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If President Donald Trump doesn’t get an Obamacare replacement bill passed into law, then he’s not going to get anything significant done in domestic policy, because he had made this goal the centerpiece of his campaign. But it won’t happen; his Presidency (at least in domestic policy) is already dead.
Trumpcare — his promised replacement for Obamacare — is so blatantly atrocious that an excellent NBC News article on it, from March 8th, was headlined, and documented that — “Experts: The GOP Health Care Plan Just Won’t Work”. This was even before the Congressional Budget Office had priced out its costs to taxpayers (which still hasn’t yet been done but can only sink it even deeper when it finally is).
Already, by the time of Sunday, March 12th, Huffington Post bannered about it, “Tom Cotton Warns GOP Health Care Bill Could Put House Majority At Risk”, and subheaded with a quote from this Republican U.S. Senator saying to Republicans in the House: “Do not walk the plank and vote for a bill that cannot pass the Senate and then have to face the consequences of that vote.”
It was already a hot potato by that time. In fact, on March 10th, CNN had headlined “Nobody wants their name on the Republican health care bill” and opened: “The White House says don't call it ‘Trumpcare.’ Critics are labeling it ‘Ryancare’ and ‘Obamacare lite.’ Hospitals hate it, and insurers are pushing the panic button. The House GOP bill to repeal Obamacare is quickly becoming a bill that nobody wants to own.”
But Trump already owned it: here is what he had actually said about the bill on March 7th:
“I'm proud to support the replacement plan, released by the House of Representatives and encouraged by members of both parties. I think really that we're going to have something that's going to be much more understood and much more popular than people can even imagine. It follows the guidelines I laid out in my congressional address — a plan that will lower costs, expand choices, increase competition, and ensure healthcare access for all Americans.” I was and is none of those things.
It is Trumpcare, and it is so bad that even with solid congressional Republican majorities, it won’t be able to pass into law.
In other words: Trump’s healthcare promises, too, have already irretrievably bitten the dust.
Before that, there had been campaign promises which he had previously casually abandoned, and the abandonment of which was an insult to the millions of people who voted for him because he had promised those things: things such as, “Lock her up!” for Hillary Clinton’s having never even been investigated for the things she did with her email that were illegal on their very face. (The FBI investigated her only on the more-difficult-to-prove charges.)
When President-elect Trump had been asked about the “Lock her up!” promise, he displayed the nerve, on December 9th, to say “That plays great before the election -- now we don't care, right?” and he didn’t even wait for an answer — because, until the election, his promise to do exactly that, about which he now said “we don’t care,” was one of his biggest applause-lines.
Clearly, then, his campaign-promises that, as President, he would impose real accountability — something which has been entirely absent at the top in America for decades, and the lack of which had fueled his campaign-crowds — were just cheap lies for votes.
And he also had promised to “Drain the swamp!” of its corruption, but likewise casually abandoned that, with Newt Gingrich saying on December 22nd, "I'm told he now just disclaims that. He now says it was cute, but he doesn't want to use it anymore” — and this was even before Trump became President! He quit the progressive promises even before he moved into the White House.
Every progressive thing that he had just so much as suggested during his campaign — such as that maybe free healthcare for poor people isn’t such a bad idea, or that maybe global warming is a problem — was simply ignored by him after he had won the Presidency.
But the healthcare-issue is the one which will decimate his Presidency, because he’s actually not even trying to deliver what he had promised on that, and yet it’s an issue that everyone cares lots about, and which (unlike the accountability-issue) he can’t simply pretend is minor.
Trump had told Scott Pelley of CBS “60 Minutes” on September 27th, while campaigning against Hillary Clinton, that he favors taxpayer-paid healthcare for Americans who cannot afford to pay for the basic healthcare they need — and this idea, of basic healthcare as a right instead of as a privilege, was something that Ms. Clinton had always said was a “one size fits all” approach that reduces consumer-choices and is inappropriate for the United States. Trump, to the contrary, promised it; he told Pelley:
“Donald Trump: By the way. Everybody’s got to be covered. This is an un-Republican thing for me to say because a lot of times they say, “No, no, the lower 25 percent that can’t afford private.” But — Scott Pelley: Universal health care? Donald Trump: I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now. Scott Pelley: The uninsured person is going to be taken care of how? Donald Trump: They’re going to be taken care of. I would make a deal with existing hospitals to take care of people. And, you know what, if this is probably — Scott Pelley: Make a deal? Who pays for it? Donald Trump: — The government’s gonna pay for it.”
