On November 8, Americans will have the chance to go to the polls and elect the next president of the United States.
Both major parties, Republican and Democrat, will make their cases to voters in the coming weeks.
Perhaps one of the most divisive topics is healthcare, and how to reform it.
Here’s where each candidate stands on healthcare reform, based on information taken from their campaign websites and public statements.
Affordable Care Act
Hillary Clinton has made it clear that she plans to build on and expand President Barack Obama’s signature policy reform — the Affordable Care Act, aka Obamacare.
As president, Clinton has said she will work to defend Obamacare from Republican-led attacks against it, according to her website. She also supports offering a “public option,” which would create a government-sponsored health-insurance option to compete with private insurers. Additionally, Clinton advocates allowing those older than 55 to be covered under Medicare. Currently the cutoff is 65.
She supports making healthcare more accessible to all American families, regardless of their immigration status. According to her platform, she will also explore cost-effective ways to make healthcare affordable and accessible to rural Americans, who currently have the fewest insurance options and can face higher costs than those in urban areas.
Clinton has also proposed doubling the funding for community health centres, and she has followed Obama’s cue to triple the size of the National Health Service Corps, an organisation that helps health professionals provide primary healthcare services to underserved communities. In exchange, participating health professionals are either given loan repayment or a scholarship throughout their medical education.
Donald Trump is strongly against the Affordable Care Act and has called it a “terrible” piece of legislation that was enacted by the most “divisive and partisan” president in US history. He has criticised the Affordable Care Act as having “resulted in runaway costs, websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices.”
Frequently touting that he will “repeal and replace” Obamacare, Trump has suggested that, as president, he will work with Congress to adhere to free-market principles as much as possible.
Trump supports modifying laws that are on the books and that prevent insurance companies from selling in different states. Currently, health insurance is regulated at the state level, and insurers must obtain a licence to offer plans in individual states. Many firms, such as UnitedHealthcare, Cigna, and Aetna, offer plans in multiple states. As free-market competition goes up, Trump asserts that prices and premiums will eventually go down.
While more competition would in theory lower prices, it’s unclear how Trump’s proposals would create legitimate competition among healthcare providers.
Trump supports amending the current tax code to allow consumers to deduct health-insurance costs from their taxes. He also claims that he wants to review current Medicaid stipulations to ensure that people don’t “slip through the cracks” just because they can’t afford health insurance, though he wants to leave Medicaid reform up to the states. He has also said that he would support relaxing current regulations around Health Savings Accounts and require price transparency from healthcare providers, though he has not explained how.
Citing that providing healthcare to those who enter the US illegally costs the US $11 billion a year, he has said he will do his best to eradicate this cost by hunkering down on illegal immigration, arguably the most prominent issue Trump is running on.
Clinton has released a comprehensive plan on addressing mental health; it promotes early diagnosis, integration of the physical- and mental-healthcare systems, training law enforcement on crisis intervention and suicide prevention, enforcing mental-health parity, and investing in mental-health research.
Her platform claims that she will build on Medicaid to “increase screenings for maternal depression, infant mental health, and toxic stress, with the goal of these screenings becoming standard practice in Medicaid.”
She strongly advocates improving early detection and streamlining the process for identifying and treating mental-health problems early on.
Clinton also announced a number of initiatives aimed at suicide prevention, including creating a national force tasked with suicide prevention that’s headed by the Surgeon General, enhancing suicide prevention and mental-health programs across high schools and college campuses, and working with colleges and research institutions to ensure that groups such as LGBTQ students and students of colour are receiving the support they need.
She also advocates an effort to improve the criminal-justice system to better handle mental-health cases. In response to a candidate questionnaire by the International Association of Chiefs of Police, Clinton emphasised the need to ensure that those in need of treatment are not sent to jail or prison as a first step, and instead receive the care they deserve.
Clinton also announced that she will enforce the Mental Health Parity and Addiction Equity Act of 2008, which she cosponsored and which “requires that mental health benefits under group health plans be equal to benefits for other medical conditions.” As part of this initiative, Clinton plans to enforce transparency by insurance providers, audit insurance companies to ascertain that they’re following protocol, and streamline a process through which patients and their families can report parity violations.
Trump has also called for mental-health reform, claiming that under the current system, families and patients are not receiving the care and support they require. He has announced his support for “promising reforms” being developed in Congress, though he has not specified which ones.
In response to his candidate questionnaire from the International Association of Chiefs of Police about law enforcement’s role in mental-health intervention, Trump said that “unfortunately, law enforcement will have to continue to play a role in how we proceed as a nation with mental health reform.”
He also expressed his hope that “community services and family involvement” would play a larger role in combatting mental-health problems as the nation moved toward solving the problem but offered no elaboration.
Clinton strongly advocates bringing down out-of-pocket drug costs for consumers, and she has for years worked to reduce the “unreasonable” cost of prescription drugs.
She has made her fight against insurance and drug companies a key tenet of her campaign platform in this election, and has done so in the past. In 2008, Clinton called for allowing Medicare to negotiate drug prices with companies to bring down costs.
She plans to deny tax breaks to drug companies in an effort to restrict “excessive profiteering and marketing” by those companies’ ads to consumers. She has said that pharmaceutical companies receive billions of dollars in taxpayer support, but then spend more money on marketing than research and development, a practice she believes needs to stop.
With regard to drug prices, Trump has said that the government needs to lower barriers into the market for drug companies that can offer “safe, reliable and cheaper products.” He has also noted that drug companies, though a part of the private pharmaceutical industry, provide a “public service,” and, as such, consumers should be given access to more options that include “safe and dependable drugs from overseas.”
Clinton has also supported importing prescription drugs from overseas, provided the drugs come from countries that meet US safety standards.
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