c-span, where history unfolds daily. as a79, c-span was created public service by america's cable and television companies and is brought to you today by your cable or satellite provider. -- health and human services secretary tom price sat down for an interview to reflect on his personal and professional life. his family and his start in georgia state politics through his time in the u.s. congress. he talks about his opposition to the affordable care act, working for the prompt administration and the priorities for the department of health and human services.

dearborn, michigan into up in atlanta, georgia? sec. price: i did my undergraduate at the university of michigan, but my mother's family is from roanoke. so when i was a kid we would take summer vacations down in roanoke and virginia beach. and my mother told me that at the age of six i announced that there was no reason for us to live here, we needed to live in virginia or the south. when i finished my medical school i interviewed for my residency from richmond south, in richmond and charlotte and atlanta, new orleans, gainesville florida, and selected the memorial hospital, which is what drew me to atlanta. i did my residency there. host: at what point did you say, i want to be a doctor? sec. price: as soon as i realized i could not be a professional baseball player, very early by the way. my father grew up on a farm.

he was a dairy farmer. and in the late 1950's, there was the bottom fell out of milk prices and so we moved from the farm in michigan, to suburban detroit. my father then went back to medical school at the age of 36 and went through medical school, the oldest person in his class. and that, through that process i was just young at the time, but i remember being intrigued by what he was doing. then of course my grandfather being a physician as well, they both inspired me. so somewhere in high school i moveht it would be good to into a career, toward a career in medicine. and i was accepted out of high school into what at that time was a combined premedical and medical program at the university of michigan, see were accepted to medical school literally out of high school. it was an extreme of the

program, no longer in existence, but it was an attempt to get primary care physicians to be selected immediately out of high school. it failed in that, except for years truly, they accepted the best and brightest so they went through the process, tending to want to move into specialties where all of the bells and whistles existed. it did not accomplish its goal, but it allowed me to gain admittance to medical school right out of high school. host: for those of us that do not understand the process, explain how you conduct surgery on the bones. surgeryce: orthopedic really captured my passion and my love in medical school. it satisfied the immediate gratification that this type a personality seemed to need in medicine. orthopedic surgery is one of the specialties where you treat all folks. you treat little babies, who

will have congenital problems, you treat all folks throughout their lifetime as they break bones and to fix them. you treat extremely active if youuals, most often, do the right thing the patient gets a well and they returned to their previous state of health and activity. and you treat folks in the older years as they have challenges from a skeletal standpoint. so it is an extremely gratifying line of work and it is from a structural standpoint, it is, they call us carpenters because we tend to put things back together like you would a wooden structure. but it is the wonder and glory of the human body that allows it to heal. host: steve scalise, when he was injured, what was going through your mind as a surgeon? sec. price: it was a terrible day.

and i recognized immediately that the entry wound that was being described was one that was very close to not just vital organs, but to nerves and blood vessels that would potentially threaten his life. and it did. i had an opportunity to speak to the physicians who took care of him and as they reported publicly, he was close to death when he arrived. he was probably saved by the individuals that tended to him on the field and tried to put compression on what would likely ephemeral artery injury, an injury in the area of the hip. and he would have lost so much blood that had they not helped he would've lost so much blood he would've lost his life. so people at the field and of course the credible talent of the physicians and caregivers where he was taken, just did a

notomenal job in saving, just saving his life but putting things back together. host: what was the most difficult procedure you undertook? sec. price: there were a couple that were extremely complex that always cause you to, to study extra hard prior to the procedures. any back surgery i found to be challenging, just because of the technical aspects of the surgery, you tend to be operating in a hole. you make a small incision, and you have to get to the bottom of it, so it is a far distance. and i enjoyed the challenge in putting folks back together who had pelvic injuries, pelvic fractures. we used to see more of them before seatbelts were utilized. the knee would strike the dashboard and at the hip would break the hip joint. those were probably the most technically challenging, but

also most gratifying as he could get folks back to their previous state of activity. host: so why politics? you were a surgeon for 20 years, moved into state politics in jordan, why? -- in georgia, why? sec. price: my wife is a physician as well and we got involved in the county medical society in atlanta, where we set up a practice. and at one time during my early years of practice in the mid-1980's or so, there was a torque to crisis, a lawsuit abuse crisis in the state of georgia and i responded to the call from the state medical society to come down to the capital and visit with my state legislators, the state representatives and a state in whatwho had a say the legislator -- and with the legislature was going to do with the issue of medical liability. i had never been in the state capital and i remember the

