Donald Trump has never met a dumb health care idea he didn’t like. We learned during the first GOP debate that he has an affinity for Scotland’s incredibly dysfunctional system of socialized medicine. We have subsequently discovered that he would replace Obamacare with “something terrific,” the details of which he still declines to reveal except to say that “the government’s gonna pay for it.” Now Trump has endorsed another bad idea that Democrats — including Hillary Clinton, Bernie Sanders, and Barack Obama — have long advocated despite evidence that it won’t work and could reduce access to crucial medications for millions of seniors.
Trump’s latest brainstorm is to permit Medicare to “negotiate” prices directly with pharmaceutical companies. He claims that this would save us YUGE amounts of money “by getting discounts as the biggest buyer of prescription drugs.” Because he is notoriously lazy about doing his homework, Trump doesn’t understand that Medicare does not negotiate prices. The Centers for Medicare and Medicaid Services (CMS) uses the leverage of the federal government to dictate prices. This is how CMS gets away with paying health care providers less than cost (and I do mean cost, not charges) for treating Medicare patients.
And, like all government price control schemes, this has created shortages. It is why Medicare patients have long endured a shortage of primary care physicians. Given the authority that Trump advocates, CMS would dictate absurdly low prices, whereupon the drug industry would stop offering medications on which they are thus denied a profit. To protect seniors from the resultant drug shortages, and prevent the stifling effect it would have on innovation, Congress prohibited CMS from engaging in direct negotiation with pharmaceutical companies in 2003, when it expanded the Medicare program to cover prescription medications via Part D.
It is unlikely that Trump is familiar with any of these facts or that we already have a gigantic federal bureaucracy that routinely negotiates prices directly with pharmaceutical companies — the Veterans Administration. The results have been as inevitable as Greek tragedy. According to a recent study conducted by Avalere, the VA covers 16 percent fewer drugs than does Medicare Part D. Democrats like Clinton, Sanders, and Obama typically respond to such facts by deploying red herrings about expensive medicines like Sovaldi, a drug used to treat liver disease. But many of the medications not covered by the VA are readily available in generic form.
Confronted by such inconvenient facts, Trump would presumably invoke The Art of the Deal and quickly move on to absurd estimates of how much Medicare can save by direct negotiations. When he announced his newfound affinity for this tired lefty proposal, he made the following claim: “They say like $300 billion could be saved if we bid them out. We don’t do it. Why? Because of the drug companies, folks.” As usual, he was thin on specifics, like where he got the $300 billion figure. According to a recent paper published by Carleton University, the actual savings would come closer to $16 billion, 5 percent of Trump’s extravagant number.
You will also notice that the villain of the piece, according to Trump, is the pharmaceutical industry. In this, he again echoes Clinton, Sanders, and Obama. The last tried to give Medicare the power to negotiate drug prices via Obamacare, but couldn’t get enough votes for the scheme even in the rogue’s gallery of Democrats that ran Congress in 2010. A year later he included it in a budget proposal that the White House dubbed “Framework for Shared Prosperity and Shared Fiscal Responsibility.” That attempt also failed. This year, Sanders has included this awful idea in his presidential platform and Clinton has of course been peddling it for decades.
Trump won’t get any farther with this scheme than his Democrat soul mates have. Indeed, it isn’t clear that he would attempt to get it done even if the voters are stupid enough to elect him President. It certainly isn’t part of any serious health care plan. After 7 months of ostensibly running for President, his website contains nothing on health care beyond a few empty pledges relating to the VA. And, as noted above, he obviously doesn’t know that the VA has already tried and failed to make a drug negotiation scheme work. Like so many of his “ideas,” this was probably a spur-of-the-moment effusion to which he had given no prior thought.
“The Donald” is not a serious man and none of his positions, including the moronic Medicare negotiation scheme, should be taken seriously. Sadly, a lot of otherwise intelligent people actually listen to him. As Thomas Sowell recently wrote, “Trump has a showman’s talent for telling people what they want to hear. But you can listen in vain for a coherent argument from him, based on facts and logic.” Trump is, in other words, a dunghill rooster who is in the presidential race because it gives him a chance to crow about himself. And let him crow, if that’s what he needs to prop up his self-esteem, but keep him away from the drugs.
