Public policy and health in the Trump era

Steffie Woolhandler; David U. Himmelstein; Sameer Ahmed; Zinzi Bailey; Mary T. Bassett; Michael Bird; Jacob Bor; David Bor; Olveen Carrasquillo; Merlin Chowkwanyun; Samuel L. Dickman; Samantha Fisher; Adam Gaffney; Sandro Galea; Richard N. Gottfried; Kevin Grumbach; Gordon Guyatt; Helena Hansen; Philip J. Landrigan; Michael Lighty; Martin McKee; Danny McCormick; Alecia McGregor; Reza Mirza; Juliana E. Morris; Joia S. Mukherjee; Marion Nestle; Linda Prine; Altaf Saadi; Davida Schiff; Martin Shapiro; Lello Tesema; Atheendar Venkataramani

doi:10.1016/S0140-6736(20)32545-9

Public policy and health in the Trump era

Steffie Woolhandler
, David U. Himmelstein
, Sameer Ahmed
, Zinzi Bailey
, Mary T. Bassett
, Michael Bird
, Jacob Bor
, David Bor
, Olveen Carrasquillo
, Merlin Chowkwanyun
, Samuel L. Dickman
, Samantha Fisher
, Adam Gaffney
, Sandro Galea
, Richard N. Gottfried
, Kevin Grumbach
, Gordon Guyatt
, Helena Hansen
, Philip J. Landrigan
, Michael Lighty

Martin McKee, Danny McCormick, Alecia McGregor, Reza Mirza, Juliana E. Morris, Joia S. Mukherjee, Marion Nestle, Linda Prine, Altaf Saadi, Davida Schiff, Martin Shapiro, Lello Tesema, Atheendar Venkataramani

Research output: Contribution to journal › Review article › peer-review

128 Scopus citations

Original language	English
Pages (from-to)	705-753
Number of pages	49
Journal	The Lancet
Volume	397
Issue number	10275
DOIs	https://doi.org/10.1016/S0140-6736(20)32545-9
State	Published - 20 Feb 2021

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10.1016/S0140-6736(20)32545-9

Cite this

Woolhandler, S., Himmelstein, D. U., Ahmed, S., Bailey, Z., Bassett, M. T., Bird, M., Bor, J., Bor, D., Carrasquillo, O., Chowkwanyun, M., Dickman, S. L., Fisher, S., Gaffney, A., Galea, S., Gottfried, R. N., Grumbach, K., Guyatt, G., Hansen, H., Landrigan, P. J., ... Venkataramani, A. (2021). Public policy and health in the Trump era. The Lancet, 397(10275), 705-753. https://doi.org/10.1016/S0140-6736(20)32545-9

@article{dcf2a4fbd0c849eea8b928cdeffa697e,

title = "Public policy and health in the Trump era",

author = "Steffie Woolhandler and Himmelstein, \{David U.\} and Sameer Ahmed and Zinzi Bailey and Bassett, \{Mary T.\} and Michael Bird and Jacob Bor and David Bor and Olveen Carrasquillo and Merlin Chowkwanyun and Dickman, \{Samuel L.\} and Samantha Fisher and Adam Gaffney and Sandro Galea and Gottfried, \{Richard N.\} and Kevin Grumbach and Gordon Guyatt and Helena Hansen and Landrigan, \{Philip J.\} and Michael Lighty and Martin McKee and Danny McCormick and Alecia McGregor and Reza Mirza and Morris, \{Juliana E.\} and Mukherjee, \{Joia S.\} and Marion Nestle and Linda Prine and Altaf Saadi and Davida Schiff and Martin Shapiro and Lello Tesema and Atheendar Venkataramani",

