Today’s Managing Health Care Costs Number is 0
It’s finally here. The countdown clock is at zero, and today is election day.
This has been a dispiriting election season – largely because there is a huge chasm between the two political parties (not just between Donald Trump and Hillary Clinton) – and this has gotten virtually no coverage. The major news networks spent more time on Hillary Clinton’s email servers than all of the candidate’s policy positions. Even news sources like NPR frankly were far more focused on the horse race and coverage of impolitic statements than the gigantic difference in what each of the parties has said they will do. And there’s good evidence that presidents, after election, work hard to accomplish what they have said they will do.
I’m reprising a post from September about a RAND study sponsored by the Commonwealth Fund about what electing Hillary Clinton would mean compared electing Donald Trump in terms of health care access and cost.
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Today’s Managing Health Care Costs Number is 29.4 million
The Commonwealth Fund sponsored RAND to use its health system microsimulator to estimate the impact of the Clinton and the Trump health care plans. This is important information as we head into the presidential debates –and frankly there has been way too little attention to the health care differences between the two major party presidential nominees.
The Trump plan, all told, would decrease the number of Americans with insurance, would increase out of pocket spending, and would predominately benefit rich people. It would increase the federal deficit, although by only a little.
The Clinton plan would further increase the number of Americans with insurance, decrease out of pocket spending, and predominately benefit those with modest incomes. It would increase the deficit by substantially more.
Clinton’s plan would mean 9.1 million more had insurance - and that insurance would be valuable enough that it would increase family economic security. The Trump plan would mean 20.3 million fewer Americans had insurance –and even that insurance would provide less protection from economic ruin.
In total, Clinton’s proposals would mean 29.4 million more insured compared to Trump’s proposals, with insurance that was more likely to shield families from ruin, accompanied by a larger deficit (or other offsetting taxes).
This is a microsimulation – and it’s only as good as the algorithms built in. It’s a complex model –but doesn’t take into effect many other things that could change – such as job loss from trade wars, increased military spending, or government shutdowns. Some of the numbers are a little counterintuitive – like how could the total impact of Trump’s proposals on the federal deficit be so much less than the impact of the ACA repeal alone. Since multiple outputs are changing simultaneously, viewers can’t sum the numbers in any column and expect them to add up nicely.
It’s easy to focus on the “horse race” elements of presidential politics – and I’ve been exasperated when I hear millenials (perhaps nonrepresentative) quoted in radio interviews suggesting that there is little difference between Clinton and Trump. There is a world of difference, and this microsimulation helps illustrate what this could mean to real people in 2018.
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