Photograph Source: The White House – Public Domain
Donald Trump is so lost on so many issues that he can’t even understand how lost he is. This is perhaps most evident with his “$20 trillion” in foreign investment. Trump’s wacky number is five times annual investment levels. It is two-thirds of GDP. But none of his aides can get him to stop repeating his imaginary number.
In the wake of the shutdown disaster, Trump seems intent on coming up with some alternative to the subsidies for people to buy insurance in the Obamacare exchanges. Not surprisingly, Trump has almost no knowledge of all the issues and complexities that have come up in the debate on health care reform over the last three decades.
Incredibly, he is completely unaware of his own ignorance. He proposes giving people money and letting them buy either their own health care or their own insurance. (It’s not clear what Trump thinks he is proposing.) Trump seems to think this is an original idea.
Given the difficulties in designing health care policy — which would be known to anyone remotely familiar with the debate — it’s hard not to be reminded of a famous Doonesbury comic strip from a half-century ago. In the strip, Michael Doonesbury, who is a typical college student, is sitting at a desk with his housemate, B.D., the star of the college football team.
B.D. asks Michael about the topic of the paper he’s writing for the biology class they are taking. Michael says he is writing on “juxta bronchial organ secretions in the higher mollusks.” He then asks about B.D.’s paper topic, which is “Our Friend the Beaver.” We are getting a ton of Our Friend the Beaver vibe out of Trump, and indeed much of the Republican Party, when it comes to their alternatives to Obamacare and the system of exchanges it created.
As people who even very casually followed the debate over recent decades know, health care presents problems that cannot be solved just by giving people money to buy their own healthcare or insurance. Most people are healthy and have relatively modest bills, but the problem is that some people do have serious issues and end up with very large bills.
This is the reason for insurance. Putting aside a few thousand dollars a year on your own is not going to cover the cost of heart surgery or cancer treatment. This means that both people who have health issues need insurance, and even healthy people buy insurance in the event they could be in an accident or develop a serious health issue.
Incredibly, Trump and many Republicans seem to think it’s some sort of slam that a large portion of the people on the Obamacare exchanges don’t use their insurance. This is also true with auto insurance and fire insurance. In any given year, most of us don’t use these; in fact, many of us may never use them in our lifetime. But we still mostly think it’s a good idea to have them in case we are in a bad car accident or our house burns down.
The big problem with health care insurance, which the “our friend the beaver” crowd misses, is that insurers don’t want to cover people who have major health issues. Unless the government forces them, insurers will either charge people with heart conditions or a history of cancer exorbitant premiums, or refuse to cover them altogether.
That isn’t a conspiracy theory; insurers don’t make a profit paying out large amounts of money in claims. This means that if we want people with serious health problems to be able to get insurance at an affordable price, the government has to regulate the market and limit the ability of insurers to discriminate based on pre-existing conditions.
For the “Our Friend the Beaver” crowd, this means that relatively healthy people will pay more than if we let insurers exclude unhealthy people from their pool. However, if the point is to ensure that people who actually need health care can get it, there is no alternative to government regulation with private insurers.
We could go the opposite direction, which would fit some of Trump’s recent anti-insurance comments, and just have a universal health care system provided through the government, as we already do now with Medicare for our older population. A universal Medicare system would eliminate the problem of selective coverage and also get rid of hundreds of billions of dollars of administrative expenses and profits being paid to private insurers.
Along with excessive payments for drugs and doctors, this is one of the main reasons Americans pay so much more for health care than even everyone else. But there is no indication Trump is looking to establish a universal Medicare system.
Instead, we have a confused 79-year-old president leading his loyal followers in the Republican Party on a bizarre path in Never Never Land, where they make bold pronouncements on healthcare that ignore all the issues that have troubled serious analysts for decades. It would be great entertainment except that at the end of the show, millions of people may not get the health care they need.
This first appeared on Dean Baker’s Beat the Press blog.
The post Trump’s “New” Ideas on Health Care appeared first on CounterPunch.org.
From CounterPunch.org via this RSS feed