TV’s Dr. Oz invested in businesses regulated by agency Trump wants him to lead

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Darius Tahir | (TNS) KFF Health News

President-elect Donald Trump’s choice to run the sprawling government agency that administers Medicare, Medicaid, and the Affordable Care Act marketplace — celebrity doctor Mehmet Oz — recently held broad investments in health care, tech, and food companies that would pose significant conflicts of interest.

Oz’s holdings, some shared with family, included a stake in UnitedHealth Group worth as much as $600,000, as well as shares of pharmaceutical firms and tech companies with business in the health care sector, such as Amazon. Collectively, Oz’s investments total tens of millions of dollars, according to financial disclosures he filed during his failed 2022 run for a Pennsylvania U.S. Senate seat.

Trump said Tuesday he would nominate Oz as administrator of the Centers for Medicare & Medicaid Services. The agency’s scope is huge: CMS oversees coverage for more than 160 million Americans, nearly half the population. Medicare alone accounts for approximately $1 trillion in annual spending, with over 67 million enrollees.

UnitedHealth Group is one of the largest health care companies in the nation and arguably the most important business partner of CMS, through which it is the leading provider of commercial health plans available to Medicare beneficiaries.

UnitedHealth also offers managed-care plans under Medicaid, the joint state-federal program for low-income people, and sells plans on government-run marketplaces set up via the Affordable Care Act. Oz also had smaller stakes in CVS Health, which now includes the insurer Aetna, and in the insurer Cigna.

It’s not clear if Oz, a heart surgeon by training, still holds investments in health care companies, or if he would divest his shares or otherwise seek to mitigate conflicts of interest should he be confirmed by the Senate. Reached by phone on Wednesday, he said he was in a Zoom meeting and declined to comment. An assistant did not reply to an email message with detailed questions.

“It’s obvious that over the years he’s cultivated an interest in the pharmaceutical industry and the insurance industry,” said Peter Lurie, president of the Center for Science in the Public Interest, a watchdog group. “That raises a question of whether he can be trusted to act on behalf of the American people.” (The publisher of KFF Health News, David Rousseau, is on the CSPI board.)

Oz used his TikTok page on multiple occasions in November to praise Trump and Robert F. Kennedy Jr., including their efforts to take on the “illness-industrial complex,” and he slammed “so-called experts like the big medical societies” for dishing out what he called bad nutritional advice. Oz’s positions on health policy have been chameleonic; in 2010, he cut an ad urging Californians to sign up for insurance under President Barack Obama’s Affordable Care Act, telling viewers they had a “historic opportunity.”

Oz’s 2022 financial disclosures show that the television star invested a substantial part of his wealth in health care and food firms. Were he confirmed to run CMS, his job would involve interacting with giants of the industry that have contributed to his wealth.

Given the breadth of his investments, it would be difficult for Oz to recuse himself from matters affecting his assets, if he still holds them. “He could spend his time in a rocking chair” if that happened, Lurie said.

In the past, nominees for government positions with similar potential conflicts of interest have chosen to sell the assets or otherwise divest themselves. For instance, Treasury Secretary Janet Yellen and Attorney General Merrick Garland agreed to divest their holdings in relevant, publicly traded companies when they joined the Biden administration.

Trump, however, declined in his first term to relinquish control of his own companies and other assets while in office, and he isn’t expected to do so in his second term. He has not publicly indicated concern about his subordinates’ financial holdings.

CMS’ main job is to administer Medicare. About half of new enrollees now choose Medicare Advantage, in which commercial insurers provide their health coverage, instead of the traditional, government-run program, according to an analysis from KFF, a health information nonprofit that includes KFF Health News.

Proponents of Medicare Advantage say the private plans offer more compelling services than the government and better manage the costs of care. Critics note that Medicare Advantage plans have a long history of costing taxpayers more than the traditional program.

