Clinton,  Trump, and Health Reform

It is March 3, 2016, the day after Super Tuesday.  This much is clear.  Hillary Clinton and Donald Trump will be the Presidential nominees for their respective parties.

What does this forebode for health reform?

It is too early to forecast with certainty, but we know these things.

One, Hillary Clinton is a progressive, whose greatest single regret is not having passed health reform in 1993 when President Bill Clinton assigned her that task. 

We know her present goals are:

·         To defend ObamaCare, build on it, fix it, and improve on it and slow growth of out-of-pocket costs.

·         To crack down on prescription drug costs and make drug companies accountable by forcing them to spend less on marketing and more on research.

·         To protect women’s access to reproductive health care, including contraceptive rights and safe, legal abortion.

·         To run on campaign focusing on being the first woman president and highlighting Trump’s negative views on women.

Two, Donald Trump is a self- described “compassionate conservative." He says he is a “deal maker.”  He vows to get leaders of both parties together to hammer out deals to make health care universal and to prevent people from “dying in the streets.”  In the past, he has taken liberal positions, advocating universal government coverage.  Now he regards ObamaCare as a “monstrosity “with deductibles so high the health law is “useless.”

To achieve his aims, he would:

·         Repeal and replace ObamaCare with an emphasis on health savings accounts. 

·         Increase competition across state lines by making health insurance portable across those lines and from one job to another. 

·         Reduce costs of insurance companies and pharmaceutical companies.

·         Make the economy so robust that Medicare and Medicaid cuts would not be needed.

·         Achieve universal coverage.

Hillary Clinton and Donald Trump share certain views in common.

·         Retention of protection of individuals with pre-existing illness.

 

·         The goal of Universal coverage.

 

·         Endorsement (but not funding) of Planned Parenthood.

·         Protection of women’s reproductive and health care rights.

Even given these agreed upon goals,  it is already apparent it’s going to be a contentious  and noisy election campaign,  on Trump’s alleged misogyny,  Clinton’s infamous email server,   her poor performance as Secretary of State,  and  mutual contrasting views on immigration,  corporate and individual taxes, and reverse inversions with companies headquartering outside the U.S.

Open your minds, put your moral blinders on, and cover your ears.  It’s going to be a clamorous,  rancorous,  noisesomeness campaign.   Translation: It’s going to get ugly.