dread going because i was worried about the severity of these challenges. This was one of the most uplifting months i spent in medical school, because the children were so uplifting. We need to absolutely make certain that every child has access to the care they need and there are a number of ways to do that. I look forward to working with you to make that happen. Senator casey i heard the word yes there. It is hard to believe that we have to ask a question about this next topic, which is victims of Domestic Violence, but it was the state of the law before the passage of legislation that the victims of were considered americans with a preexisting condition. Question number two would you commit to maintaining the , protections that ensure that victims of Domestic Violence will not be discriminated against when they are purchasing Health Insurance . Dr. Price i think it is vital that the victims of Domestic Violence and others, anybody, we need a system in place for individuals to not get priced out of the market and for individuals who are not able to purchase coverage. Senator casey i dont want to get hung up about getting priced out of the market. I am asking for a guarantee that that circumstance will never be bar coverage, treatment, or care. Dr. Price it shouldnt be. That is an administrative role and its a policy decision that legislators. Dr. Senator casey i think we can agree on that. There is a protection that prohibits discrimination on the basis of Health Status or disability. Yes or no. Dr. Price i think its absolute imperative that we have a system in place that works for patients and anybody not raining access to the coverage they want or need is not a system that works for patients. Casey what im getting at is we had a state of the law before the aca where individuals like that, whether they had a preexisting condition, paying premiums for years and they say they have a preexisting condition as a child, women were discriminated against. It is a remarkable stain on america that we let this happen. My concern is not just a series of concerns. What you could do is areas of focus in replacement plans and it would be it is medicare, and i heard about three targets, the individual market, and the medicaid, and employersponsored coverage. I hope if there is a subject of those, we will ensure protections that are in place right now. Thats why am asking those questions. I will follow up more in writing. Duly noted. I appreciate your using your seven minutes to ask questions. Deferred toson has senator paul. Center paul i did some of my training it ready. I wish everybody could come to grady and see what its like to work in one of our Biggest Charity hospitals. We are often doing work that is incredible. Compoundounds, fractures. I remember being there as a student and an intern. Getalculated what we could minimum wage. I think its important that we get somebody with that kind of reasoning and Critical Skills in charge of our government. I think what i regret about this kind of hearing and what a lot of people in america regret is the that drawl and the rancor and the partisanship. We all want the same things. To question your motives is insulting. To question whether you are honest is insulting. Did youuestion of going to Public Service to enrich yourself . Dr. Price i have a passion for Public Service and a passion for people. Thats what guided our decision. Some might think it was a foolish decision for both of us. Center paul if you take a pay cut . Dr. Price i did not consider it. Senator paul i would guess it was a pay cut. I think we arent separated that much. I think we want the most amount of insurance at the least amount of cost. We want people to get access to health care. What are your motives . What should we do with health care . Do you want more people to be insured . Do we just agree on how we do it is not necessarily the motives . Time is shortnow for everybody, the principles that i think are imperative for health care is one is affordable for everybody, provides access to health care and coverage for everybody. Something thats of the highest quality and responsive to patients. One that incentivizes innovation. Its innovation that drives quality. Choices are preserved by patients. They should be choosing whos treating them. We have been accused of having no replacement ideas for how to fix the system. How many bills do you have that would regarded as replacement bills or ways to improve the Health Insurance system . Dr. Price i have one large term that,ince 2009 and beyond pieces of legislation. Beenr paul its insinuated that america does not have compassion. When you worked as an emergency room physician, did you always agree as part of your engagement that it was free to all comers went ahead and ability to pay. Dr. Price anybody that showed up in need of care was provided that care. That was true not only in a residency but are private practice as well. Paul those that say we have no compassion extol the socialism. Venezuela is a disaster were people cant eat. I think its important that we do have a debate with our country between socialism and communism and america and capitalism. One of the things its extraordinary about our country away 4004, we gave ilion dollars privately through churches and charities are in we are an incredibly compassionate society. Athink this was misplaced in number of this or that within health care. We do help each other. Not only do we help each other, i will bet you half of the physicians in my community have gone on International Trips and done charity work. That is lost when we say we are a heartless country. I would argue the opposite. The greatness of the compassion of our country, we give away more than the gross domestic country of most of these 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 insurance. We made it illegal to sell certain types of an expensive insurance. . Ould we ensure more people could be legalized sailed more types of insurance . Dr. Price choice is vital. If we have is a principal having patients have those, patients will select the kind of coverage that they want and the choices that should be available are a full array of opportunities. Paul do you think Health Savings accounts would help . Dr. Price they make a lot of sense for many individuals. We dont need to force anybody to do anything. They ought to have the choice to be able to select. Senator paul i am a big supporter of allowing