Why Trump’s Obamacare Promise Will Be So Hard to Keep
Mr. Trump accurately describes problems with the current health care system for Americans under 65: “You have deductibles that are so high, that after people go broke paying their premiums which are going through the roof, the health care can’t even be used by them because their deductibles bills are so high.”
.. The real reason health care premiums and deductibles are so high is that medical care is very expensive in the United States — far more costly than it is anywhere else in the world. The United States pays very high prices to doctors and hospitals and drug and device makers, and Americans use a lot of that expensive medical care.
.. Most of the G.O.P. plans manage to be less expensive for the federal government — by offering stingier federal payments in helping people buy insurance and allowing the coverage people buy to be skimpier. But those proposals will tend to increase, not decrease, the amount many Americans spend on their health care.
.. If the bill eliminates requirements to pay for maternity care or prescription drugs, for example, that could lower the sticker price of a health plan, but will make health care much more expensive for anyone who has a baby or takes medication.
.. There will be people who will be better off under a Republican plan. Higher-income, healthy people who buy their own insurance have been the most disadvantaged group under Obamacare, and their fortunes would improve.
.. The consensus Democratic approach to making Obamacare “far better” has been to make it more expensive for the federal government, but less expensive for individuals. Proposals circulated by President Obama and Hillary Clinton would involve more federal spending on subsidies to help make insurance more affordable for more people, but at the expense of higher taxes.
So far, the Republican plans have tended to engage in the same trade-offs, but tilt in the opposite direction, emphasizing government savings over program generosity.