Crippled America: How to Make America Great Again Hardcover Donald Trump (2016)
HEALTH CARE IS MAKING US ALL SICK
THE BASIC DIFFERENCE BETWEEN the politicians’ way and my way is that I’ve actually had to do the things that politicians only talk about doing.
I’ve hired thousands of employees. I’ve had to negotiate with contractors and unions. I’ve had to provide health care coverage for my workers. I know what the real costs are, I know what the problems are. I know what works and what doesn’t work.
Most important, I know where the waste is and how to provide good medical coverage at reasonable costs.
Politicians don’t want to hear the truth, nor do they want to tell you the truth. They’re total hypocrites, especially when campaigning for reelection. They love to take to the stump and condemn “reckless government spending” and “government waste.” And yet virtually every bill passed by Congress is loaded with special goodies for their districts.
We call this the “pork barrel” approach, which is a real disservice to pigs, who are only eating to survive. The pork barrel in politics is creating government waste in order to reward some special donor or interest group or to mollify a cranky member of Congress in return for his or her vote.
And we’re paying for it.
I get very angry when I think about how our “Affordable Care” Act was rammed down a lot of sore throats by the Democrats.
Even Nancy Pelosi, the Democratic House Majority Leader at the time, conceded that most supporters of the bill had not actually read it.
Clearly, the public didn’t understand what “Obamacare” was providing: its complexity, its concessions to the insurance lobby, its taking away of the right to keep your current physicians, and, naturally, the hidden, escalating costs of health care, especially for state treasuries and businesses of all sizes. And for individuals who are young and healthy, there’s no way out of it without paying a fine.
Virtually all Republicans—and a growing number of Democrats—realize this is already a disaster that will only get worse. Premiums are skyrocketing—up 30 percent to 50 percent—and that will only get worse.
Look, I’m lucky. I’m able to afford the best health care in the world for myself and my family and my employees. I know that, but I also know that most people can’t do that and need some help. This is a subject that has been really important to me for a very long time.
There’s no question. Obamacare is a catastrophe, and it has to be repealed and replaced. And it was only approved because President Obama lied 28 times saying you could keep your doctor and your plan—a fraud and the Republicans should have sued—and meant it. As the different provisions kick in over the next few years, individual deductibles are going to continue to rise. People will have to get hit by a truck to be eligible for coverage because those deductibles are going to be so high.
Medical people hate it.
Doctors are quitting all over the place.
I have a friend who is one of the best doctors in the country. You would know the names of many of his patients. He told me, “Donald, I’ve never seen anything like this. I can’t practice medicine the way I want to anymore. I have more accountants and computer programmers working for me than I have nurses.” He’s right. There are now more than 100 codes for doctors to get reimbursement from insurance companies.
We’ve turned the “paperwork” or “computer folders” in our medical system into the same nightmare as our 80,000-page tax code.
As I’ve repeatedly said, the “un-Affordable” Care Act has to be replaced. Where I differ from what others say—as usual—is in the way I would change it. Many years ago, long before anybody else was talking about it, I knew we had to make changes in the system. I knew it because I saw what effect health care costs were having on the bottom line. I knew it because at that time we had more than 40 million Americans without any insurance at all, and now we are forcing “part-time” jobs down the system.
I said then that we needed to find a plan for everyone that was affordable, well-administered, and that provided freedom of choice. You know, a plan that actually allows you to keep your doctor if you want to. At that time I talked about a single-payer plan which, in our then much less complicated system, may have had a chance of working. But it was only one of several suggestions from a nonpolitician at a time when many different concepts and ideas also were discussed. This was 15 years ago, but it still gets brought up a lot by other people. I guess they have nothing new to complain about. As usual, because they have no solutions of their own, they resort to “gotcha politics,” which gets us nowhere closer to solving this problem or any other. They are all talk and no action. The Affordable Care Act is a clear example of that.
