Trump had offered to Paul Ryan, on January 26th, a postponement on offering an Obamacare-replacement until after Obamacare collapses of its own accord after the new (much costlier) premiums come out late in 2017, but perhaps Ryan said no to that; it’s not what happened. They didn’t take that road.
In any case, House Republicans — and this includes Ryan their leader — naturally didn’t like Trump’s suggestion that “the Dems would come begging to do something because ’17 is going to be catastrophic price increases [which is already set to happen in the Obamacare exchanges], your deductibles are through the roof, you can’t use them, and they will come to us,” which would then mean that those same House Republicans wouldn’t be the people writing the legislation; Trump and “the Democrats” would do it and get the credit for it, which was a real fear they had about this new President, who was well known for saying that he would work with either Party or both Parties in order to get his legislation passed. So, Trump was quoted as having told these congressional Republicans, on January 26th, “But I think, congressmen, we have no choice, we have no choice, we have to get it going,” and then Paul Ryan issued his plan on March 7th, and it promptly busted.
Trump, then, yet again, in an interview published on April 2nd in Britain’s Financial Times said, “If we don’t get what we want, we will make a deal with the Democrats and we will have in my opinion not as good a form of healthcare. … But we are going to have a very good form of healthcare. It will be a bipartisan form of healthcare.” He was repeating his implicit threat to House Republicans — his threat to Paul Ryan.
What would happen, in such a case, if the most-supported Presidential candidate, the most popular American politician of all, Bernie Sanders, told Trump he’d endorse Trump’s opening Medicare to all U.S. citizens funded through taxes? Trump has already acknowledged that it would be vastly more cost-efficient than is the existing hodge-podge:
On September 27th of 2016, while campaigning against Hillary Clinton Trump told CBS “60 Minutes”: “Donald Trump: By the way. Everybody’s got to be covered. This is an un-Republican thing for me to say because a lot of times they say, “No, no, the lower 25 percent that can’t afford private.” But — Scott Pelley: Universal health care? Donald Trump: I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now. Scott Pelley: The uninsured person is going to be taken care of how? Donald Trump: They’re going to be taken care of. I would make a deal with existing hospitals to take care of people. And, you know what, if this is probably — Scott Pelley: Make a deal? Who pays for it? Donald Trump: — The government’s gonna pay for it. But we’re going to save so much money on the other side. But for the most it’s going to be a private plan and people are going to be able to go out and negotiate great plans with lots of different competition with lots of competitors with great companies and they can have their doctors, they can have plans, they can have everything.”
He was describing there the Swiss system, which instead of America’s for-profit insurance companies uses non-profit ones and then lays out in detail the criteria for all health plans that will be approved by the government, so that now there are 60 insurers there, all of which offer one or more of the authorized types of plans; insurers don’t supply any dividends and profits to investors (there are no investors) but only meet the requirements of the law, the government, so that all Swiss citizens can rest assured that the insurance company makes no difference — only the different categories of the government’s authorized plans do. Everything is the same within a given plan, except that the insurers can and do vary from one-another on price, on all but the basic plan. I’ve further described elsewhere the Swiss system, and its well-proven superiority — in every way — over America’s. More details about the Swiss system can be found here. The history of the Swiss system is here.
If such a plan were to be proposed by Sanders and endorsed by the President using his White House bully pulpit to sell it to the public, and yet fail to get almost all congressional Democrats and at least enough Republicans behind it to pass it, then both Trump and Sanders would look golden, and everyone who had voted against it would then look lousy; so, it would probably pass. And, in either case, Sanders — for his leadership in this — would be ideally positioned to beat any Democrat in the 2020 Presidential primaries, and (if polling thus far is any indicator) he’d easily beat Trump (or especially Pence) in the general election. But it wouldn’t be only his plan; it would be a compromise between his original proposal, Medicare for all, and the one that Trump described to Scott Pelley on September 27th. But that’s what any “bipartisan” plan necessarily would be: a compromise.
Sanders wouldn’t get Medicare for all, and Trump wouldn’t get preservation of the existing — i.e., for-profit — insurance companies. Instead of Sanders’s governmental insurance system, or Trump’s for-profit corporate-offered insurance system, it would be a strictly regulated non-profit insurance system — which would be based upon the Swiss model, which is already proven to be vastly superior to the American model.
If Sanders would want to propose to Trump something along these lines, he could add for special appeal to Democratic healthcare-consumers — i.e., for patients who favor the Democratic Party — in his proposal a public-option (i.e., a government-provided) insurance plan, so long as it won’t be competing against the other (the non-profit) ones, but perhaps instead it would be paying a fixed percentage of any year’s excess of income over and above expenses, into the general revenue, that’s to say, into taxes. The government, then, would be serving like a residuary charity, whose beneficiaries are the general public — which is what any government is supposed to be, regardless. Then, if Trump won’t accept that proposal, Sanders could ask Trump what in Trump’s proposal Trump would be willing to sacrifice in order to get Sanders to sacrifice such a public option. And together, they’d offer the negotiated plan to both Parties in Congress, as a truly bipartisan compromise.
The instance where Trump told Pelley that Trump wants a government-funded universal health insurance system, isn’t the only instance where Trump had proposed a taxpayer-funded universal U.S. healthcare insurance system. On January 15th, he told the Washington Post: “We’re going to have insurance for everybody. … There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”
The Swiss system is neither socialistic (government-provided) nor capitalistic (for-profit and investor-based) but is instead non-profit and strictly regulated by the government; and it’s already proven to work far better than the capitalistic American system, and equally well (overall) as do the more socialistic health care systems that are provided in all industrialized countries except for the (bottom-of-the-barrel) United States (which is by far the most-capitalistic — investor-corporate-“private” as opposed to governmental-“public” — of all systems in the industrialized world).
Investigative historian Eric Zuesse is the author, most recently, of They’re Not Even Close: The Democratic vs. Republican Economic Records, 1910-2010, and of CHRIST’S VENTRILOQUISTS: The Event that Created Christianity.