note = "Funding Information: KG is a member of the Board of Canopy Health, a limited Knox-Keene licensed health plan in California, serving as one of 3 University of California San Francisco board members for this health plan for which UCSF is a principal equity shareholder. KG is also a member of Physicians for a National Health Program, an organisation advocating for a single payer health plan in the USA. AG is a leader of Physicians for a National Health Program, a non-profit organisation that favours expanding insurance through a single payer programme, AG is not paid by this organisation but some travel has been reimbursed. AV reports grants from Robert Wood Johnson Foundation, grants from National Institutes of Health, grants from Center for Financial Security (University of Wisconsin), grants from Commonwealth of Kentucky, outside the submitted work. All other authors declare no competing interests. Funding Information: Trump's pro-corporate agenda was epitomised by his appointment of Alex Azar (a former Eli Lilly executive) to head the US Department of Health and Human Services, a signal to the pharmaceutical and other industries that their price gouging and anti-competitive behaviours would escape regulation. As discussed, President Trump's well-publicised promises to reduce drug prices yielded no results. Instead, he supported large corporations. For example, in 2018, the administration threatened sanctions against Ecuador for promoting breastfeeding, which might cut into the market of US manufacturers of infant formula. 334 Azar celebrated Gilead's donation of 2·4 million bottles of emtricitabine and tenofovir (Truvada) to prevent HIV transmission in 200 000 patients, which was met by scorn from activists who labelled Gilead's actions a publicity stunt aimed at slowing the market entry of a generic competitor and promoting the firm's new drug. 335 After preliminary data showed that remdesivir shortened COVID-19 hospitalisations, Trump made a deal with Gilead to secure 90\% of the world's supply of the drug for the USA in August and September, 2020. The deal will pay Gilead approximately US\$3100 per 5-day course of treatment, for a drug that costs approximately US\$10 to manufacture and the development of which was partly funded by government grants. 336 Similarly, the US Government has given US\$10 billion to firms (eg, Moderna, Sanofi, GlaxoSmithKline) developing COVID-19 vaccines, without placing restrictions on the prices they can charge. Funding Information: The Commission was supported by grants from the Doris Duke Charitable Foundation and the Open Society Foundations, which covered costs of some members' travel and lodging for Commission meetings, and some data purchases. Commissioners were not compensated for their participation. Additional support came from in-kind contributions by the Boston University School of Public Health and the Roosevelt House Public Policy Institute at Hunter College of the City University of New York, which hosted Commission meetings. Some staff members of the Open Society Foundations attended some in-person Commission meetings as observers but played no role in drafting the report or recommendations. Jaime R Torres and Antonio I Fernandez (both from Latinos for Healthcare Equity) provided general advice and data for the Puerto Rico panel. Prof Alfredo Morabia (Barry Commoner Center for Health and the Environment, Queens College City, University of New York, NY, USA) was the senior adviser to the Commission. Mark Almberg (an independent consultant) served as the Commission's fact checker and editorial adviser.",

year = "2021",

month = feb,

day = "20",

doi = "10.1016/S0140-6736(20)32545-9",

language = "English",

volume = "397",

pages = "705--753",

journal = "The Lancet",

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Woolhandler, S, Himmelstein, DU, Ahmed, S, Bailey, Z, Bassett, MT, Bird, M, Bor, J, Bor, D, Carrasquillo, O, Chowkwanyun, M, Dickman, SL, Fisher, S, Gaffney, A, Galea, S, Gottfried, RN, Grumbach, K, Guyatt, G, Hansen, H, Landrigan, PJ, Lighty, M, McKee, M, McCormick, D, McGregor, A, Mirza, R, Morris, JE, Mukherjee, JS, Nestle, M, Prine, L, Saadi, A, Schiff, D, Shapiro, M, Tesema, L & Venkataramani, A 2021, 'Public policy and health in the Trump era', The Lancet, vol. 397, no. 10275, pp. 705-753. https://doi.org/10.1016/S0140-6736(20)32545-9

TY - JOUR

T1 - Public policy and health in the Trump era

AU - Woolhandler, Steffie

AU - Himmelstein, David U.

AU - Ahmed, Sameer

AU - Bailey, Zinzi

AU - Bassett, Mary T.

AU - Bird, Michael

AU - Bor, Jacob

AU - Bor, David

AU - Carrasquillo, Olveen

AU - Chowkwanyun, Merlin

AU - Dickman, Samuel L.

AU - Fisher, Samantha

AU - Gaffney, Adam

AU - Galea, Sandro

AU - Gottfried, Richard N.

