Donald Trump at CPAC

7 Things Wrong with Donald Trump’s 7-Point Health Care Plan

Republican Presidential Candidate Donald Trump released his “Health Care Reform Plan” today. Instead of throwing everything The Donald says out the window, I thought I would waste my time listing, point-by-point, my critiques of his reform plan.

Here goes nothing.

HEALTHCARE REFORM TO MAKE AMERICA GREAT AGAIN
Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare. This legislation, passed by totally partisan votes in the House and Senate and signed into law by the most divisive and partisan President in American history,

We can argue until we’re blue in the face about President Obama being divisive and partisan. What we can’t argue about is that Congress has an incredibly low approval rating. 1 If you’re looking for divisive and partisan, look no further than Congress.

has tragically but predictably resulted in runaway costs,

“On average, premiums have risen by about 5.8 percent a year since Obama took office, compared to 13.2 percent in the nine years before Obama.” 2

websites that don’t work,

Website works fine now. 3

Screen Capture of Healthcare.gov Home Page.
Screen Capture of Healthcare.gov Home Page.

greater rationing of care,

Sure, if you’ve got the money, you get whatever care you want. But, if you’re like over 40 million Americans before Obamacare, rationing takes the form of you not getting any healthcare.

Rationing of care? Been there, done that. 4

Rationing by price, or ability to pay, is familiar to most Americans.

higher premiums,

See above. True, premiums are higher. But so is inflation. Just in case you missed it above:

“On average, premiums have risen by about 5.8 percent a year since Obama took office, compared to 13.2 percent in the nine years before Obama.” 5

less competition and fewer choices.

“Trump said that under Obamacare, “you have no options,” for health insurance plans. That is true in about 10 percent of the counties where individuals buy their coverage on the government’s insurance exchange.” 6

“The Centers for Medicare and Medicaid Services reported that 9 out of 10 returning customers using the national exchange, healthcare.gov, were able to choose from among at least three companies.” 7

Obamacare has raised the economic uncertainty of every single person residing in this country.

Uncertainty is a broad term. What could The Donald mean? In the past, when Republicans talk about “Obamacare” and “economic uncertainty” they talk about jobs, time spent on the job, and small businesses cutting jobs.

“President Obama’s health-care reform hasn’t meant less time on the job for American workers, according to three newly published studies that challenge one of the main arguments raised by critics of the Affordable Care Act.” 8

“…a December report by the Congressional Budget Office, which found Obamacare could reduce American work hours by the equivalent of 2 million total jobs over the next decade. However, the CBO projected that workers were likely to reduce their own hours voluntarily, because they would no longer have to hang on to full-time jobs to maintain health insurance, rather than being forced out by their employers.” 9

As it appears Obamacare is certain to collapse of its own weight,

I encourage you to Google “obamacare collapse” 10 and look at the number of right-wing articles that appear. However, if you read further, most of what the “collapse” refers to is the closing of most of the co-ops 11 created by Obamacare.

the damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next President and a Republican congress lead the effort to bring much-needed free market reforms to the healthcare industry.

Do I even need to respond to this last part? Our Republican Congress has “lead the effort” to repeal Obamacare 62 times. 12 Where is the Republican “reform?”

But none of these positive reforms can be accomplished without Obamacare repeal. On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.

Good luck. We’ll see if you still have a Senate Majority if you’re the top of the GOP ticket.

However, it is not enough to simply repeal this terrible legislation. We will work with Congress to make sure we have a series of reforms ready for implementation that follow free market principles and that will restore economic freedom and certainty to everyone in this country.

Again, there have been over 60 votes to repeal Obamacare. There have been no votes to reform. There have been no votes or discussion to make Obamacare better.

By following free market principles and working together to create sound public policy that will broaden healthcare access,

“According to the CDC and Census data, for the first three months of 2015 the uninsured rate is 9.2% down from 15.7% before the Affordable Care Act was signed into law. For just the 18 -64 demographic the same study shows the uninsured rate at 13% down from 22.3% in 2010 when the ACA was signed into law. These represent the lowest uninsured rates in over 50 years according to the study.” [Note] Obamacare Facts, “Obamacare: Uninsured Rates” [/note]

make healthcare more affordable

Again? Okay. “On average, premiums have risen by about 5.8 percent a year since Obama took office, compared to 13.2 percent in the nine years before Obama.” 13

and improve the quality of the care available to all Americans. [emphasis his]

Accountable care organizations, prevention and wellness completely covered, better care access on evenings and weekends, electronic health records, and remote care are just a few of the patient benefits from Obamacare. 14

Any reform effort must begin with Congress. Since Obamacare became law, conservative Republicans have been offering reforms that can be delivered individually or as part of more comprehensive reform efforts. In the remaining sections of this policy paper, several reforms will be offered that should be considered by Congress so that on the first day of the Trump Administration, we can start the process of restoring faith in government and economic liberty to the people.

Congress must act. Our elected representatives in the House and Senate must:

“What is clear, however, is that the Republican alternatives, such as they are, would remove coverage from many who have it now.” 15

  1. Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.

Pretty much repeats my last point. Many people who gained health insurance through Obamacare would lose it under Republicans.

