Killer Health Care ‘Choice’

Mick Mulvaney, director of the Office of Management and Budget.

Mick Mulvaney, director of the Office of Management and Budget.

Since his election as president, Donald Trump has promised to improve health care in the United States, offer coverage to all and to make it less expensive.

As the months progressed, Trump added “choice.” Consider it lesser coverage.

Trump lieutenants use choice to explain away the contradictions of a policy that promises more, better and cheaper health insurance simultaneously. The number of people covered is secondary, they say, ignoring the danger of losing health insurance.

Choice would fool many into buying cheap, insufficient insurance. This would cause the cost of robust coverage to increase.


“It’ll be better health care, much better, for less money,” Trump told Lesley Stahl of CBS News in a “60 Minutes” interview conducted three days after his election.

“We’re going to have insurance for everybody,” Trump told The Washington Post in an interview the weekend before his Jan. 20 inauguration. “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.”

“I am also calling on this Congress to repeal and replace Obamacare with reforms that expand choice, increase access, lower costs and, at the same time, provide better health care,” Trump said Feb. 28 to a joint session of the House of Representatives and the Senate.


“The fact that certain groups will pay less tax is not central to the issue,” said Mick Mulvaney, director of the Office of Management and Budget. Mulvaney was responding to a March 12 question from George Stephanopoulos of ABC News on “This Week.” Stephanopoulos had asked if predictions were correct that the House’s health care bill would cover millions fewer Americans, force millions of those with health insurance to pay more and cut taxes for wealthy people.

“Congressman Morgan Griffith from Virginia had some really good ideas regarding things like changing the expansion date or perhaps putting work requirements in on Medicaid — those are great ideas that would improve the bill,” Mulvaney said. Stephanopoulos had asked about House Republicans, such as Griffith, meeting with Trump and discussing the end of Medicaid expansion in 2018 rather than 2020, as proposed by the bill.

“Nobody will be worse off financially in the process that we’re going through, understanding that they’ll have choices that they can select the kind of coverage that they want,” said Tom Price, secretary of health and human services, on the March 12 “Meet the Press.”


“Lack of access. Lack of jobs. Very poor health care in the past,” said Dr. Mitch Jacques of the Cabin Creek Health Clinic in Dawes, West Virginia. He was answering a question from Michael Barbaro of The New York Times about health conditions before Obamacare. The March 10 edition of “The Daily” podcast, which Barbaro hosts, contains the interview.

“It was not uncommon for someone to go to the emergency room and have a major heart procedure, and not follow up with anyone,” Jacques said about pre-Obamacare treatment in the coal-mining area of southern West Virginia.

“By 2020, there may be virtual elimination of the Medicaid expansion, under the Affordable Care Act,” Jacques said in answer to a Barbaro question of effects expected if the House bill succeeds Obamacare. “If that occurs, many of our patients will lose their insurance,” he said. The group that operates the clinic estimates a loss of 20 percent to 30 percent.

“What would that do to the community?” Barbaro asked.

“Without question, if the Republican policy goes through, and health care is withdrawn from 20 to 25 percent of our patients, a number of those people will die for lack of appropriate health care,” Jacques said.

Choice is the word. For too many, death would be the sentence.

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