Diary

Breaking a promise? Donald Trump and Obamacare

From The Wall Street Journal:

In WSJ Interview, Trump Says He Is Willing to Keep Parts of Health Law

President-elect hints at possible compromise after vows to repeal the Affordable Care Act

By Monica Langley and Gerard Baker | Updated Nov. 11, 2016 5:53 p.m. ET

NEW YORK—President-elect Donald Trump said he would consider leaving in place certain parts of the Affordable Care Act, an indication of possible compromise after a campaign in which he pledged repeatedly to repeal the 2010 health-care law.

In his first interview since his election earlier this week, Mr. Trump said one priority was moving “quickly” on President Barack Obama’s signature health initiative, which Mr. Trump said has become so unworkable and expensive that “you can’t use it.”

Yet, Mr. Trump also showed a willingness to preserve at least two provisions of the law after Mr. Obama asked him to reconsider repealing it during their meeting at the White House on Thursday.

Mr. Trump said he favors keeping the prohibition against insurers denying coverage because of patients’ existing conditions, and a provision that allows parents to provide years of additional coverage for children on their insurance policies.

“I like those very much,” Mr. Trump said.

There’s more at the original, but what I see is Mr Trump opening the door to back away from the promises he made during the campaign.

On health care, Mr. Trump said a big reason for his shift from his call for an all-out repeal was the meeting at the White House with Mr. Obama, who, he said, suggested areas of the Affordable Care Act, widely known as Obamacare, to preserve. “I told him I will look at his suggestions, and out of respect, I will do that,” Mr. Trump said in his Trump Tower office.

“Either Obamacare will be amended, or repealed and replaced,” Mr. Trump said.

The White House wouldn’t comment on Mr. Obama’s discussion with Mr. Trump on health care.

Translation: as President, Mr Trump will attempt to ‘fix’ the laughably-named Affordable Care Act, something President Obama has asked Congress to do for a couple of years now.

I cannot say that I am surprised. We have noted previously that there are two, and only two, options:

  1. Either we will have the government guarantee access to health care to everybody, in which case we are only debating the best way to do that; or
  2. The government will not guarantee access to health care for everybody, in which case those who cannot or will not buy health insurance or cannot pay for services in cash will and should be denied health care when they need it, even if the consequence of that is death.

All of the “repeal and replace” Republicans have, in effect, agreed with the first option, replacement simply being another way of guaranteeing health care coverage. They are opposed to “Obamacare” not for what it does, or attempts to do, but simply due to how it’s being done — which is, admittedly, terrible — and whose name happens to be on it.

Let me state that again: a whole lot of people are opposed to Obamacare because it has been nicknamed for President Obama!

That’s one lousy reason to oppose it. I oppose it because I prefer the second option, that the government not guarantee health care, and I accept the consequence that comes with it.

There really aren’t that many ways to achieve the first option:

  1. A complete government system, some form of single-payer, such as extending Medicare to cover everybody. Hillary Clinton proposed allowing people between 55 and 64 to “buy in” to Medicare, and Bernie Sanders simply wanted a single-payer system.
  2. Some form of public-private combination, using the current insurance system, with some form of grant or subsidy or “public option” to enable those who cannot pay for insurance to do so. That’s what we have right now with the Affordable Care Act.

If you are going to support some form of universal health care coverage, those are your two options, period. Private charity can’t cover everybody, and the private health insurance system cannot without someone paying the premiums for those people who cannot do so themselves. Either you are going to have to agree with some sort of complete government system, or you are going to have to support something along the lines of the Affordable Care Act. It really is that simple.
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Cross-posted on The First Street Journal.
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