Democratic presidential nominee Hillary Clinton has followed Barack Obama in writing an article in a leading medical journal about healthcare reform. Like the president's August article in JAMA, Clinton's NEJM article touts the Affordable Care Act's achievements in expanding coverage to millions more Americans while acknowledging that the law needs some fixing.
Unfortunately, we did not learn anything about Republican presidential nominee Donald Trump's healthcare thinking. NEJM's editors invited both Clinton and Trump to tell readers what specific policy changes they support to improve access to care and quality of care and control healthcare costs. But only the Clinton campaign responded.
Earlier this week during the first presidential debate, we learned almost nothing about either candidate's healthcare positions, because moderator Lester Holt didn't ask about the issue. That frustrated health policy wonks and journalists like Modern Healthcare Editor Merrill Goozner, who picked out a stray Trump debate comment about the need to build more hospitals and thoroughly debunked it.
Clinton's NEJM article doesn't say anything she hasn't already said in her extensive healthcare proposals. Those proposals include offering additional tax credits and out-of-pocket caps to make medical care and prescriptions drugs more affordable for consumers and establishing new federal oversight over drug price increases.
She pleads in the article for Republican cooperation. “Health and health care in America should not be a partisan or divisive issue,” she wrote. “As President I will work tirelessly with anyone dedicated to improving our families' health and ensuring that the promise of affordable, quality health care is achieved for all Americans.”
But it's not at all clear that such cooperation will be forthcoming if she is elected, though some Democrats claim GOP colleagues privately say they would be open to working with them on measures to improve the functioning of the ACA exchanges.
A senior Republican Senate aide told Morning Consult that there are at least eight GOP senators willing to work on ACA fixes. “If we don't win this presidential (election) we can't say, 'In four years we'll win and fix it then, suffer until then,' ” the aide said.
And if Trump wins the election? All we've got is a brief seven-point statement on his campaign website, which recycles standard Republican talking points like allowing insurers to sell plans across state lines. The lack of healthcare policy details from Trump is unprecedented in my experience reporting on presidential candidates over the past 30 years.
Last month, Trump promised to provide more details about his healthcare agenda in a future economic speech. But we, along with the editors of NEJM, are still waiting.
Maybe we'll hear more at the next presidential debate on Oct. 9.
