Election is doing little to help voters understand health-care challenges

It takes more than words to treat illness. Campaign rhetoric, unlike the Affordable Care Act, will not provide health insurance to 20 million Americans. These difficult tasks require real health policy. They require difficult choices that come with a price tag. 

This election cycle is not offering much enlightenment on the health care policy debate. Our decades-long national discussion seems mired in vague solutions and oversimplification. As we approach another election, we must remember that strong leaders provide clear direction and specifics on how to achieve goals and objectives. 

For 10 years, via this column, I have attempted to describe and explain the complex nature of health care delivery and finance in America. If only I had known about Donald Trump’s plan earlier. His plan as stated: “Repeal Obamacare and replace it with something great.”  Right. Thanks Donald. 

Oversimplification of complex problems is enticing and can help one speak to the masses. However, it is dangerous and fundamentally at odds with good leadership. 

One doesn’t need to rely on left-leaning organizations or moderate news outlets for an evaluation of Donald Trump’s grasp on policy. Prophetically, we can turn to conservative news outlets and conservative health care policy experts for an evaluation of Donald Trump’s health care reform plans. From George Will to Mitt Romney, from Redstate to the Weekly Standard, conservatives from all corners have major concerns about the prospect of a President Trump.  The reviews are quite telling.

Redstate, a conservative website, described Donald Trump’s explanation on health care policy with Joe Scarborough as, “close to content-free as you can get and still have sounds coming from people’s mouths.”

Regarding Donald Trump’s idea to allow insurance to be sold across state lines, Robert Graboyes, a healthcare scholar at the conservative Mercatus Center, said Trump’s plan, “would do practically nothing to change anything.”

Here are two comments describing Donald Trump’s assertion that he can save taxpayers $300 billion per year if Medicare negotiated drug prices:

“It’s more than the entire government pays (for Medicare prescription drug coverage).”

— Paul Howard at the conservative Manhattan Institute.

Gail Wilensky, head of the Medicare program under President George H.W. Bush, stated Trump’s estimate was “just silly.”

We may be able to forgive the real estate mogul for not knowing the finer points of health-care policy and finance if it were not part of a larger pattern that he exhibits.  Indeed, asking Donald Trump for specifics on policy is a moving target and a fool’s errand. He purposefully speaks in vague broad strokes as cover for his lack of knowledge on a wide range of topics.  However, we certainly do know that his plans will be “huge,” “great,” and will most certainly “make America great again.”

Again, in health care policy, specifics matter. Case and point, Donald Trump lacks the understanding that unpopular policy rules are needed to enable and finance the very popular coverage of pre-existing conditions he supports. 

“In simple terms, Trump’s promise to bar insurers from using pre-existing conditions to screen customers but simultaneously to scrap the companion provisions that make the bar feasible is either the fraudulent offer of a huckster who takes voters for fools, or clear evidence of stunning ignorance about how insurance works. Take your pick.”

— Economist Henry Aaron (U.S. News and World Report)

Our founding fathers were well educated, highly intelligent, and knew that complex problems required complex thought and solutions.  Now, nearly 250 years later, leaders that can grasp and understand complex issues are needed more than ever.

Americans on both sides of the political aisle agree — narcissism and ignorance don’t cut it. So, I conclude with one last observation from the right side of the political aisle:

James Capretta, at the Ethics and Public Policy Center, a conservative think tank, said this of Donald Trump: “(He) is a buffoon who shows no understanding of health care and is totally unfit to be running, much less winning.”

Michael J. Pramenko M.D. is the executive director of Primary Care Partners. He is chairman of the Board of Monument Health and is a past president of the Colorado Medical Society.


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