remarkable novelty to me of calling your state representative out. you simply send a little card and the state representative will come down and talk with you. i thought that was pretty neat. but i had to the most pleasant, warm congenial conversations i had had with the two individuals that were obviously working hard, but they didn't have a clue what i did as a physician, so i remember driving home from the experience thinking, this does not make a lot of sense. you have folks who are engaged in policymaking who really do not have a gut sense about what it is physicians do to try to help care for patients. that is probably what pete my -- peaked my interest on the policy side. so we worked with a number of other folks over the years to get what we got were good folks into office. and in 1996i was asked to run

for the state senate in georgia and we were successful in that endeavor and one thing led to another and each step in the progression felt like the right step to take. host: your wife is in state politics. who is the better politician? sec. price: anybody in politics, you have to take your hat off to because it is not just an individual affair, it is a family affair and the amount of effort and passion that goes to participate in representative government is real and it is taxing. my wife does a great job. she is passionate about what she does, she is knowledgeable and she spends a remarkable amount of time studying the issues and working on issues, so i enjoyed my time in the state legislature. , threed 8 years, 4 terms in the minority, one in the majority. i became the first public and majority leader in the history

of the state senate and that was really a remarkable election, remarkable night that i remember well. and came to congress in 2004 and served in the united states house of representatives from 2004 through this past january. host: how did you meet your wife, betty? sec. price: we met as residents in atlanta. she was doing her residency in anesthesia, i was in orthopedics and we met and the rest is history. host: one child, one son? sec. price: one son. outside up in rosso -- of atlanta. he went to vanderbilt and it stayed in nashville. host: let's talk about what you do here, because you have said we do not have one health care system, we have five -- explain. sec. price: let me talk about health and human services,

because some people think only about health care, health and human services is the largest department in the federal government, 80,000 employees, only exceeded by the defense department. otherwise it has the largest number of employees. it has folks spread all around the world, literally doing what they can to make sure that the american people are safe from disease, but also on the human services side, that we assist individuals with disabilities, individuals in the community, to make certain that they are able to gain the kind of well-being and improvement in their health and life as possible. hhs has some of the iconic institutions that people think about when they think about the federal government and health care, the national institute of cms,h within hhs, the cbc, the substance abuse and mental health services administration. so the fda, all sorts of

individuals working day and night to try to improve the health and well-being of the american people. when i talk about the health systems it is important for people to appreciate that because we tried to balance these systems and make it so that as folks move from one system to the other, that that is a seamless transition. so for seniors, medicare health system in effect for those that are low income we have medicaid, a system that is in effect. most of us receive health coverage through our employer, through the self-insured plans. about 175 going americans receive this coverage -- 175 million americans receive this coverage. and we have the indian health system. the individual small group market, which has been was greatly affected where the exchanges occur, where the aca occurs. that group of folks, about 20

million, about 10 million of them on the exchange so when you focus on a nation that has over three and a million people and you whittle it down to a system where only 10 million individuals are being covered, that is the area where we see oftentimes the greatest challenges. that is where folks have seen syndicate increases in their premiums, huge increases in their deductible. that is where i hear from folks, both on the provider side, the doctors and caregivers that know that they are seeing people who have an insurance card, but they cannot afford to care because they cannot afford the deductible, that is where individuals see the narrowing of networks, so they cannot see the doctor that they want to see. so article is to make certain -- our ogoal is to make sure there are seamless transitions within the systems, but also allows doctors and families to make medical decisions and not the federal government. host: when you say patients and

doctors, the insurers play a big role, don't they? sec. price: they do. if the government is making health care decisions for you, we believe that is not the place where the decisions ought to be. if insurance companies are making the decisions, we do not believe that is where they should be made. it should be made between families and providers or physicians. that is the goal. that is the ultimate goal that we have for all individuals in our health care system, because we know then that individuals are getting the kind of care from whom they desire most. host: in 2009 we covered a number of pieces you gave outlining your plan to repeal the of portable care act. what were the key elements of what you are proposing back then? sec. price: we tried to focus on and continue to focus on for the bulls of health care, because -- principles of health care, because when you talk about those it takes the ideological differences away.

