Dr. Nicole Saphier: Trump, Biden and the cold, hard truth about the future of America's health care system

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Former Vice President Joe Biden is calling for major changes in America’s health care system. That may sound appealing to many Americans at first glance but would lead to bankrupting Medicare and ultimately forcing most or all of us onto a substandard system of single-payer government health care.

In a major flaw, the plan being pitched by Democratic presidential nominee Biden and his running mate — Sen. Kamala Harris, D-Calif. — does nothing to deal with the soaring costs of health care.

In sharp contrast, President Trump has an effective plan to improve health care. But his administration and campaign have not effectively communicated it.

The Trump administration has been focused on the universal reduction of the cost of medical services and prescription drug prices. This is vital because health care costs have been skyrocketing out of control for years.


Last month the president signed an executive order to sure that people with pre-existing medical conditions are covered by health insurance —  the most popular provision of the Affordable Care Act (ObamaCare).  However, an executive order, although symbolic, has to be followed by swift and effective action, all of which must be communicated for people to be aware of and understand. 

The failure to control health care cost is a major problem with the Affordable Care Act. Under the act, premiums in the individual health insurance market rose 105% from 2013 to 2017, while since 2018 — under the Trump administration — premiums have begun to decline.

Medicare Part D and Advantage costs have also fallen since Trump took office, contrasting their rise under the Obama- Biden administration. And significantly, the consumer price index (CPI) of prescription drug costs saw its first reduction in 50 years recently under the leadership of President Trump. 

Individually these are small feats in the fight to improve our health care system, and more needs to be done. But collectively, these steps are moving the needle to a more sustainable health care system through market competition and individual choice. 

Granted, these steps are complicated and not very exciting to read about. They don’t lend themselves to sound bites that can be described in a minute or two in presidential or vice-presidential debates.

“Medicare-for-all”— the government takeover of health insurance advocated by failed Democratic presidential candidates Sens. Bernie Sanders of Vermont, Elizabeth Warren of Massachusetts and others — sounds so much simpler and appeals to many. Yet in reality it is a recipe for disaster and should be more properly labeled the Unaffordable Care Act.

Although they deny it, the health care plan advocated by Biden and Harris would put our country on the road to “Medicare-for-all” and a bankrupt health care system.

When the topic of health care was raised at the vice-presidential debate last Wednesday, Sen. Harris did her best to give a rosy — but inaccurate — description of the Biden health care plan.

No one really knows what Harris’ position on health care is, because she’s been flip-flopping after abandoning her own failed presidential campaign and becoming Biden’s pick for vice president. Like every vice-presidential candidate, she has been required to embrace the positions of her presidential running mate.


In the short-answer format of the debate, where topics frequently changed, Vice President Mike Pence was unable to refute the fear-mongering and bombastic statements put forth by Harris regarding health care and pre-existing conditions. That’s too bad, because the American people would have benefitted by hearing from Pence about how he and President Trump plan to protect our health care and make it more affordable if they are reelected.

Expanding access to affordable medical care should be a top priority for any administration. But focusing only on the issue of the health insurance coverage — without addressing the fundamental issues causing the rise in health care costs — is failing to see the forest through the trees. This would forcibly lead to the collapse of the private health care system and is the great failure of ObamaCare and what could be called the even worst alternative of BidenCare.

As described by Harris herself, the Biden plan will lower the age of Medicare eligibility from the current 65 to 60 and allow others to buy into the program. This would dramatically increase the costs of the Medicare program.

The age of Medicare eligibility has not changed since the program was created in 1965, providing subsidized health insurance to virtually all Americans when they turn 65. The program was created because as people retire they lose employer-provided health insurance and usually face increased health care needs as they age.

However, Medicare funds are running low, with some projections estimating the program’s insolvency by 2026 if changes to reduce the overall cost of care are not made.

When Medicare was created in 1965, the life expectancy of Americans was approximately 70 years old.  By 2019 it was nearly 79 years old, according to the Centers for Disease Control and Prevention. This means that older Americans are currently utilizing Medicare benefits for nearly a decade longer than originally expected.

The extended length of benefit eligibility, coupled with the rise in health care costs and other changes under ObamaCare. has cost the Medicare system billions of dollars and left it a precarious financial position.

Lowering the Medicare eligibility age, allowing younger people to purchase Medicare insurance, and slashing Medicare reimbursements to hospital systems and health care providers — as Biden advocates — will ultimately force millions more of us into “Medicare-for-all” — except there won’t be Medicare as we know it by that point. It will be a diluted version of Medicaid, the health insurance program for low-income people

But here’s the cold, hard truth: The federal government doesn’t have an infinite supply of taxpayer dollars that can be tapped to fund the Medicare expansion that Biden and Harris are calling for. And the government doesn’t have infinite borrowing capacity on top of the current national debate that is now approaching a staggering $27 trillion.  


Donald Trump would not have won the 2016 election and Joe Biden would not have been chosen as the Democratic presidential nominee if they had advocated pie-in-the-sky unaffordable and substandard health care under a “Medicare-for-all” system. Yet this is where Biden’s plan are leading us, although he won’t admit it.

Rather than going down the dangerous and harmful path Biden is offering us, our nation should be focused on further decreasing the cost of health care delivery — not forcing Americans into a system of government health care that we don’t want or need, and that would do far more harm than good.


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