Trump Policy Issues, Part 1

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There is some ‘real talk’ that is presently occurring, as it should be, in the Republican Presidential primary season. Hopefully the country is going to see calming forces beginning to prevail, which allows each candidate to dive into his platform and discuss how said platform will be the best option for America. In other words, Donald Trump’s campaign needs to grow up, stop calling people names, and tell the American people what he honestly stands for. Thus far, the mud-slinging has done nothing but help Trump, because the mud-slinging distracts from his platform. But, as the field narrows down and people begin to talk shop, candidates are going to have to turn to their platforms.

The first we’re taking up is healthcare.

Before we get into Trump’s policy, I want to talk about realistic avenues to take, regarding Obamacare. First off, there is no candidate that can effectively guarantee that he will repeal Obamacare. The Executive Branch of the government only executes law. They don’t write law – even though they can influence Congress, they can only sign or veto legislation. Currently, Congress has a Republican majority in both House and Senate, and they have tried to push legislation through to reform the act – but all legislation has been vetoed. However, every House seat and 34 Senate seats are up for election. There’s no guarantee that a Republican President is going to walk in the oval office with Congress on his side.

I also want to talk a little bit about Obamacare, in general. I’m on the team that felt that a massive overhaul of our healthcare industry was needed, but feel that the Administration failed everyone with this passage. The Affordable Care Act was hastily draw and pushed through, with every single representative knowing this Act would have to be revised in the future to be effective. I would argue the hastiness of it was somewhat necessary, and I don’t find issue with passing an act that will have to be modified, as long as a legitimate backbone is put in place to grow off of. I do believe that the backbone of the ACA is strong, and further revisions can be made to strengthen it. However, the principle of the matter is what is wrong with the passage of the ACA.

The bill was hastily drawn up and passed because Democrats had the opportunity to do this. There is no denying this. The problem with that is that it creates a wave where the government looks to be partisan in order to pass their platform, when it should sell the platform to both sides. It was a mistake for Congress and Obama to sign in a bill that had zero Republican support. This is why Republicans are angry, and they should be. This was a massive overhaul of the healthcare industry. Both sides have to be included when it comes to massive legislation like this. Otherwise, you’re ignoring half of your population. Legislation like this is irresponsible and dangerous – it causes more partisan divide, it has a domino effect in budget planning and the passage of other bills, and it creates chaos.

The ACA had some Republican support and some Republican modification. The bill wasn’t 100% Democratic written and supported. However, when it came down to the final hours, Democrats chose to march forward instead of crossing the line and working toward a bipartisan effort. This, in part, is irresponsible. Congress often has a difficult job, but we should expect them to be able to do it, or they should be voted out of office. Part of that job is to find a middle ground, and the Democrats in Congress failed. Voters responded to this loudly, and some of them lost their jobs. That’s fair. However, moving forward, the country needs to get over the division and start working together to responsibily modify the ACA, and get bipartisan support. Afterall, if principle matters, then principle needs to be set by example.

That being said, Donald Trump released a 7-point plan for healthcare reform. It is as follows:

Congress must act. Our elected representatives in the House and Senate must:

  1. Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.
  2. Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.
  3. Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.
  4. Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.
  5. Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.
  6. Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.
  7. Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.

The first thing I want to point out is, as with many of Trump’s plans for change, this grows government and takes away from state rights and regulation. The first order (after repealing – which has already been covered) takes state regulatory measures out of the picture, and expands the federal government. This just creates a mess, as stated, because it takes away a state right to regulate commerce, and it gives that job to the Feds. As explained, no-go. Trump needs to break this down to show that state rights of regulation are not removed.

With the tax refund issue, what it would do would replace the tax credit system already in place with the ACA, and the sytem that’s been in place and works. What this means is that your relief depends on your income, not on your health needs. This would help upper and middle class, but would still cheat the lower class, which is the class that is consistently hurt the most when it comes to healthcare reform. The tax credit system already in place grants exemptions that are equal, regardless of income bracket. This falls under the “if it ain’t broke, don’t fix it” category.

Health savings accounts already exist. Trump proposes something that can be easily exploitable and is not realistic, and is vague at best. Will HCAs have yearly limits? Will multiple family members be allowed to contribute? Will interest be tax free? Will there be regulations on usage? This, to me, feels like Trump is putting a pretty bow on something already sold to us. Trump’s plan seems easily exploitable and wouldn’t exist as laid out here. There’s too much potential to hide income and transfer it, tax free. Congress wouldn’t allow it or propose it.

Price transparency is a great idea and theory. It’s also not been attainable by any healthcare reform to date. What Trump is selling here is a pipe dream he can’t accomplish. Period. Its success depends on the success of his other point plans, as well, which some aren’t as promising as written out and summarized on his webpage.

Block-grant medicaid is one of the only factors that would be greatly beneficial with no real risk. It puts states in more control of medicaid spending, and requires adherence to a realistic budget that would cut costs and wasteful spending. It actually puts states in control and in responsibility of budget shortfalls.

The last point basically undercuts U.S. pharmaceutical and healthcare innovation. Straight up. It’s basically opening up international free trade in the pharmaceutical sales. Goodbye regulation and investiment into the U.S. industry. This move is completely counter to Trump’s own platform of U.S. first. While I understand that reform is needed in the pharmaceutical industry, you don’t make that reform by cutting off your nose to spite your face. This is what worldwide/free market competition would do in the United States.

All in all, Trump’s plan kind of begs, borrows, and steals from platforms already in existence in the Republican party, but it’s a lot more vague and general. A lot of these provisions have already been, and continue to be fought out in Congress. The answer isn’t to regurgitate the same ideas already brought forth – it is to demand bipartisan support for further healthcare reform and improvements. His plan is vague and sketchy in its implementation, and does not address some of the most basic, primary concerns about healthcare reform that have been expanded and included in the ACA. It doesn’t address mandates and pre-existing coverage, which are not mutually exclusive, and are the biggest issue with healthcare reform.

But, we’ve come to expect general dodgy behavior from Trump when it comes to addressing specific issues, haven’t we?

 

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