Donald Trump

Donald Trump Is Totally Incoherent On Health Care Policy Because Policy Is Irrelevant to His Campaign

His flip-flop on Obamacare's individual mandate is an admission that policy details don't matter.

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Gage skidmore / Foter

Donald Trump made it very clear last night that he does not support Obamacare's individual mandate to purchase health insurance. Asked whether he supports mandates on the American people, Trump jumped in, cutting off Fox New host Sean Hannity to say, "No, I don't support them."

Less than a week ago, however, Trump felt very differently. Asked by CNN's Anderson Cooper about what would happen to the insurance market without the law's health insurance requirement, Trump said, "Well I like the mandate."

Last night's response was a follow-up on an early flip-flop, tweeting last week that he would "repeal all of #Obamacare, including the mandate, period."

The best way to understand this rapid change is not as a meaningful shift from one position to another. It's better viewed as an admission that he has no coherent position at all, and that the underlying policy details are utterly irrelevant to him.

This is always the case when Trump talks about health care. Figuring out what his actual policy preferences are is essentially impossible, and if you try to take all of his statements together, in some sort of context, you end up with what Philip Klein of The Washington Examiner recently described as a mix of "incoherence and socialism."

Trump has variously supported replacing Obamacare with a free-market system, covering everyone through a system paid for by the government, providing care to people using "the concepts of Medicare," allowing the government to use its buying power to negotiate with drug companies, instituting an ill-defined competitive bidding process even though one already exists in Medicare, and—if you are inclined to be generous—vague support for allowing insurance to be purchased across state lines. ("We're going to take the lines out of play.") 

Even when he gestures towards a real policy idea, he does so in ways that suggest that not only does he not really understand the idea, he does not care to understand it. The details are irrelevant. If anything, displaying an understanding of the details might suggest that Trump had become too caught up in the compromises of governance that he claims he will be able to overcome as president. 

The most consistent refrain in Trump's answers to health care is his declaration that "we're not going to have people dying in the streets," a line he sometimes repeats multiple times in a single response, as if America's streets were strewn with dead corpses. The line, of course, is not responsive to questions about how, exactly, he would replace Obamacare, or to any meaningful aspect of national health care policy. At best, it is reference to ensuring that people who cannot pay still have access to emergency care. But Trump's plan for what to do with people in such situations—"we're going to get them into a hospital and take care of them"—ignores that since 1986 the United States has required hospitals to take people regardless of whether or not they can pay, via the Emergency Medical Treatment & Labor Act. If he is proposing a policy, it is one that already exists.

But Trump is not really proposing policy, because for both him and his supporters, policy is utterly beside the point. Nothing that Trump says about health care or any other policy, from taxes to abortion to deportation, even when he seems to venture near to something resembling a policy idea, should be taken seriously as a policy proposal. Instead his words should be understood as expressive statements meant to reflect some broad sentiment that plays well with his supporters rather than descriptions of actual plans he intends to put in place.

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102 responses to “Donald Trump Is Totally Incoherent On Health Care Policy Because Policy Is Irrelevant to His Campaign

  1. Leave them alone! The Republicans haven’t indulged in a good ol’ cult of personality since Lincoln.

    1. Lincoln was so totes awesome. He was like the second coming of Reagan.

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  2. Suderman is right of course. It is a shame that Suddernan didn’t go the next step and ask himself why Trump’s supporters don’t care about his policy pronouncements. The answer of course is because they don’t matter. What politicians policy proposals do matter? It is not like any of them ever follow through. What exactly is the difference between “he is not promising anything and is just giving a bunch of platitudes” and “he is just blowing smoke up your ass and won’t follow through on any of the detailed policies he is promising”?

    From the voters’ point of view, I can’t see any difference. Can you?

    1. Why the heck don’t libertarians see this as an opportunity? Clearly Trump is not a rigid ideologue. From a libertarian view, that’s good! Nobody thinks a libertarian ideologue had a chance at being elected. So what’s the next best thing? Someone open to cost-effective solutions that work: libertarian solutions.

      So come up with some libertarian-oriented healthcare proposals that can be sold to Trump as practical solutions. “Lowering the cost of healthcare” through deregulation. Etc. He’s a business guy. Appeal to him on that basis.

      Stop whining about the vagueness and impurity of candidates and think like the Fabian socialists: incremental progress and compromise.

      1. Your optimism is both exciting and terrifying.

        1. When you get lemons….

      2. Because I’m not convinced that the 22 regular commenters at Hit&Run; will be the ones to have the biggest influence on this guy who’s not a rigid ideologue.

