Trump's Health Plan: Pay Your Own Medical Bills Using Money You Saved - The Atlantic

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Five disgruntled Republican physicians and one nurse warmed up the conference room at a Hilton DoubleTree hotel in Pennsylvania yesterday. All were members of the U.S. Congress, gathered for a rally that Donald Trump would call “a meeting talking about health care.”

On the day that health-insurance enrollment began for 2017, the Trump campaign chose to keep the focus on medicine. Health-insurance premiums will be increasing in exchanges for some two to five percent of Americans this year. The U.S. has the most expensive health-care system in the world and needs a great deal of improvement. The candidate has been hostile toward the current health-care system and toward Hillary Clinton’s proposals, but has offered almost nothing in the way of solutions. Perhaps today was the day for a plan.

First to the mic stepped John Barrasso, an orthopedic surgeon from Wyoming. “People need a better way, and that is why we are here,” he said, setting the stage. “There is a better way than Obamacare.” He said that he believes that “government is the problem” and that Hillary Clinton is proposing “more Obamacare,” though it was unclear what part of the system he was referring to. “Republicans are here today to offer solutions,” he said.

Before he could get into those solutions, he introduced another orthopedic surgeon, Tom Price of Georgia.

“We want a system that’s affordable for everybody, that’s accessible for everybody, that’s of the highest quality, and provides choices for patients—all of those things have been destroyed by Obamacare,” Price said. “This is what happens when you put the government in charge,” he continued (although the U.S. health-care system is run by insurance companies, pharmaceutical companies, and hospital consortia).

So, the surgeon offered, we need Donald Trump and Mike Pence “to put in place a real health solution. That solution exists. We’ve been working on that solution for years, literally.”

A promising note, which he used as a segue to introduce gynecologist Mike Burgess of Texas.

Burgess said we need to repeal Obamacare. He said that Obamacare collapses “the market.” The elaborate law “tells you what you have to buy.” (Obamacare created a marketplace for health care to attempt to encourage competition among insurance companies.) “When did more federal money going into anything ever result in a cheaper price to the consumer?” he asked. No one raised a hand to mention all the Americans on Medicare and Medicaid, and the millions receiving subsidies to purchase insurance in the free market using exchange websites.

With that he introduced anesthesiologist Andy Harris of Maryland, who said that he’s tired of hearing his patients complain about Obamacare. “It’s going to get worse. The only solution is—” he paused for another hopeful moment,“Trump Pence.”

So close that time.

Then Harris introduced nurse Renee Ellmers from North Carolina. “We’ve got to defeat this,” she said, apparently referring to the entire system established by the Affordable Care Act. She acknowledged that President Obama likened the current law to a starter home. “Well, you know what? If it’s a house, it’s an outhouse.”

The audience and others on stage laughed and applauded. An outhouse.

“And, yes, Hillary Clinton only wants to make it worse,” she continued. “How many of you have been to a doctor and felt like the doctor spent more time on the computer than taking care of you?” she said, referring to electronic medical records. “That’s Obamacare. We’re here to support Donald Trump and Mike Pence because we know that they are the answer.”

With that she introduced another doctor from Tennessee, representative Scott DesJarlais. “I got a message for Barack Obama and Hillary Clinton,” he said. “Obamacare is going to fail, period.” The nurse, Ellmers, behind him jumped and clapped as she shouted, “Yes!”

He went on to call Obamacare “a gateway to socialized medicine.”

Then he introduced Cynthia Lummis, a representative from Wyoming, who is not a health-care professional, but does have an undergraduate degree in animal science. “When the government tells the American people ‘this is how you’re going to live your life,’ Americans get angry,” she added.

Then Price came back to the mic to build the energy to a climax, drawing the crowd into a chant: Trump! Trump! Trump!

Then 20 minutes passed.

Then Ben Carson wandered on stage.

He talked about how he was once a neurosurgeon nearby, in Baltimore. He said that Trump’s success in the hotel industry bodes well for his success in health care. We need to drain the swamp and tell the people in the government, “You’re fired!” Much applause.

He then introduced Mike Pence. Pence said that Carson was “one of the great leaders of the United States of America,” without explanation. Pence said that he considers himself a Christian, a conservative, and a Republican—in that order. He furrowed his brow and waited for applause. He emphasized that Donald Trump is a man who doesn’t quit.  “We’re going to make him the next president of the United States of America!” A standing ovation. “We’re going to lower taxes across the board,” he said. He offered that he would “end the war on American energy.” He said they would “end illegal immigration once and for all.”

