RFK Jr. and Oz, the Political Dynamics of the Trump Healthcare Duo

While Robert F. Kennedy Jr. seems headed for a rough nomination fight because of his views on vaccines and his broad critique of U.S. healthcare, Mehmet Oz, M.D., is winning support because of his support of Medicare Advantage.

President-elect Donald Trump announced last Thursday, Nov. 14, that Kennedy, 70, was his pick to head the Department of Health and Human Services, passing over safer but less famous people such as former Louisiana governor Bobby Jindal and former surgeon general Jerome Adams.

Trump announced Tuesday that Mehmet Oz, M.D., 64, a cardiothoracic surgeon who became famous as the host of “The Dr. Oz Show,” was his pick for CMS administrator. CMS, which stands for the Centers for Medicare & Medicaid Services, is part the Department of Health and Human Services and, just as the name suggests, runs the Medicare and Medicaid programs.

Trump has not announced his picks for the other top healthcare jobs in the federal government: FDA commissioner, the National Institutes of Health director, the Centers for Disease Control and Prevention director and the Surgeon General.

Healthcare leaders, lobbyists, academics and journalists are now busy handicapping the chances of Kennedy and Oz being confirmed by the Senate, which the Republicans now control, 53-47. Senate confirmation requires only a simple majority.

This morning Johnathan Martin, Politico’s senior political columnist and politics bureau chief, published a column listing Republican senators who, for various reasons, might be willing to stand up to Trump and oppose at least some of his controversial cabinet picks. The list included Sens. Mitch McConnell of Kentucky, John Cornyn of Texas, Todd Young of Indiana, Susan Collins of Maine, Bill Cassidy of Louisiana, Thom Tillis of North Carolina, and Lisa Murkowski of Alaska. Before Matt Gaetz withdrew from consideration for the attorney general's position, some political observers thought Republicans might pick their battles and limit their opposition to Trump's to Gaetz. The political dynamics of Republicans senators pushing back on Trump's pick may have gotten more complicated.

Kennedy has resisted being labeled as anti-vaccine. But he has questioned both the safety and efficacy of many vaccines, and numerous public health officials and experts and healthcare leaders say Kennedy has stirred up groundless doubts vaccines that will lead to increases in infectious disease that vaccines prevent. Kennedy is chairman (currently on leave) of the Children’s Health Defense, which advocates against vaccine mandates and whose educational materials say sanitation, not vaccines, have led to a reduction in contagious diseases and that vaccines contain dangerous ingredients.

The Washington Post and other news organizations have reported that several Republican senators are enthusiastic backers of Kennedy. Others (Murkowski, for example) have been more reticent and have expressed concerns about his position on vaccines.

Kennedy has also talked a great deal about unhealthy food as a cause of the rising number of people in the U.S. chronic disease. He is critical of food additives, especially dyes (today’s Wall Street Journal has story about dyes used in the Fruit Loops and other breakfast cereals) and what he sees as the undue influence large food companies have on food regulators at the FDA. His beliefs about food may have broader appeal and are shared by some Democrats.

“I have heard him say a lot of things that are absolutely right,” Sen. Cory Booker, a New Jersey Democrat who follows a vegan diet, said in a hallway interview yesterday. When a reporter asked Booker about Kennedy’s views on vaccines, Booker said he was concerned about anyone who puts out information that would “undermine the safety of our children.”

Trump’s nomination of Oz as CMS administrator was in some ways more surprising than selecting Kennedy for the top job at HHS. Kennedy endorsed Trump said at his Madison Square Garden rally on Oct. 27 that he was going to let Kennedy “go wild” on health, food and medicine. Oz was on few if any lists of possible Trump healthcare nominees.

Oz, now in the spotlight, is drawing scrutiny. A New York Times story yesterday said Oz has “sown misinformation — about Covid treatments, weight loss hacks and unproven supplements" as well as promoting mainstream recommendations to eat healtheir foods.

“Dr. Oz is unfit to run CMS,” Lawrence O. Gostin, a Georgetown University law professor who specializes in global health issues, wrote on X. “He peddles conspiracy theories on vaccines & fake cures. He profits from fringe medical ideas. By nominating RFK Jr. & Mehmet Oz, Trump is giving his middle finger to science.”

But Oz may have an important ally in the health insurance industry and, more particularly, among insurers who sell Medicare Advantage plans, which all the major insurers do. The Better Medicare Alliance is a trade group for Medicare Advantage plans.

“Better Medicare Alliance congratulates Dr. Mehmet Oz on his selection to serve as the next administrator of the Centers for Medicare & Medicaid Services. Dr. Oz recognizes the value of Medicare Advantage and the high-quality, affordable, and comprehensive health care it provides to more than 34 million seniors and individuals with disabilities,” Mary Beth Donahue, president and CEO of the organization, said in a prepared statement Tuesday after the Oz’s selection was made public.

Oz spoke enthusiastically about Medicare Advantage on his “The Dr. Oz Show” television. In a clip from the show posted his on Youtube channel, Oz talks about the wellness, vision, dental, hearing and prescription benefits included in many Medicare Advantage plans.

“Believe it or not it is possible to get health insurance plans now with a zero dollar monthly premium. Millions of people are doing it and so could you,” Oz says during the clip.

In an opinion piece posted June 11, 2020, on the Forbes website, Oz and his co-author, George Halvorsen, former CEO of Kaiser Permanente, floated the idea of expanding Medicare Advantage program to all Americans who are not covered by Medicaid and funding it with 20% payroll tax on all workers that would be split 50-50 between employers and employees.

“More than 70% of the healthcare costs in America today come from chronic diseases, and standard Medicare providers make more money when their patients are in poor health,” wrote Oz and Halvorsen. “They even benefit when their piece-work-payment-model patients have health disasters or medical complications. In contrast, Medicare Advantage plans benefit financially when people have fewer heart attacks, lower levels of diabetic complications, fewer asthma attacks and lower levels of chronic diseases.”

The Medicare Advantage plans have been criticized, though, for being more expensive than traditional Medicare, and the Biden administration moved to trim payments to the plans over the heated objections of the insurer. Some patient advocates criticize the Medicare Advantage plans for luring enrollees in with zero premiums and generous benefits but then imposing limits and costs on enrollees when they use healthcare services.