so we believe, and i did then and i continue to believe the system of health care should be one that is accessible for everybody, remembering it is systems, not a system. systems should be affordable for folks, they should be able to afford coverage, everybody should be able to afford coverage regardless of economic situation. the care provided should be of the highest quality, that regardless of your station in life, the system you are in, the quality of care ought to be of the highest it can possibly be in the world. the choices ought to be available to patients, it should be their choice who is taking care of them, when and where and the like. it is important to incentivize innovation, because it is true that innovation that we advance science and the ability to care for folks. and finally we think the system should be responsive to people. if it is responsive to insurance companies and government and not

responsive to patients, which is where we find ourselves often times right now, it can work for insurance companies and government, but not for patients. we wanted to work for patients. accessibility, fort ability, choices, innovation and responsiveness. those are principles we should adhere to. host: when the president says he wants obamacare to fail, is it just twitter rhetoric or is he serious? sec. price: i think it punctuates his frustration not having in place a system that he understands is not responsive to patients. so when he looks at this and we look at the current system and aca on the exchanges, often times we see folks that are able to get the kind of care they desire. they may again, as i mentioned, they may have coverage but they are not able to get the care that they desire or need. it is a system not working for patients. that is where the president reveals his frustration and where we have huge frustration

because it is not a system that is working for the people who are the end users of the system. host: i have to ask, you are in west virginia at the boy scout jamboree, where you a boy scout? sec. price: i was. i did not get far. our son was an eagle scout. host: so when he turned to you and said you are fired when you did not get the health care bill passed? sec. price: i think he was having fun. it was a remarkable event and the warmth he felt from the crowd and the enthusiasm that he felt from the crowd was palpable. it was a remarkable event. i think that statement was simply the same kind of frustration and punctuation that the president has shown in the area of health care that he does not believe the system is working for people.

and his charge to congress, remember this is a man that had not been involved in politics, comes in to office after hearing for seven years that the people here in congress who are now in the majority, have said they want a change, they wanted to repeal and replace india after a eplace of months -- r and yet after a number of months, it was not coming out. host: what do your colleagues tell you today? sec. price: often times they call me or send me emails of -- that express their frustration about something in the system. these are not things that are unknown to people, it is the burden of washington rules and relations that get in the way of caring for patients. medicalectronic

records requirement that sound like a wonderful idea, but sometimes we turn physicians into data entry clerks instead of being physicians and doctors. i hear from patients about them going to a doctor and seeing the top of the head of the doctor, king into as plun computer where they are telling them. that is what i hear from former colleagues. is of the sad things i hear men and women that have been practicing for 20-25 years or 30 years, they are healthy, at the top of their game, top of their career, have incredible experience and expertise that we as a society, from which we benefit remarkably and many of them are looking for the exit doors. they are trying to figure out how to get out of the practicing of medicine. my grandfather was a doctor in the practice until he was 94 years old. when i was a child, most

physicians if they were healthy practice into their 70's. it is not unusual to have a practicing physician practice until 75 or 80. now doctors in their mid-50's, certainly by 60 or 65 they are looking to move onto something else, maybe another career. ontoonto retirement -- or retirement. it is important to step back and say why, why is it these gifted individuals who have been blessed with the expertise to be able to help cure their fellow man, why are they looking to get out of the practice of medicine? i was a just one of the big reasons is the kind of decisions made in this town that have made it more difficult for doctors to care for patients. that is one area we are trying to concentrate on, decrease the burden of physicians to be able to care for their patients. host: you said members of congress go home and talk with constituents, so they will be back in a couple of weeks.

what have they been hearing and what will happen with the affordable care act? sec. price: regardless of what has happened to date, the challenges we have seen, people with insurance cards but not care, that is not changing. we hear almost daily about another insurance company that has decided to exit the exchange market. this is the individual small group market, not medicare or medicaid or self-insured plans, it is the individual small group market. we will have a third of counties that will have only one insurance company providing coverage on the exchange next year, that is not a choice for people. so choices are being violated. that was happening prior to the president being sworn in. >and we had some counties that

are bear counties. this is the system again that may be working for the government or the insurance companies, but it is not working people or patients. our charge, our challenge to fulfill the mission of the health and human services department is to improve the help and well-being of the american people requires us from a responsibility standpoint to try and help the system, to try and fix the system in a way that makes it work for patients. for us, that means putting in place a system that allows them to make decisions. host: the department of health and human services, are we doing enough to keep people healthy before they need to see an emergency care physician or go to the hospital? wellness, that are living, better exercise -- better living, better exercise? sec. price: we are doing better, but there are still certain

things we need to work on. butjust as the department as a nation. childhood obesity, severe mental illness, and in the opioid crisis we face. i selected those three for a number of reasons, but not the least of which, we are losing on every single one of them. 60% of our young people are overweight, 20% are clinically obese. host: why is that? sec. price: there are a lot of reasons, that when you boil it down, there are more calories going in then going out. a lot of it is diet, a lot is activity, but those young people will not be having necessarily health challenges of themselves when they are 60, 70, or 80. if something doesn't change, they will be having issues at 25 or 35. health challenges for them means health challenges for the nation.

