'Consolidation has gone too far, we need more government regulation': Dr. Ezekiel Emanuel

Yahoo Finance’s Alexis Christoforous and Brian Sozzi discuss the state of America’s health care system with University of Pennsylvania Vice Provost of Global Initiatives and Former Obama White House Health Policy Adviser, Dr. Ezekiel Emanuel.

Video Transcript

BRIAN SOZZI: Health care is top of mind for voters as we approach the 2020 presidential election and the world looks to get a grip on the COVID-19 pandemic. Joining us now to discuss is University of Pennsylvania Vice Provost of Global Initiatives and former Obama White House Health Policy Advisor Ezekiel Emanuel.

Doctor, good to see you this morning. Certainly want to touch upon the broader health care landscape with you right now. But we did get news this morning, Bill Gates in another interview saying the FDA has lost credibility. Very alarming comments from Bill Gates here. Do you agree with that assessment?

EZEKIEL EMANUEL: Well, it's not a matter of agree or disagree. The polling data does suggest that trust in the FDA is down. I saw one poll that said one in 10 Americans trust the FDA and the pharmaceutical industry about safety and effectiveness.

That is a very bad place to be. And it also means that a new administration is going to have to spend some time rebuilding that kind of trust, doing things to increase transparency so people have the data, increase the prominence probably of the advisory committees that rule on drug approvals. So I think there's a lot of work to be done.

ALEXIS CHRISTOFOROUS: And also a lot of work to be done, Doctor, when it comes to people trusting in a new vaccine. We know how quickly companies are working on a COVID-19 vaccine. And just this morning, President Trump on an-- on an interview with-- at Fox News said that he believes we're going to have a vaccine in the matter of weeks. Those are his words. What's your reaction to that?

EZEKIEL EMANUEL: Well, he-- he may know something the rest of us don't. We've already seen that that can be the case. But you know, whether we get a vaccine really depends upon nature, not upon his rhetoric. It depends upon how many people who are in the trials are exposed, how many people convert, how protective the vaccine actually is, and that's determined by the environment, not by his rhetoric.

I do think it's extremely important that any data that's submitted to the FDA, even if they're only going for an emergency use authorization, be viewed at and critically assessed by one of these advisory committees. We gotta stop having Steve Hahn, the commissioner, make a decision on emergency use authorization all on his own. We need to see the data. We need an external advisory committee that actually is not beholden to President Trump actually evaluate the data, and only then make a decision, and that's not going to be rushed through.

BRIAN SOZZI: Doctor, is big pharma putting more Americans at risk by what appears to be, from the outside looking in, rushing through these stages to-- to vaccine development?

EZEKIEL EMANUEL: I don't think it's the rushing through stages. I mean, we are going faster than normal. The size of the studies are smaller than normal. You know, 30,000 people in a randomized controlled trial, with 15,000 people getting the COVID vaccine is way smaller than any other previous vaccine trial.

On the other hand, we have a pandemic. It has had trillions of dollars of impact on the US, not to mention the whole world. I think Melinda Gates said that we've reversed, in 25 weeks, 25 years of work in trying to alleviate poverty, and poor health, and poor education. So it's very urgently needed.

I think skipping some of the stages is not the problem. The problem is do the data confirm effectiveness? Do we have a system in place to really assess safety over time, especially severe safety events?

And that's, I think, where the public is really wary. The drug industry itself probably needs a strong FDA to reassure people that every time they take a pill it really is safe and effective. And I think they are nervous, too, about the undermining of the trust of the FDA for political gain.

ALEXIS CHRISTOFOROUS: I know, Doctor, that you've taken a look at health care systems around the world. Where does America stack up against the others?

EZEKIEL EMANUEL: Badly. We're not in the top 10. We're not the worst, but we're not in the top 10. And we're-- we're definitely, given how much we spend, we're getting a very bad return, and you can see that in the response to COVID.

BRIAN SOZZI: Doctor, I'm sure you saw the Gilead for Immunomedics deal continue, just a continued wave of deals in the health care space. How are these big combinations going to impact the future of health care?

EZEKIEL EMANUEL: In general, it's a bad idea. You know, you're looking at a pharmaceutical company. There are plenty of startups. And we've changed the model of how companies develop drugs. It's no longer the big pharmaceutical companies, the Mercks, the Pfizers, and the other-- sorry-- the others who are doing the basic research.

They have startups doing this basic research, and then they buy them to further develop them in human trials. So that's the new model. But I would say, also, consolidation in the hospital market has been a problem, because they've, as we've seen on private health insurance, raised their rates substantially. So consolidation. I think at the moment, has gone too far, and we really do need some-- the government to step in.

Like many other parts of the economy in terms of tech and other areas, we need more government regulation. You know, bigger is better to some point, allows you to invest capital, to take on bigger initiatives. But at some point, it tips over into, you know, dominating a market and just raising prices, not actually raising efficiency or quality. And that's been shown pretty much in the health care industry in many areas.