With news of more exchanges closing, fewer healthy enrollees signing up, insurance companies pulling out, and health insurance premiums set to spike, this October we will see a tighter turn in the death spiral of ObamaCare. There is no doubt about the higher premiums and lack of choices in ObamaCare. What should be done in its aftermath is up for debate. This makes the November presidential election a significant turning point in our national healthcare conversation.
When it comes to American medicine, the choice for president is as stark as it ever has been: go further down the road to complete government and insurance company control over the “healthcare system,” much of which is devoted to financing and administration, or begin turning to a more patient-doctor directed, personalized, free-choice system. From my perspective as a physician (and as a patient), Donald Trump offers far more hope than what Hillary Clinton has already announced: repeal ObamaCare vs. double down on this top-down, centrally controlled, anti-choice system.
A side-by-side comparison of the two candidates’ plans by the Kaiser Family Foundation shows basically this for Clinton and Trump, respectively:
- More taxpayer subsidies, more mandated benefits, a “public option,” price ceilings on insurance premiums and out-of-pocket spending (Clinton) vs. more insurance options [across-state-line purchases would bypass costly state mandates]; tax deductibility for premiums, and expanded health savings accounts (Trump)
- Spending $500 million to advertise subsidies and Medicaid and more federal funding to encourage Medicaid expansion (Clinton) vs. block granting Medicaid to states (Trump)
- Allowing people age 55 to 64 to buy into Medicare [Ponzi schemes constantly need new "investors” to pay the early "investors”] and stop paying for services rendered but only for “value” (Clinton)
- Limit out-of-pocket spending for covered prescription drugs (Clinton) vs. allowing more competition (Trump)
- Fund Planned Parenthood and repeal the Hyde Amendment, which forbids taxpayer funding of abortions (Clinton) vs. de-fund Planned Parenthood and make the Hyde Amendment permanent
Some Republicans are concerned about Trump’s rehabilitated positions on some issues and say “we don’t know what he’ll do once in office.” Clinton, on the other hand, has been completely consistent in what she wants for healthcare, at least since she headed the Clinton Task Force on Health Care Reform in 1993.
This contest is not about likability. It’s about who will enact an agenda that will propel the U.S. towards a path of greater health, prosperity and safety—or the opposite. Regarding your medical care, this election boils down to a choice between more government intrusion or less; free-market medicine vs. government controlled markets; individual liberty vs. Washington, D.C. decision-making for your medical treatment; and patient privacy vs. government intrusion into every aspect of your life.
It is true that Trump at one time said that single payer medicine seemed to work in some places. But his views are changing. As a doctor, I would be concerned about a colleague who maintains the same views even as he matures and experiences practice with all of its lessons learned. The physician who fails to learn from new research, techniques, or personal growth is the one to be feared, not the one who alters recommendations or treatment plans after learning of better ideas and techniques.
The biggest objection by many of the establishment Republicans may be that Trump is simply an outsider who lacks government experience. The reticence to let someone who doesn’t like your rules into your clubhouse is understandable, but let’s remember: The Republican clubhouse has not been at 1600 Pennsylvania Avenue since January 2009. As to experience, where have our pedigreed elected officials brought us thus far? Terrorism at our doorstep, riots in the streets, almost $20 trillion in debt, 46 million on food stamps, and a healthcare system that is in a death spiral. It will be hard for Trump to do worse.
We need to remember what Ronald Reagan said: “Government is not the solution to our problem. Government is the problem.” This is so right when it comes to medical care. Virtually every intervention our government has employed with regard to medical care, starting in 1965, has made it more expensive, less efficient, and less private. It has interfered with quality and led to vast amounts of fraud, abuse, and waste.
With medical care, the question for the election boils down to this: the prospect of less government involvement in our care, or a guarantee of continued progress to a complete government takeover.