Lost in all the coverage of the firing of FBI Director James Comey last week were a pair of in-depth interviews President Donald Trump gave that included lengthy comments on health care — one with Time magazine and the other with The Economist.
He acknowledged to Time interviewers that health care was not an area of expertise in his previous job. “It was just not high on my list,” he said. But he added that “in a short period of time I understood everything there was to know about health care.”
Among the president’s more questionable claims was his description of the House-passed health bill as “You’re going to have absolute coverage.”
The last full estimate from the Congressional Budget Office predicted that a previous version of the bill would result in 24 million fewer people with insurance after 10 years.
Trump also told The Economist that “we’re getting rid of the state lines,” a reference to allowing health insurers to sell across state lines. Not only is that not in the GOP bill, many experts agree such a policy would not work to increase competition.
Possibly the most curious comment was this one, also in The Economist interview: “[T]his was not supposed to be the way insurance works. Insurance is, you’re 20 years old, you just graduated from college, and you start paying $15 a month for the rest of your life and by the time you’re 70, and you really need it, you’re still paying the same amount and that’s really insurance.”
“He seems to think it’s like a life insurance policy, which you can buy at a certain age and it keeps you at a fixed premium dollar forever,” said Gail Wilensky, a health economist who ran the Medicare and Medicaid programs under President George H.W. Bush. Except “you can’t buy health insurance that way,” Wilensky said. “Even if you stay continuously insured, that’s just not how it works.”
On the other hand, Wilensky said, it might not matter all that much how well a president understands the intricacies of health policy. “It matters whether he thinks it’s important,” she said. The president she worked for was much more comfortable on issues of foreign relations and defense. “It wasn’t that he didn’t care” about health, she said. “He just didn’t know that area the way he knew other areas.”
Jonathan Oberlander, a health policy professor at the University of North Carolina-Chapel Hill, points out that a deep understanding of a subject by itself is not enough to produce policy change.
“Bill Clinton thought he knew health policy, and look at how that turned out,” he said, referring to the collapse of his health reform plan in Congress in 1994. Still, “ignorance surely doesn’t help,” he added.
David Blumenthal, president of the Commonwealth Fund and co-author of a book on presidents and health care, agreed with both Wilensky and Oberlander.
“A president has to know enough to sell the plan” to Congress and the public, he said. “But presidents can make mistakes by getting too deep in the details.” He pointed to not only Clinton but also President Jimmy Carter as chief executives who got mired in the small print of health policy.
At the same time, however, Blumenthal said that a president has “to lay out principles and parameters that the Congress knows if they meet he will sign the bill.” And while Trump has done that, “I don’t think he’s been entirely consistent with what he’s said, so it’s not clear how much the Congress is being guided by his principles,” he said.
One health issue Trump is clearly not ignorant about is his power to stop paying insurance companies who are providing help to some low-income policyholders in the health insurance exchanges. The “cost-sharing reductions” are the subject of a lawsuit that was appealed by the Obama administration, and Trump could, in fact, stop the payments by dropping the appeal.
Insurers say uncertainty about whether they will get that money is a key reason they are asking for higher rates or dropping out of markets.
Trump did not help allay that uncertainty. He told The Economist that “we don’t have to subsidize it. You know if I ever stop wanting to pay the subsidies, which I will.”
–Julie Rovner, Kaiser Health News
I’m sorry the man knows absolutely nothing about healthcare, or anything else. I’m just tried of his BS and his deranged childlike attitude. As of right now, we have 1345 days, 11 hrs:58 min until he is out of office
#1 The CBO estimates, they are not absolute. Additionally they have been way off on their estimates in the past.
#2 This “GOP” bill is not the end of the changes. There are more to come.
Obama knew about health care,oh wait he was wrong about premiums not going up to unaffordable prices for working people. ….
the irony in this article is sickening
“The last full estimate from the Congressional Budget Office predicted that a previous version of the bill would result in 24 million fewer people with insurance after 10 years.” How many of these are people who are only it it because of the Mandate?
He knows hes covered, end of story…
Richard Smith says
Well if our president, house & senate cannot come up with a rock solid heath-care plan then why not assemble a group of health-care insurance companies and stick them in a room for a week to hash out a plan that covers all people across the country under the age of 65 that includes reasonable benefits at affordable costs? They are the experts that should know the most about heath-care versus anyone in government.
Mr. Trump should educate himself with regard to healthcare because he’s facing
a mental health crisis himself. But then again he’s lost his ability to assimilate information.
His short-term memory is waning.
If you observe him speaking, you’ll notice the excessive use of non-specific nouns
and an obvious handicap with memory and spelling (look at his tweets).
