Health Scare-Trump Cabinet Nominations Round II

The Trump Administration has fired all diplomats and staff associated with the Obama Administration, many of them career employees of the government, without securing replacements. Among other things, this means the nation’s nuclear arsenal, which comes under the Department of Energy and is currently overseen by a nuclear physicist, who has also been given his walking papers, will be administered by former Texas governor and Dancing with the Stars contestant, Rick Perry, who has not yet been confirmed. As promised, here is Round II of the Trump nominations to run important government agencies, their views, and what it might entail for you.

What’s at Stake	Nominee	Perspectives	Analysis
The Food and Drug Administration (FDA) oversees food and drug safety for the nation. This is one of the most powerful non-cabinet level positions. This agency conducts surveillance on food safety and oversees the standards by which new drugs, including biologicals are approved for sale in the U.S. It also reviews over the counter medications, cosmetics, and natural food products like vitamins. The agency enforces strict labeling, as well as contamination prevention standards. It also determines which food can be imported into the U.S.	James O’Neill is under consideration for Commissioner of the FDA. The other individual under consideration is a venture capitalist who own a genetic testing company, Balaji S. Srinivasan. The third person under consideration is an actual MD, Scott Gottlieb, and he served as deputy commissioner for the FDA from 2005-2007.	Here is a direct quote from Mr. James O’Neill, “We should reform FDA so there is approving drugs after their sponsors have demonstrated safety-and let people start using them, at their own risk, but not much risk of safety,” unquote.[1] Regarding Balaji, just the fact he is a venture capitalist in the healthcare industry should be scary enough, because excessive profiteering in U.S. healthcare is a bigger problem than the insurance question. Dr. Gottlieb is a member of the conservative American Enterprise Institute and is at least, experienced and qualified for the job.	O’Neill will kill people if he allows the pharmaceutical industry, which uses unethical direct to consumer advertising, coercion throughout the medical system, and heavy lobbying to get what it wants, police itself. Case in point, during the Bush Administration Pharma was successful in preventing Medicare from being able to negotiate the price of drugs for their programs when Part D was added. How has that worked out for you? Dr. David Kessler, who served as FDA Commissioner under Bush and Clinton has this to say, “This will set back the competitiveness of the American pharmaceutical industry, which has been the envy of the world, by 50 years.”[2]
The Department of Commerce is the federal government agency which oversees the collection of economic, financial, and trade data across the land, which is used for policy making. Additionally, the U.S. Census Bureau is also part of this agency and a new national census is due shortly, since the last full census was in 2010.	The nominee for Secretary of Commerce is Wilbur Ross, a former banker who is now a billionaire through acquiring businesses and restructuring them.	Mr. Ross is a former Democrat, with an Ivy league education, at Harvard and Yale. He is 79 years old, which makes the number two appointee for this role very critical. Ross will want to influence trade deals, but there may be conflicts of interest given his far-flung business interests. His current wife, Betsy McCaughey has also been named an economic advisor.	He is certainly competent to run the Commerce Agency, because of his banking and business experience. Ross was a latecomer to the Trump camp, as he was a supporter of Senator Marco Rubio in the primary election. Ross replaces another billionaire, who was appointed by Obama.
The U.S. Trade Representative negotiates international trade agreements, which are crucial to the economy.	Robert Lighthizer is the nominee for U.S. Trade Representative. If he pursues Trump’s agenda, his job would include renegotiating NAFTA and the Trans Pacific Trade Agreements.	Lighthizer is an attorney, which is a requirement for this job, He has a history of representing steel workers in trade litigation disputes. A big concern was the Chinese “price dumping” of steel to drive American producers out of business.	Several unions are interested in renegotiating trade agreements if it means saving American jobs, which could coincide with Trump’s agenda.
The Small Business Administration (SBA) works to promote business and provide financial assistance for small business development. The SBA has a 124 billion loan portfolio.	Linda McMahon, wife of the impresario of World Wrestling Entertainment and a billionaire, is the nominee to run the SBA. She had an unsuccessful run for the senate in Connecticut. She was the CEO of WWE, which made a mint in pay-for-TV.	McMahon had been a supporter of Governor Chris Christie’s presidential run. She knows how to run a business and grow it.	It is difficult to see how a billionaire from the entertainment industry will give much of a boost for small businesses, but heh, this is a political appointment. Thanks for your checks Linda.
The Office of Management and Budget (OMB) oversees the financial reporting for the federal government.	Mike Mulvaney is the nominee to head the OMB. He is a founding member of the ultra-conservative, House Freedom Caucus and is responsible for getting rid of Speaker of the House, John Boehner.	Mulvaney will be looking for ways to cut taxes and reform the tax code.  He came to office in 2010 with the Tea Party Movement. He demanded a dollar-for-dollar spending cut proposal to authorize the Hurricane Sandy Disaster Relief funding.	Mulvaney once favored shutting down the government versus voting for a spending bill. He will be the one putting the brakes on infrastructure spending and torpedoing the Affordable Care Act.
The Department of Homeland Security (DHS) was started after 9/11 and secures the nation’s borders, airport security, and cyber security infrastructure. The agency is also responsible for enforcement of immigration laws.	Thomas P. Bossert has been appointed as head of the Department of Homeland Security. He comes from the private sector and was formerly a security advisor under George Bush.	Bossert is a beltway insider, with previous national security experience. He is a senior fellow at the Atlantic Counsel, working on the Cyber Statecraft Initiative. (Donald Trump's Cabinet Is Taking Shape: Here's The Latest List, 2017)	Since one of Trump’s platforms was to build a wall between Mexico and the U.S. this will come under the purview of the DHS and you can expect huge cost overruns. Trump also wants to vet immigrants based on religion and has threatened to send back millions of residents.
Special Adviser to the President-which can mean just about anything you can imagine.	Jared Kushner, Donald Trump’s son-in-law and himself a real estate magnate also with daddy’s money has already been appointed to this newly created role.	Kushner was responsible for jettisoning Chris Christy from the cabinet and holds sway with Trump. U.S.policy on Israel and the West Bank will be influenced by him.	The appointment of any family member is considered in violation of the anti-nepotism laws, which have prevented Congressman even from having their children work as interns. But why should this be any different, Trump didn’t disclose his income tax return, hasn’t set up a blind trust, and has gleefully exclaimed he is exempt from prosecution as president. (Nixon thought so too.)
The Director of Trade and Industrial Policy is a new office under president elect Trump.	Peter Navarro has been appointed to this role. He is a professor of economics and public policy at the University of California, Irvine.	He has been highly critical of China’s trade policies and we can expect some action here. Navarro is the author of  "Death by China".	I think we can expect the Trans Pacific Trade Agreement to go away. The problem is, China will absorb the vacuum left by the U.S. extraction. It remains to be seen how a professor will fare with the sharks and oligarchs in Trump’s cabinet.
The Department of Veterans Affairs oversees the administration of veteran’s healthcare and other veteran’s benefits.	David Shulkin is the nominee for Secretary of Veterans Affairs. He is a physician and was an Obama appointee to Veterans Health in 2015. He has experience running large healthcare entities, like the University of Pennsylvania and Beth Israel Medical Center in New York.	He was responsible for cutting the time veterans had to wait for treatment and restoring credibility to the agency.	He rejects privatization of the Veterans Administration as it would add billions to the cost of providing care. Good call and good health care, both provided at the capable hands of Dr. Shulkin.
The Department of Labor is responsible for enforcing the nation’s labor laws, including collective bargaining, and enforcement of ERISA, PPACA, COBRA, FMLA, and other health & welfare laws. The agency oversees workplace safety and administration of unemployment benefits. This agency also makes legislative recommendations.	Andrew Puzder is the nominee for Secretary of Labor and he is the Chief Executive of the Hardee’s and Carl’s Junior chains. He obtained his JD from Washington University School of Law in St. Louis.	It is rumored that Puzder is most like Trump in personality. I wonder if that includes crotch-grabbing. He is also anti-union. Unlike Trump, he has only been married twice. As Secretary of Labor he could determine which businesses are inspected, audited, or fined.	He is adamantly opposed to minimum wage laws, overtime requirements, and of course, the mandate to provide medical insurance to his workers. His goal is to deliver the least expensive, but profitable unhealthy food to the public, so that we as taxpayers can foot the bill for the diabetic epidemic. Don’t expect Puzder to look out for your job security.

