Friday, March 31, 2017

Donald Trump Properly Understood Healhcare Policy In 2000

This is an interesting article.  The bulk of the article is about comparisons between the US healthcare system and the more efficient and less costly systems that provide universal access in other nations.  The US system provides a good example for other nations about what not to do.  Many of our politicians believe that there is no difference between purchasing a TV and purchasing healthcare.  They are married to a free market vision of healthcare that was destroyed by a Nobel Laureate free market economist many years ago.  Kenneth Arrow, who provided the critique, was one of the most highly regarded economists in the world.  However, his message has been ignored by politicians who use free market ideology to reject almost any kind of system subsidized by government.

Obamacare, which is built on a model developed by the conservative Heritage Foundation,  was designed as a compromise between free market advocates and those who would have preferred a single payer system like the Canadian system.  It allows consumers to purchase healthcare insurance in the health insurance market.  That was not enough of a compromise for most Republicans.  The government provided subsidies that enable low income citizens to purchase insurance policies and the government played a role in defining the benefits available on the market.  In order for any insurance market to work it was also necessary for the government to provide insurance companies with a risk pool of potential consumers that included healthy individuals who might otherwise not purchase insurance.  Without government mandates insurance companies would be forced to charge premiums that reflected the high costs of insuring a pool of high risk consumers.

Not too long ago, Donald Trump argued that the Canadian system provided a good model for a universal coverage system that was efficient and less costly:

“I’m a conservative on most issues but a liberal on this one. We should not hear so many stories of families ruined by healthcare expenses. . . . We must have universal healthcare. . . . The Canadian plan . . . helps Canadians live longer and healthier than Americans. There are fewer medical lawsuits, less loss of labor to sickness, and lower costs to companies paying for the medical care of their employees. . . . We need, as a nation, to reexamine the single-payer plan, as many individual states are doing.”

We all know what happened to Trump's good idea.  He ended up with a plan cobbled together by Paul Ryan that he could not sell to Republicans were even more conservative than Paul Ryan. Trump would have been able to sell the Canadian plan to Democrats but not to Republicans who cater to the interests of the insurance industry and to a free market system of healthcare insurers.

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