Why Trump and Sanders Share a Mandate for Universal Health Care
Policy + Politics

Why Trump and Sanders Share a Mandate for Universal Health Care

GOP presidential frontrunner Donald Trump says Sen. Ted Cruz is a “total liar” for labeling him an advocate of expanded Obamacare or universal national health care along the lines being touted by democratic socialist Sen. Bernie Sanders in the Democratic presidential contest.

During an appearance on ABC’s This Week on Sunday Trump insisted he would dismantle the Affordable Care Act if he is elected president and stressed that he doesn’t favor a “single payer” universal government program that essentially would provide Medicare coverage for all.

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Yet despite the blustery real estate tycoon’s protests about Cruz’s characterizations, Trump espoused a form of national healthcare coverage that would include the 33 million Americans who still are not covered by Obamacare. Without providing any specifics during his televised appearance, Trump vowed to “work something out” that sounded suspiciously like a distant cousin to Sanders’ single-payer concept.

“If somebody has no money and they’re lying in the middle of the street and they’re dying, I’m going to take care of that person,” Trump said. When chief anchor George Stephanopoulos pressed the billionaire businessman to describe how he would accomplish that, Trump said he would “work something out.”

“We’re going to work with our hospitals,” he said. “We’re going to work with our doctors. We’ve got to do something. You can’t have a – a small percentage of our economy, because they’re down and out, have absolutely no protection so they end up dying from, you know, what you could have a simple procedure or even a pill. You can’t do that."

“We’ll work something out,” Trump went on. “That doesn’t mean single payer.”

“And if this means I lose an election, that’s fine, because, frankly, we have to take care of the people in our country. We can’t let them die on the sidewalks of New York or the sidewalks of Iowa or anywhere else.”

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A recent Kaiser Family Foundation tracking poll found that 58 percent of Americans support enactment of a national health plan in which all Americans would get their insurance through an expanded form of Medicare, although Democrats are far more enamored of that approach than Republicans are. The downside of that approach, of course, is that Medicare spending is growing out of control, according to a new Congressional Budget Office analysis.

And any move in that direction would necessitate trillions of dollars in new taxes over the coming decade, just when CBO warns the deficit and debt will begin to surge again.

Trump has raised his idea of health insurance coverage for all in the past, although he appears to be talking about a far more complicated approach than simply extending Medicare-style coverage to everyone. During an interview with CBS’s 60 Minutes last September, Trump said that Obamacare was “a disaster” – with excessive premiums and deductibles -- and that he would replace it with a program that would “take care of everybody.”

“Everybody’s got to be covered,” he said. “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 . . . I am going to take care of everybody. I don’t care if it costs me votes or not.”

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As for how to finance his ambitious proposals, Trump said, “The government’s going to pay for it. But we’re going to save so much money on the other side. But for the most it’s going to be a private plan and people are going to be able to go out and negotiate great plans with lots of different competition with lots of competitors with great companies and they can have their doctors, they can have plans, they can have everything.”

This is all too much for Cruz, who is struggling to overtake Trump in tonight’s GOP caucuses. “Donald Trump and Hillary Clinton and Bernie Sanders have the identical position on health care, which is they want to put the government in charge of you and your doctors,” Cruz said yesterday during an appearance on NBC’s Meet the Press.

While Cruz’s assertion is a gross distortion of where Trump and the two Democrats stand on health care reform in general, there are clearly some similarities, as Politifact noted today. .

For instance, Trump, Clinton and Sanders all favor allowing the federal government to negotiate drug prices to bring down the cost. However, Clinton opposes Sanders’ $1.8 trillion idea for expanding the Medicare program to include all Americans, financed by major tax increases. Instead, she advocates building on the Affordable Care Act and containing unreasonable increases in rates and fees.

Trump once voiced admiration for single-payer, but he hasn’t presented a health care plan beyond his sketchy proposals. It’s also true that the conservative Heritage Foundation in 1989 presented a national health care plan that required, “All citizens should be guaranteed universal access to affordable health care,” and using car insurance as a model, “Mandate all households to obtain adequate insurance.” Trump has suggested a system in which insurance companies considered financially stable can offer plans across state lines – a popular idea among Republicans. He also called for the federal government to negotiate with hospitals and drug companies for lower prices and to provide coverage for poorer Americans.