When it comes to health care, there is a deep divide between the policies of President Donald Trump and Joe Biden. But the distinction isn’t so much Trump vs. Biden as it is the American people vs. special interest groups.
When the first debate is held, the theme of the night will be domestic policy, and health care is sure to be hotly debated — as it should be; it’s a top issue for American families. Biden will be touting the Affordable Care Act, adding a “public option” to appease the large contingency of his party that still demands “Medicare for all.”
For his part, Trump has consistently resisted a government takeover of medicine and is looking to create an environment where patients can be in charge of their health care decisions.
Yet polls show that both parties are unhappy with their candidates’ positions and with Congress for failing to address the issue, regardless of who is in the majority.
Biden and members of his party are resurrecting the campaign ads about pre-existing conditions as the proverbial bogeyman to compel voters through fear. Though many solutions exist to address this problem, the left is continuing to tout the failed government takeover of health care known as the Affordable Care Act, or ACA. The hard truth is that the ACA, or “Obamacare” as some call it, doesn’t protect people who have underlying conditions.
The promise to protect people with underlying conditions may have worked on paper, but, according to a study, the reality is the ACA did not decrease bankruptcies related to medical bills, nor did it result in better health outcomes, which are measured in mortality rates among the nonelderly. Obamacare may have provided an insurance card in more Americans’ wallets, but what matters to families is that it decreased access to affordable care.
A clear example of how the law contributed to the increase in health care cost is the movement by insurance companies, middlemen and hospitals toward consolidation. Consolidation in the hospital industry alone created an increase in incentives to move patient care from inpatient to outpatient care. This resulted in hospitals going on a buying spree of outpatient facilities and physician practices to secure referrals for services based in the hospital.
Hospitals commonly argue that consolidation would reduce costs but fail to explain that the savings in costs go to the hospital, while patients often see an increase in their out-of-pocket expenses due to the consolidation.
Rather than building on the support for special interests, Trump has issued a large number of executive orders that have focused on patient care, health care price transparency, and affordability of services and medications.
The common theme has been to put the patient — not government and certainly not insurance bureaucrats — in charge of decision-making. Trump’s first health care plan, the Choice and Competition report, allowed for options that have been readily accepted by many who are priced out by the exchange plans.
In addition to creating a more competitive market, another executive order focused on health care price transparency has rattled the industry by mandating that all negotiated prices between hospitals and insurers be disclosed. This transformative principle has an approval rate of nearly 90 percent of Americans on both sides of the political aisle, according to a July poll. As loved as this order has been by the American people, it has been equally despised by the special interests that benefit from the hidden nature of prices in health care.
Perhaps another distinction between these plans is in where they are focused. Biden, in his commitment to broadening the ACA, is focused on benefiting the insurance industry and its lobbyists. The direction of the president’s policies is more in line with helping the patient by focusing on making things affordable. Obamacare didn’t do anything to bring down the cost of care; in fact, it did the complete opposite.
As you watch the debate, make sure you pay attention whenever you hear the words “health care.” And ask yourself this question: Are they talking about health care or health insurance? How you answer may tell you exactly who the candidate is trying to help.
David Balat is the director of the Right on Healthcare campaign at the Texas Public Policy Foundation.