Donald Trump unveils seven-point healthcare reform plan

Donald Trump finally released his healthcare plan Wednesday that details his Presidential campaign promises, including how he would repeal and replace the Affordable Care Act (ACA).

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“Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act-Obamacare,” the 2016 Republican presidential candidate wrote online. “(No) positive reforms can be accomplished without Obamacare repeal. On day one of the Trump administration, we will ask Congress to immediately deliver a full repeal of Obamacare.”

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To accomplish this goal, Trump wrote, he would require Congress to do the following:

• Completely repeal the ACA. “Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to,” he said.

• Modify the existing laws that prevent the sale of health insurance across state lines. “As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up,” he explained.

Next: Trump addresses physicians

• Allow individuals to deduct health insurance premium payments from tax returns under the current tax system. Trump says this will allow the free market to provide insurance coverage opportunities to companies and individuals, as “we must also make sure that no one slips through the cracks simply because they cannot afford insurance.”

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• Allow the use of health savings accounts for individuals. Contributions into these accounts will be tax-free and allowed to accumulate, and would become part of the individual’s estate, which could be passed on to heirs without the fear of death penalties. “These plans should be particularly attractive to young people who are healthily and can afford high-deductible insurance plans,” Trump said.

• Price transparency will be required from all healthcare providers, especially physicians and healthcare organizations such as clinics and hospitals. “Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure,” he explained.

• Block-grant Medicaid to the states because almost every state already offers benefits beyond what is required in the current Medicaid structure. Trump says this is important because “the state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.”

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• Remove the barriers to enter into free markets for drug providers that offer safe, reliable and cheaper products. “Congress will need the courage to step away from the special interests and do what is right for America,” he said.

These seven points will help lower healthcare costs for all Americans, Trump said. He also hinted that he would consider other reforms if they serve to lower costs, remove uncertainty and provide financial security for individuals.

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“(Further), we must also take actions in other policy areas to lower healthcare costs and burdens,” he said. “Enforcing immigration laws, eliminating fraud and waste and energizing our economy will relieve the economic pressures felt by every American. It is the moral responsibility of a nation’s government to do what is best for the people and what is in the interest of securing the future of the nation.”

Trump concluded his plan by calling for reform to the country’s mental health programs and institutions.

“Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones,” he wrote. “There are promising reforms being developed in Congress that should receive bi-partisan support.”

Reactions were mixed from physicians after news spread Thursday of Trump’s plan.

“Most of what Trump has outlined is reasonable and I would support his ideas,” said Leon Driss, MD, an internist from Lakeside, Arizona.

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Not addressing Medicaid reimbursement, however, was a big faux pas, Driss said.

“Medicaid is a difficult program with which to participate with a difficult population to provide healthcare to as a physician,” he explained. “So if Trump wants to expand Medicaid to the states to make sure everyone has healthcare, then he will have to ensure physicians are appropriately reimbursed for their services to people in this program.”

Don Blackmon, MD, an internist from Pensacola, Florida, said he feels that not addressing Medicare remains an issue within Trump’s plan, however he said it is still ideal because the plan makes the private sector private and puts Medicaid in the hands of the states-as long as it is done with basic and minimal regulations.

While Richard Ohnmacht, MD, FAAP, said he agrees with Trump in that insurance plans crossing state lines is a positive that would allow for more competition in the market, he criticized his overall message, comparing him to the Easter Bunny.

“I believe that much of this plan is consistent with the season-that is if you believe in the Easter Bunny, then much if this plan is for you,” said Ohnmacht, a pediatrician from Cranston, Rhode Island. “The state has no more of an idea how to run Medicaid than the feds-both do a miserable job. Second, in an industry so highly influenced by powerful lobbies, it is pure fantasy to think that one can easily create a competitive marketplace.

“Finally, Obamacare has not made access a problem. Everyone can see the doctor,” he continued. “The problem is that the cost of healthcare is not being contained and that in the very near future, there won't be any primary care doctors to see all these patients with their shiny new insurance policies.”