our goal for them is to demonstrate the importance of exercise, being legally fit, adhering to an appropriate diet, making certain you are not doing things that are likely to result in a horrible lifestyle. severe mental illness is an area we have been in an experiment in the last 40 or 50 years that says every single individual in this nation can be mainstreamed into public life. in the had huge success pharmaceutical area for severe medical desk severe mental illnesses. -- severe mental illnesses. the homeless population has a history of severe mental illness. we have moved from housing in substandard clinical settings and we have transferred them to by and large, being housed in substandard criminal justice settings that are no longer writing the care and treatment they need. that is irresponsible as a

nation and we need to do all sorts of things to improve that situation so those that are almost forgetting the care they need from a mental illness standpoint so they can move into some sort of residential setting or productive activity and have their mental illness treated in a way. allow those folks to go without treatment. the opioid crisis is something that has devastated no bounds. it cuts across all demographics in our country. committees large and small, rich and poor, every racial category completely. every class of individual, nobody, there is no bounds that has been spared by this opioid crisis. 52,000 americans die of an overdose in 2013, 30,000 from opioids. the number in 4016 and 2017 are

no better. more individuals dying now of an overdose then automobile accidents and gunshot wounds or violent activity. who doood you blame -- you blame? sec. price: there is a lot of responsibility to go around. when opioid began to increase in terms of prescriptions in this nation and it's important to appreciate that the folks addicted to opioids, 80% of them began with a legal description for a legitimate health care problem. 20 years ago, the government through the veterans and ministration decided they would say, pain is the fifth vital sign. at theracticing medicine time and i got a letter from the government that said pain is the fifth vital sign and you need to make sure you are registering

pain as a vital sign. vital signs are things like your pressure, pulse, respiratory rate, temperature. know how to measure it, we get exactly the same results. symptoms are things that the patient perceives, whether it's pain or illness or not feeling well or nausea. thingsre the kinds of that are symptoms. when you make the symptom +, you distort the practice of -- symptom sign, you distort the practice of medicine. you provide greater reimbursement or not penalize them if they make certain patients did not have pain. we don't want anyone to have for, but it's an incentive an increase in opioid prescriptions across his nation. nation, we write

over 90% of the prescriptions of her opioids in the world, which led down a path that led to an accentuation of the disease. we have to turn that around and there are things we are doing here that the president has resolved and making sure we resolve this challenge and crisis because he has heard in every visit he has had across this land. those are the three clinical priorities. host: let me go to your point about mental health. you can fix of bone, but there is a stigma with mental health. why? sec. price: there is a stigma with mental health and addiction. individuals oftentimes don't seek treatment or share concerns and fears they are having with family members, those loving individuals that would assist them in working through what is obviously a real challenge.

,e as a society need to work one of the things we are trying remove that signal from a mental illness and the area of addiction because only when we are able to open our arms and say we want to help and be of assistance and lift you up and provide a hopeful future so you know there is help available and also you can realize your dreams as you move forward in life. host: how do you manage your day-to-day structure? sec. price: it's as busy as it's been since i was a resident of it some up, sundown, and then some. i have had great people all around me whether it's in those iconic agencies like the and i h or cdc or folks across the wo i hadrld.

-- across the world. you and our fellow americans can be incredibly proud of the work we are doing as a nation and the work that those americans are doing on the frontlines of an was anous disease that awful crisis and challenge in western africa. it would have been more deadly to not just africa but potentially the world had they not been there. so much so, we have seen an increase in capability and capacity of liberia itself to identify infectious disease, treated on the ground in the country along with some assistance we continue to provide. it is exciting work the men and women of the department of health and human services are doing around the world to keep american citizens safe. host: is this a job you always wanted? sec. price: interesting question. my friends and wife told me i

