Donald Trump Remains Clueless on Health Care at Tonight's GOP Debate

On the campaign trail, Donald Trump has repeatedly promised to repeal and replace Obamacare.
But he's been even more vague than most Republicans when it comes to what, exactly, he'd replace it with. His typical answer is that he'd replace it with "something wonderful," which is a plan in the sense that become-a-millionaire is a career strategy.
At tonight's GOP debate in New Hampshire, Trump, who in a previous debate had some nice words for single-payer health care, was asked by Mary Katharine Ham about whether, given his various commitments on health care—he's also said he wants universal coverage that the government will pay for—he might actually be closer to Bernie Sanders on the health care question.
In his answer, Trump claims he's for common sense, and the proceeds to not make much sense at all.
I don't think I am. I think I'm closer to common sense. We are going to repeal Obamacare.
We're going to repeal Obamacare. We are going to replace Obamacare with something so much better. And there are so many examples of it. And I will tell you, part of the reason we have some people laughing, because you have insurance people that take care of everybody up here. I am self-funded. The only one they're not taking care of is me. We have our lines around each state. The insurance companies are getting rich on Obamacare. The insurance companies are getting rich on health care and health services and everything having to do with health. We are going to end that. We're going to take out the artificial boundaries, the artificial lines. We're going to get a plan where people compete, free enterprise. They compete. So much better.
In addition to that, you have the health care savings plans, which are excellent. What I do say is, there will be a certain number of people that will be on the street dying and as a Republican, I don't want that to happen. We're going to take care of people that are dying on the street because there will be a group of people that are not going to be able to even think in terms of private or anything else and we're going to take care of those people. And I think everybody on this stage would have to agree…you're not going to let people die, sitting in the middle of a street in any city in this country.
One problem with this answer is that Trump is wrong that "the insurance companies are getting rich on Obamacare." While it is true that the insurance industry pushed for and got an individual mandate to buy insurance as part of the law, as of yet they are not getting rich on the law. As Philip Klein noted earlier this week in The Washington Examiner, major insurers including UnitedHealth, Aetna, Anthem, and Cigna have all reported losses from their Obamacare lines this year.
More generally, Trump's answer isn't very good because it's not really responsive to the question. He insists he's not close to Sanders' view, and declares his support for competition and free enterprise, but doesn't attempt to square this with his previous support—which Ham quoted to him—for coverage paid for by government. He spends most of his answer ranting about how he wouldn't let someone die in the street (excepting, I imagine, those he chooses to shoot in the middle of Fifth Avenue).
The obvious takeaway from this response is that Trump not only has no plan to replace Obamacare, he has idea what he's talking what he's talking about when it comes to health care policy, and doesn't care that he's clueless. It tells us nothing at all about health care, but it does tell us about Donald Trump and his presidential campaign.
That Donald Trump is weak on policy is not exactly hot breaking news at this point in the campaign, but it's nonetheless telling that Trump, who has arguably improved as a candidate in many ways, has remained so proudly ignorant for this long.
Correction and update: In the original version of this post, I said that Trump was wrong to claim that he is self-funded, because his campaign is largely funded by donors. That's right, but I misunderstood and misrepresented Trump's claim, which was not about his claim but about his health care. That's still not terribly responsive to the question, but it was an error on my part, and for that I apologize. I also Trump's statement about state lines, meanwhile, is presumably a reference to allowing people to buy insurance across state lines (though his language is garbled enough that anyone not already familiar with this idea is unlikely to understand it). And it's still not directly responsive to the original question about Trump's support for making the government pay for universal coverage. Still, I've removed that language from the post, since it does at least suggest some sort of policy he might be in favor of.
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Trump has said before he knows more about the military than anybody and tonight he said he knows more about banking than anybody - you think he doesn't know more about health care and insurance and campaign financing than anybody as well?
Trump knows all about making deals, yo.
