Is Donald Trump's healthcare plan more progressive than Hillary's?

[geek tragedy]

Earlier, a post supporting Bernie Sanders claimed that Trump is/can run to Clinton's left on health care because he wants to "break up health care monopolies." (link available by PM/in comments if requested).

I certainly disagreed with that, since Trump's health care plan is, in my opinion, recycled rightwing nonsense.

But, a lot of people found that unpersuasive.

Since agreement/disagreement with that claim broke down along partisan lines (Bernie supporters saying he could, Clinton supporters saying no he can't), let's compare the two health care plans, including pharmaceutical spending, taken directly from the campaign websites:


Trump Plan

Congress must act. Our elected representatives in the House and Senate must:

1.Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.
2. Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.
3. Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.
4. Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.

5.Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.

6.Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.

7.Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.

Clinton health insurance plan:

Building on the Affordable Care Act to expand coverage for millions of Americans, Hillary will:

• Make premiums more affordable and lessen out-of-pocket expenses for consumers purchasing health insurance on the Obamacare exchanges. Hillary believes that in order to expand coverage for families, we need to reduce the cost of purchasing health insurance on the Affordable Care Act exchanges. Her plan will provide enhanced relief for people on the exchanges, and provide a tax credit of up to $5,000 per family to offset a portion of excessive out-of-pocket and premium costs above 5% of their income. She will enhance the premium tax credits now available through the exchanges so that those now eligible will pay less of a percentage of their income than under current law and ensure that all families purchasing on the exchange will not spend more than 8.5 percent of their income for premiums. Finally, she will fix the “family glitch” so that families can access coverage when their employer’s family plan premium is too expensive.


• Support new incentives to encourage all states to expand Medicaid. Hillary will fight for health insurance for our lowest income residents living in every state across the nation. Hillary will follow President Obama’s proposal to allow any state that signs up for the Medicaid expansion to receive a 100 percent match for the first three years, and she will continue to look for other ways to incentivize states to expand Medicaid to meet the health needs of their most vulnerable residents.


• Invest in navigators, advertising and other outreach activities to make enrollment easier. Today, as many as 16 million people or half of all those uninsured are eligible but not enrolled in virtually free Medicaid coverage or exchange coverage for as little as $100 a month or less. Hillary will ensure anyone who wants to enroll can understand their options and do so easily, by dedicating more funding for outreach and enrollment efforts. She will invest $500 million per year in an aggressive enrollment campaign to ensure more people enroll in these extremely affordable options.


• Expand access to affordable health care to families regardless of immigration status. Hillary sponsored the Immigrant Children’s Health Improvement Act in the Senate, which later became law and allows immigrant children and pregnant women to obtain Medicaid and CHIP. She believes we should let families—regardless of immigration status—buy into the Affordable Care Act exchanges. Families who want to purchase health insurance should be able to do so.


• Continue to support a “public option”—and work to build on the Affordable Care Act to make it possible. As she did in her 2008 campaign health plan, and consistently since then, Hillary supports a “public option” to reduce costs and broaden the choices of insurance coverage for every American. To make immediate progress toward that goal, Hillary will work with interested governors, using current flexibility under the Affordable Care Act, to empower states to establish a public option choice.


Going forward, Hillary will build on these efforts and fight to ensure that the savings from these reforms benefits families—not just insurance companies, drug companies, and large corporations.

• Defend the Affordable Care Act. Hillary will continue to defend the Affordable Care Act (ACA) against Republican efforts to repeal it. She'll build on it to expand affordable coverage, slow the growth of overall health care costs (including prescription drugs), and make it possible for providers to deliver the very best care to patients.


• Lower out-of-pocket costs like copays and deductibles. The average deductible for employer-sponsored health plans rose from $1,240 in 2002 to about $2,500 in 2013. American families are being squeezed by rising out-of-pocket health care costs. Hillary believes that workers should share in slower growth of national health care spending through lower costs.


