Despite widespread concerns and unhappiness with Obamacare, the 2016 presidential race has yet to fully focus on how best to fix its many problems. This must change. With Donald Trump and Hillary Clinton now the de facto nominees for their respective parties, they must both release detailed plans so that the American people can judge which candidate has the better health-care plan.
Right now we only know each candidates’ positions in the broadest possible strokes. The Democrats largely want to increase regulation of health insurance and pharmaceutical companies, which they claim would increase coverage and decrease prices. As for the Republicans, they largely want to gut or repeal Obamacare and offer a fairly uniform set of fixes – selling insurance across state lines, creating Health Savings Accounts for everyone, and instituting legal malpractice reform.
None of this will suffice. The American people deserve more than the standard political talking points. This is especially true of Mr. Trump, whose positions are even less clear than his opponents. Will his policies offer a better likelihood that our patients will have more choice and less expense than that of his counterpart?
For many of the following reasons, there are reasons to believe the answer might be “yes.”
First, Donald Trump has lived his entire life in the business world. Unlike Mrs. Clinton, he understands what it means to have to turn a profit and deal with an ever-growing bureaucratic burden. Mrs. Clinton, on the other hand, has never held a significant private sector job nor dealt with the onerous regulations placed on businesses big and small. In fact, she has often supported their very creation. Given this dichotomy, it is far more likely that a businessman rather than a lifetime politician will be better able to address the private sector’s ability to improve patients’ health.
Secondly, Mr. Trump’s policy, during the primaries, of not accepting donations allowed him to be far more resistant to the steady drumbeat from large pharmaceutical entities, large insurance corporations, and major hospital entities to cut deals that weaken personalized medical care. Patients and physicians do not have large PACs nor huge lobbying war chests. Now that the general election campaign is upon us and millions of dollars will be flowing into his coiffures, it is hoped that his resistance to these large forces will continue. Mr. Trump has presented himself to date as an independent soul, answering to no one. It would be welcome if Mr. Trump would be able to hold these “mega-interest” groups at arm’s length.
Third, Mr. Trump states that he wishes to open up the marketplace to competition for drug purchases, a step in the right direction. Leveling the pharmaceutical playing field will help Americans whose cost for prescription drugs is over 10 percent of healthcare dollars. It is well understood that the cost of research and development of new products is very high. But it needs to be recognized that all individuals benefit from advances in various medications. To date, the American citizen has been burdened for the cost of these worldwide benefits.
Fourth, as a businessman, Mr. Trump better understands that government intervention in any business drives consolidation and even creates monopolies. This has been borne out in recent years, and Obamacare has only accelerated this trend. In the last decade the number of pharmaceutical entities has decreased from 60 to 10. In just the last few years, the consolidation in the insurance industry has left us only three major players. The number of Healthcare Group Purchasing Organizations has dwindled to four. Private practice physicians who own their own practice have also dwindled from 75 to 25 percent over the past decade, and the numbers are only worsening.
This trend in all facets of the healthcare industry is going to leave us with a single provider/single payer system in all but name, if it is allowed to continue. Americans will surely suffer from a quality of care and budgetary deficits. Ask Britain about their NHS which has undergone recent physician strikes and amazingly poor statistics in quality.
Given his background, Mr. Trump seems best able to identify and address these problems. That is not to say that he will successfully do so – just that he has the better chance. Like Mrs. Clinton, he still needs to lay out a detailed plan that the American people can analyze for themselves. Only then will we be able to know for sure whether he will move health care in the right direction.
To be clear: The above synopsis does not advocate that Donald Trump should become our nation’s leader. But it does represent a hope that when it comes to health care, he has the expertise necessary to bring real reforms to this crucial public policy question. The American people have been waiting for answers for too long as it is.
