Choosing a President
How will your choice affect your business?
By Jerry Connolly, PT, CAE
October 10, 2016
The conventions of the national political parties have come and gone and a historic presidential election approaches. It has been a tumultuous primary season with results that few predicted; a political outsider as the candidate of the usually more traditional GOP, and the first woman as the nominee of a major political party.
Donald J. Trump was nominated by the Republicans in July and received a small polling bump coming out of the convention. A week later, Hillary Rodham Clinton was named to head the Democratic ticket amid questions of her campaign’s ability to unify the party. In the ensuing weeks and months, it has been the Republicans who have faced division in their ranks. Clinton’s postconvention rise in the polls has been determined to be less her own doing and more a result of Trump’s inability to stay on message. This is reminiscent of an Old West fable about the cowboy who brushed his teeth every morning with gunpowder, then spent the rest of the day shooting off his mouth. Needless to say, he didn’t become sheriff.
As this column is being written, Republicans are worrying if the public’s image of Trump is beyond repair. His gunpowder-for-toothpaste moments include calling Mexicans rapists, mocking a disabled reporter, and getting into a verbal fight with the parents of a fallen soldier.
Because both major candidates suffer terrible public approval ratings, many Americans display disappointment, even anger, about their Election Day choices. Polls suggest that some will vote for their candidate, but most will vote against a nominee.
Nevertheless, the choice is to be made: to vote or not. If it is the former, then for whom do you pull the lever? While there are many reasons a person may earn your eventual vote, this column will view our choices through the lens of health care.
Donald Trump and Hillary Clinton have been very vocal about their positions on health care issues. Lesser-known candidates, but also on the ballot in most states1 Libertarian Gary Johnson and Green Party nominee Dr. Jill Stein have health care views that are more difficult to ascertain. But for the sake of comparison, all four of these campaigns were researched.
Businessman Trump favors a universal “market-based” plan that would offer a range of choices. He wants to return authority to the states and operate under free market principles. He favors allowing individuals to buy insurance across state lines and would provide individuals tax relief to help make health insurance affordable.2
Former Senator and Secretary of State Clinton promises to defend and expand the Affordable Care Act (ACA), reduce out-of-pocket costs and the cost of prescription drugs, and ensure women have reproductive health care. She also wants to expand access to health care for rural Americans and will continue the transformation of the health care system to reward value and quality.3
Libertarian candidate Johnson opposes federal government health insurance requirements and thinks Obamacare will cause the U.S. economy to “collapse.” In October 2012, the former New Mexico governor called the ACA “a torpedo in a sinking ship.”4
The idea that government can require an individual to buy something simply because that individual exists and breathes in America is an incredible blow to the bedrock principles of freedom and liberty. Says Johnson, “Government cannot create a system that will reduce costs while increasing access. Only competition and the price transparency that competition will bring can accomplish the imperatives of affordability and availability.”4
Green candidate Stein believes health care is a human right and supports a “Medicare for All” single-payer public health insurance program to provide everyone with quality health care at a reduced cost. Moreover, the internal medicine physician maintains that Americans can lower health care costs by reducing pollution, making consumer products safer, integrating public transportation with walking and biking, and increasing the availability of healthy food choices.5
Stein does not defend the ACA because she believes we cannot grow our way incrementally to a single-payer system. “You have to kiss it goodbye and expand Medicare in one fell swoop.” In addition, the environmental health activist believes health care costs will be reduced by eliminating the endless stream of pollution into our air, our water, our consumer products, etc., that derive from fossil fuels.6
Diving more deeply into the positions of the candidates of the two major parties who will appear on the ballot nationwide, we find that Clinton supports a public-option insurance plan and allowing Americans to enroll in Medicare when they turn 55. In a statement released in July of this year, Clinton affirmed “her commitment to give Americans in every state the choice of a public-option insurance plan, something she has supported during this campaign and going back to her 2008 presidential campaign.”7
Under her affordable health care and prescription drug plan, a patient could make three sick visits to a doctor without it counting toward their annual deductible, families ineligible for Medicare could receive a tax credit for out-of-pocket health care expenses, prescription drugs for patients with chronic or serious health conditions would be capped at $250 per month, and prescription drug imports from Canada would be legal. Clinton favors increased funding for autism and Alzheimer’s research and treatment.8
Clinton identifies her greatest political regret as failing to pass health care reform in the early 1990s. She told AOL.com, “Health care is a basic right. We are 90 percent covered, we gotta get to 100 percent, and then we gotta get cost down and make it work for everybody. And even though we didn’t get it then, we’ve got it now and I’m going to defend it and improve it.”9
Trump’s health care reform plan is based on “free market principles.” He would repeal Obamacare, reduce barriers to the interstate sale of health insurance, institute a full tax deduction for insurance premium payments for individuals, make Health Saving Accounts inheritable, require price transparency, block-grant Medicaid to the states, and allow for more overseas drug providers through lowered regulatory barriers. He has also said he opposes cuts to Medicaid and Medicare. Trump believes that enforcing immigration laws could reduce health care costs.10
Trump claims the insurance companies are getting rich on Obamacare. And that he wants to revitalize free enterprise in health care financing and delivery. But he acknowledges that such an approach inevitably leaves people behind. “We need to take care of those people,” he said.11
Trump suggested that he supported universal health care on September 27, 2015. “I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now,” he said.12
It has been said about many elections that voting doesn’t really matter because there isn’t much difference between the candidates. Comparing the above four candidates on health care alone, suggests that this year the candidates are distinguishable and the choices are clear.
Whatever you think about those choices, at least we live in a country where we are privileged to have one. Vote on Election Day.
References
1. Libertarian Party candidate for president will appear on the ballot in 39 states. The Green Party will be on the ballot in 27 states. https://ballotpedia.org. Accessed August 12, 2016.
2. Diamond D. Donald Trump hates Obamacare – so I asked him how he’d replace it. Forbes, July 31, 2015.
3. Clinton Campaign Website, www.hillaryclinton.com.
4. Goins C. Libertarian nominee Gary Johnson on Obamacare: “a torpedo in a sinking ship.” Politic365. Accessed October 17, 2012.
5. Scheer R. Scheer Intelligence: Jill Stein – Presidential Candidate. Huffington Post, February 8, 2016.
6. Stein J, Schettler T, Rohrer B, Valenti M. Environmental threats to healthy aging. Greater Boston Physicians for Social Responsibility and Science and Environmental Health Network, 2008. www.agehealthy.org/pdf/GBPSRSEHN_HealthyAging1017.pdf.
7. Kelly N. Hillary Clinton to Congress: come back to D.C. and fund Zika research. The Atlantic, August 9, 2016.
8. Hillary Clinton Presidential Campaign, 2016/Healthcare. https://ballotpedia.org.
9. Rappeport A, Sanger-Katz M. Hillary Clinton takes a step to the left on health care. New York Times, May 10, 2016.
10. DonaldJTrump.com. Healthcare reform to make America great again. Accessed March 3, 2016.
11. Team Fix. Transcript of the New Hampshire GOP debate, annotated. Washington Post, February 6, 2016.
12. Diamond D. On ‘60 Minutes,’ Donald Trump says Obamacare is a disaster – but his own plan is even worse. Forbes, September 27, 2015.
Jerome Connolly, PT, CAE, is a registered federal lobbyist whose firm, Connolly Strategies & Initiatives, has been retained by PPS. A physical therapist by training, he is a former private practitioner who throughout his career has served in leadership roles of PPS and APTA. Connolly also served as APTA’s Senior Vice President for Health Policy from 1995 to 2001.