麻豆传媒

President-elect Donald Trump's nomination of cardiothoracic surgeon and former talk show host Mehmet Oz, MD, to serve as Centers for Medicare & Medicaid Services (CMS) administrator has divided policy experts, with some saying he is not qualified for the job while others assert that his medical degree and skill as a communicator will be advantageous.

"Not since the Wizard of Oz himself has there been a bigger fraud than this guy," said Brad Woodhouse, executive director of Protect Our Care, a Washington-based nonprofit focused on expanding access to quality healthcare, in a . "Dr. Oz is wholly and deeply unqualified to lead CMS, and his incompetence would put more than 140 million Americans who rely on Medicare and Medicaid at risk."

During his run for the Senate, Oz called the Affordable Care Act the "wrong system," Woodhouse noted, adding that Oz "exploited the public's trust in him as a doctor to push quack medical cures, such as fad diets and the use of hydroxychloroquine to treat COVID-19, in order to line his own pockets. He is a grifter and a threat to public health."

But Matt Salo, founder and CEO of Salo Health Strategies, took a different view, arguing that there aren't a lot of "set in stone" qualifications when it comes to leading CMS. "It's not so much, 'Can you lead an agency of 6,000 people?' It's 'What is the message ... that you've been tasked with carrying?'" said Salo, who formerly headed the National Association of Medicaid Directors.

"Being a spokesperson, being a messenger, is a very, very different skill set than being a manager," Salo said, making the case that Oz would be "quite good at grabbing the bully pulpit" and communicating the administration's priorities.

A Varied Career

Trump announced Oz's nomination on Tuesday. "America is facing a Healthcare Crisis, and there may be no Physician more qualified and capable than Dr. Oz to Make America Healthy Again," he wrote in a .

Oz has published New York Times bestsellers and hosted radio and TV shows including the "Dr. Oz Show." He graduated from the University of Pennsylvania School of Medicine. Although he continues to have an active medical license, Oz stopped performing surgeries in 2018, .

Oz previously served as and was vice-chairman and professor of surgery at Columbia University College of Physicians and Surgeons in New York City, according to ABC News.

Georges Benjamin, MD, executive director of the American Public Health Association (APHA), said in a phone interview that although there are concerns around Oz's "unscientific theories and health claims," as a physician, Oz "brings medical knowledge to the table." He added that Oz's master's degree in business administration from the Wharton School of the University of Pennsylvania is also an advantage.

Benjamin noted that past administrators -- appointed by both Republican and Democratic presidents -- typically have had either managerial experience in government or experience managing complex organizations. Oz has neither. "Is he somebody that, if he pulled up his sleeves, could do this job? I don't know for sure," he said.

A Senate confirmation hearing would be a good way to learn more about Oz's values as well as any possible conflicts of interest, but Trump has the process. Benjamin warned that allowing Trump to do so would be a mistake for the Senate. "They would absolutely regret doing that.... There are a lot of skeptical people out there" who want to know more about Oz's background, he said.

Medicare Advantage

Many of Oz's stated policy positions align with those of the public health community, including universal coverage, "red flag" laws, and universal background checks, as well as his interest in tackling climate change, Benjamin said. On the other hand, he added, his support for expanding Medicare Advantage is something that APHA will be watching.

"He's a really big proponent of the Medicare Advantage (MA) program," said Andrea Ducas, MPH, vice president of health policy at the left-leaning Center for American Progress in Washington. "At one point, he pitched the idea of having that essentially be the foundation for an actual insurance plan," she added, referring to Oz's proposed "" idea.

"My concern is that ... he'll push the gas pedal right on the slide toward MA, which is troubling for a number of reasons, but most especially because we know that that program is not delivering as intended," Ducas said.

Donald Berwick, MD, MPP, president emeritus at the Institute for Healthcare Improvement in Boston and a former CMS administrator, voiced similar reservations about Medicare Advantage, saying that plans are being "way overpaid" compared to traditional Medicare, have serious gaps in service, and often shift costs to patients. One from the Medicare Payment Advisory Commission (MedPAC) estimated that Medicare Advantage pays 22% more to cover enrollees compared with traditional Medicare enrollees.

"There are real concerns about what we pay Medicare Advantage plans," said Benjamin. But if Oz is confirmed as CMS administrator, Oz will be tasked with implementing the administration's agenda rather than his own, he said.

Managerial Experience an Issue

Berwick sees the primary goal of the job as protecting beneficiaries in the Medicaid and Medicare programs, and ensuring they get the care they need, while also attempting to reduce costs and waste. In particular, he hopes the next administrator will commit to ensuring adequate payment levels in Medicaid and

But Salo said the new CMS administrator might not call those shots. When it comes to changes to Medicare and Medicaid, "I don't know that either RFK [Jr.] or Oz has been appointed to carry on their own agendas on anything, whether that's [Medicaid] work requirements or privatization of Medicare," he said, referring to Robert F. Kennedy Jr., Trump's choice to run HHS. "You don't put people in charge of HHS or CMS, and then just say, 'Go do whatever you want to do.' They take their marching orders from much higher up."

Citing Oz's support for discredited treatments, including hydroxychloroquine for COVID, Berwick stressed the need for an administrator "dedicated to science." Berwick also underscored the enormity of the job, which he likened to being the CEO of a very large company, given the thousands of staff, 10,000 contractors, and "well over 100 million beneficiaries."

"I think you need a leader who's very skilled at management, and I don't know Dr. Oz's level of experience and interest in that part of the job," Berwick added.

Abortion Also in Play

Sen. Patty Murray (D-Wash.), chair of the Senate Appropriations Committee, expressed her disappointment with Oz's nomination . In addition to the "raft of alarming pseudoscience," she said Oz endorsed, Murray was "profoundly concerned" by Oz's "extreme abortion views given CMS's oversight of reproductive healthcare."

Mini Timmaraju, JD, president and CEO of Reproductive Freedom for All, an abortion-rights group, expressed similar concerns. "Mehmet Oz is an unqualified anti-abortion extremist who has no business leading one of the largest federal agencies overseeing Americans' healthcare," Timmaraju said in a . "Pennsylvania voters already rejected him and his bold-faced attacks on reproductive freedom -- and now Trump is giving him an opportunity to force them on all Americans."

Oz has also said that abortion during any stage of pregnancy is "," suggesting he favors "personhood" ideology, the press release noted.

Oz's nomination garnered support from at least two Republican physicians in the Senate.

"Glad to hear @DrOz has been nominated for CMS administrator," said Sen. Bill Cassidy, MD (R-La.), in a . "It has been over a decade since a physician has been at the helm of CMS, and I look forward to discussing his priorities. This is a great opportunity to help patients and implement conservative health reforms."

Sen. Rand Paul, MD (R-Ky.), also , stating, "His medical background as a cardiothoracic surgeon and public health advocate makes him an excellent fit for this position."

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