Eakinomics: Health and the President’s 2020 Agenda

The Republican convention has wrapped and the presidential race is officially in the stretch run. But what is the race about? It is fair to ask what the president and Joe Biden would seek to do if elected. Let’s start with the president today. Usually this question would be answered – at least in part – by the Republican platform as adopted at the convention. Unfortunately, this year there was no platform process, vote, or adoption. Instead, the campaign released this document as a guide to what are viewed as the key issues and the president’s stance on them.

Consider, for example, the section on healthcare (spelled as one word, an abomination I despise).

HEALTHCARE

• Cut Prescription Drug Prices
• Put Patients and Doctors Back in Charge of our Healthcare System
• Lower Healthcare Insurance Premiums
• End Surprise Billing
• Cover All Pre-Existing Conditions
• Protect Social Security and Medicare
• Protect Our Veterans and Provide World-Class Healthcare and Services

This is pretty thin, to be generous. None of it is exactly new. And there are several classes of ideas here. We can classify “Put Patients and Doctors Back in Charge of our Healthcare System,” “Protect Social Security and Medicare,” and “Protect Our Veterans and Provide World-Class Healthcare and Services” in the empty rhetoric category. These are simply aspirational goals and placeholders awaiting the strategy and tactics that compose a real policy.

In contrast, “Cut Prescription Drug Prices,” “End Surprise Billing,” and “Lower Healthcare Insurance Premiums” are areas where there were serious legislative efforts that did not get over the finish line in the president’s first term and – for drug prices and premiums – administrative actions that the president undertook. Does this list mean that these are viewed as policy failures in the first term? What will be different in a second term? Is legislation now the only acceptable outcome? What should the legislation contain? This category of policy issues raises more questions than it answers.

The remaining item – Cover All Pre-Existing Conditions – is, in contrast, very straightforward. Right now, everyone is covered even if they have a pre-existing condition. The only way that would change is if the lawsuits against the Affordable Care Act are successful. If so, there is existing legislation sponsored by Colorado Senator Cory Gardner that would guarantee coverage for people with a pre-existing condition and ensure that people are not charged more because of it. (A few similar bills have the same goal). If needed, the administration should seek a legislative solution, and they have a vehicle to deliver success. They should just say so.

There are two months left to flesh out details and evaluate the debate, but it is off to an inauspicious start. The Biden campaign tends to overpromise what can realistically be delivered and can’t be taken seriously as a result. The Trump agenda is simply too vague to rely on in any way at all.