When asked by reporters about the depth of his knowledge about the health care system, he said "Tremendous!"
Of course, that's the same answer he gives about the depth of his humility, so I'd take it with a grain of salt.
It's very easy to presume the The Donald's success is largely A) Inherited wealth, and B) Good staff hires. I have worked for, and made money for, bosses who weren't really capable of doing so themselves.
The point being that Trump's ignorance is not hard to believe, even given his wealth.
Hater. You just don't want America to be Great Again.
c) political connections
d) declaring bankruptcy four times
e) utter shamelessness and being a great clown (for his TV success)
I didn't watch the debate. Out of curiosity what did Cruz say about Obamacare?
Trump said he doesn't care what Canadians have to say about the subject.
It's not Cruz's fault his parents failed to place fake birth notices in the Hawaiian newspapers.
He can only make great-ify? one country at a time. They need to wait their turn
Cruz said that he would sponsor repeal of every word of Obamacare and every illegal executive order that supports it. Happily, he didn't suggest that we replace this government monstrosity with anything that is government-sponsored.
That is promising
So he must have run out of time before he finished his answer.
Stop crushing my dreams!
He made a nice point in this regard - that anything Obama has enacted by executive fiat, can be overturned by the next president by executive fiat.
Too bad Canadians can't be president.
Undoing the executive orders alone would cripple the ACA
Several of the EO's are actually propping ACA up. Like deferring the employer mandate until sometime when Obama's out of office.
Could it be that Trump was referring to his own health care coverage when he said he was "self-funded?" I think that that is more in context with what he was saying.
What Trump doesn't seem to understand is that medical facilities are presently required by law to render health care to indigents at no cost.
Yes, but Suderman is an idiot.
Also, the lines around the state refers to insurance plams not being able to sell across state boundaries.
"What Trump doesn't seem to understand is that medical facilities are presently required by law to render health care to indigents at no cost."
At no cost to them. And, claiming strong libertarian sympathies, I'm asking you give this some thought.
None of us wish the poor to be left in the gutter to die, regardless of Tony's claims. As members of a society, we simply cannot allow that to happen, regardless of the free-riders who might game whatever solution we can find.
So, what solution might there be that reduces the free-rider problem to a minimum?
Well, one where the decisions regarding care are made individually and locally; the MD or nurse right there chooses whether the the care is appropriate, or, triage, says 'nope'. And how might it be paid for? Well, those of us who buy insurance might find the bill higher than it would be if we left 'em to die, but a whole lot less expensive than covering 'pajama-kid-with-hot-chocolate'.
IOWs, for all the whining, what we had, pre-O-care, may well be the best we can hope for.
Put another way, that 'system' was ad-hoc, was non-centrally-planned, had no bureaucracy to direct it, did not require the IRS forms to fund it, did not require people to spend hours on the phone or on the web to sign up, did not require gov't-specified pricing, and so on and so on.
And was likely tons cheaper than what the asshole and the hag hung around out necks.
Comments?
I have several relatives who are doctors, and they all say the same thing: Medicare doomed the entire system, and it's only a matter of time.
When I talk to people who are bitching about $19,000 IVIG infusions and how it's SO WRONG, not a single fucking one of them even knows what a charge master is.
When an indigent patient goes into a hospital ER for a broken leg and gets charged 20 grand, thank the government. Medicare requires them to do so. They aren't allowed to to give discounts. They can bill it and send it to collections, or write it off. In negotiating Medicare payments, our lovely government demanded a discount of (something like) 90% off of rack rates, so hospitals set these rack rates ridiculously high so they don't lose money on Medicare patients.
Right now, I'm ignoring how the fed-gov distorted the market, and addressing how that market 'adapted' as all distorted markets do prior to Obo fucking it up.
"They can bill it and send it to collections, or write it off."
And the actual costs are, ad-hoc, transferred to those of us who pay our bills. I'm arguing that the distortion-costs were far less under that, ad-hoc, system than they are under O-care, with similar outcomes.