Then he said it: “We’re going to repeal and replace Obamacare.”

He said that the health law is “plain and simple, a government takeover of health care,” referring to the individual mandate and subsidies. He said he’s very proud that not one Republican in Congress voted for Obamacare. Applause for partisanship. He mentioned “free-market solutions.” Then he said the polls looked good for Trump, and he is going to win. The people stood and chanted “Trump! Trump! Trump!” He said “repeal and replace” again. “This government takeover of health care called Obamacare is failing in states across America,” Pence said.

Then he talked about premiums increasing. He furrowed his brow and shook his head. He said that right here in Pennsylvania, people would “see their rates spike drastically with absolutely no help from the government.” He furrowed his brow. At this point it was unclear if help from the government was good or bad.

“Hillary Clinton’s plan is actually to introduce what’s called single-payer into the system,” he said, falsely. “More government-run health care.”

Then he said he was going to pull Obamacare off the market so it would stop burning up everyone’s wallets. A standing ovation.

“Part of the reasons costs went up is because Obamacare dictates that Americans buy a government-designed health care plan,” he said, falsely.

Then he said Obamacare is killing jobs, although unemployment in the U.S. is lower than it was in the years before the law.

“It’s time to end this government takeover of healthcare and start over with American solutions,” he said. “We’re going to repeal Obamacare—lock, stock, and barrel.” A standing ovation.

He said that he would use the free market, the American way. He mentioned allowing health insurance to be purchased across state lines, which is one of two concrete ideas that Trump and Pence have offered. The other is to make it easier for people to open savings accounts to pay for their own health care when they get sick (“health savings accounts”). “They allow you to control your health care dollars,” Pence said. Indeed they do, and many large employers already offer this option.

He also said he would empower Americans with more information about the cost and quality of care in their hometowns. This would be great and is an element of Obamacare as well, though it has proven difficult for the government to force this transparency. Pence offered no plan to accomplish this. Theoretically when everyone is paying cash for their medical care, providers will compete aggressively to offer the lowest prices, with billboards and subway ads. The wealthiest people will get the most care.

Then he offered another thing that’s part of Obamacare, also without a plan: “Donald Trump and I will protect Americans with pre-existing conditions so that they’re not charged more or denied treatment just because they’ve been sick. As long as they pay their premiums consistently,” he said, which is how insurance works. In this case, as long as a person has enough money in their (health) savings account to pay for exorbitant health insurance (that they might have to pay because of a pre-existing condition), he and Trump will support that person.

“We didn’t see these rate increases when the states were running things,” he said, falsely. “So we’re going to empower the states, once again, to manage our health insurance industry.”

He said Clinton would offer “more Obamacare” which was “a government takeover of health care from the start,” and that he would like a system based on “free market principles.” Then he said we need a health-care system based on “free market principles and consumer choice,” and then he furrowed his brow and said “it’s time to come home.”

Then everyone stood up and applauded. Then Pence introduced the man who would “restore freedom to our health-care economy,” Donald Trump. As he walked on stage, I couldn’t see anyone in the audience who wasn’t taking a picture. “The Star-Spangled Banner” played. Trump said that a lot of people were “enthused and excited” about his campaign. He said that Ben Carson would be “very much involved” with his administration.

He said he will immediately “repeal and replace Obamacare.” He then said he would ask Congress to convene “a special session, so we can repeal and replace.” Congress will be in session already in January. “Obamacare has to be replaced,” he said, “it is a catastrophe.” He said, falsely, that Clinton “wants to put the government totally in charge of health care in America. If we don’t repeal and replace Obamacare, we will destroy American health care forever.”

The people stood and chanted “Trump! Trump! Trump!”

He repeated what Pence said, that he would like to have people use health savings accounts, where they save money tax-free that can be used to pay for health care. “It will be a much better health care [sic] at a much less expensive cost.”

It won’t be, though. When everyone pays for their own health care individually, they lose collective purchasing power and the pharmaceutical companies and hospital systems can charge whatever they want, offering care to only those who can afford high costs.

Then Trump took a hard right turn, and with the rest of his twenty minutes, he talked about bringing back manufacturing jobs, China, NAFTA, great negotiating, Mexico, currency manipulation, “clean coal,” steel-workers’ jobs being stolen by China, more choices for school for children, “bringing education local” [standing ovation], tax cuts, rebuilding the military [standing ovation], that we are “far less safe today than we were before we started,” vocational training, the fact that he went to Wharton, African Americans in the inner cities, and the enthusiasm of crowds at his rallies.

And that’s it. That was the health care meeting.

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