Quite possibly the cruelest thing Trump said at the debate last night

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There hasn’t been a lot of talk of healthcare policy during the 2016 presidential debates, but it was touched on on Wednesday night.

And during that discussion, Donald Trump’s immediate response topped out at what could be his cruelest comment of the debate.

“But Obamacare has to go. It’s — the premiums are going up 60%, 70%, 80%. Next year they’re going to go up over 100 per cent,” Trump said. “…I’m really glad that the [Obamacare] premiums have started — at least the people see what’s happening, because she wants to keep Obamacare and she wants to make it even worse, and it can’t get any worse. Bad health care at the most expensive price. We have to repeal and replace Obamacare,” he said.

In his natural, jerky fashion, Trump said that he was glad that healthcare premiums are going up. The thing is, they’re not just going up for Obamacare. They’re going up for millions of Americans with private insurance too.

The data is out there

According to Kaiser Health’s annual Employer Health Benefits Survey, the reason why premiums are going up is because people are getting higher deductible healthcare plans.

The reason they’re getting higher deductible healthcare plans is, in large part, because drug prices are on the rise, and employers and insurers are passing those costs on to patients. You see, this isn’t just about Obamacare. It’s about the whole country’s system.

Business Insider’s Bob Bryan covered the Kaiser report when it broke, and he put it quite succinctly:

As we’ve noted before, this increase in high-deductible plans is affecting inflation data and causing patients to notice the increased costs of drugs.

One explanation for this is that increasing drug prices and costs from medical suppliers have gotten so bad that employers finally decided to share the price hikes with workers. Additionally, there is some evidence that people tend to be more cautious with their healthcare spending in general when they have a high-deductible plan, even for nondeductible costs, so employers are trying to slow the total spending.

“Notice the increased cost of drugs” is probably an understatement. Ever since the name Martin Shkreli — the former CEO of drug company Turing, which increased the price of a life-saving AIDS drug by around 5,000% — became familiar in households across the nation, Americans have been appalled at excessive price gauging in the drug industry.

And then of course there was the EpiPen scandal. Our collective national anger was palpable when we found out in August that Mylan, the company that makes the life-saving anti-allergy drug, had increased the price of a 2-pack to $608, up from around $100 when the company bought the drug in 2007.

These things are legal, but it’s obvious the American people don’t think they’re right. And turning back to the debate, it’s obvious Trump doesn’t see the connection between what has become a nation-wide outrage, and the prices Americans are paying at pharmacies, and the hospital bills that are emptying out their bank accounts.

This is ignorant and cruel.

Because knowing is half the battle

What’s more, anyone running for president should know about this connection. Our country’s upward drug cost trend isn’t new to anyone who follows policy. In August the Congressional Budget Office released figured showing that Medicare Part D Prescription Drug Program drug costs skyrocketed 17% from 2013 to 2014. This has been happening for a while, it’s just taken some time to trickle down into Americans’ pockets.

Obviously, Trump doesn’t understand the problem, and it couldn’t be more clear that in this case, that lack of understanding makes it impossible to find a solution. This problem goes deeper than just nuking Obamacare. We have to start rethinking the way we allow pricing to be structured in this entire system.

As for Trump’s opponent, Clinton put out her drug cost plan on September 2. It involves creating a panel to monitor drug price increases and alternative treatments to expensive drugs. It will attempt to expand access and fine drug companies that jack up the prices of drugs that have been on the market for a long time (like EpiPen).

Wells Fargo analyst David Maris broke down more of the highlights in a report last month:

Clinton’s plan would also cap monthly and annual out-of-pocket costs for patients with chronic or serious health conditions. It would prohibit manufacturers from paying generic drugmakers to delay launching cheaper products, and would eliminate corporate write-offs for direct-to-consumer pharmaceutical advertising.

Lastly, additional funding would be on tap for the FDA to help approve generic drug applications more quickly. While this menu of policy proposals certainly has manufacturers worried, most of these ideas would require Congressional approval, which we believe could be hard to come by if Republicans continue to control the House and/or Senate.

Talk to pharmacists, policy wonks, healthcare professionals and other actors in the industry, and they will tell you that these are proposals they have thought about because the problems they intend to solve are playing out right before our eyes.

For example, drug companies have already been sued for “pay-to-delay.” That’s when one company pays off a another company to get them to delay the release of generic competition.

Another example: The Mylan scandal has had legislators on both sides of the aisle talking about how the government can help the FDA speed up generic drug approval.

But we haven’t done anything yet. And we won’t do anything if Trump is elected. He’s doesn’t have the attention span, or more importantly the compassion, to understand the nuance of this policy.

And people are literally sick over it.

This is an editorial. The opinions and conclusions expressed above are those of the author.

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