Sunday, April 10, 2016
Trump Health Plan Has GOP Critics Bewitched, Bothered, and Bewildered
According to the New York Times, Donald Trump’s 7-Point Health Care plan has Republican critics bewitched, bothered, and bewildered. (Robert Pear and Maggie Hagerman, “Donald Trump’s Health Care Ideas Bewilder Republican Experts.” NYT, April 8, 2016).
The plan’s main features are :
1. Repeal ObamaCare
2. Allow insurance sales across state lines
3. Allow full deductions of premiums
4. Allow states to have block grants for Medicaid
5. Allow individuals to have Health Savings Accounts
6. Require price transparency for all health providers
7. Remove barriers to free markets for drug purchases from foreign firms who offer safe generic drugs.
Many of these elements are in other GOP proposals, so what’s the problem? Why do GOP critics call his plan “vague” and an “economic mishmash’”?
Well, although Trump asks for “full repeal” he says” Everybody’s got to be covered.” This statement bewitches conservatives. He does not seem to realize Universal coverage is not in the GOP’s playbook, but is the rallying cry for Democrats. He does not seem to acknowledge that keeping Medicare intact and covering all is financially unsustainable without modifying it. Not everything in health care, especially Medicare, is “negotiable” when it comes to matters of health, life, and death.
Trump wants full deductions for health care expenses, but only 145 million of 330 million Americans submit tax returns asking for deductions, so full deductions would not help the poor or the low income middleclass.
Critics complain full repeal would take away subsidies from 13 million who have enrolled in ObamaCare plans. “If you repeal the Affordable Care Act, you’ve got to have a serious way to expand coverage to replace what you have taken away,” said Gail R. Wilensky, administrator of Medicare and Medicaid under President George Bush from 1990 to 1992. “There’s nothing I see in Trump’s plan that would do anything more than cover a couple million people.”
Trump declines to name the health care experts he proclaims are advising him. This worries members of the GOP establishment, who consider themselves experts in health care matters.
Trump promises he would send lumps of money in the form of block grants to help states manage Medicaid, but would not cut any money from Medicaid, the fastest growing federal health program. This bothers the GOP, who, in the main, says Medicaid needs to be cut.
James C. Capretta, a senior fellow at the Ethics and Public Policy Center, a conservative nonprofit group, said Trump has underestimated how difficult it would be to uproot a law embedded in the health care system. It took a herculean political effort to put in place the Affordable Care Act,” said Mr. Capretta, who worked at the White House Office of Management and Budget. “To move in a different direction, even incrementally, would take an equally herculean effort, with clear direction and a clear vision of what would come next. I just don’t see that in Trump’s vague plans to repeal the law and replace it with something beautiful and great.”
Grace-Marie Turner, Galen Institute president, a champion of free-market health policy, said Mr. Trump’s proposals were sketchy and inadequate. “He has to discard some of his ideas, like the importation of prescription drugs, because they would be damaging and unworkable, And he has to flesh out his other proposals with much more detail if he hopes to persuade voters that he has a credible plan to replace ObamaCare.”
Democrats must be saying, “A bird in the hand (ObamaCare) is worth one in the bushes (Trump’s seven point proposal). The bushes contain noxious weeds - drug firms and insurers that depend on profit to survive, popular ObamaCare provisions, and vocal poor and minority voters dependent on government assistance,
If the Trump continues to foul the Republican nest, this discussion may be irrelevant,