Though not a government agency, this week, Trump created a presidential task force to evaluate the safety of vaccinations, with only one caveat, there were no scientists or doctors included to lead the review. The effectiveness of vaccinations has been proven through many Cochrane published gold-standard studies, by actual scientists. I guess this is the loose style that Trump will deploy in administering our government resources, which has scary implications for national health.

If anyone wishes to harm the U.S.A., the transition chaos created by the Trump Administration certainly makes the nation vulnerable on many fronts. Though America loves to criticize the educated, one would think that even the less enlightened would still be concerned about the safety of their energy supply, their medications, and their food supply.

And this is the healthpolicymaven signing off, wishing you fully informed consent in all our decisions.

The healthpolicymaven is a trademark of Roberta E. Winter and Praevalere Inc. Feel free to share this article with anyone whom you feel may benefit. She is the author of a guidebook to the U.S. healthcare system, which was published in 2013.

https://www.amazon.com/Unraveling-U-S-Health-Care-Personal/dp/1442222972

References

Donald Trump's Cabinet Is Taking Shape: Here's The Latest List. (2017, January 14). The New York Times. Retrieved from http://www.nytimes.com/interactive/2016/us/politics/donald-trump-administration.html

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[1] Trump Weighs Nontraditional Pick for FDA, Thomas M. Burton, Wall Street Journal, Saturday January 14, 2017

[2] Trump Weighs Nontraditional Pick for FDA, Thomas M. Burton, Wall Street Journal, Saturday January 14, 2017