Obamacare has been a major part of the 2016 election, and will continue to act as a wedge between the parties long after we have a new commander-in-chief. Nevertheless, it feels like both major presidential candidates have failed spectacularly when it comes to discussing medicine in this country. Here’s a look at what they’ve been saying — and what it might mean for the future.

Trump’s Health Care “Plan”

Donald Trump’s plan for health care in America is about as logical as his other proposals. He has sworn to repeal “every word” of Obamacare, and keeps giving the law’s architect, Jonathan Gruber, public tongue lashings. But beyond that, what he intends to “do about” health care is still a mystery.

Trump has contradicted himself at every turn. On February 18, he publicly claimed he “like the mandate” required under Obamacare, but days later indicated he wants to repeal the whole law, including the personal mandate to purchase health insurance. Years ago, Trump stated publicly that

he was in favor of universal health care in America, but on the campaign trail spent some time tilting at Bernie Sanders, who Trump claimed “wants to give it all away for free.”

Trump has no cohesive worldview or even a coherent political platform. What he’s released so far on health care isn’t a plan — it’s a return to the status quo and to every problem Obamacare set out to address. Even the GOP is worried about what Trump is saying about health care. His campaign website and stump speech rhetoric claims America will “take care of everybody” under his administration, but his “plan” contains no mention of expanding coverage.

What it does mention is allowing insurance companies to sell coverage across state lines, but there’s no indication this would improve either customer service or medical care for the average American. It’s substantially likelier that this setup would further degrade the quality of health care services in this country, since every insurer would almost certainly move their headquarters to less-regulated states, such as Delaware, in order to continue predatory business practices. No — selling across state lines is a solution for a problem that doesn’t exist.

In an unlikely overlap, Trump agrees with Democrats that Medicare should negotiate for lower drug prices, the way Europe has done for years. But that’s where the similarities between the Republican and Democratic candidates end. In every other respect, what Trump proposes is the definition of regressive, and will see millions of Americans returned to “uninsured” status, and many millions more denied coverage for pre-existing conditions, for being elderly, or for being a woman.

Clinton’s Health Care Plan

Hillary Clinton has spent the last year and a half promising America that her presidency would be Obama’s third term, and nowhere is this more obvious than in her plans for health care. If Clinton is elected, she would fight to keep the Affordable Care Act intact, but would add contingencies for low-income Americans who still struggle to pay for medicine.

The result would be an America where millions more Americans would be insured than have coverage currently. Trump’s plan would rip this safety net away from 16 million people and simultaneously cause out-of-pocket costs to balloon. Both plans would increase the deficit, but only Clinton’s resembles forward social progress.

If Donald Trump has failed America by not knowing a thing about how health care or health insurance actually works, Hillary Clinton has failed by not being ambitious enough. At every turn, she wishes to keep insurance companies where they are, which is right smack in the middle between customers (that’s us) and doctors.

One thing both Republicans and Democrats should be able to agree on, based on objective fact, is that medicine is one place where profit should have no vote. Doctors have a right to earn a living, but the monolithic and abusive bureaucracy we call “insurance” has called the shots for far too long.

Throughout her long primary against Bernie Sanders, who made universal healthcare one of his signature issues, Clinton repeatedly attacked the very idea, even literally shouting at a rally: “It will never, ever happen!” All this, despite championing universal healthcare in her previous presidential bids. A universal, single-payer, public option for health care could save middle-class families as much as $5,000 per year.

Instead, Clinton is fiddling around at the edges. She would create new tax credits (up to $2,500 for individuals) to help alleviate the burden of expensive medical procedures and would lower from 9.7% to 8.5% the amount of one’s income one is expected to pay toward insurance plans purchased on the Obamacare exchanges.

One more key point worth mentioning is Clinton’s potential conflict of interest. It’s an established fact that Clinton took more money in campaign donations from the top pharmaceutical companies than all of her GOP rivals combined, which casts some doubt on whether she’ll actually do anything about drug prices in such a compromised state. What it might mean is that Clinton will be willing to speed up the FDA’s approval process for investigational drugs, but this sometimes results in sub-par products and that’s no good for us as consumers.

She has, however, signaled tepid support for a public option after the Democratic Platform Committee added it to what they’ve called “the most progressive party platform ever” in America’s history. As discussed, a public option would result in the greatest number of uninsured Americans finding relief — if it ever comes to pass.

Health Care as a Right?

Americans are fast approaching a consensus on whether health care should be a luxury purchase or a right. Helping things along is the knowledge that the UN, and dozens of other countries, came to this realization some time ago and officially ratified the idea in the Universal Declaration of Human Rights.

A nation should be judged in part by how it treats its most vulnerable citizens. By this metric, one of our major parties is moving in the right direction, while the other is content to march decisively backwards into the past.

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