They’ve waited six years for this. Now Congressional Republicans, with Donald Trump in the White House, will likely send Obamacare off to its grave. What will replace it? Probably another law with a lot of promises under the heading of another slick acronym. But it still won’t satisfy most Americans. That is, unless Trump gives us a health care system that’s very un-Republican.
Count me as one of the many who never liked Obama’s Affordable Care Act. But my reasons are very different than the GOP’s. I’m in favor of a single payer plan. I’ve never believed that the availability and cost of health care insurance should be dictated by the free market.
I’m not alone. According to a December 2015 Kaiser Family Foundation poll, 58 percent of Americans “favor the idea of Medicare-for-all.”
Now don’t confuse this with socialized medicine. Most doctors and nurses would still be employed by private businesses. The government wouldn’t own and operate the hospitals. But it would collect the taxes needed to be able to pay the bills itself.
And believe it or not, Donald Trump has been an advocate for this approach to health care.
Two years ago, on the Late Show with David Letterman, Trump happily told a story about a very ill friend in Scotland who got picked up by an ambulance, spent four days in a hospital “with great doctors, great care” and was discharged with no bill to pay.
Who pays the bills in Scotland? For 90 percent of the people, it’s the government-run National Health Service. The rest rely on private insurers, doctors and hospitals.
Trump also told Letterman “just look at your doctor’s bills” for evidence of the fraud and abuse which plaques our system. He believes he could negotiate a deal with them, hospitals and the American taxpayer to make healthcare more accessible and affordable for everyone.
And it’s a view he’s held for a long time.
In a 1999 interview on Larry King Live, he said he was “very liberal when it comes to health care” and added, “I believe in universal health care. I believe in whatever it takes to make people well and better.”
Soon afterwards his book “The America We Deserve” was published. In that he states, “the goal should be clear: Our people are our greatest asset. We must take care of our own. We must have universal healthcare.” Maybe not immediately, but he said we need to transition to “an equivalent of the single-payer plan that is affordable, well-administered, and provides freedom of choice.”
Fast forward to September 2015. On 60 Minutes Trump told Scott Pelley “everybody’s got to be covered.” Acknowledging it was “an un-Republican thing” to say, he even declared “the government’s gonna pay for it.” He wasn’t proposing a single payer system. For most people “it’s going to be a private plan” they’ll be able to negotiate “with lots of competitors with great companies.”
“Even if this means I lose an election,” Trump said in defense of this position on the eve of the Iowa caucus, “that’s fine, because, frankly, we have to take care of the people in our country.”
But Trump has never provided any details for how he’d accomplish this. The position paper on his campaign website merely stated he’d repeal Obamacare and replace it with a system “following free market principles … to create sound public policy that will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans.”
Free market principles means little to no government involvement. That’s what Tom Price wants. The Georgia Congressman is Trump’s pick to head the Department of Health and Human Services.
To “get Washington out of the way,” Price sponsored the Empowering Patients First Act of 2013. It proposed replacing every section of Obamacare with a system of tax incentives to encourage Americans to obtain health insurance. No more government requirement to have it though. But gone too would be the prohibition against denying coverage due to pre-existing conditions. And insurance companies could again impose annual and lifetime coverage limitations.
In other words, not everyone would have health insurance.
But in his confirmation hearings this past Wednesday, Price said he would be working to get the President’s ideas, not his, into law. And in an interview with The Washington Post last weekend, Trump reiterated it will include “insurance for everybody.”
If Trump delivers that, it will upset a lot of Republicans. But not most Americans. We’ll just be anxious to see if Trumpcare can stop the runaway costs of health care services and insurance.
• Rich Moniak is a Juneau resident and retired civil engineer with more than 25 years of experience working in the public sector.