      3. Someone open to cost-effective solutions that work: libertarian solutions.

        You seem to have libertarianism confused with technocracy.

        1. No, I haven’t, and I’m puzzled as to why you think that. E.g. deregulating healthcare to make it more affordable isn’t “technocracy.”

          1. Libertarianism isn’t about “solutions.” It’s about liberty.

            1. To be fair, deregulating healthcare would go a long way towards liberty, regardless of the economic solutions it provides.

              1. Exactly. Ideological purism gets us little in the real world. The socialists didn’t get us into the mess we’re in because they were purists about “social justice” and “fairness.” We don’t advance liberty with a pouty “all or nothing” attitude. We need to work with what we’ve got and make incremental advances where we can. Trump is not a libertarian, but there’s opportunity there.

      4. Trump is not a business guy. He’s an authoritarian con artist who plays a business guy on tv. In an actual free market with no eminent domain or bankruptcy court “favors,” he’d be a fucking bag lady. Don’t try to appeal to him with a business plan, he’d look at you like a labrador being lectured on particle physics and then probably have you killed for practicing black magic.

        1. Do we need to get a doll and let you point to where the Donald touched you?

          1. Do you disagree? Trump has never actually run a successful business, which is literally his only selling point. The fact that he is a serious contender for the GOP nomination is horrifying.

            1. Nonsense. He’s got dozens of successful businesses. And he’s still less horrifying than Clinton or Sanders.

    2. What? Policy proposals don’t matter? Did Obamacare go away overnight?

      1. They only matter to the extent you can trust the person who is proposing them. Obamacare is still here. The question is what reason is there to trust any of the Republicans who are promising to repeal it?

        Maybe you trust them but the Trump supporters don’t. They might be wrong but they are hardly being unreasonable .

    3. Politicians, so it goes, lie about everything anyway so who friggin cares he has no idea or flip flops?

      Knowing what we know about Obama and his tired, predictable stances on policy vis-a-vis certain issues, is Trump that much worse; if at all?

      I’m surprised Reason is pulling a ‘I’m from Canada, eh’ like the retarded kid in The Simpsons when it comes to Trump’s popularity.

      Seems pretty clear to me people are reacting to the status quo.

      Heck, I’d even be moved to vote for him just, like Seinfeld said, out of spite. How much worse can he be than any of the candidates really? Hillary is a witch, Sanders is a populist and Cruz likes freaky ass sex (allegedly).

      I can see why some Americans are like ‘fuck it. Time to vote for the Commodus wannabe!’

      I could be wrong. I am, after all, from Canada, eh?

    4. There’s something to be said for a president with “policy” proposals that could probably garner the support of about 10% of Congress. He’ll end up blowing massive amounts of smoke. Congress will ignore him and do that whole Legislative thing. That’ll leave Trump to do the Executive thing and stay out of the legislating.

      It might actually be interesting to see what happens when both parties in Congress have a common enemy in the White House.

      1. You mean having the system function as it was intended to function? That is preposterous. What the hell are you some kind of anarchist?

      2. What would Congress not like about Trump?

  3. Supporters of any policies he does offer have to realize that there is very little if anything stopping him from reversing course once elected and shrugging off any criticism. In fact, this is a consequence of the general trend of administrations becoming successively more shameless.

    1. That of course is absolutely true. Isn’t it also true of every other candidate? And given the sorry record of political candidates in this country keeping their promises, what reason is there to think it is more true for Trump than anyone else?

      I honestly don’t understand why people think these sorts of arguments are persuasive.

      1. I honestly don’t understand why people think these sorts of arguments are persuasive.

        It’s because they are sheep.

        1. Baa.
          *leaves tiny pellets of shit*

          1. “Don’t know mutton bout history…”

            1. Mmm…Mutton. I really wish range wars hadn’t reduced the availability of lamb to modern Americans.

              1. Recently spoke with an Aussie who said it’s typical there to have lamb shank a couple times a week. It’s one of their more economical meat choices.

      2. I honestly don’t understand why people think these sorts of arguments are persuasive.

        Agreed, but therefore you will understand when I say that I honestly don’t understand why *you* think *your* arguments (“why not vote for him, he’s like every other candidate in this way”) are persuasive.

        1. I never said they were. Let me ask you something. Since you think your vote is meaningless, why do you bother following politics at all? I am very sympathetic to your points about politics being a waste of time. The day I finally come over to your side, however, I can’t imagine caring or reading magazines like this again. It would be like following the WNBA or something.