AU - Grumbach, Kevin

AU - Guyatt, Gordon

AU - Hansen, Helena

AU - Landrigan, Philip J.

AU - Lighty, Michael

AU - McKee, Martin

AU - McCormick, Danny

AU - McGregor, Alecia

AU - Mirza, Reza

AU - Morris, Juliana E.

AU - Mukherjee, Joia S.

AU - Nestle, Marion

AU - Prine, Linda

AU - Saadi, Altaf

AU - Schiff, Davida

AU - Shapiro, Martin

AU - Tesema, Lello

AU - Venkataramani, Atheendar

N1 - Funding Information: KG is a member of the Board of Canopy Health, a limited Knox-Keene licensed health plan in California, serving as one of 3 University of California San Francisco board members for this health plan for which UCSF is a principal equity shareholder. KG is also a member of Physicians for a National Health Program, an organisation advocating for a single payer health plan in the USA. AG is a leader of Physicians for a National Health Program, a non-profit organisation that favours expanding insurance through a single payer programme, AG is not paid by this organisation but some travel has been reimbursed. AV reports grants from Robert Wood Johnson Foundation, grants from National Institutes of Health, grants from Center for Financial Security (University of Wisconsin), grants from Commonwealth of Kentucky, outside the submitted work. All other authors declare no competing interests. Funding Information: Trump's pro-corporate agenda was epitomised by his appointment of Alex Azar (a former Eli Lilly executive) to head the US Department of Health and Human Services, a signal to the pharmaceutical and other industries that their price gouging and anti-competitive behaviours would escape regulation. As discussed, President Trump's well-publicised promises to reduce drug prices yielded no results. Instead, he supported large corporations. For example, in 2018, the administration threatened sanctions against Ecuador for promoting breastfeeding, which might cut into the market of US manufacturers of infant formula. 334 Azar celebrated Gilead's donation of 2·4 million bottles of emtricitabine and tenofovir (Truvada) to prevent HIV transmission in 200 000 patients, which was met by scorn from activists who labelled Gilead's actions a publicity stunt aimed at slowing the market entry of a generic competitor and promoting the firm's new drug. 335 After preliminary data showed that remdesivir shortened COVID-19 hospitalisations, Trump made a deal with Gilead to secure 90% of the world's supply of the drug for the USA in August and September, 2020. The deal will pay Gilead approximately US$3100 per 5-day course of treatment, for a drug that costs approximately US$10 to manufacture and the development of which was partly funded by government grants. 336 Similarly, the US Government has given US$10 billion to firms (eg, Moderna, Sanofi, GlaxoSmithKline) developing COVID-19 vaccines, without placing restrictions on the prices they can charge. Funding Information: The Commission was supported by grants from the Doris Duke Charitable Foundation and the Open Society Foundations, which covered costs of some members' travel and lodging for Commission meetings, and some data purchases. Commissioners were not compensated for their participation. Additional support came from in-kind contributions by the Boston University School of Public Health and the Roosevelt House Public Policy Institute at Hunter College of the City University of New York, which hosted Commission meetings. Some staff members of the Open Society Foundations attended some in-person Commission meetings as observers but played no role in drafting the report or recommendations. Jaime R Torres and Antonio I Fernandez (both from Latinos for Healthcare Equity) provided general advice and data for the Puerto Rico panel. Prof Alfredo Morabia (Barry Commoner Center for Health and the Environment, Queens College City, University of New York, NY, USA) was the senior adviser to the Commission. Mark Almberg (an independent consultant) served as the Commission's fact checker and editorial adviser.

PY - 2021/2/20

Y1 - 2021/2/20

UR - https://www.scopus.com/pages/publications/85100872258

U2 - 10.1016/S0140-6736(20)32545-9

DO - 10.1016/S0140-6736(20)32545-9

M3 - Review article

C2 - 33581802

AN - SCOPUS:85100872258

SN - 0140-6736

VL - 397

SP - 705

EP - 753

JO - The Lancet

JF - The Lancet

IS - 10275

ER -