Guest MINDSETTER™ Gardiner: Measure President Trump by Healthcare Reform

Friday, November 11, 2016

 

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Donald Trump

Thanks to a rustbelt revolution, on Friday, Jan. 20, 2017 Donald J. Trump will be sworn in as the 45th President of the United States. Trump’s insistence on better trade deals and willingness to pull back from bad deals was music to the ears of America’s workers. Americans and our immigrants, persons of all races and creeds, love and live for their families. A decent full time paycheck in a skilled job or position makes that possible for many. We all share that. Weeks ago Trump said “we want a young economy.” Amen I thought. We all do. 

President-Elect Trump starts with majorities in the House and Senate and a strong claim to a mandate particularly on tax cuts and to repeal and replace Obamacare. Plans for a great infrastructure re-building, taking care of veterans, all must be paid for. President-Elect Trump's promised tax cuts and the repeal and replacement of Obamacare are the core of his economic program, the engine of growth that could pay the bills.

Enacting tax cuts in the first 100 days is almost assured. In August, Trump had already met with the Chair of the House Ways and Means Committee and there appears to be agreement on three rates for individuals, 0-12% for lower income, a mid-range bracket of 25% and a cap of 25% on pass through business income, such as that earned by sole proprietors, partners, and Subchapter S taxpayers. An expanded standard deduction will help everyone, and the top rate will be 33%. The corporate rate tax rate will be cut to 15% to mitigate corporate departure from the U.S. Tax cuts are not in doubt. The more difficult task, performed responsibly, will be repealing and replacing Obamacare gracefully.

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Obamacare is not affordable for the middle class. And it’s projected that by 2024 one in five dollars spent in the U.S. will be on healthcare. Surely we should try to do better. Trump promised to repeal Obamacare, Hillary dug in, but Trump made the right call. Late in October, the Obama Administration confirmed news of double digit increases in the cost of “Affordable” insurance all over the country. Some “Exchanges” are now down to one carrier. Obamacare seems finished.

Repealing Obamacare probably needs to be done with some conservative regard for the status quo. It won’t be acceptable to just go back to what we had. Policies are in effect. Insurance companies are relying upon the existing law. Consumers and voters want to preserve the ability to purchase insurance even with a pre-existing condition. And yes, it can be done. That part of President Obama’s legacy will survive. 

Donald J. Trump won my vote promising a nationwide market, and competition and getting rid of the mandate. Trump must demand the repeal of Obamacare and a replacement, a great replacement, the best replacement, and If Congress fails, Congress had better not fail. You don’t want to have to read those tweets.

Don’t believe your local health insurance employee or board member who says a nationwide market can’t be done. Yes. We. Can. With one nationwide or “all states” market, insurance companies would be competing for an enormous flow of premiums. 

Don’t be surprised if millennials were adding affordable health insurance to their two year cell phone agreements by 2018, or have it linked to their first credit card, or new automobile purchase, or their apartment, or ho hum, their employer loves the lower cost created in a better marketplace. Huge opportunities create huge investment and extraordinary innovation. We’ve seen what can happen when the government fosters commerce by creating and defining one great big opportunity. Imagine if health insurance reform actually spurred economic growth? Granted, a better marketplace may not cure all, but it needs to be tried.

Expect medical savings accounts (HSA/MSA’s) like IRA’s to be part of the reform. But repeal of the mandate must be part of the reform. A compulsory purchase does not allow consumers to regulate costs in any way. It’s no surprise Obamacare could not make insurance affordable and simply transferred costs from some subscribers to other subscribers working hard to pay for it all. The mandate, and the state sized monopoly markets have to go. Trump’s first 100 days will be measured not by the low hanging fruit of “wrestling” tax cuts rather, President-Elect Trump will be measured by whether or not he delivers a great healthcare reform that truly leads to affordable health insurance and saves us from that grim sounding rusty future where 20% of all dollars spent in the U.S. are spent on healthcare. We don’t work for health insurance. We work for ourselves and our families.

 

Michael J. Gardiner is an attorney residing in Providence. He was a Republican candidate for office in 2010 and 2012.

