Donald Trump has accomplished “a number of fairly serious achievements,” in his first year as president — in the eyes of real-life super villain Vladimir Putin, at least. Unless you consider “most cabinet re-orgs in 12 months” an achievement along with it, he’s only really accomplished one — the tax plan.

Since taking office, Trump has generally focused on pandering to his base of support. However, while a sizable portion of adults 65 and older voted for Trump, his tax plan makes no allowances for those staring down the highest health care costs they will face in their entire lives.

Medical Deduction Squeaks Through

Those who have followed the back-and-forth this bill has endured between the US House of Representatives and Senate will know that House Republicans sought to remove from the bill a deduction that 8.8 million Americans take advantage of every year.

That is the deduction for medical expenses that allows taxpayers to deduct expenses not covered by insurance when they amount to over 10 percent of the person’s adjusted gross income. For those 65 and over, the threshold is 7.5 percent. In the new bill, the 10 percent threshold is restored for all beginning in 2020.

Senators disagreed with the removal of the deduction proposed in the House bill, possibly a result of the older group that occupies senatorial seats. Even with the deduction staying in place, the state of elder care in the United States is a depressing topic.

Social Security Still At-Risk

It’s no secret that the Social Security program intended to provide medical care for retired Americans is bleeding out. The program is expected to begin paying out more in benefits than it takes in in revenue by 2022. At that rate, by 2034 the program would be entirely broke.

With the implementation of the new tax plan, changes to the program’s Cost of Living Allowance (COLA) will come into play as well. The new plan replaces the standard consumer price index (CPI) with an adjusted means of calculating the cost of basic needs for those on Social Security.

Such adjustments are made based on the assumption that cheaper alternatives to the ones people currently use are available. For example, in some situations, this could mean using generic medicines instead of brand-name drugs. However, other situations are more precarious.

Take, for example, the costs associated with placing someone in an elder care facility. Less reputable facilities have been shown to be hotbeds for elder abuse. Do you want the GOP’s tax plan to dictate whether your mother or father receives quality care in a home they pay for? That doesn’t sound right.

Single Payer: A Better Solution

If there’s an upside to this plan, it’s that Social Security reserves might be made to last a little longer, but this comes at the risk of millions of people losing care they need to live.

It is possible, however, that we could implement a different system in the time between Trump’s new plan and 2034. What would that look like? Many people favor a single-payer option.

We’re getting a tax break in the first few years of the new plan, but for all but the upper crust, that break won’t last. Corporations are not failing in the current system, and the difference in money they’ll be allowed to keep would be much better spent on caring for America’s citizens than lining the pockets of CEOs.

It’s not likely that a real single-payer system would operate on corporate surpluses, though. Implementing such a system would likely require a small tax increase — but it would ultimately reduce overall health care costs by as much as 50%. Yes, you pay more taxes, but ultimately the nation has more money in its pocket — stimulating the economy at the same time as it ensures all are cared for.

Corporate greed from insurance companies and pharmaceutical manufacturers is the biggest thing standing between America and a working single-payer system. For now, however, we’ll have to deal with what Trump has given us. Let’s hope that eventually repealing it won’t be as dramatic as the process of putting it in place was.

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