          1. It’s important to know what’s going on in the world around me, John, if for no other reason than my own situation. Not paying attention would be like closing my blinds and locking the door and sitting down and watching old movies 24/7. I consider doing that to be foolish. I don’t want to open the blinds one day and not recognize what I see outside.

            1. I guess. But unlike politics, I can actually have an effect on the street I live on. I honestly can’t say that someone who shuts out all of this crap and losses themselves in their job or their family or whatever is making a bad decision. In fact, they might be pretty smart.

        2. And I also was speaking about Trump supporters. I don’t understand why such arguments are ever going to persuade someone who is already supporting Trump to stop. I didn’t mean it as my agreeing with that assertion, though frankly I find it hard not to most days.

  4. not only does he not really understand the idea, he does not care to understand it. The details are irrelevant.

    Exactly. He’ll have his best people do the idea understanding and detail development.

    1. You sneer, but that’s an opportunity. See my comment above. Libertarians can be some of those “best people.”

      1. Libertarianism is not technocracy.

      2. That might be viable if Trump had ever said the words “that is not in the government’s purview.”

  5. All you need to know is that he’ll have the best health care system – he’ll make deals with every hospital individually to insure we get everything we want and don’t even have to pay for it. You’ll get sick of all the winning.

    1. Or you won’t be sick of the winning!

      1. False. The reason we need better health care is to cure the future victims of Winning Sickness once Trump is elected in a 50 state landslide. #trumpurtunity #PutTrumporShutUp

    2. Under Trump, Healthcare will totally not suck.

  6. The age of incongruity dawns through beams of inscrutability.

    1. Shouldn’t it be the other way around?

      1. Are you saying AG isn’t making sense?

  7. Of course policy is beside the point. Even by the standards of contemporary American politics, Trump is running an emotion-driven campaign. (In fairness, so is Sanders.) The Trump supporters whom I’ve seen don’t care about policy; they want a candidate who is angry at the same something-or-other that they are.

  8. His policies don’t matter. His following is very loyal. They will cheer him on no matter what. He could say “We will have people dying in the streets” and they will still vote for him.

    Why?

    1. The answer to that question is obvious.

      First, his supporters have long figured out that every politician is lying and will sell out once in office. So, there is no reason to worry about what they say. Since you can’t believe anything any of them say anyway, what is the point of obsessing about the details of what they say?

      Second, since actual trustworthy options are not available, the next best alternative is to vote for someone that the powers that be hates and is likely to do something, even if no one is sure what that would be. Of course, he could always make it worse. But Trump’s supporters are so dissatisfied with the current state of affairs, they figure no one could do any worse and an outsider who at least is willing to stand up to the system would likely do better.

      Third, because Trump is so hated by the media and so dismissive and confrontational against the PC culture, his supporters figure that even if he is just like the rest and sells them out on every issue, at least electing him will be telling the system to fuck off. And that is better than doing as they are told and electing another politician who will sell them out anyway.

      1. Second, since actual trustworthy options are not available, the next best alternative is to vote for someone that the powers that be hates and is likely to do something, even if no one is sure what that would be. Of course, he could always make it worse. But Trump’s supporters are so dissatisfied with the current state of affairs, they figure no one could do any worse and an outsider who at least is willing to stand up to the system would likely do better.

        I agree with this statement wholeheartedly.

  9. The line…is not responsive to questions about…any meaningful aspect of national health care policy.

    Maybe because we don’t need a national healthcare policy at all?

    1. You…monster. Every other advanced nation has one! It is a national disgrace that we don’t…tearatters…bagfuckers…kochtopus!!1!

  10. Trump has no policy stance.

    His candidacy isn’t about policy to his supporters. It’s about a mood.

    Trump’s candidacy isn’t about policy to him. It’s about being on television a lot.

    That’s why he can’t be trusted on any issue.

    . . . or, rather, he can’t be trusted to stand on any issue.

    1. That’s why he can’t be trusted on any issue.

      . . . or, rather, he can’t be trusted to stand on any issue.

      If that is the case and I am not saying it isn’t, then why is Reason so panicked about Trump being a fascist? To quote the famous movie line, say what you want about national socialism but at least its an ethos. No one who is as flexible and opportunistic as Trump can fairly be called a fascist or really much of a danger to be any worse than what we currently have.

      Indeed, aren’t most of our biggest problems the result of politicians of both parties disregarding the public’s concerns and trying to “lead and create a legacy”? I think a bit of political cravenness and bending to the popular will might be an improvement.

