Saturday, September 24, 2016

Why Isn't Healtcare Reform A Hot Topic On The Campaign Trail?

Spending on healthcare is around 18% of US GDP.  Moreover, healthcare spending by households, which includes increases in co-pays and deductibles along with higher premiums, has been growing faster than household income.  The US spends much more on healthcare than any other advanced economy in the world.  Access to healthcare is also more limited in the US than it is in many other advanced nations.  One would think that it would get more attention than it has been getting in the political campaigns.  This article describes Donald Trump's healthcare plan that consists primarily of replacing Obamacare with something else that he does not describe in any detail.  It also describes some the proposals by Hillary Clinton that are much more detailed but well below what is needed to contain address the affordability and access issues.  However, it does not explain why it is not a big issue in either campaign.  

There are lots of reasons why healthcare has not been a hot topic in the political campaigns.  In the first place, trying to change a healthcare system, that represents 18% of the US economy, would be a huge task, and there would be a lot of resistance to change by its benefactors and the politicians allied with them.  Hillary Clinton learned this lesson the hard way when she attempted to change the system in her husband's administration.  Donald Trump, has no real interest in policies.  He only cares about winning an election.  That is why he separates himself from most Republicans who want to cut Medicare spending.  He is supported by a large majority of Americans covered by Medicare.  He has consistently argued that Republicans have lost general elections in the past by proposing cuts in Medicare.  Another reason for the lack of attention to healthcare is rather depressing.  Most Americans have a poor understanding about how the system works, and how it compares with systems in other advanced economies.  Unfortunately, most politicians are reluctant to discuss complex problems, with complex solutions, in political campaigns.  Trump has been successful by appealing to emotional issues and Clinton, who loves policy discussions,  has been warned against presenting herself as a policy nerd.  It will be interesting to see how debates, which are supposed to be about presidential policies are dealt with in forthcoming debates between Trump and Clinton.

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