talked about this at times in my for trying passion to help people and my passion this justthy society, feels like the culmination of a life's work. the 20 plus years in clinical practice i had caring for patients, which was incredibly rewarding, overlap with the 20 plus years i had in the representative life in the state senate and congress. to have the opportunity this time in the nation's history and the health system we have come to leave this remarkable department, is as fulfilling as anything. host: we were confirmed largely along party lines vote. was that indicative of the debate we are in now? sec. price: sadly, i think things are way too divided, especially in the area of things that ought not be ideological. those principles of health care

earlier, i doubt there is anybody out there who would disagree fundamentally with providingamentals of choices for patients and incentivizing innovation. when you get to specifics, you get to the leads on some of these things and it becomes ideological. my goal is to try and lower the temperature of the discussion and debate and try to bring ours together for not just health care system, but the human services side, as well, so individuals are able to leeward communities in a way that allows them to succeed. host: when did you first meet donald trump? a numbere: i met him of years ago at an event in new york city in passing. him in spring, early summer of 2016. i was privileged to serve on what was called the trunk leadership council, a group of

30-40 individuals of various sectors of our society and i was on a health care team charged with trying to bring forward health care solutions to mr. trump as he was running his campaign. askedwas privileged to be to join his cabinet. host: how did he ask you? sec. price: a meeting in trump tower about 8-10 days after the election. we had a conversation where he asked some very piercing and probing questions and then over period of days, he gave me a telephone call and offered me the position and i left -- lept at the opportunity. host: let's talk about your baseball career. what position did you play? sec. price: i played shortstop

and pitcher. i grew up outside of detroit, the tigers were my team and i was 14 in 1968 when they won the world series over the st. louis cardinals in seven games and i went to games 3, 4, and five, and flew to st. louis with mike paper route money -- and it wasute money about that time i realized i didn't have the talent to be a major league baseball player so i played intramural softball in college and played on the congressional baseball team one year, the first year i was here. betting 1000 -- i am battin g 1.000 in a major league ballpark. i practiced a couple times with friends and i and in the right direction. host: there were a couple of

booze in ths in the audience. sec. price: i heard them. there were cheers and the nats couldn't have been more gracious. amet dusty baker and it was pleasure. he was from atlanta and i remember his face there. it was a great opportunity and i was inspired. that was hhs night at the ballpark and we had over 3000 employees from hhs to come out to the game and we had a good game, the nats one. host: do they have what it takes for the playoffs? sec. price: absolutely. we will wait another year for them, but the nets welfare externally well in the playoffs. host: after four years in this position, or eight years, what do you want to leave the hind -- leave behind?

sec. price: i want to improve the health and safety and well-being of the american people. i would like to be able to say we moved those three clinical areas in the right direction, that we turned that awful tide and scourge of the opioid crisis in the right direction, that we just mental health and severe mental illness in a better way, more responsive to those individuals and we tried to encourage young people to become more fit. at the end of the day, if we can have a health care system more responsive to the patients and develop greater trust on the trust of the physicians and providers out there, trust in their federal government we are looking out for them. host: do you miss the house? sec. price: there are things about the legislative branch i miss, a camaraderie that exists there, an opportunity to engage in a bunch of different issues.

but i feel like this is where i'm supposed to be right now. this is an incredible honor and privilege to serve in this position and to be able to hopefully move our health care system in a much that are >> next, live, your calls and comments on washington journal. then a discussion on the possible renegotiation of the north american free trade agreement. after that, steny hoyer of maryland talks about the immigration program. the-span's coverage of solar eclipse on monday starts at 7:00 eastern with the washington journal, live at nasa's goddard space center in maryland. a nasa research space scientist and jim garman, the chief scientist at goddard will be our

guests. at noon eastern, we join nasa tv as they provide live views of the solar eclipse. reaction of the solar eclipse over the continental united states. one, all-day coverage monday, starting at 7:00 a.m. eastern. we will take a look at preparations for the first solar eclipse over the u.s. in 100 years plus programs on the nasa budget, mars exploration and more. gaining at noon eastern on c-span. this morning, reuters health yasmin talks about the congressional budget office premiums will be raised by 20%. and a discussion on race relations in the u.s. with robert woodson and bernard

anderson. always, we will take your calls and you can join the conversation on facebook and twitter. "washington journal" is next. ♪ host: good morning. today is saturday, august 19, 2017. president trump has ousted his chief strategist, steve bannon. he is out at the white house. he had been accredited with helping trump when last year's presidential election and is seen as the key architect of the president's nationalism policies. the last week was also marked by the president's contradictory who's to blamet for the violence in charlottesville.