• Reduce the cost of prescription drugs. Prescription drug spending accelerated from 2.5 percent in 2013 to 12.6 percent in 2014. It’s no wonder that almost three-quarters of Americans believe prescription drug costs are unreasonable. Hillary believes we need to demand lower drug costs for hardworking families and seniors.


• Transform our health care system to reward value and quality. Hillary is committed to building on delivery system reforms in the Affordable Care Act that improve value and quality care for Americans.


Hillary will also work to expand access to rural Americans, who often have difficulty finding quality, affordable health care. She will explore cost-effective ways to broaden the scope of health care providers eligible for telehealth reimbursement under Medicare and other programs, including federally qualified health centers and rural health clinics. She will also call for states to support efforts to streamline licensing for telemedicine and examine ways to expand the types of services that qualify for reimbursement.

Hillary is continuing a lifelong fight to ensure women have access to reproductive health care. As senator, she championed access to emergency contraception and voted in favor of strengthening a woman’s right to make her own health decisions. As president, she will continue defending Planned Parenthood, which provides critical health services including breast exams and cancer screenings to 2.7 million women a year. And she will work to ensure that all women have access to preventive care, affordable contraception, and safe, legal abortion—not just in principle, but in practice, by ending restrictions like the Hyde Amendment.

Clinton drug price plan:

Stop direct-to-consumer drug company advertising subsidies, and reinvest funds in research. Almost every country in the industrialized world bans or severely restricts direct to consumer advertising because it increases prescription drug costs, and can include confusing, misleading or incomplete information or exaggerated claims if not regulated effectively. Clinton’s plan would eliminate corporate write-offs for direct-to-consumer advertising, saving the government billions of dollars over the next decade. She would use the proceeds to help invest in research, by devoting the funds to help pay for making permanent and simplifying the R&D tax credit. And going forward, Clinton’s plan would establish a mandatory FDA pre-clearance procedure for these ads funded through user-fees paid for by pharmaceutical manufacturers in order to be sure that the ads provide clear and understandable information to consumers.

Require drug companies that benefit from taxpayers’ support to invest in research, not marketing or profits. For years, Hillary Clinton has made the case that Americans should get the value they deserve for the billions of dollars in support they provide through federal investment in basic research and incentives for R&D. Drug companies should not be allowed to reap excessive profits or spend unreasonable amounts on marketing if they want to receive support that is designed to encourage life-saving and health-improving treatments. Clinton’s proposal would require pharmaceutical companies that benefit from federal support to invest a sufficient amount of their revenue in R&D, and if they do not meet targets, boost their investment or pay rebates to support basic research. If elected President, she will convene business leaders, experts on drug pricing, and consumer advocates to set new parameters for federal support in order to ensure this requirement. The basic principle is based on a provision of the Affordable Care Act that required insurance companies to pay rebates to consumers if their profits and administrative costs were an excessive share of benefits actually paid out to consumers.

Hillary Clinton will lower costs for Americans by limiting out-of-pocket spending, increasing competition, and demanding value for their purchase:

Cap monthly and annual out-of-pocket costs for prescription drugs to save patients with chronic or serious health conditions hundreds or thousands of dollars. Americans should be able to afford prescriptions for their conditions throughout the year, and not have to stop taking a needed medication. Following the example of states like California and Maine, Clinton’s plan will require health insurance plans to place a monthly limit of $250 on covered out-of-pocket prescription drug costs for individuals to provide financial relief for patients with chronic or serious health conditions, ensuring Americans can get the care their doctors prescribe. The cap would apply to prescriptions covered by insurance that are specifically approved by FDA for the treated condition. Up to a million Americans could benefit from this proposal every year.

