Many voters have indicated that the economy is their major issue of concern. An important consideration affecting this economic issue is the costs associated with healthcare. Regardless of how robust our individual health may be at the moment, there is no question that each of us will experience an interaction with the healthcare system in this country.
The Peterson Kaiser Family Foundation Health Tracker has conducted analyses relating to healthcare costs and outcomes. The bottom line is that compared to other large wealthy countries, our healthcare system costs us twice as much and has worse health outcomes. The difference comes to over $6000 per year that we in the US pay over our peer countries.
Another factor to bear in mind is that according to Peterson KFF analysis, inflation associated with medical costs typically outpaces consumer prices in the Consumer Price Index. It appears that if we want to compare which candidates will be better for the economy, we need to include their policies toward healthcare.
Most everyone has heard how Donald Trump responded to the healthcare question at his debate with Kamala Harris. Asked what his healthcare plan would be, he responded that he had a « concept of a plan. » There are some striking things that voters should consider in weighing their election choice in light of the healthcare issue.
First thing to keep in context is that Americans currently carry $220 billion in medical debt. This is not a trivial amount with over 3 million Americans dealing with $10,000 or more in medical debt. Texas has averaged 10.7% of its population carrying medical debt and features the largest uninsured population in the US.
Another important thing to keep in mind is that despite JD Vance stating that Trump in his first term salvaged the best US program for expanding healthcare insurance coverage -the Affordable Care Act, Trump’s actions were very much a full-on effort to terminate the program and gut it when his termination efforts failed.
Consider these earlier actions by Trump and see if you see a potential administration that will act in our best behalf. What you will see are efforts to sabotage, not salvage, the program fully in contrast to the constitutional duty that the President « take care that the laws be faithfully executed ».
-On day one in office in 2017, Trump signed an Executive Order as reported by CNN that stated « It is the policy of my administration to seek the prompt repeal of the Patient Protection and Affordable Care Act » -aka Obamacare.
-The House followed through on the Executive Order and passed the American Health Care Act which repealed the subsidies and regulations of the ACA. In celebration of the House passage in the Rose Garden while standing with House members, Trump triumphantly stated « Make no mistake:this is a repeal and replace of Obamacare. » It was a one vote difference by John McCain in the Senate which blocked the law’s final passage. Possibly studies such as that by the non-partisan Congressional Budget Office showing the law would result in 23 million people losing health coverage played a role in Trump’s failure to kill the ACA.
-Trump was able to eliminate a tax penalty for not having health insurance. This meant that the insurance pool would shrink and lose more healthy persons thus increasing insurance costs.
-Trump signed Executive Orders that slashed funding for advertising and promoting sign-ups by 90% - including a 84% cut for navigators who would assist people in signing up.
-Trump promoted and expanded short term insurance plans which did not have to follow ACA rules such as covering pre-existing conditions. This would further dilute the insurance pool forcing higher costs for the ACA.
-A final effort by Trump just before being voted out of office involved employing the US Department of Justice to support a lawsuit against the ACA at the US Supreme Court. The lawsuit failed.
Keep in mind - there was not a better healthcare plan provided during Trump’s term in office that would improve upon the Affordable Care Act nor is there one now.
However, the « concept » related to healthcare Trump speaks of is clear - destroy anything done by President Obama during Obama’s presidential term.
Following his roasting by Obama at the White House Correspondant’s Dinner in 2011, Trump kicked into his petty revenge mode (the roasting had addressed Trump’s fake birther issue that Obama was not born in the US). It was there that according to Roger Stone that Trump decided to « show them all. » Our country went through 4 years of this petty nonsense. Bringing Trump back will not salvage the ACA (if it ever needed to be salvaged) He will not provide us with anything better. Trump’s only « concept » is to protect and enhance his fragile ego.
45 million Americans now rely on the ACA for health insurance. They, along with everyone else, need more than a « concept of a plan » -especially a « concept » that is based upon petty revenge.
W Laurence Doxsey, Retired, Former Director of Office of Sustainability for City of San Antonio, former Environmental Officer for US Department of Housing and Urban Development, former Sustainability Officer for City of Austin, resides outside Medina.