UnitedHealth, CVS, and Cigna are all substantial players in the Medicare Advantage market. It’s not always a good relationship with the government. The Department of Justice filed a 2017 complaint against UnitedHealth alleging the company used false information to inflate charges to the government. The case is ongoing.

Oz is an enthusiastic proponent of Medicare Advantage. In 2020, he proposed offering Medicare Advantage to all; during his Senate run, he offered a more general pledge to expand those plans. After Trump announced Oz’s nomination for CMS, Jeffrey Singer, a senior fellow at the libertarian-leaning Cato Institute, said he was “uncertain about Dr. Oz’s familiarity with health care financing and economics.”

Singer said Oz’s Medicare Advantage proposal could require large new taxes — perhaps a 20% payroll tax — to implement.

Oz has gotten a mixed reception from elsewhere in Washington. Pennsylvania Sen. John Fetterman, the Democrat who defeated Oz in 2022, signaled he’d potentially support his appointment to CMS. “If Dr. Oz is about protecting and preserving Medicare and Medicaid, I’m voting for the dude,” he said on the social platform X.

Oz’s investments in companies doing business with the federal government don’t end with big insurers. He and his family also hold hospital stocks, according to his 2022 disclosure, as well as a stake in Amazon worth as much as nearly $2.4 million. (Candidates for federal office are required to disclose a broad range of values for their holdings, not a specific figure.)

Amazon operates an internet pharmacy, and the company announced in June that its subscription service is available to Medicare enrollees. It also owns a primary care service, One Medical, that accepts Medicare and “select” Medicare Advantage plans.

Oz was also directly invested in several large pharmaceutical companies and, through investments in venture capital funds, indirectly invested in other biotech and vaccine firms. Big Pharma has been a frequent target of criticism and sometimes conspiracy theories from Trump and his allies. Kennedy, whom Trump has said he’ll nominate to be Health and Human Services secretary, is a longtime anti-vaccine activist.

During the Biden administration, Congress gave Medicare authority to negotiate with drug companies over their prices. CMS initially selected 10 drugs. Those drugs collectively accounted for $50.5 billion in spending between June 1, 2022, and May 31, 2023, under Medicare’s Part D prescription drug benefit.

At least four of those 10 medications are manufactured by companies in which Oz held stock, worth as much as about $50,000.

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Oz may gain or lose financially from other Trump administration proposals.

For example, as of 2022, Oz held investments worth as much as $6 million in fertility treatment providers. To counter fears that politicians who oppose abortion would ban in vitro fertilization, Trump floated during his campaign making in vitro fertilization treatment free. It’s unclear whether the government would pay for the services.

In his TikTok videos from earlier in November, Oz echoed attacks on the food industry by Kennedy and other figures in his “Make America Healthy Again” movement. They blame processed foods and underregulation of the industry for the poor health of many Americans, concerns shared by many Democrats and more mainstream experts.

But in 2022, Oz owned stakes worth as much as $80,000 in Domino’s Pizza, Pepsi, and US Foods, as well as more substantial investments in other parts of the food chain, including cattle; Oz reported investments worth as much as $5.5 million in a farm and livestock, as well as a stake in a dairy-free milk startup. He was also indirectly invested in the restaurant chain Epic Burger.

One of his largest investments was in the Pennsylvania-based convenience store chain Wawa, which sells fast food and all manner of ultra-processed snacks. Oz and his wife reported a stake in the company, beloved by many Pennsylvanians, worth as much as $30 million.

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

The rising price of paying the national debt is a risk for Trump’s promises on growth and inflation

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By JOSH BOAK and FATIMA HUSSEIN

WASHINGTON (AP) — Donald Trump has big plans for the economy — and a big debt problem that will be a hurdle to delivering on them.

Trump has bold ideas on tax cuts, tariffs and other programs, but high interest rates and the price of repaying the federal government’s existing debt could limit what he’s able to do.

