Why isn’t healthcare coming up more among the presidential candidates?
Election time is creeping closer by the day, but all talks on healthcare have basically been radio silence in comparison. What gives?
With this upcoming presidential election, I was a bit confused as to why healthcare was being ignored. In the past two elections, healthcare was always a central point of debate, especially during the 2012 election with the ACA being all the rage in discussions. I know that many people believe that since Obamacare was passed, there aren’t any needs to talk about healthcare since it’s pitch perfect. But I can debate that. There are so many issues with regards to public health such as lack of access to care, reproductive health rights, medication and insurance costs, Medicare financing, and even the future of the ACA. As we’re steadily approaching the elections in November, candidates aren’t really discussing much about policy specifics or anything in regards to healthcare. For the most part, the candidates have been vague in regards to their views. All we knew is that Clinton wanted to build on the ACA, Sanders wants a single-payer plan, and Trump… well Trump wants to “repeal it and replace”. Regardless, below are some images I’ve found that do neatly organize some of the candidates’ views on healthcare.
After some research myself, I put together a paragraph on the healthcare views from the “Big 3”: Donald Trump (R), Hillary Clinton (D), and Bernie Sanders(D).
With the notion of single-payer healthcare, it’s something that is actually on the verge of being plausible given the number of Sanders’ supporters. As his primary platform for healthcare, Senator Sanders has pushed for the idea of a single-payer healthcare system that is essentially an expanded Medicare-for-all plan, and for many of the millennials and new generational “young’ins” it’s something that has high appeal but also presents disadvantages to the healthcare industry. As much as I despite private insurance and its practices, it’s a large portion of the industry today and insurance is what pays the bills… literally. By dismantling the ACA, as an extension of single-payer healthcare, would also essentially take away most of the teeth from private insurance companies and healthcare exchanges. However, that doesn’t mean that private options will go away but they will only be necessary in elective or more time-sensitive cases. Similar to many other countries that have a single-payer insurance scheme, the “medicare for all” plan would be the primary go-to plan in cases of preventative care or primary care, but because of possible waiting times or cases that are not covered by medicare, there is always the option of private insurance for cases of elective surgery and care that may not be covered. Just because medicare for all, extends its plans to all, it doesn’t mean that everything is covered as well. As a form of cost containment, some countries have developed a list of “top priorities” that are covered by these single-payer healthcare plans. These priorities are often the most important, significant, and impactful treatments in the country, and are thus covered. Although the ACA could be repealed and dismantled, I do still believe that there will be private insurance companies and maybe some healthcare exchanges, albeit on smaller scales. However, there are many that believe that a system like this can help attain the maximum value of the healthcare system and to end unnecessary waste through cost containment. Although I do not think that a single-payer system is feasible in our current state of affairs, but one way to achieve a similar outcome is through the state level. States could apply for a federal waiver, where everyone hospitalized could be covered by medicare, however it is still unlikely to bring about such a radical change. One thing that I believe single-payer can help adjust are pharmaceutical costs though, because the country as a whole would be the purchaser, it can negotiate with big pharma companies to help contain costs on prescription drugs, increase transparency on pricing, as well as increase cost-effective use of generic drugs, since it is the “only” purchaser.
Donald Trump, the top contender for the Republican nomination and the presidential election, has said repeatedly that he would repeal he ACA. As a businessman himself, Trump believes healthcare reform should be in the form of free market principles. He favors reducing barriers to purchasing insurance across state lines, making insurance premiums tax deductible. However, a model like this can only succeed if there is an appropriate amount of competition among healthcare providers, but looking at our current state of healthcare today, it appears that that large organizations will form and essentially, monopolize certain areas thus preventing free market principles from effectively taking place. One of the most alarming points that Trump has made is his intentions on creating and implementing a policy that would allow people to purchase healthcare insurance across state lines, but the problem is that the home states would not be able to regulate those forms of contracts and as a result, would sacrifice those state law protections. Although the country is ingrained in a “free market ruelz!” mentality, these markets are also subject to severe dysfunction and that the natural monopoly that would form may not always work out in the patients’ favor. Nonetheless, “repealing the ACA” is a feat that is all talk, without any of the walk. You can’t just “executive order” it away, or have the legislation repeal so simply. Not only would dismantling the ACA have fiscal repercussions, but it would also require accompanying reforms in Medicare laws as well. Even people who originally opposed the act, would find it difficult to repeal it now, especially since many of the voters would also lose benefits that they acquired under the ACA.
Lastly, let’s look at Hillary Clinton. Former Secretary of State, as well as the most likely candidate in earning the Democratic nomination, Clinton has stated that she would keep the ACA but would try and push for additional reforms in the act along with some tweaks here and there. If anything, Clinton appears to have the most viable plan about modifying and refining the ACA going forward. Some ways that she hopes to change healthcare is by increasing enforcement of current ACA requirements. In doing so, she hopes to contain costs more effectively and block/modify insurance organizations from unreasonable rate increases. Known for trying to champion a healthcare reform, similar but more ambitious than the ACA back in the 1990’s, Clinton shows her support again and hopes to build on it to slow the growth of out-of-pocket costs. One of the biggest industries in healthcare is in pharmaceuticals, but unsurprisingly, it was also one of the untouched areas in the ACA. One of the reasons why the ACA was able to be passed was because there were no regulations in regards to cost containment of prescription and generic drugs or any other policies that would garner the industries’ anger. As a result, though, prescription drugs have now become one of the most burdensome out-of-pocket costs. Because of this, Clinton also wants to try and enhance tax credits for families to help offset out-of-pocket and premium costs above 5% of their income. In these past few years, Medicaid had tried to expand itself for other states to adopt the federal system, even offering financial incentives, however many states have yet to adopt it, so Clinton has stated that she would try to continue expanding Obamacare and Medicaid to all states. As a result, residents could receive financial help from both the state and federal levels, the only reason why some states have not adopted the federal help is due to “political clashes”, as stupid as it is… it’s free money.