      1. I see him becoming a Bill Clinton 2.0

        1. That is not a bad guess.

    2. His candidacy isn’t about policy to his supporters. It’s about a mood

      90% of his support is based on the national chimp-out that people are having about him. The people who hate him the most are the ones who have pushed and maintained a particular cultural narrative about how a liberal society is supposed to be run, and have no problem burying people who dare to stand against that narrative. Along comes Trump with his “fuck you” money and no scruples about engaging these types in public warfare, and it’s not hard to see why his support has been so consistent.

      John’s larger point about the GOP not having the balls to put their credibility on the line for conservative principles is why Trump’s supporters don’t care about Cytotoxic-type whining that he could kill the GOP “brand” for generations. When the “brand” has shown itself to be completely and utterly mendacious, it’s not hard to see why they’d prefer to burn it to the ground.

      1. It’s important to remember that 67% of registered Republicans are voting against him.

        God only knows what will happen in Nevada. Those crazies broke for people like Ron Paul in droves, and the casino industry is a pretty tight, clubby bunch.

        But, near as we can tell, Trump is yet to win over two-thirds of the Republican Party.

        It’s also telling that if the Republicans have burn their brand with Trump now, it’s just as their brand is starting to mean something again. It was the Boehner-Bush brigade that watered the message down to nothing. They’re finally being kicked to the curb.

        Why burn the brand now?

        1. It’s important to remember that 67% of registered Republicans are voting against him.

          No Ken. 67% of them are voting for other candidates. That is not the same as “voting against him”. Voting against him implies none of those 67% will support Trump if and when their preferred candidate bites the dust. And I have seen no evidence of that being the case.

          Trump is not the first choice of 67% of Republican voters. so what? I think Cruz is getting like 23%. That means by your definition 77% of voters are voting against Cruz. Not really.

          1. Effectively, there are only two candidates in the Republican race right now: Trump and Not-Trump.

            The question every Republican primary voter asks himself is whether or not he’ll vote for Trump.

            Two thirds are voting for Not-Trump.

            In the context of this conversation, two-thirds are not voting to burn the party down by voting for Trump. They’re voting to keep the party by voting for someone else.

            1. Effectively, there are only two candidates in the Republican race right now: Trump and Not-Trump.

              Only if you assume that none of that 67% would vote for Trump if their preferred candidate is not available. And that is just not true. If it were, Trump would not be doing so well in head to head polls with Hillary and Sanders. He would be down by 12 or 15 points at least. And he is not.

              1. Why would any of them vote for Trump if their preferred candidate is not available? There’s no discernible difference between Trump and Hillary except that Trump has donated more money to Democrats in his lifetime.

  11. The idea that, when the general election comes around, Trump will be presented as one of the only two viable candidates that Americans can “realistically” vote for is saddening. That the other of the possibilities will be either an avowed socialist or un-convicted felon-with no alternative as far as the main stream media will be concerned-absolutely boggles my mind.

    I like to think that other people would have more shits to give about the future of the country and the validity of the electoral process rather than the future of these two parties, but I think I’m about to be disappointed.

    1. Yeah, we’re looking at really slim pickin’s here.

      In the general election, I’d expect Hillary to do to Trump what Ronald Reagan did to Walter Mondale.

      Scratch that. Mondale won in his home state. Trump won’t win in New York.

  12. It’s a little before schedule but America was due for its Nero or Caligula moment.

    1. like EXCEPTIONALLY before schedule?

  13. as if America’s streets were strewn with dead corpses

    Dead corpses? Those are the worst kind!

    1. Marzipan corpses are the best kind.
      No wait… chocolate coated marzipan corpses mmmmm.

  14. Trump isn’t a policy guy. He’s here to class the place up. Let the floor managers in the Senate and Congress deal with policy.

    1. Who do you think he will hire as the official White House greater? Mike Tyson? Official greeter is often a good gig for former champs. Or will he go away from sports altogether, maybe an fading pop star, Madonna perhaps.

      1. I would think that Trump would have the sense to make the White House Greeter someone impossibly hot and female.

        I await the link posting of potential candidates…

        1. Trump is a Kate Upton man if I have ever seen one.

      2. official White House greater

        Wait. Is that a thing?
        NOTHING LEFT TO CUT!!!

        1. No it is not. Casinos, however, have celebrity greeters at the door. And Trump hiring one for the White House was the joke.

          1. Honestly it wouldn’t have surprised me if it was an official job with full benefits and a pension.

        2. IT WILL BE A THING WHEN TRUMP MAKES AMERICA GREAT AGAIN!

  15. The good news is, once the Democratic frontrunner is chosen, the media will stop having fun with Trumpmania and will go full bloodthirsty hyena pack attack on his ass.

