Follow the Money: Nominee for Secretary of Health and Human Services Traded Health Care Stocks and Owned Tobacco Stocks While in Congress

By Roy Poses, MD, Clinical Associate Professor of Medicine at Brown University, and the President of FIRM – the Foundation for Integrity and Responsibility in Medicine. Originally published at Health Care Renewal

At least the US president-elect seems to be making the problems of conflict of interests and health care corruption less anechoic.

Dr Price’s Stock Portfolio

The latest relevant big story was first picked up by Sheila Kaplan writing in Stat. It seems that Dr Tom Price, once a practicing orthopedic surgeon, then a Congressman, and now Mr Trump’s pick for Secretary of DHHS, owned and owns lots of health care related stocks:

his stock portfolio includes investments in pharmaceutical, medical device, and health insurance companies, the heart of the industries he would be overseeing as secretary.

In particular,

Among Price’s holdings are some in Innate Immunotherapeutics, Ltd., a biomedical company in which another lawmaker is a major shareholder. According to his financial disclosure statements, on Aug. 31 he bought between $50,001 and $100,000 worth of stock the firm.

Representative Chris Collins, a New York Republican, is a director of the company, which develops drugs to treat multiple sclerosis. He lists assets in the firm worth between $5,000,001 and $25 million. Price also purchased a smaller amount of stock in Innate Immunotherapeutics in 2015.

Collins is also a member of Trump’s transition team.

In March, Price invested between $1,001 and $15,000 in Amgen; Eli Lilly and Co.; Pfizer; Biogen; Bristol-Myers Squibb; Zimmer Biomet, a medical device company; Aetna; and Athenahealth. Also that month, Price sold the same amounts in Gilead, Abbott Laboratories, and Thermo Fisher Scientific.

So for readers of Health Care Renewal, this is very familiar. We have discussed ad infinitum the conflicts of interest that may affect physicians, particularly due to financial relationships with big health care corporations. The issue is that physicians swear oathes to put the health of their individual patients first, and to support the public health in general. Yet the interests of, for example, drug, biotechnology, device companies may be at odds with this primary mission. Such companies in this age of promoting “stock holder value” may primarily be about increasing revenue by selling as much of their products as they can, and let the Devil take the hindmost. Yet physicians ought to use drugs and devices judiciously, and only when their benefits for individual patients outweigh their harms. The concern is that physicians who have financial interests in such and other health care related companies may consciously or unconsciously allow their professional decisions to be influenced by their personal financial advantage.

Dr Price appears to be a member of the US House of Representatives full time, and no longer a practicing physician. But he has not relinquished his Georgia medical license (look here). So he should still be bound by his oath as a physician.

Dr Price’s Active Stock Trading

But wait, there’s more. Last week, the Wall Street Journal noted that Dr Price was not simply a long-term owner of stocks, he was an active trader.

President-elect Donald Trump’s pick to run the Health and Human Services Department traded more than $300,000 in shares of health-related companies over the past four years while sponsoring and advocating legislation that potentially could affect those companies’ stocks.

Rep. Tom Price, a Georgia Republican, bought and sold stock in about 40 health-care, pharmaceutical and biomedical companies since 2012, including a dozen in the current congressional session, according to a Wall Street Journal review of hundreds of pages of stock trades he filed with Congress.

In the same two-year period, he has sponsored nine and co-sponsored 35 health-related bills in the House.

His stock trades included Amgen Inc., Bristol Myers Squibb Co., Eli Lilly & Co., Pfizer Inc. and Aetna Inc.

This raises more issues. First, that Dr Price was actively trading these stocks suggests that his financial holdings might have been more salient to him than, say, a long-term investor who just buys stocks and puts them away in a retirement portfolio. This increases the likelihood that his stock holdings, and their recent performance, may well have influenced his decision making.

Moreover, this emphasizes that we should be concerned not so much about the effect of financial relationships on Dr Price’s clinical decisions – in fact, it appears that he is a full time Congressman, and hence is not practicing – but on his decision making as a national legislator with considerable influence on health policy and the public health. As a congressman, Dr Price also took an oath to “support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; that I take this obligation freely, without any mental reservation or purpose of evasion, and that I will well and faithfully discharge the duties of the office on which I am about to enter.” So the concern is that the immediate profitablity of his actively traded stock portfolio might influence how Dr Price legislates.

