THE VIEW FROM HERE
This is written the day before the vice presidential debate. Neither vice presidential candidate, Indiana governor Mike Pence nor Virginia senator Tim Kaine, are particularly well known outside their home state. The best that can be said from the perspective of the Donald Trump campaign is that the debate will likely move attention away from a pretty bad week dominated by the candidate’s taxes and, rather bizarrely, the story of his dealings with a Miss Universe beauty queen in the 1990’s.
As an overall comment, even by the standards of recent presidential campaign debate, the discourse this year has been pretty lame. Yes, character matters, as does temperament and the physical health of the candidate, and actions taken 20 or 30 years ago provide some insight into what type of person the nominee is. On the other hand, voters have a right to understand where the candidates stand on major issues.
One such issue is health care. Before the advent of President Obama’s health care plan, often called Obamacare, passed by one vote during President Obama’s second year in office, no one would have said that the United States had an ideal health system. There were a large numbers of uninsured citizens, sometimes onerous preexisting condition requirements and a mostly employer paid system that divorced the paying decision from the needs of recipients.
Nevertheless, it is becoming increasingly clear that Obamacare is not the answer, and not just because of broken promises assuring people that they could keep health coverage that they like. Indeed, no less a leading Democrat than Bill Clinton sharply attacked the current system this week. Mr. Clinton pointed to people “with premiums doubled and their coverage cut in half”, as well as “small businesspeople and individuals who make just a little too much to get any of these subsidies.” An analysis in The New York Times this week said that the law “will have to change to survive.”
Under Obamacare, the newly established exchanges for individual purchasers (as opposed to employers) have proved too expensive for many consumers, but also unprofitable for many insurers. While the law provides for penalties for nonpurchasers of insurance, the policies offered have not proved attractive to many young, healthy consumers, who have chosen to go without coverage.
In addition, as mentioned by Mr. Clinton, many relatively small businesses are hit hard by the new program, especially employers of over 50 employers now required to offer coverage to workers with 30 or more hours a week or be hit with a “pay or play” penalty. In addition to bearing the risk of sharply higher premiums, employers are also deeply unhappy about the administrative and paperwork burden of the new law.
It is difficult to know what a President Donald Trump or a President Hillary Clinton would do about health care. Mr. Trump pledges to repeal Obamacare, something he presumably could do (or at least defund it) with both houses of Congress in GOP hands. However, he would quickly come under pressure to come up with substitute measure that are not just a restoration of the unsatisfactory system before Obamacare and would have to deal with people who regard Obamacare premium subsidies as an entitlement. We have heard nothing about this.
Ms. Clinton promises to improve Obamacare and sometimes makes noises about a “single payer” (critics would say socialized) system, but she would have zero chances of enacting this system if, as almost everyone expects, the GOP controls at least one house of Congress after the election. We are very light on details from her as well.
And of course, there are many other important issues that have received almost no discussion so far in the race. Reform of the Social Security system, which is projected to run out of money to pay promised benefits within 20 years, is another key topic. But focusing on issues like health care and Social Security seems beyond the pale in this strange political year.