    1. I think they’ll let the Republicans nominate him first, then he’ll be presented in the same light that most here at HnR see him. In the end, he’ll get absolutely crushed in the general election by Clinton.

      I hated typing that. I’m a fairly optimistic person and the cognitive dissonance I’ve been experiencing lately whenever I read the news is terrible. I can’t tell if it’s me who’s crazy or the general voting population.

      We’ll know after Super Tuesday how screwed we are.

      1. I think they’ll let the Republicans nominate him first, then he’ll be presented in the same light that most here at HnR see him. In the end, he’ll get absolutely crushed in the general election by Clinton.

        And he is not being presented that way now? The press is going easy on him or something? His poll numbers might not go up, but since he is probably the most known commodity in the race, they are certainly not going down. The old trick of the media smearing the Republican before the country knows who they are trick isn’t going to work with Trump.

        1. It’s not so much that they’re being easy on him as I haven’t seen that laser-like focus that the media can give on certain gaffes and issues that make them seem much bigger than they actually are (eg binders full of women). I remember Ron Pauls stance on the drug war being grossly misrepresented as well while Obama’s connection to Bill Ayers (sp?) being downplayed as a non-issue.

          Maybe I just haven’t been paying enough attention but it doesn’t seem to me that Trump has really gotten both barrels yet.

          1. The media has obsessed about his every move for months. And they have gone after “gaffe” after “gaffe” and no one cares. You are kidding yourself.

          2. The media go pack hunting on any Republican once he’s nominated, They can stand a Republican being nominated, what they set themselves implacably against is one getting elected.

            The GOP ought to be used to that now, but some of their operatives believe that thy can find that candidate whom the press will love as much as the love Democrats.

  16. Even when he gestures towards a real policy idea, he does so in ways that suggest that not only does he not really understand the idea, he does not care to understand it.

    Because people love him regardless. He said Mexicans are rapists; so he received a lot of love for it, of course.

    What? You still think all of this is because people are tired of the establishment? Please. The moment people stop starting their opinions with “What we should do is….” then I will believe they are tired.

    1. He didn’t say all Mexicans are rapists. He said it was just the ones coming over the border.

      1. He didn’t even say that. He said Mexican rapist come across the border and the government not only lets them come but doesn’t deport them after they are arrested. And that is pretty much true, at least if they are arrested in a sanctuary city.

        1. “When Mexico sends its people, they’re not sending their best. They’re not sending you. They’re not sending you. They’re sending people that have lots of problems, and they’re bringing those problems with us. They’re bringing drugs. They’re bringing crime. They’re rapists. And some, I assume, are good people.”

          This is the actual quote.

          1. And it doesn’t say all Mexicans are rapists. It says the people who come here often tend to be the ones who are leaving for a reason. And that is ture and has been true since the country started. None of us are descended from royalty or had families who did well. If they had done well, they wouldn’t have left and come here.

  17. I’d rather read an article on things Trump has been consistent on. You don’t even have to go back ten years. I want to know what he’s been consistent about in the past 2 years. He could still turn out to be one of the most liberal or most conservative presidents we ever had. I simply have no idea.

    1. He’s consistently a dickhead.

      1. What are you views on Hats. Good or Bad?

        1. People are not wearing enough hats

          https://www.youtube.com/watch?v=O2QJvc_SxFQ

          1. +500 Bartholmew Cubbins

      2. Someone has it right

      3. Someone has it right

    2. check out Trump’s 1990 interview in Playboy. He is actually pretty consistent – at least on trade and the military.
      http://www.zerohedge.com/news/…..rview-1990

  18. This our nation’s most important elections ever. A successful car salesman versus a bungling bureaucrat.

  19. Trump is no more or less “coherent” than any of the other scam artists, f.f.s.

    But by all means, dream on:

    In your dream, Donald Trump is not a fraud,
    In your dream, Sanders is not a fraud,
    In your dream,all the rest are not frauds,
    In your dream, Obama is not a fraud,
    In your dream, Reagan was not a fraud,
    In your dream, all the rest were not frauds,

    In your dream, the constitution was not a scam,
    In your dream, the Supreme court is not a scam,
    In your dream, 9/11 was not a scam…….”

    Lyrics excerpted from:

    “Dreams [Anarchist Blues]”:

    https://www.youtube.com/watch?v=QMXtoUtXrTU

    Regards, onebornfree.
    onebornfreedotblogspotdotcom

    1. Sadly, Trump is actually less coherent than the other scam artists.

    2. Sadly, Trump is actually less coherent than the other scam artists.

      1. Squirrel joke needed, aisle 5.

  20. Way to many comments. Donald Trump is incoherent….fullstop.

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