individuals to join together in groups and by insurance. Do you think this has the possibility with the millions of people in the individual market. I was a small physician with four employees. Itone were to get sick, could be devastating to the economics of giving them employment. Join together in pools where instead of me buying insurance as for people, i can buy it in a group of 100,000 people. The law is preventing that. You had some bills for expanding that. Could you mention some of the health plans and how that might help somebody get insurance . Dr. Price they are entities that would allow individuals who are lined in some way to purchase Coverage Even though they dont Work Together in the same group. Health pools are one of the secrets to solving the Small Group Market conundrum we find ourselves in. Anybody could pool with anybody else for the purpose of purchasing healthcoverage. It is not a new idea. The model for it is the blue shield that existed decades ago, that allowed people to pool their resources together for Major Medical coverage and hospitalization. It makes a lot of sense. It allows insurance to work the way it is supposed to, which is just read the risk and anybodys adverse Health Status does not drive up the cost because the pool is large enough. Thank you, senator paul. Senator franken. I tell you how we get really big risk pool, medicare for everyone would be the biggest risk pool. Dr. Price, it was nice meeting you, the other day. I enjoyed our discussion about our great hair. Cause ofs the leading formidable debt in the United States . In theentable death United States . I will defer to you. It is smoking. That hits home. I lost my dad, he was a lucky strike smoker from world war ii. He prided himself on the fact that he never smoked a cigarette and itfilter, for years was an incredible tragedy. I lost my dad, too. Physician, you may know that smoking kills approximately , in000 americans each year total of 170 billion each year in health care cost. Between 1993 and 2012, you were a shareholder of tobacco, of a big tobacco company. Meaning you personally benefited from tobacco sales. Voted against landmark legislation in 2009 that gave the fda the authority to regulate tobacco. Carson price, you are a position which means you took a hippocratic oath, pledge to do no harm. Square reaping personal financial gain from the sales of and to give product that kills millions of americans every decade with also voting against measures to reduce the death toll inflicted by tobacco . It is an interesting question and a curious observation. No idea what stocks i held in the 90s or the 2000s or now. All of these decisions for us are through mutual funds and pension plans. Dont it, and i will not bet here. I would suspect that in your pension plan, that there are components of that that are that may have something to do with tobacco. I find it very hard to believe that you did not know that you had tobacco stocks. Thatd it hard to believe in the questions about your stock portfolio, you said you did not know things. Over the last four years, you traded more than 300,000 in healthrelated topics. Stocks, while at the same time, advocating legislation that would affect the performance of the stocks. We talked a little bit about the zimmer biomed. Your broker bought this on march, 2016. You introduced a bill, a week , you say you did not not did not know them, that you had this stock, it was to delay a federal rule that would have reduced the profitability of the companys joint to delay a rule that would hurt the company. Once you found out that your broker bought it, you kept the stock. You purchased this 50,000 to 100,000 worth of stock in a Biomedical Company that we talked about, little bit. The single largest purchase in the last three years in a private deal that was not made available to the public, and i find it absolutely amazing that you responded that he did not know you got a discounted price. That is amazing, because we discussed this. I believe that is the nature of a private placement offering. I paid executive the same price as everybody else, i disclosed it was a private offering that went to about 20 people, including your colleague, chris collins, his chief of staff and a permanent lobbyist and you reported 100,000 in profits on this purchase. 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 chairman of the budget committee, you have chief of staff, the sound like sweetheart job innd i think our this body and in congress and in government is to avoid the appearance of conflict and you have not done that. About your latest plan, empowering patients first act. Some of it is detailed in this article from the new england journal of medicine, to both carefully vulnerable versus cash for the powerful. Dhhs. S picked for the sick, theor poor, and the health of the public and much greater concern for the economic wellbeing of their physician caregivers. I would commend this to every member of this committee before making a vote, because what your it gives a tax credit to americans b Health Insuranceuying americans buying Health Insurance. It makes a difference if they are poor or to bill gates. It is an incredibly regressive system. And the want to expansion of medicaid. That has people in minnesota scared out of their minds. I heard a lot about obamacare being a disaster. That the costmit of health care in this country has grown, less than it did in the previous 10 years. At ito covered has also covered 20 million more people, but forget them, in 2008, i would go around the state of minnesota and in every the fw hall, in every cafe, i would see a Bulletin Board where it would have a spaghetti dinner for someone who had gone bankrupt because they had gone through their annual cap or their lifetime cap. I am frightened about what you are going to do, and so are millions of americans. I know that you do things that help physician groups. Wouldt in provisions that onvent these findings efficiency 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 this is not going to create access are all americans, what you talked about, the empowering patients first act. This is going to unravel something that has given a lot of americans hes of mind, knowing that the kids can stay on their health care until they are 26. Knowing that if they have a preexisting condition, that will not stop them from getting care. That is what this hearing should be about. R tpror yes