Not only is the federal debt at roughly $36 trillion, but the spike in inflation after the coronavirus pandemic has pushed up the government’s borrowing costs such that debt service next year will easily exceed spending on national security.

The higher cost of servicing the debt gives Trump less room to maneuver with the federal budget as he seeks income tax cuts. It’s also a political challenge because higher interest rates have made it costlier for many Americans to buy a home or new automobile. And the issue of high costs helped Trump reclaim the presidency in November’s election.

“It’s clear the current amount of debt is putting upward pressure on interest rates, including mortgage rates for instance,” said Shai Akabas, executive director of the economic policy program at the Bipartisan Policy Center. “The cost of housing and groceries is going to be increasingly felt by households in a way that are going to adversely affect our economic prospects in the future.”

Akabas stressed that the debt service is already starting to crowd out government spending on basic needs such as infrastructure and education. About 1 in 5 dollars spent by the government are now repaying investors for borrowed money, instead of enabling investments in future economic growth.

It’s an issue on Trump’s radar. In his statement on choosing billionaire investor Scott Bessent to be his treasury secretary, the Republican president-elect said Bessent would “help curb the unsustainable path of Federal Debt.”

The debt service costs along with the higher total debt complicate Trump’s efforts to renew his 2017 tax cuts, much of which are set to expire after next year. The higher debt from those tax cuts could push interest rates higher, making debt service even costlier and minimizing any benefits the tax cuts could produce for growth.

“Clearly, it’s irresponsible to run back the same tax cuts after the deficit has tripled,” said Brian Riedl, a senior fellow at the Manhattan Institute and a former Republican congressional aide. “Even congressional Republicans behind the scenes are looking for ways to scale down the president’s ambitions.”

Democrats and many economists say Trump’s income tax cuts disproportionately benefit the wealthy, which deprives the government of revenues needed for programs for the middle class and poor.

“The president-elect’s tax policy ideas will increase the deficit because they will decrease taxes for those with the highest ability to pay, such as the corporations whose tax rate he’s proposed reducing even further to 15%,” said Jessica Fulton, vice president of policy at the Joint Center for Political and Economic Studies, a Washington-based think tank that deals with issues facing communities of color.

Trump’s team insists he can make the math work.

“The American people re-elected President Trump by a resounding margin giving him a mandate to implement the promises he made on the campaign trail, including lowering prices. He will deliver,” said Karoline Leavitt, the Trump transition spokeswoman.

When Trump was last in the White House in 2020, the federal government was spending $345 billion annually to service the national debt. It was possible to run up the national debt with tax cuts and pandemic aid because the average interest rate was low, such that repayment costs were manageable even as debt levels climbed.

Congressional Budget Office projections indicate that debt service costs next year could exceed $1 trillion. That’s more than projected spending on defense. The total is also greater than nondefense spending on infrastructure, food aid and other programs under the direction of Congress.

What fueled the increased cost of servicing the debt has been higher interest rates. In April 2020, when the government was borrowing trillions of dollars to address the pandemic, the yield on 10-year Treasury notes fell as low as 0.6%. They’re now 4.4%, having increasing since September as investors expect Trump to add several trillions of dollars onto projected deficits with his income tax cuts.

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Democratic President Joe Biden can point to strong economic growth and successfully avoiding a recession as the Federal Reserve sought to bring down inflation. Still, deficits ran at unusually high levels during his term. That’s due in part to his own initiatives to boost manufacturing and address climate change, and to the legacy of Trump’s previous tax cuts.

People in Trump’s orbit, as well as Republican lawmakers, are already scouting out ways to reduce government spending in order to minimize the debt and bring down interest rates. They have attacked Biden for the deficits and inflation, setting the stage for whether they can persuade Trump to take action.

Elon Musk and Vivek Ramaswamy, the wealthy businessmen leading Trump’s efforts to cut government costs, have proposed that the incoming administration should simply refuse to spend some of the money approved by Congress. It’s an idea that Trump has also backed, but one that would likely provoke challenges in court as it would undermine congressional authority.

