The White House is planning an overhaul of healthcare regulations based on what it sees as the success of waiving restrictions during the coronavirus emergency, according to a senior adviser to President Trump.
In an interview with the Washington Examiner, acting Chairman of the Council of Economic Advisers Tomas Philipson said the waivers, from expanding telemedicine to helping accelerate vaccine development, enabled a more “nimble or faster” response to the unfolding pandemic.
“The president enabled a great set of deregulations to take place through the emergency declaration he made,” Philipson said. “The question is, how can we learn from that experience to basically deregulate healthcare more going forward.”
Trump declared a national emergency on March 13, paving the way for a temporary lifting of restrictions.
“We had some very old and obsolete rules that we had to live with,” he said. “We’re breaking them down now. And they’re very usable for certain instances, but not for this.”
Trump issued emergency authorization allowing doctors to operate across state lines, expanding remote doctor’s visits, and accelerating the Food and Drug Administration’s approval process for tests and therapies, for example.
Philipson, who specialized in healthcare economics before joining the White House, said the move revealed the extent of needless bureaucracy clogging the sector.
“The overall conclusion I have drawn from what we are doing is that COVID has essentially … exposed the excessive regulation of the healthcare sector we have, whether that’s on the FDA, CDC, or NIH or CMS side,” he said.
The FDA, in particular, was criticized as a bottleneck for tests. Its regulations were blamed for delaying the rollout of testing. Since then, it has streamlined the process so that in some cases, for example, laboratories can begin using newly developed tests before getting emergency approval if they have been internally validated.
Philipson said the next step was to study the response to learn how to reduce the 10 years and $2 billion it takes on average for a new drug to win approval. After all, he added, a terminal cancer patient would consider their need for treatment as just as urgent as someone struck down by a novel infectious disease.
“The lesson from this is really that when things go very quickly, look how valuable it is for patients,” he said.
“I think some discussion of this is going to come out of this crisis about how to eliminate some of the hurdles we have at some of the HHS agencies.”
Opponents accuse the administration of using a public health emergency to score an ideological victory in loosening protections for consumers, patients, and the environment.
Public Citizen’s Vice President of Legislative Affairs Lisa Gilbert said: “In this moment of crisis, things that look like across-the-board relaxation of health and safety protection, processes for testing, things that are rolled back in the name of business and speed make us nervous.”
At the same time, Trump’s conservative allies sense an opportunity. The Heritage Foundation released a report this week recommending a deregulation push to help revive the economy.
In particular, it called on the White House to review the healthcare waivers with a view to making them permanent.
It said: “The FDA should carefully reconsider the many establishment registration, device listing, and general operating procedure rules it has recently waived; the EPA should consider making permanent many recent expedited approval processes; and HHS should consider making permanent its changes in telemedicine and medical practices.”
Philipson said the administration was open about deregulation as a pillar of its economic policy but said the benefits would be popular with the public.
“It’s up to the analysis going forward, but I think many of the things we are doing in the healthcare space, the public is going to be sympathetic to because there’s going to be such an urgent need for these things to go quickly,” he said. “And there’s many regulations, both on the reimbursement side and on the approval side, for medical treatments that are slow in nature.”
