Caution advised re: Trump's 'healthcare quality' EO

Friday, June 28, 2019
Chris Woodward (

doctor writing prescriptionAn executive order this week from President Donald Trump aims to increase transparency on healthcare costs, but some organizations still see problems.

"We appreciate the president's focus on lowering medical costs, making prices transparent, and expanding how Health Savings Accounts [HSAs] can be used," says Twila Brase, president and co-founder of Citizens' Council for Health Freedom. "However, we are deeply concerned by the 'Health Quality Roadmap,' which will initiate a significant intrusion in the lives of half the American population – and which we believe will lead away from individualized, personalized medicine."

That "roadmap," she explains, "is a way to pull information from the exam room together and then use that information on patients and doctors to look for patterns of performance of medical procedures that are outside the recommended standards of care."

"In other words," Brase continues, "they want to pull all this information together on patients and doctors – and then they want to let outsiders look into all of this data and come up with what they think is a good-performing doctor and a bad-performing doctor when they're not even in there."

Read the Executive Order, issued on July 24, 2019:
Price and Quality Transparency in American Healthcare to Put Patients First

HHS Secretary Alex Azar is in favor of increased data collection and data dissection for both the quality initiative and for the value initiative. However, Brase says HHS doesn't want to pay doctors for anything other than what they say is "quality" and anything other than what they say is "value."

Brase, Twila (CCHF)"But they get to value those terms," she adds. "And this is just another way to ration care to the American patient by letting outsiders decide what is good care and what is unacceptable care or unnecessary care, and then make it difficult for doctors to even provide the care that they know the patient needs."

So what if anything does Brase do from here?

"… There's going to be a proposed regulation to create this 'Health Quality Roadmap' – and at that point, we are going to submit public comments opposed to the entire initiative," she answers. "It's possible that the proposed regulation will look differently than it appears in the executive order, however that is doubtful, and my guess is that we'll have to use the regulatory process to oppose it as well as we will tell the president that we oppose this initiative."

All things considered, Brase says patients depend on their doctors, and patients need to understand that doctors are being targeted.

"They're being controlled, and data is being used to control and target their doctors; and therefore lots of doctors are deciding to leave before they need to leave," she says. "This is a concern for patients because they're losing their doctors out of these initiatives to track doctors and control doctors, so it's something that patients should be aware of and it's something that we're trying to stop."


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