Doing that would actually cost far less than what the U.S. (including the government, the insurers, and the patients) now spends on healthcare. Hillary Clinton was wrong; he was correct on that. Recent OECD data on healthcare costs show that the U.S., which is the only OECD country that handles healthcare as a privilege instead of as a right, spends by far the world’s highest percentage of GDP on healthcare, 16.9 percent; and also show that the average U.S. life expectancy is 78.7 years; by contrast, Canada spends 10.2 percent, and their life expectancy is 81.0 years. The OECD average expenditure is 9.3 percent , and life expectancy is 80.1 years. So: the U.S. spends almost twice as high a percentage of GDP as every other OECD nation, and yet gets markedly inferior results. This makes the U.S. far less economically competitive than it otherwise would be; but, the healthcare industries finance conservative politicians such as Hillary Clinton, Barack Obama, and all Republicans; so, those politicians don’t like single-payer — it would take the excess profits out of exploiting the sick, and those excess profits help to fund their political campaigns and get them elected.
The American people’s financial losses produce exceptional financial gains for the investors in healthcare-related stocks, and also inflate the pay for executives in those firms. This helps to fund lots of what conservatives such as Antonin Scalia lovingly call “free speech” — campaign commercials.
Here are the latest available data, and they show that, still today, the U.S. is somewhat worse than average, for quality of care, and astronomically higher than any nation on both per-capita healthcare costs, and the percentage of GDP that goes to healthcare costs. For examples: across 45 countries tabulated by the OECD, the U.S. healthcare-expenditure per capita was $8,713 and 16.4% of GDP, whereas the average OECD country paid $3,453 and 8.9% of GDP. France paid $4,124 and 10.9% of GDP, and Japan paid $3,713 and 10.2% of GDP. The U.S. also was tied with Brazil, Chile, and South Africa, for having the highest percentage of healthcare-costs that’s paid privately rather than by the government.
In any case, with our existing healthcare-for-profit, instead of healthcare-as-a-right, system, the U.S. ends up paying lots more than our competing nations, yet getting inferior results. (Apparently, postponing care until one is being rushed into an emergency-room is both atrociously poor care, and extremely expensive care. But it’s the most profitable for the sickness-industries — so, President Trump wants it to continue. Republicans care lots more about corporate stockholders than they do about the public’s welfare; and, unlike Democrats, they don’t pretend not to. That’s the difference between the two Parties.)
Consequently: What Trump was promising on healthcare was the only way to reduce America’s healthcare costs. It would also — if the experience of the other OECD countries, all of which treat basic healthcare as a right not a privilege, is to teach us anything — considerably increase the quality of our healthcare, yet cost far less.
But Trump instead (like his predecessors) cares more about the profits to healthcare-providers than about the healthcare of the American people and about the competitiveness of the American economy.
All of the progressive-sounding things that Trump said, were just lies. But he’s pushing hard the conservative-sounding things. He’s trying to fulfill only his conservative (i.e., pro-aristocracy, anti-public) promises. But conservatism is based entirely upon lies (saying it’s being done ‘for the benefit of the ruled, not of the rulers’); so, one can only hope that his now-doomed Presidency will achieve as little as possible — as little harm to the nation as possible, so that nothing should pass in the far-right Republican-controlled Congress and get signed into law in this far-right Republican White House — by either Trump, or (if the President becomes the current Vice President, Mike) Pence. A four-year total deadlock would thus be the best that can realistically be hoped for, now.
Obama’s Presidency was lousy, but Trump’s (and/or Pence’s) could be even worse. A country that’s becoming more and more an aristocracy — or what’s commonly called an “oligarchy” — and less and less an actual democracy, does better to block political change, than to allow it. America today is certainly in that situation; it’s in decline.
Investigative historian Eric Zuesse is the author, most recently, of They're Not Even Close: The Democratic vs. Republican Economic Records, 1910-2010, and of CHRIST’S VENTRILOQUISTS: The Event that Created Christianity, and of Feudalism, Fascism, Libertarianism and Economics.
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