As the WSJ article noted,

Mr. Price, an orthopedic surgeon who chairs the House Budget Committee, has played an influential role in shaping health legislation. He sits on the Ways and Means Committee’s health panel, which oversees Medicare. He also is a member of the Republicans’ Congressional Health Care Caucus that has called for repeal of the Obama administration’s landmark health overhaul.

Beyond just the issue of conflict of interest is that of Dr Price’s apparent comfort with the ethical and sometimes criminal track records of the companies from whose stocks he appears to have profited. We on Health Care Renewal have been documenting the ethical misadventures, and sometimes crimes committed by large health care organizations which claim they operate for the good of patients and the public, but seem more to operate for the benefit of their insiders, particularly top management. Many of the companies held by Dr Price have lengthy lists of such bad behavior. See the links above to some individual companues for many more, sometimes sordid details.

If Dr Price, who is not only a physician but a legislator with significant influence on health policy, is unaware of these companies’ track records shame on him. If he owned these stocks with full knowledge of the companies’ track records, more shame on him.

Dr Price’s Tobacco Stocks

But wait, there’s more.

The WSJ article also noted:

Mr. Price also has traded in shares of … tobacco stocks, including Altria Group Inc., whose products are regulated under the Food and Drug Administration, a part of HHS.

An article in Wired implied that Dr Price’s tobacco holdings may have affected his legislative decision making. Price voted against

a law that now requires the FDA to regulate tobacco as a drug.

That now goes beyond just a relatively simple set of conflict of interest issues. At least drug, biotechnology, and device companies make products meant to benefit patients and the public’s health, if used properly and judiciously. For that matter, insurance companies, like Aetna, are supposed to help patients afford needed medical care.

But tobacco companies are different. Although they are legal in the US, there is overwhelming evidence that their products are harmful to health, and this harm is not outweighed by any health benefits, nor any benefits to society other than the money tobacco companies can make from them. Most doctors now would recommend their patients stop smoking and, if they are not smoking, never start to smoke. It is extremely hard to reconcile Dr Price’s professional status and his ownership of tobacco stocks.

A physician legislator with a powerful role in health policy owning tobacco stocks may appear to be abusing his entrusted power for private gain. That is the ethical definition of corruption used by Transparency International (although it is not a legal definition.) No wonder that in a commentary in New York Magazine on Dr Price’s stock holdings suggested that they mean in Dr Price’s eyes

The appearance of corruption is totally fine.

Conclusions

Mr Trump’s ongoing behavior does have some silver linings. It is making the public more aware of the dangers of conflicts of interest and corruption, not just in health policy or health care. And it is also making the public aware how we have to follow the money, all the money that flows around our new plutocrat-in-chief to be, and his rich and well connected cronies.

If we cannot restrain the increasing pile of conflicted and possibly corrupt political appointments, we will be in for much worse than the health care dysfunction Health Care Renewal has been lamenting for more than 10 years.

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

18 comments

  1. divadab

    It’s a very happy new year for systemic corruption – the rot at the top is disgraceful and there seems to be little will for change or even enforcement of existing rules.

    Of course the tribal division of society into opposing polities is also well advanced, to the extent that wrongs are only possible by the opposition, and our team epitomises only good.

    That these congresscritters are able to continue to trade in stocks of companies they are supposed to be regulating is unacceptable. I used to work for Ernst & Young (when it was Arthur Young, one of the big 7), and even the lowliest of audit staff was pretty much forbidden to trade or hold any stocks of AY clients or related companies. Just because of potential access to privileged confidential information. How is it that similar rules do not exist for our elected representatives, who not only have privileged information, but also power to make policy?

    The current situation is an invitation to corruption. A permission slip to trade on their positions’ access. It’s a breach of a fundamental rule of internal control – simply, do not put temptation in peoples’ way. But I suppose why not when the Democratic party’s presidential candidate used a family charitable foundation to accept massive funding from foreign powers WHILE SHE WAS SECRETARY OF STATE.

  2. Dave

    Trump is an environmental disaster.
    Trump is corrupt.
    I still support Trump over Hillary Clinton.