 

Related Slideshow: Winners and Losers - 2016 Election

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Winner

Joe Trillo and John DePetro

While most Republicans in Rhode Island were hiding in the bushes, Trillo (the former GOP lawmaker) and DePetro (the WPRO talk show host) were loyal advocates for Donald Trump from the beginning and through the rough spots.

Both could be big winners and could score slots with the administration -- want to go to the White House? You now know the rings you need to kiss.

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Winner

Donald Trump, President of the United States

The most unlikely candidate pulled off the biggest victory in Presidential history. The billionaire developer was underestimated which set forth much of his success during the primaries and in the election. The next four years will never be dull.   

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Winner

General Michael Flynn

The Rhode Island native and URI grad will have a major roll in the Trump Administration and America's foreign policy. As top GOP consultant Ian Prior wrote in GoLocal in July about Flynn when he was on the VP shortlist:

Of course, there are any number of national security experts that can prosecute the case against Hillary Clinton, but Flynn is unique. He is a registered Democrat that was appointed by President Obama in 2012 to serve as Director of the DIA. Even more importantly, he resigned two years later over what he believed to be a misguided approach by the administration as it concerned ISIS.

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Loser

Nellie Gorbea, Secretary of State

This year's election was one of the the most mismanaged in modern Rhode Island history. First, the Chief-of Staff of the Secretary of State's office gets into a battle with talk show host John DePetro on social media. The action seemed inappropriate at best for the head of the office administering the election.

Then, the state's Presidential election hit a number of rough spots with faulty equipment and a failed repair and triage system that lead to long lines and frustration in a number of communities across the state.

The job of Secretary of State has three major components:

1) Take care of the State's achieves

2) Maintain a database of businesses

3) Run the state's elections

She needs to assure voters that she understands the problems and correct the mistakes.

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Loser

Brandon Bell, GOP Chair

Both Democratic Congressional candidates won big. The GOP had a net loss in the legislature.

Bell went all in on taking out Speaker Nick Mattiello -- a pro-business legislator, instead of recruiting a large number of competitive candidates. If Mattiello delivers of paper ballots like his campaign claims - Bell will have wildly miscalculated at every level and will have left the GOP a weaker party.

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Losers

Cicilline and Langevin

A Trump win greatly increases the likelihood that Rhode Island will lose a Congressional seat in the next federal redistricting. Rhode Island will be more like Vermont and Delaware -- two Senators and just one House member. This will mean a big loss for Rhode Island's clout in D.C.

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Winner

Allan Fung, Republican Mayor of Cranston

Fung had just the kind of night he wanted to have. He ran up big numbers against Democrat Mike Sepe and put parkinggate in his proverbial rear window.

The margin of victory is impressive -- Fung ran up 68% of the vote and has established himself as one of the top Republicans in Rhode Island.

Now, the personable Fung is the GOP frontrunner to challenge Raimondo as it does not look like she is going to Washington, D.C. now.

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Loser

RI's Broken Technology Infrastructure 

No money, no car, and no vote.

Lets see if we got this right. You have to wait in line to vote in some locations for as much as two hours because not enough scanners were deployed. Some days you can't register your car because the Hewlett-Packard system is not deployed and the state is now suing the company. And, tens of thousands of folks most in need have not been able to get their most critical benefits (or the from benefits) because the UHIP technology was flawed despite hundreds of millions being spent. 

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Winner

Speaker of the House, Nick Mattiello

If Mattiello does hold on to his House seat, he will be a stronger Speaker than ever before. He has added more Democrats to his majority and was the architect to many of the Democrats victories. 

The simmering stress between Mattiello and Raimondo will turn into a vibrant boil over during the next two years. Raimondo was no help to Mattiello or House members -- they had to clean up for her truck tolls and absorb her unwillingness to release 38 Studios documents.

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Loser

Gina Raimondo, Governor

Raimondo's options and national political network just took a major blow. No longer can Raimondo jump to the Clinton Administration to avoid a difficult reelection. Moreover, national Democratic connections are now in Siberia as the Presidency, the House and the Senate are all in Republican hands.

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Loser

Peter F. Neronha United States Attorney District of Rhode Island 

In a short period, it is highly likely the Neronha and a few other high profile political appointees will be replaced by the Trump White House. 

The impact of Ray Gallison and others is an unknown.

 
 

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