  1. Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.

Removing the prohibition of selling health insurance across state lines will encourage health insurers to move and relocate to less-regulated states. What does this mean for the consumer? Less-regulated insurance plans.

But don’t take my word for it. 16

Screen Shot 2016-03-03 at 11.52.15 AMScreen Shot 2016-03-03 at 11.52.47 AM Screen Shot 2016-03-03 at 11.52.47 AM

  1. Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.

If you currently receive employer-based insurance, deducting medical insurance premiums would be “double-dipping,” as most premiums are paid with pre-tax dollars.

Trump is correct that we cannot currently fully deduct health insurance premiums. My question is how do you pay for these deductions? How much would this cost?

As far as Medicaid, Obamacare did expand the reach of Medicaid. It was Republican-controlled states that declined Medicaid Expansion.  17
Screen Shot 2016-03-03 at 12.12.19 PM Screen Shot 2016-03-03 at 12.12.08 PM

  1. Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.

We can already use Health Savings Accounts. They are already tax-free. They already are allowed to accumulate. They already are a part of an individual estate and passed on without an estate tax, or death penalty. They already can be used by any family member.

  1. Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.

Wait, do you mean like the comparison tool I can use with my insurance provider? Where I can look up the procedure, the facility, and the physician performing the procedure? 18

Screen Shot 2016-03-03 at 12.30.23 PM copy

True, it’s not complete transparency, but that’s not an Obamacare problem. That’s a medical industry problem that can still be fixed and needs to be fixed.

  1. Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.

Are these the same states that have refused to accept federal funds to administer state Medicaid programs? Are these the same states that refuse to administer their state Medicaid programs, privatizing that administration instead?

  1. Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.

Drug reimportation, while not typically a Republican policy centerpiece, is an idea with bipartisan support. 19 Traditionally, the barrier to implementing drug reimportation has been the pharmaceutical industry and the politicians they buy through lobbying.

Looking at the big picture, though, we need to look at where the pharmaceutical industry spends money. The price of drugs is a more complex issue than “drugs are cheaper in other countries.”

“Advertising dollars spent by drug makers have increased by 30 percent in the last two years to $4.5 billion, according to the market research firm Kantar Media.” 20

“The AMA’s new policy recognizes that the promotion of transparency in prescription drug pricing and costs will help patients, physicians and other stakeholders understand how drug manufacturers set prices. If there is greater understanding of the factors that contribute to prescription drug pricing, including the research, development, manufacturing, marketing and advertising costs borne by pharmaceutical companies, then the marketplace can react appropriately.” 21


Like much of Donald J. Trump’s campaign and candidacy, this plan is a bunch of hot air. There is nothing of substance. There is nothing within this “plan” that is new. There’s nothing here that would actually help Americans.


Footnotes

  1. Rasmussen Reports, “Congressional Performance:
    Voters Still Say Congress Is For Sale“, February 22, 2016
  2. Politifact, “Trump: Obamacare health care premiums ‘going up 35, 45, 55 percent’“, October 25, 2015
  3. Healthcare.gov
  4. Scientific American, “Health Care Rationing Is Nothing New [Excerpt]“, January 18, 2013
  5. Politifact, “Trump: Obamacare health care premiums ‘going up 35, 45, 55 percent’“, October 25, 2015
  6. Politifact, “Trump wrongly says Obamacare has ‘no options,’ competitive bidding“, February 21, 2016
  7. Politifact, “Trump wrongly says Obamacare has ‘no options,’ competitive bidding”, February 21, 2016
  8. Washington Post, “No, Obamacare isn’t killing full-time jobs, new evidence shows“, August 12, 2015
  9. Mother Jones, “Cruz Claims ‘Millions’ Have Lost Their Jobs Because of Obamacare“, January 28, 2016
  10. Here you go! https://www.google.com/search?client=safari&rls=en&q=obamacare+collapse&ie=UTF-8&oe=UTF-8
  11. Rasmussen Reports, “Congressional Performance: Voters Still Say Congress Is For Sale“, February 22, 2016
  12. CNN, “House sends Obamacare repeal bill to White House“, January 6, 2016
  13. Politifact, “Trump: Obamacare health care premiums ‘going up 35, 45, 55 percent’“, October 25, 2015
  14. Newsweek, “Five Ways Obamacare Has Improved You Health Care“, March 23, 2015
  15. The Atlantic, “Republicans Should Reform Obamacare, Not Repeal It“, June 29, 2015
  16. New York Times, “The Problem With G.O.P. Plans to Sell Health Insurance Across State Lines“, September 1, 2015
  17. ObamaCare Facts, “ObamaCare Medicaid Expansion”
  18. Take a look at Healthsparq, a company that provides this service across the country.
  19. The Hill, “Senate Republicans criticize Obama as drug reimportation amendment fails“, May 24, 2012
  20. American Medical Association, “AMA Calls for Ban on Direct to Consumer Advertising of Prescription Drugs and Medical Devices“, November 17, 2015
  21. American Medical Association, “AMA Calls for Ban on Direct to Consumer Advertising of Prescription Drugs and Medical Devices”, November 17, 2015

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