    At a certain point, voting for a president becomes outright survival versus moral philosophy.
    There is no environment left after a nuclear war. Your health doesn’t matter.

    If Price is getting rich off the voluntary stupidity of white trash, so be it.

    1. Spring Texan

      That’s a nasty and hateful remark about “white trash” — it’s too late to edit your post, but that’s really out of line.

  3. Dave

    Trump is an environmental disaster.
    Trump is corrupt.
    I still support Trump over Hillary Clinton.

    At a certain point, voting for a president becomes outright survival versus moral philosophy.
    There is no environment left after a Neoclear war. Your health doesn’t matter.

    If Price is getting rich off the voluntary stupidity of white trash, so be it.

    1. Dave

      Apologies for the double post.
      The comment software has changed since yesterday.
      I’m not a techie and can’t describe the difference accurately.

      1. ChiGal in Carolina

        You might also apologize for your use of the white trash meme which has been thoroughly discredited by numerous links on this blog.

        What a way to start the New Year! Let’s throw out the old…

        1. Dave

          OK, OK< I heartily apologize, lots of trashy black, brown and yellow people self destruct as well.

          Maybe self destruction is less infuriating when you see it in other cultures and races than your own.

          1. i wonder why

            so, it’s ok for Dave to talk about “trashy” people; but, it’s not
            ok to call him on that. Pretty strange.

            1. Outis Philalithopoulos

              (1) People have been calling him on it. See the above comment by ChiGal.

              (2) Calling for other commenters to be banned is generally not okay.

          2. Spring Texan

            nah, it’s not ok to talk about “trashy black, brown and yellow people” either.

            Yucch.

          1. Dave

            OK, people that voluntarily commit cigarette suicide, of any color, are noble beings who have been deluded into thinking that their lungs are a place for Mr. Market to have free reign. It’s not their fault, nor should they be censored for their choices, nor belittled in any manner. Happy?

  4. Pespi

    Not to get too off topic, but were Bush’s cabinet members as hilarious corrupt as Trump’s? I was too young at the time to have any memory.

    1. Jim Young

      Not quite as easily recognized at the time.

      It took me a month or two to think I’d want to impeach Bush (after voting for him) over letting ENRON rape our economy, then eventually investors and even their own pension funds. The thought of Cheney made me hesitate but I was ready to risk even Cheney taking over by August.

      Friends who voted for Trump are already regretting voting for him, perhaps because of his driving more people away after being declared the Electoral College winner, instead of really working to unite people. From what I can tell, they only recognize a few of the most atrocious appointees, as bad enough to make them regret their vote.

      At least they do regret their votes much earlier than I did in 2000, and I think they, and very many more, will feel far more regret when they see how far off the appointees, economic policies that personally affect them (and deliberate anti-science and intelligence monitoring rejection) are from what they thought they voted for.

    2. Benedict@Large

      One high note in all of this is that Trump is actually doing us a service by exposing beforehand (via the Senate’s consent inquiry) the corruption of his staff members. Of course this will depend on how aggressive the Democrats will actually be in questioning the nominees.

  5. Jazz Paw

    Given that, to my knowledge, doctors are not usually very good investors, it would be interesting to find out whether Dr. Price made or lost money on his stock trades or whether he outperformed the S&P 500 index.

    In particular, health care stocks have badly underperformed the market in the last 12-18 months, so for him to have profited he should have sold his holdings a while ago or shorted same.

    What little I know about him suggests he thinks of himself as a smart “player”, which makes me think he is like most gamblers: he thinks he’s about even on his bets.

    1. Benedict@Large

      What we are referring to here is Dr. Price’s investments in stock that he made based on insider information that he would have obtained directly as the result of his duties as a member of Congress. While he may (or may not) be a lousy investor otherwise, he would almost certainly have made money on these investments, and probably a lot of it.

  6. DarkMatters

    Same old, same old. back in 2008-9, I stopped wondering what Obama was going to do when he appointed Geithner, Rubin and Summers as financial advisers, and Rahm Emmanuel for chief of staff. Corruption for some reason is easier to discuss when it comes from Republicans, while Democrats are given more of a pass.

    The only good news is that they’ll have to build a new cabal in the Executive branch, and this might hopefully take some time before it reaches peak efficiency.

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