BTW, I have no idea what a "charge master" is.
The idea that 'uninsured deadbeats were killing off hospitals' was a bullshit meme in both directions. First off all uninsured patients were billed and sent to collections - hospitals didn't just shrug thei shoulders and say oh well. The bills would usually be negotiated down to the reimbursent levels that insurers or Medicare would have paid. In fact the total cost of all uncompensated care was in the $30bn / year range before obamacare.
So government is basically requiring hospitals that participate in Medicare to screw people without health insurance?
Yes.
Exactly.
Not just Medicare. Health insurance companies negotiate discounts as well, or more accurately some multiple of the Medicare rate. So EVERYTHING is tied to the rack rate. And hospitals are required to bill someone, somewhere that rate.
Some are quicker than others to simply write it off when you say you can't pay.
It's health insurance that really screwed up the system.
They are the ones that first negotiated lower payments to hospital.
"Sorry, we won't pay full price, only 10%".
And then the hospital raises the price 1000%, so they get reimbursed the same. But completely screws over someone without insurance.
I could believe the story about the govt demanding a 90% discount and actually getting no discount, but I find it hard to believe that the insurance companies are that stupid. What good does it do them to get a fake discount?
Insurance companies tie their negotiated rates to the Medicaid rate.
But according to advisory boards I have attended, it is simpler than that. Hospital X observes that 40% of their patients are Aetna so they need $400M in annual revenue from Aetna. So both sides agree to move numbers around until the projected revenue is where both sides are willing to sign. No one actually cares about the cost of individual procedures. The negotiations are at a much higher levels. Which makes a lot of sense.
Veterinarians do all of the same procedures for a fraction of what human medicine costs - part is less fear of malpractice and a large part is very little insurance and government involvement.
You mean Medicaid, not Medicare, right?
I feel the same way about tonight's so-called "top issue", immigration. Everything designed to "fix" it will likely make whatever you find wrong with it worse.
The uninsured have never been a significant problem in terms of medical costs; basic medical care just isn't very expensive.
The US health care system represents a collusion of politicians, doctors, hospitals, drug companies, and insurers to extract the maximum amount of money from people; it's the ultimate in rent seeking. And universal coverage and socialization of cost is an attempt to get rid of even the last vestiges of price signals and choice.
As someone who has lived in Europe, I can tell you that it certainly was better than European health care systems. But it was still unnecessarily expensive. Many drugs that are OTC in Europe are covered prescription drugs here, for example.
Meaningful reforms would include (among others): (1) make many drugs OTC, (2) get rid of the employer tax exemptions for health insurance, (3) greatly simplify medical licensing, (4) grant prescription privileges to many more professionals (including pharmacists and many nurses), (5) shrink Medicare/Medicaid and cut costs and services massively over time.
Sounds like a plan that would cut Doctor salaries. Can't have that in the US.
Making drugs OTC would also eliminate pain undertreatment.
But only for emergency cases.
Eventually, opposing repeal of Obamacare will be the least worst option.
Bad.
We need busing from Oakland to Oregon.
http://gizmodo.com/oregon-was-.....1539567040
I have some very bad news for that author about the histories of gun control and minimum wage.
Playa,
Asking for comments just a bit up-thread re: med care.
... and about progressivism and the Democrats in general.
Even worse, the same people continue the same kind of policies today while calling their opponents "racists".
Because the Portland of 2016 is exactly like the Portland of 1859.
Oh, it never really changes.
OT:
I'm a non-ticket-holder attendee to the Metallica concert at the ballpark this evening; I live close by.
Not griping, living in a city means you get that sort of stuff. But of their oeurve, is there anything that made an impression that an old fart might recognize? Used in a commercial? Spoofed as "Stairway to Heaven" is?
"Enter Sandman" is a very popular song.
Danke.