He’s also showing signs of trouble balancing himself when walking, he’s irritable,
unpredictable, and he’s prone to flights of fancy and ever-increasing narcissistic tendencies.
I think that he’ll be impeached soon, perhaps using dementia as a defense for the charges
leveled against him. His father had Alzheimers Disease and it seems as if he is
in the early stages of this same terrible disease. I certainly wouldn’t wish this on anyone,
but the POTUS might just have the same malady. Something is terribly wrong.
Just google: “Trump dementia’ and you’ll arrive at 900,000+ hits.
Trump will not finish his term. Mike Pence is probably going to be the next president, and
if not him, then it’s Paul Ryan.
Buckle up folks. There’s a bad moon rising.
Or “there’s a bathroom on the right.”
Al Cycle says
Well did Trump say that if you like your health plan you could keep it or if you like your Doctor you can stay with them? I would think who said that would not know anything about the plan they were trying to implement!
Katie Semore says
@Geezer, couldn’t have said it better myself. People would be wise to understand that what you said is correct and when it is all said and done those that placed a halo on Trump’s head and called him King are going to look pretty stupid.
Never trust anyone who says he understands everything !
Remember Polois famous quote. We don’t know what’s in it , we’ll read it after it’s approved.
A cure for stupidity is our only hope. So yes, yes we’re doomed.
CLINTON still LOST LOL
Lovin Flagler Beach says
From comments Trump has made, (Australia has better health care than the US) and promises (No one will lose coverage. There will be insurance for everybody. Healthcare will be a “lot less expensive” for everyone — the government, consumers, providers. ) , I have the impression that personally he would prefer socialized medicine. I don’t think he realizes that is what he describes leans toward a one payer system or socialized medicine.
But at any rate, there is too much opposition to socialized medicine or “medicare for all” in the republican party and Trump’s base for him to advocate for it.
Goodbye Obamacare goodbye! Obama screwed up the healthcare system so bad it will be hard to overcome all the damage he has done. Thanks a lot democrats for leaving Trump with such a mess to clean up.
Sherry Epley says
As a person who was a “small group underwriter” for a major insurance carrier for 11 years. . . please believe me when I say that long gone are the days when insurance companies “cared” about human beings!!!! Their current focus in ONLY on “Maximizing Profits”. . . as are “most” (not all) doctors, clinics and hospitals.
Sure, those who do the work of calculating risks and rates for every health treatment “could” give great advice about how to create effective and cost efficient health care for all. . . BUT, they would NEVER do that! They would not honestly tell anyone how to make that happen BECAUSE it would eliminate their “middle man” industry altogether, or at a minimum cut drastically into their profit margins.
Yes, we need true experts to guide our governmental leaders because those in Congress don’t have a clue either. . . it just should not be those whose “profits” hang in the balance. There are plenty of economists around who specialize in such things. The massive problem is that those currently in power do not trust such things as statistics and actual FACTS. This dilemma is just another symptom of a much bigger disaster. . . . which has an almost “cult” following. . . against all logic and reason. . .”Alternative Facts” !!!!
Sherry Epley says
BTW Dear Geezer. . . you are “Right On” as usual! Unfortunately, trumps followers are so hooked into their cult. . . they would not vote to impeach him. . . not ,matter how mentally ill he is.
However. Pence could be even more dangerous BECAUSE he does still have his wits about him and he has powerful influence in Congress. Not Good, either way!
I send you heart felt greetings from beautiful NAXOS, and Santorini Greece!
Trump is a moron, he lives in his own alt reality.There is something definitely wrong with him mentally.
I disagree with the notion that Pence has his wits about him, if he did, he would have not accepted to be trumps VP and if he did not know what he was getting himself into, he knows now, and has lost any credibility. Pence is a liar just like trump. He has become another “yes sir, how far do you want me to bend over” person. Just like his brainwashed, clueless supporters.
Hillary was not the strong candidate that we needed…as due to dam mistakes she made, was lynched by the GOP mob and her own discontent financially distressed DEMS. She carry too much baggage. But oh my that leads us to a current communist POTUS that is obstructing justice in favor of interference with our elections and espionage for a foreign power that has never been an ally of USA. Now we have Russiagate and meanwhile the GOP Congress and Senate still give him green flag!
Since when we are given our news by TASS..? Shameful!
Edith Campins says
Republicans had seven years to come up with a better plan. They did nothing.
Trump said he had a plan that would cover everyone and cost less. He lied.
If they wanted to serve the people they would work with Democrats to fix the flaws the AHCA and make it better. Instead they are busy selling out our country to the Russians and constantly lying to the American people. Not one Republican has the courage to call out Trump for the incompetent, dangerous idiot he is.