Russell Vought, the White House budget director during Trump’s first term and Trump’s choice to lead it again, put out an alternative proposed budget for 2023 with more than $11 trillion in spending cuts over 10 years in order to potentially generate a surplus.

Michael Faulkender, a finance professor who served in Trump’s Treasury Department, told a congressional committee in March that all the energy and environmental components of Biden’s Inflation Reduction Act from 2022 should be repealed to reduce deficits.

Trump has also talked up tariffs on imports to generate revenues and reduce deficits, while some Republican lawmakers such as House Budget Committee Chairman Jodey Arrington, R-Texas, have discussed adding work requirements to trim Medicaid expenses.

The White House was last pressured by high rates to address debt service costs roughly three decades ago during the start of Democrat Bill Clinton’s presidency. Higher yields on the 10-year Treasury notes led Clinton and Congress to reach an agreement on deficit reduction, ultimately producing a budget surplus starting in 1998.

Clinton political adviser James Carville joked at the time about how bond investors pushing up borrowing rates for the U.S. government could humble the commander in chief.

“I used to think that if there was reincarnation, I wanted to come back as the president or the pope or as a .400 baseball hitter,” Carville said. “But now I would like to come back as the bond market. You can intimidate everybody.”

What to know about Brooke Rollins, Trump’s pick for agriculture secretary

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By BILL BARROW and ADRIANA GOMEZ LICON, Associated Press

WASHINGTON (AP) — President-elect Donald Trump has selected former White House aide Brooke Rollins to lead the Department of Agriculture in his second administration.

Here are some things to know about Trump’s choice and the agency that Rollins would lead if she is confirmed by the Senate.

She is a lawyer with agriculture ties — and a strong relationship with Trump

Rollins, 52, graduated from Texas A&M University with an undergraduate degree in agricultural development before completing law school at the University of Texas. She served as domestic policy chief during Trump’s first term, a portfolio that included agricultural policy. After leaving the White House, she became president and CEO of the America First Policy Institute, a group helping to lay the groundwork for a second Trump administration.

Over the years, Rollins has forged a strong enough relationship with Trump, who has prized proven loyalty in his Cabinet and top adviser picks, that she was among the people floated as a potential White House chief of staff. That job went to Susie Wiles, Trump’s co-campaign manager.

Rollins, in an interview earlier this year, called Trump an “amazing boss.”

USDA is about more than farms

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President Abraham Lincoln founded the USDA in 1862, when about half of all Americans lived on farms. The sprawling department now reaches into every American neighborhood, grocery store and school cafeteria.

The USDA is the primary agency overseeing the nation’s farming, forestry, ranching, food quality and nutrition. The agency has a dual purpose of promoting and regulating agriculture practice and products. The agency oversees multiple support programs for farmers; animal and plant health; and the safety of meat, poultry and eggs that anchor the nation’s food supply. Its federal nutrition programs provide food to low-income people, pregnant women and young children. And the department sets standards for school meals.

The next USDA chief could figure prominently in Trump 2.0

Trump did not offer many specifics about his agriculture policies during the campaign. But if he keeps his pledge to impose sweeping tariffs, farmers could be affected quickly — and potentially harshly. During the first Trump administration, countries like China responded to Trump’s tariffs by imposing retaliatory tariffs on U.S. exports like the corn and soybeans routinely sold overseas. Trump countered by offering massive multibillion-dollar aid to farmers to help them weather the trade war.

The ripple effects could extend to consumers’ grocery bills, as well. When things are going smoothly, agriculture secretaries are not usually prominent faces of an administration. But when the nation’s food supply is at issue, it could be another story.

Gomez Licon reported from Fort Lauderdale, Florida.