Increase competition for prescription drugs, including specialty drugs, to drive down prices and give consumers more choices. Hillary Clinton’s plan will increase competition for traditional generics and generic versions of specialty drugs such as newer “biologics:”

•Clear out the FDA generic backlog: Clinton’s plan will fully fund the FDA’s Office of Generic Drugs to clear out their multi-year generic drug approval backlog, which has kept competitors off the market, and can help lower overall prescription drug prices.
•Increase competition for specialty drugs including new “biologic” drugs – which are often the most expensive new treatments: Specialty drugs, such as biologics, have provided new treatments and improved health for people suffering from chronic illnesses such as rheumatoid arthritis, Crohn’s disease, and multiple sclerosis, and people suffering from serious illnesses such as cancer. But often these drugs are the only ones on the market - and with no competition to keep the price down, drug companies can charge excessive prices. Clinton’s plan will increase competition for new treatments derived from biological sources by encouraging generic versions. Lowering the biologic exclusivity period from 12 to 7 years will spur greater competition and save up to $5 billion for the federal government over 10 years. This is especially important because biologics are often the most expensive new drugs, such as new heart disease treatments, which may cost $10,000 per year. The FDA should also give prioritized, expedited review to biosimilar applications that only have one or two competitors in the marketplace (situations where such drugs are most likely to be excessively priced).

Prohibit “pay for delay” arrangements that keep generic competition off the market. Hillary Clinton would prohibit “pay for delay” agreements that allow drug manufacturers to keep generic competition off of the market – lowering prices for Americans, and saving the government up to $10 billion.

Allow Americans to import drugs from abroad – with careful protections for safety and quality. Hillary Clinton believes that it’s unfair that drug companies charge far lower prices abroad for the same treatment, while imposing higher prices on Americans. Countries in Europe often pay half of what Americans pay for the same drugs. Clinton would allow Americans to safely and securely import drugs for personal use from foreign nations whose safety standards are a strong as those in the United States. The FDA and other regulatory agencies would set careful standards for re-importation to ensure safety and quality for Americans.

Ensure American consumers are getting value for their drugs. Clinton’s plan will ensure that new drugs coming on the market provide value and high quality to consumers, rather than adding to cost without improving treatments and outcomes. Clinton recognizes that new drugs can constitute incredible breakthroughs in treating diseases from Hepatitis C to cancer to heart disease – and we need to ensure that there are proper incentives for real innovations that bring effective products to market. Clinton believes that Americans should not face extreme costs, or pay too much for drugs that do not in actuality improve on available treatments. She has a long and strong record of supporting the evaluation of the value, quality, and comparative effectiveness of new drugs. That’s why she’ll build on provisions in the Affordable Care Act that invest in private research, and other private efforts, to use the results of private-sector analyses to hold drug companies accountable for justifying their costs and ensure Americans pay drug prices that reflect the improved value new treatments provide.

Hillary Clinton will leverage America’s negotiating power as a backstop.

Where competition alone isn’t enough to hold pharmaceutical companies accountable and drive prices down, Hillary Clinton’s plan would leverage America’s strong bargaining power to demand higher rebates and lower costs from drug companies. Her plan will:

Demand higher rebates for prescription drugs in Medicare. To contain the cost of prescription drugs for low-income individuals, people with disabilities, and seniors, Hillary Clinton’s plan will require drug manufacturers to provide rebates for low-income Medicare enrollees that are equivalent to rebates in the Medicaid program. Under current law, the rebates offered in the Medicaid program are more generous than those offered in Medicare. Hillary Clinton would require pharmaceutical companies to provide higher rebates in the Medicare low-income subsidy program, ensuring that rebates are at Medicaid levels. This would save more than $100 billion in Medicare costs.

Allow Medicare to negotiate drug and biologic prices. Hillary Clinton has long believed that Medicare should use its leverage with more than 40 million enrollees to negotiate and drive down drug and biologic prices for seniors and others in the program. Today, drug prices in Medicare are negotiated by a disparate set of benefit managers, rather than using the full bargaining power of the program. Clinton believes that we should drive the best bargain for Americans, and especially for senior citizens, by allowing Medicare to negotiate drug prices, notably for high-cost drugs with limited competition.

12 votes, 0 passes | Time left: Unlimited
	Trump's plan is or very well could be to the left of Clinton's plan.
	4 (33%)
	No way is Trump's plan to the left of Clinton's plan, period.
	6 (50%)
	2 (17%)
	0 DU members did not wish to select any of the options provided.
Show usernames Disclaimer: This is an Internet poll