Whether you are elated, appalled, or just plain amazed that Donald Trump is the Republican primary front runner by a considerable margin, one thing should be clear: he’s not a policy guy.
So far, The Donald’s lack of policy specifics seems not to have hurt him. He’s successfully deflected the more searching debate questions, provided vague generalizations or given incomprehensible responses, and—when all else failed—insulted the debate moderators or his fellow Republican candidates.
So far, so good, for the Trump campaign. But is it time to change tactics?
As the number of competing candidates dwindles(So long, Jeb!),the focus in debates and interviews becomes sharper. With the original crowded field winnowed to just a handful,interviewers and debate moderators have time to probe a lot more deeply.And even if the questioners are relatively gentle, every other surviving candidate will be eager to pour scorn on policy statements that lack either substance or rationality.
Like Donald Trump’s healthcare proposals so far.
He’s said he wants the government to negotiate Medicare drug prices, he likes health savings accounts, he wants to be able to buy insurance across state lines, and he wouldn’t cut Medicare. And that’s pretty much it, except for one very big thing: he would “repeal and replace” Obamacare. But by what? “Something terrific” he says.
It’s easy to mock, but all of us – liberals and conservatives — should worry that we might just find ourselves with an incoming president trying to impose such an incoherent healthcare vision that our present system would look like a paragon of rationality.
So, maybe it’s in all our interests that Donald Trump should have a healthcare policy that’s more intelligible than he’s offered so far(nicely satirized by Ian Morrison in a recent THCB post). It would presumably have to be one with conservative appeal, be understandable by the average voter, be different from other candidates’ proposals, and play to Donald Trump’s biggest strength: he’s a successful businessman, not a politician.
In the hope that Donald Trump is able to develop a more coherent policy, imagine this debate exchange:
Megyn Kelly: On behalf of Fox News, welcome to the twenty-fifth Republican presidential primary debate. Nice to see you again, Mr. Trump. Tell us about your plans for American healthcare. You have said you will replace Obamacare by “something terrific”?
Donald Trump: I’m gonna to do it as soon as I’m in the White House door.
MK: Go on.
DT: I’m gonna make the whole thing work like a business. The same way my hotels are a business. We’re gonna save big bucks by having proper competition, just like in the hotel business. I’ll tell ya, if hotel rates had gone up like healthcare costs, I’d be a trillionaire not just a billionaire. What we’re gonna do, we’re gonna let every American choose what insurance to buy, just like they can decide where to stay to get the best deal. And we’re gonna do it with a lot less government interference.
MK: How’s that going to work?
DT: See, we’ll give everyone a voucher that they use to buy the insurance they want. Just like they can choose a superior Trump brand resort or a crummy Motel 6.
MK: Why would anyone choose the Motel 6 option for their health insurance?
DT: The voucher will cover the Motel 6 costs, but people are gonna have to use some of their own cash if they want a superior brand. Like mine.
MK: So, back to healthcare, there’ll be more competition between insurers. But isn’t there competition today?
DT: Nah, not really. Most insurance is bought by employers who only want to keep their [bleep] unions happy. If regular people had to use their own cash to get anything more than Motel 6 insurance they’d buy only what they need, for a lot less money. But everyone would have insurance, like I’ve always said.
MK: Where would the funding for the vouchers come from? This is beginning to sound like Senator Sanders’ Medicare for All proposal.
DT: That Bernie! Well-meaning guy, but he’d bankrupt us all with new taxes. I’ll tell ya where the money for my plan would come from. We’ll end this deal where some people get insurance for free from their employers and others don’t get anything. Companies shouldn’t be in the insurance business anyway. Aetna doesn’t build airplanes, so why should Boeing provide insurance? That’s nuts. We’ll get rid of monopolies. We’ll get rid of Medicaid, won’t need it anymore. We’ll get rid of a zillion bureaucrats. And we’ll use vouchers to make Medicare competitive, too. And we’ll do it with no new taxes.
MK: So, you’ll turn the whole healthcare system over to the insurance industry?
DT: There’s gonna have to be a few rules, so they can’t gang up, but we’re gonna make them compete. Just like hotels compete. My way for healthcare, it’s how businesses made America great, and it’s gonna make America great again.
Senator Cruz (interrupting): Giving everyone insurance coverage is communism! Remember what the Bible says: “For whoever has, to him more shall be given, and he will have an abundance; but whoever does not have, even what he has shall be taken away from him.” That’s the Republican way!
Senator Rubio: Amen!
Well, it’s only an imaginary debate segment. But it’s better than Donald Trump has produced so far.
Roger Collier is the founder of the Campaign for a Rational Healthcare System (www.rational-healthcare.com). He was formerly CEO of a national healthcare consulting firm.