By Thomas Clairmont, M.D.
Foster’s Daily Democrat (Dover, N.H.), Dec. 27, 2015
Health care now represents almost 20 percent of the economy. It is surprising that there is so little discussion about an issue that affects everyone and costs so much. Repeal of Obamacare is on every Republican’s list, but the replace part is elusive. I have tried to elucidate the candidate’s positions and provide some analysis. At this stage everyone should state their plan.
Jeb Bush – will give you a tax credit to buy an “affordable” portable plan. No definition of what affordable is – less than 10 percent of income going to health care is an accepted definition. He keeps all the unnecessary insurance companies in business.
Ben Carson – supports Health Savings Accounts. A poor idea because they attract healthy and wealthy individuals, leaving sicker patients in increasingly expensive plans. They also discriminate against women whose annual care costs $1,000 more then men’s.
Chris Christie – says nothing about health premiums for the 26-64 groups. For Medicare “if you can afford to pay more you will.” This does zero for you and does nothing to reduce your health care costs.
Ted Cruz – “Repeal every blasted word of Obamacare.” This brings back pre-existing conditions, annual and lifetime caps, kicks your kids off your insurance the minute they graduate, and sends millions of people off Medicaid to fend for themselves. Why does this nonsense get applause?
Donald Trump – “I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now.” This is a nod towards single-payer that does indeed take care of everyone, provides better coverage and saves money.
Marco Rubio – will give you a refundable tax credit to purchase insurance. We don’t need insurance companies going forward, so having individuals trying to decide what expensive plan to buy does nothing for improving access or controlling costs.
Hillary Clinton – retains the Affordable Care Act, says she will lower out of pocket and prescription costs but doesn’t say how. The Affordable Care Act is not universal, has not lowered costs and has way too many expensive options.
Bernie Sanders – the only candidate with a concrete plan you can actually read. Endorses HR 676 – the Expanded and Improved Medicare for All Act – “Access to health care is a human right.” Don’t be fooled by Clinton’s ruse that this plan increases taxes. Your new tax bill includes full coverage and you pay no premium. Many of us believe we need someone in charge of health care, negotiating for us all because we have no bargaining power as individuals. Every other country in the world provides full coverage to their citizens at less than half of the costs in the United States.
It is time the candidates start talking about helping you. You are already paying 2.9 percent of your income for Medicare, — 10 percent of your property tax pays for our Portsmouth employees’ health care, and your income tax covers over 4 million federal employees, the military, and 70 million people on Medicaid and the Children’s Health Insurance Program, including refugees. Then you pay part/all of your premium and then your insurer adds deductibles, co-payments, co-insurance and inconvenience.
A powerful new movie, “FIX IT,” makes a compelling case for scrapping this current dysfunctional multi-payer system and expanding Medicare to cover everyone with one plan — comprehensive, affordable, permanent and secure. Watch the trailer at fixithealthcare.com
We will show this movie on Jan. 9 at 10 a.m. at the Portsmouth Public Library. Your attendance and comments are welcome.
Dr. Thomas Clairmont is a board-certified primary care physician practicing in Portsmouth, specializing in internal medicine.