Beats hell out of "In a Gadda da Vida", which some old farts find a sort of an anthem.
Fade to Black or GTFO
Which is also your spoof of Stairway to Heaven
"Which is also your spoof of Stairway to Heaven"
Dunno enough about music to identify the specifics, but I'm guessing the 'chord progressions' are similar between the two.
I gave it 3 minutes. Well, I gave it three minutes; how's the weather in the south land?
85 tomorrow. I wish the pool was a bit warmer. I'll be tossing the kids around in it all afternoon.
A pool, eh? Next time it gets 100 plus degrees, we're coming over to your place. We'll bring beet and bbq.
It's also when Metallica changed their style to become pop/MTV friendly.
Yeah.
Nothing they did after Blaster of Muppets mattered to me.
Hopefully, the explosions during 'One' will still be epic.
I dunno how old a fart you are but the entire album "Master of Puppets" is something of a masterpiece even for folks like me who don't follow that genre very closely.
True dat
Whiskey In The Jar
Orion? Rodrigo y Gabriela did a great cover of it https://youtu.be/L0CsLefLisE
Supposed to be a response to sevo
TASTY!
But not what I'm hearing from the stadium.....
Yeah that probably wasn't very helpful but I couldn't resist. The original is still cool though
Saw them live, highly recommend. Love the 11:11 album.
Me too! Back when 11:11 came out. They brought a lot more energy on stage then I was expecting. Unfortunately I missed them on their most recent tour.
Trump wants single payer, and in his heart, he wants to take your niece's AR-15 away, too?
Screw Donald Trump.
How poor is your position when you have to flat out lie about your opponent's positions?
What are you talkin' about?
Are you saying Trump didn't really admire single payer?
Are you saying he wasn't really against "assault weapons"?
Supporting the Second Amendment and being against single payer are two of a very few reasons why I might consider voting for a Republican in the general election--and if The Donald doesn't even have those two basics nailed down, then that's pretty pathetic.
He had those positions 20+ years ago and has moved away from them since then.
WTF is with you autistic retards that think no one can ever legitimately change their position on any issue.
"He used to oppose the stuff that I like but now he doesn't so he's obviously a lying loser" is an idiotic pov.
He had those positions 20+ years ago and has moved away from them since then.
Yes, when he started contemplating running for president in the GOP. What makes you think you can trust him not to move back once he gets into office?
If you believe Trump, you should believe Feinstein and Holder when they say they don't want to take away anybody's guns, too.
"WTF is with you autistic retards that think no one can ever legitimately change their position on any issue."
I have no problem with the idea that people's positions change, but I care what their positions are on certain issues. And if Donald Trump's positions on gun control and single payer are indistinguishable from those of a progressive, then why would I vote for him? Because he has the right to change his positions over time?
Fuck that noise.
And Fuck Donald Trump.
He might as well be Christie or Obama. You think I'd vote for him because he doesn't talk PC? It's the positions, stupid! I might vote for him to stop single payer when ObamaCare collapses or to preserve our Second Amendment rights, but if I don't believe in him on those issues, he's offering nothing else to libertarians like me.
P.S. I might be on the autism spectrum somewhere, I don't know, but I only have one pair of chromosomes, thank you.
?i would suggest you to look..=http://bit.ly/1SBPuN1
"...Trump not only has no plan to replace Obamacare, he has idea what he's talking what he's talking about"
The Donald virus has infected your computer...
Trump's answer is still better than Sanders', who keeps lying about what other "advanced nations" and "Europe" are doing. But, then, Sanders seems to be ignorant of anything that's more than a few hundreds miles from his home or DC.
From the context, I gather that Trump by "self-funded" meant he's self-insured.
I think his answer's pretty clear: He wants to eliminated barriers to interstate competition in health insurance, maintain the legality of health savings plans, and make sure the indigent have care provided by them, such as by Medicaid. Was that so complicated?