In a Rose Garden Speech, Trump Pretends to Have a Healthcare Plan

Trump Speaking in the Rose Garden on June 14

We’re hearing a lot about the Mueller Report, but the Democrats plan to make healthcare their main 2020 campaign issue. Mr. Trump and other Republicans’ promised to repeal the Affordable Care and Patient Protection Act, which Fox News nicknamed Obamacare, and replace it with something better. Although it’s been years, the Republicans still have no replacement plan. The 2017 Republican healthcare bill was scored by the Congressional Budget Office to cost 24 million Americans their health insurance. That plan died a quick and merciful death and we haven’t seen anything else. 

Earlier this year, Trump promised that “The Republican party will soon be known as the party of health care.” But how? If they don’t want to get smothered in 2020, the Republicans need to come up with something. Or, as President Trump tried yesterday, they can pretend that they have come up with something.

Since Donald Trump does not have a healthcare plan, and yet wanted to give a healthcare speech in the White House Rose Garden to a group of small business leaders, he needed to spread some smoke and wave some mirrors. Smoke and mirrors are Mr. Trump’s rhetorical strong point. His trick, which sounded pretty convincing despite his basic lack of ideas, was to present several tiny proposals about fringe healthcare issues, together with a few outright falsehoods, to create the impression that he was working on comprehensive healthcare reform – as if 1 + 1 + 1 + 1 could somehow equal 100.

First, Trump talked about re-introducing “short-term health plans and association health plans millions and millions of Americans. Many of these options are already reducing the cost of health insurance premiums by up to 60 percent and, really, more than that.” These are the less-regulated plans that the Affordable Care Act largely abolished because they provide limited benefits and poor coverage for pre-existing conditions. Nevertheless, Trump inexplicably promised that: “we will always protect patients with preexisting conditions.  Always.  (Applause.)  We’re always going to protect the patients.  Preexisting conditions.” When Trump’s promises and policies go to battle with one another, which should the public believe?

Second, Trump boasted that his administration would reduce the cost of prescription drugs, which any ill person knows is a serious issue in the United States: “We’ve reduced prices now by a — quite a bit.  And this year is the first year, Alex Acosta — right? — in 54 years — 53 years that drugs prices have come down.  And I want to congratulate you and all the people that have worked so hard with you.  (Applause.)  That’s really an incredible thing.  First year.”

Also, that claim turns out to be flat-out false. The Associated Press found that the median price increase in prescription drugs last year was 9.1 percent, with 96 drugs increasing in price for every one whose price went down. Again, Trump made a promise, but gave no plan to achieve it.

Third, Trump promised to attack the problem of surprise medical billing, which occurs when patients have unexpected medical bills for unexpected procedures, or where insurance fails to cover expenses that patients reasonably thought it should. This initiative is real and Trump should receive much credit if it passes. Fixing corrupt billing practices is not, however, a comprehensive solution to the United States’ healthcare system.

Fourth, Trump announced an initiative to increase Health Reimbursement Arrangements. This is a type of employer-funded flexible spending account that people can use to cover out-of-pocket expenses, copayments, and deductibles. Trump explained that these plans could be used to purchase insurance on the open market. Again, this sounds like a good idea, but it is only one tiny piece. If it becomes a way to let employers get out of providing group insurance, it could be a big step the wrong way.

After hearing a few brief speeches from supportive small business owners, Trump complained about Senator Bernie Sanders’ proposed socialist healthcare program:

“Socialist healthcare would crush American workers with higher taxes, long wait times, and far worse care.  Their plan would eliminate Medicare as we know it and terminate the private health insurance of 180 million Americans and even more than that now.” Sounds scary, doesn’t it?

It seems obvious at this point that the Republican Party will not, and may not wish to, propose comprehensive healthcare reform. By presenting several tiny fixes to existing programs, President Trump created the impression that he had a comprehensive plan, when he only presented a few bits and pieces, some of which were obvious steps backwards.

What can the public speaking student make of all this? Trump presented examples of health care ideas. Examples are good. I always told my speech students to give examples. But examples need to prove a larger point, and Trump didn't make a larger point. It is unlikely that these few examples will provide the comprehensive coverage at lower cost that Trump has repeatedly promised. Although some of his proposals may have merit, they fall far short of being a comprehensive healthcare proposal.

The setting made a difference. President Trump gave this basically trivial speech in the White House Rose Garden. In a relaxed setting, surrounded by the trappings of national power, Trump set the scene as if something important were happening – even though nothing important was. 

Smoke and mirrors. Repeal and replace the ACA? Doesn't seem likely. So, instead, Trump presented some minor proposals that attacked fringe problems. His total proposal appears to be less than the sum of its parts.

Image: White House YouTube page