On October 31, 2024, the Medicaid and CHIP Payment and Access Commission (MACPAC) met for Day 1 of their October meeting. Topics ranged from medication coverage for opioid use disorder (MOUD) to provisional plans of care to Multi-Year Continuous Eligibility for Children.
Dr. Marty Makary, a surgeon, health care policy expert, and author, has been nominated for the role of FDA Commissioner in President-elect Trump’s second administration. The appointment is expected to impact drug regulation, health policy, and FDA transparency initiatives if confirmed.
Background and Qualifications
With a medical degree from Thomas Jefferson University and a residency completed at Georgetown University Hospital, Makary currently serves as a surgery and public health professor at Johns Hopkins University. His work focuses on medical ethics and health care reform. As a specialist in gastrointestinal surgery, he emphasizes laparoscopic and minimally invasive techniques, prioritizing safety and reducing medical errors in hospital care.
In addition to his clinical contributions, Makary is a public health advocate and a regular contributor to major media outlets. His commentary often highlights health care transparency, medical errors, and health equity issues. A New York Times bestselling author, his books, The Price We Pay and Blind Spots, examine systemic flaws in the U.S. health care system and suggest reforms.
Policy Positions and Priorities
His policy positions emphasize transparency, affordability, and innovation. Key priorities include enhancing access to health care information, reducing costs, and addressing medical errors. He supports COVID-19 vaccination for high-risk groups while advocating for clear communication about benefits and risks, particularly for younger individuals. He also supports recognizing natural immunity in vaccination policies.
Another critical focus is transparency in the health care system. Makary has called for greater public access to information about hospital performance, costs, and quality of care, as well as increased transparency in clinical trials, drug pricing, and the drug approval process.
His agenda includes significant efforts to reduce health care costs. He has criticized profit-driven practices and proposed reforms to lower spending and expand affordable care. Initiatives include promoting generic drugs to enhance market competition and opposing pay-for-delay agreements that delay affordable medications.
Concerns about regulatory delays at the FDA have led Makary to advocate for streamlining drug approvals while maintaining rigorous safety standards. His focus includes addressing chronic diseases, rare cancers, and emerging pandemics. Strengthening oversight of clinical trials and implementing robust safety protocols for approved drugs are key components of his patient safety initiatives.
Leadership at the FDA: Opportunities and Challenges
If confirmed, his leadership at the FDA could bring a balance between facilitating access to innovative treatments and ensuring safety standards. Challenges may include managing public scrutiny over accelerated drug approvals and navigating resistance from the pharmaceutical industry to proposed reforms. Maintaining public trust will be critical to success, with transparency playing a central role.
In broader health care reform, there may be opportunities for collaboration with figures such as Robert F. Kennedy Jr., despite differing views on vaccine policy. Shared priorities, such as improving transparency in the pharmaceutical industry or strengthening public health systems, could provide common ground.
Conclusion
The nomination of Dr. Makary as FDA Commissioner introduces the potential for significant changes in the agency’s role in public health. If he is confirmed, his ability to address key challenges, implement reforms, and build public trust will determine the impact of his leadership.