Warren Buffett gives away another $1.1B and plans for distributing his $147B fortune after his death

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By JOSH FUNK, AP Business Writer

OMAHA, Neb. (AP) — Investor Warren Buffett renewed his Thanksgiving tradition of giving by announcing plans Monday to hand more than $1.1 billion of Berkshire Hathaway stock to four of his family’s foundations, and he offered new details about who will be handing out the rest of his fortune after his death.

Buffett has said previously that his three kids will distribute his remaining $147.4 billion fortune in the 10 years after his death, but now he has also designated successors for them because it’s possible that Buffett’s children could die before giving it all away. He didn’t identify the successors, but said his kids all know them and agree they would be good choices.

“Father time always wins. But he can be fickle – indeed unfair and even cruel – sometimes ending life at birth or soon thereafter while, at other times, waiting a century or so before paying a visit,” the 94-year-old Buffett said in a letter to his fellow shareholders. “To date, I’ve been very lucky, but, before long, he will get around to me. There is, however, a downside to my good fortune in avoiding his notice. The expected life span of my children has materially diminished since the 2006 pledge. They are now 71, 69 and 66.”

FILE – The children of Berkshire Hathaway Chairman and CEO Warren Buffett, from left, Howard Buffett, Susie Buffett, and Peter Buffett, pose for a photo at the CenturyLink Center exhibit hall in Omaha, Neb., May 1, 2015. (AP Photo/Nati Harnik, File)

Buffett said he still has no interest in creating dynastic wealth in his family — a view shared by his first and current wives. He acknowledged giving Howard, Peter and Susie millions over the years, but he has long said he believes “hugely wealthy parents should leave their children enough so they can do anything but not enough that they can do nothing.”

The secret to building up such massive wealth over time has been the power of compounding interest and the steady growth of the Berkshire conglomerate Buffett leads through acquisitions and smart investments like buying billions of dollars of Apple shares as iPhone sales continued to drive growth in that company. Buffett never sold any of his Berkshire stock over the years and also resisted the trappings of wealth and never indulged in much — preferring instead to continue living in the same Omaha home he’d bought decades earlier and drive sensible luxury sedans about 20 blocks to work each day.

“As a family, we have had everything we needed or simply liked, but we have not sought enjoyment from the fact that others craved what we had,” he said.

If Buffett and his first wife had never given away any of their Berkshire shares, the family’s fortune would be worth nearly $364 billion — easily making him the world’s richest man — but Buffett said he had no regrets about his giving over the years. The family’s giving began in earnest with the distribution of Susan Buffett’s $3 billion estate after her death in 2004, but really took off when Warren Buffett announced plans in 2006 to make annual gifts to the foundations run by his kids along with the one he and his wife started, as well as the Bill & Melinda Gates Foundation.

Warren Buffett’s giving to date has favored the Gates Foundation with $55 billion in stock because his friend Bill Gates already had his foundation set up and could handle huge gifts when Buffett started giving away his fortune. But Buffett has said his kids now have enough experience in philanthropy to handle the task and he plans to cut off his Gates Foundation donations after his death. Buffett always makes his main annual gifts to all five foundations every summer, but for several years now he has been giving additional Berkshire shares to his family’s foundations at Thanksgiving.

Buffett reiterated Monday his advice to every parent to allow their families to read their will while they are still alive — like he has done — to make sure they have a chance to explain their decisions about how to distribute their belongings and answer their children’s questions. Buffett said he and his longtime investing partner Charlie Munger, who died a year ago, “saw many families driven apart after the posthumous dictates of the will left beneficiaries confused and sometimes angry.”

Today, Buffett continues to lead Berkshire Hathaway as chairman and CEO and has no plans to retire although he has handed over most of the day-to-day managing duties for the conglomerates dozens of companies to others. That allows him to focus on his favorite activity of deciding where to invest Berkshire’s billions. One of Buffett’s deputies who oversees all the noninsurance companies now, Greg Abel, is set to take over as CEO after Buffett’s death.