Trump is right about lousy U.S. health care; but how would his plan make it better?


Give credit where it is due. President Trump raised eyebrows this week when he said the Australians have better health care than the United States. He followed that up with this tweet:

It all depends, of course, on how you define good health care. But by almost any measure, the president was correct.

The United States spends more for health care than any other industrialized nation. It isn’t even close. Figures from the Organization for Economic Cooperation and Development show the United States, in 2015, spent $9,451 per capita on health care. The nearest nation to that was Luxembourg, at $7,765. Canada, with its socialized medicine, spends $4,608. Sweden, long thought to be one of the most overtaxed developed nations, spent only $5,228.

And we don’t pay more because we get more. Apparently, we pay more because we use more technology, according to a 13-nation study by the Commonwealth Fund. That study said, “Despite spending more on health care, Americans had poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions.”

But while the president was right, that doesn’t mean the health care plan he and a majority of House Republicans endorse would do anything to improve the situation.

Obamacare never was aimed at controlling costs or improving care. It focused on one thing — getting as many Americans insured as possible. As the OECD chart shows, spending on health care continued to rise on a steady course even after Obamacare became law.

The Republicans’ current plan (Trumpcare?) rearranges the rules of Obamacare. It does away with the individual mandate, which would tax anyone who refuses to get health insurance. But without some guarantee that all, or at least many, healthy people are insured, insurance companies cannot cover pre-existing conditions without significantly raising premiums.

Trump’s plan would provide $8 billion in subsidies for pre-existing conditions, but it would change the rules. State could get waivers that allow them to let insurers not cover pre-existing conditions if they offered alternatives. These might include setting up high-risk pools or letting insurance companies charge higher premiums to high-risk people, or reducing the benefits those people receive.

As some critics have noted, $8 billion isn’t much on a national scale.

Much of the plan’s effects remain unknown, mainly because no one can predict how individual states will react. However, it doesn’t seem to be aimed at controlling costs any more than was Obamacare.

Nor does the plan seem to do much to ensure better quality health care.

In short, the president was right, but he can’t just leave it at that. He needs to explain how his plan would give the nation health care that is cheaper, more effective and more inclusive than those in other nations.

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About the Author

Jay Evensen

Jay Evensen is the Senior Editorial Columnist for the Deseret News. He has 32 years of journalism experience covering politics and a variety of other assignments at news organizations ranging from United Press International in New York City to the Las Vegas Review-Journal and the Deseret News, where he has worked since 1986. During that time, he has won numerous local, regional and national awards. Most recently, he was given the Cameron Duncan Media Award, given annually in Washington, D.C., by the advocacy group RESULTS, to the journalist judged to have done the most to further the cause of the world's poorest people.

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