To succeed in business, you have to be flexible and you have to change with the realities of the world. The world has changed; I’ve changed. I don’t think a single-payer system makes sense anymore. If I did, I would say it; I wouldn’t need anyone else to say it for me. Maybe a single-payer system works in other countries. It works incredibly well in Scotland, for example, and maybe it could have worked here at a different time.
But not anymore.
So what can we do about it? There’s no question we need real health care reform. We can’t let Americans go without health care because they don’t have the right resources. Sadly, that statement might cost me—but I still believe Republicans have big, beautiful “hearts” and want to help the poor and the sick—and can do so at the right price. I can’t even imagine what it must be like to be sick and unable to go to a doctor. This only throws people back into emergency rooms that are overcrowded and inefficient already.
The Census Bureau has reported that 10 million people have now been added to the system. We have to find a way to take care of those people who can’t take care of themselves. I believe that very strongly—even if it costs me.
I know Americans agree with me, because wherever I go in Ohio, Florida, Iowa, South Carolina, and New Hampshire, when I say it, people give me a standing ovation. The real argument is how do we take care of those who cannot take care of themselves? How do we make sure Americans have access to good health care so that our kids get everything they need, and that even people who can’t afford the basic programs get at least reasonable care?
To me, for politicians to claim that we have an answer to every problem is silly. When you listen to some politicians reeling off their prepared answers, you almost fall for it. They’re so smart that they already have a solution to every problem, and it’s always better than everyone else’s solutions. How convenient. But not for our country, because nothing gets done. Nothing gets solved, and we don’t win. What I hear is a lot of ridiculous promises from politicians about how they intend to fix everything. They’re all experts. But nothing ever happens. They’re all talk and no action.
Most of them have gotten really good at saying absolutely nothing. They’ve all got some kind of program, but when you listen to them, you still don’t know what they’re talking about.
My approach is completely different. I approach complicated problems such as how to provide health care for most Americans at a price we can afford the same way I solve the toughest business problems. We should hire the most knowledgeable people in the world on this subject and lock them in a room—and not unlock the door until they’ve agreed on the steps we need to take.
A lot of times when I speak, people say I don’t provide specific policies that some pollster has determined are what people want to hear. I know that’s not the way the professional politicians do it—they seem to poll and focus-group every word. But there’s nobody like me.
I ask people to look at what I’ve done throughout my whole career. Look at how successful I’ve been doing things my way. So they have a choice: They can pretend some impossible solution is actually going to happen, or they can listen to the person who has proved that he can solve problems.
I started in a relatively small real estate company based in Brooklyn and made more than $10 billion. I now live on what is considered the best block of real estate anywhere in the world—Fifth Avenue between 56th Street and 57th Street, right next to Tiffany’s in the heart of New York City.
That doesn’t mean I don’t have some ideas about the right approach to take. First of all, we cannot cut either Social Security or Medicare benefits. That’s off the table. Those programs can be saved by growing the economy. Second, there are some simple changes that would provide real benefits.
As I’ve said, I’d like to see a private insurance system without artificial lines drawn between states. We need to get rid of those lines and let people and companies cross state lines to purchase the best plan for them. The government should get out of the way and let insurance companies compete for your business.
I have a big company. I have thousands of employees. If I’m negotiating for health insurance for my people in New York or California or Texas, I usually have one bidder in each state. Competition brings down prices, and the way the law is now, it discourages real competition between insurance companies for customers. They have virtual monopolies within the states. That makes no sense. It’s very stupid and unfair for us.
You know who loves a lack of competition? Those insurance companies, who are making a fortune because they control the politicians. They’ve paid for them with their contributions, and it’s a good investment from their perspectives. For our country, not so much. They give money to almost all the politicians. I’m using my own money so I am free to do what’s right, and serve the people, not the lobbyists.
Nobody understands business better than I do. You want better plans at a better price? Increase competition for customers.
The government doesn’t belong in health care except as the very last resort. The main way the government should be involved is to make sure the insurance companies are financially strong so that if there is a catastrophic event or they make some kind of miscalculation, they have the resources they’ll need to handle it.
If we follow my logic, our health care system, and our economy, will be well again very soon.