The election is bearing down upon us like a term paper that is due tomorrow, but first, let’s clean the apartment.
Healthcare is a hot topic in every election, and this one is no exception. The following is a breakdown of each presidential candidate’s healthcare plan through my own highly filtered and polarized lenses. The information about each candidate’s plans was painfully extracted from their respective websites, hillaryclinton.com and donaldtrump.com.
At the top of both candidates’ lists is the Affordable Care Act, a.k.a. ACA, a.k.a. Obamacare. As one would guess, Secretary Clinton wants to defend and expand it and Mr. Trump wants to completely repeal it. Clinton supports the “public option,” which was part of the original ACA but was eventually removed. This would give people the option of buying a government-funded health insurance plan where marketplaces lack adequate competition to offer affordable choices. She would also allow individuals 55 years of age or older to buy into Medicare.
Fun experiment: Ask anyone you know over 65 years of age what it was like turning 65 and getting Medicare. The vast majority will likely state that it was one of the best things about turning 65 (typically right up there with retirement).
At the top of both candidates’ lists is the Affordable Care Act, a.k.a. ACA, a.k.a. Obamacare. As one would guess, Secretary Clinton wants to defend and expand it and Mr. Trump wants to completely repeal it.
Trump wants to completely repeal the ACA. This means popular aspects of the ACA would be repealed as well. Denying coverage because of pre-existing conditions would no longer be illegal. Screening tests and preventive services such as cholesterol checks, mammograms, colonoscopies and vaccines, which are now covered completely by insurance companies, could start carrying copays.
Birth control, which is now provided free of cost, could start carrying copays as well. Lifetime limits on claims could be reinstated, meaning that individuals whose medical costs exceed a certain amount (commonly cancer patients undergoing chemotherapy) could have their insurance coverage dropped. Of particular relevance to college students, insurance companies would no longer be required to allow young people to stay on their parents’ insurance until the age of 26.
To provide affordable healthcare coverage without the ACA, Trump is proposing enabling patients to purchase health insurance across state lines. He also proposes to make Health Savings Accounts (HSA) contributions tax free. This means individuals could take the extra money they have after paying for housing, food, clothing, education and transportation and place it into an account they can use to pay for medical care. This is a great solution for those who have such funds remaining after paying for all their necessities.
Somehow, immigration made its way into both candidates’ health plans. Clinton wants to allow everyone to buy insurance through the health insurance marketplaces regardless of their immigration status. Trump wants to enforce immigration laws to “relieve economic pressure felt by every American.”
What makes the immigration issue particularly nuanced is a law passed in the 1980s that prohibited emergency rooms from denying care to someone because of their ability to pay. Prior to this law, emergency rooms could turn away patients because of their lack of insurance, but now anyone presenting to an emergency room gets care, regardless of their immigration status.
Receiving care in the emergency room is costly, so denying outpatient care due to immigration status carries the potential of driving more patients to use emergency rooms as their primary care providers. To put that into perspective, a typical outpatient doctor’s visit will cost about $100 (give or take), whereas the same care in an emergency room could cost up to $1000 (give or take).
The current state of healthcare in this country is a result of decades of a for-profit system. This November, voters are facing the decision to once again commit to the for-profit system or to finally move away from it.
But if as a voter you’re feeling that isn’t a big enough burden on your shoulders, then tune in in two weeks when we review the candidates’ plans to control prescription drug costs.
Dr. Ali Javanbakht is the UCSB Student Health Medical Director