The Donald lays out his plan:

  • The repeal of the Affordable Care Act, more popularly known as Obamacare, as well as the individual mandate that requires Americans to purchase health insurance.
  • Allowing the sale of insurance across state lines by repealing the McCarran–Ferguson Act.
  • Allowing individuals to fully deduct health insurance premium payments from their taxes, as businesses can.
  • Allowing all individuals to use health savings accounts, rather than just those with high-deductible health plans.
  • Requiring “price transparency” from healthcare providers, including doctors, clinics and hospitals.
  • Turning Medicaid into a block grant to the states, decentralizing the social welfare program from federal control.
  • Removing “barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products”, weakening control of the pharmaceutical industry and the Food and Drug Administration over drug testing, production and approval.

Let's see if there's any meat on this little chicken wing.

1. The repeal of the Affordable Care Act, more popularly known as Obamacare, as well as the individual mandate that requires Americans to purchase health insurance.

This would mean so-long to pre-existing condition coverage, universal basic levels of coverage, and would throw all the Obamacare members back into the horrible individual commercial market that created the worst of the American insurance mess in the first place.

2. Allowing the sale of insurance across state lines by repealing the McCarran–Ferguson Act.

My personal favorite of all GOP memes.  The theory is that if insurance is cheaper in Arkansas and you live in New York, the only thing keeping you from paying Arkansas rates is a pesky regulation.  But insurance is more like real estate.  You won't get Arkansas land prices for your proposed New York condo development if you deal with an Arkansas realtor. Some states are more expensive than others, period.  Also, we already have cross border insurance companies; United Healthcare, Aetna, Humana, and Cigna to name a few.

3. Allowing individuals to fully deduct health insurance premium payments from their taxes, as businesses can.

This provison carries an "Easter Egg" which is appropriate for the season.  First, you are not paying income tax now on your premium, since it's not counted as income in the way that your pay is.  Second, this carries an implicit threat that business will get out of the insurance business altogether and convert premiums into some kind of pay, which will then make it taxable.  If that happens, it would be nice if the premiums were non-taxable.  However, you won't notice the benefit, because you will now be paying the entire premium out of pocket.

4.  Allowing all individuals to use health savings accounts, rather than just those with high-deductible health plans.

Another GOP meme.  The accounts allow for pre-tax payments on almost anything even remotely considered a medical expense.  And this is good.  But behind it, again, is the idea that your work based insurance will end and you will have to fund these accounts with your own money.  Now when it ends (and it will if the GOP takes the election), your company may or may not increase your pay to cover your insurance payments - at the beginning.  But what they won't do (and this is why they want to get out of the insurance business in the first place) is cover the annual premium increases like they had to before.  If your premiums go up ten percent in one year and you have to pay it out of pocket, having the money might reduce that ten percent to seven percent.  Feeling better now?

5. Requiring “price transparency” from healthcare providers, including doctors, clinics and hospitals.

An absolutely necessary requirement to any free market is price transparency.  (The other absolutely necessary requirement is quality transparency, which Donald fails to talk about). But what "price" is Donald talking about.  The price on your bill is marked up between 200 and 1,000 percent of costs.  That's one price.  Your insurance company then gets a discounted price.  That's another price.  Or will this be something else?

6. Turning Medicaid into a block grant to the states, decentralizing the social welfare program from federal control.

This little thing is appearing on the Democratic side as well.  If Medicaid is turned into block grants to be run by the states, there goes any universal medical care standards.  Because we know that medical care is really an ideological issue and that people in the Red States really want less care than people in the Blue States.

7. Removing “barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products”, weakening control of the pharmaceutical industry and the Food and Drug Administration over drug testing, production and approval.

I'm not sure what sort of entry barriers are being put up by Big Pharma.  But both Big Pharma and anyone mixing their own drugs in their basements would love to have drug testing standards reduced or removed.  I mean, what could happen?  According to free market theory, no one will produce shoddy drugs, because the market will weed them out, right?  Right?

Nothing new here.  Repealing Obamacare alone turns the clock back about five years. Killing the FDA turns it back about 100 years.  It will be grand to be able to get a decent bottle of snake oil again.

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unagidon is a contributing editor to Commonweal.

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