A Physician Comments on Donald Trump’s Health-care Plan

By Elizabeth Lee Vliet, MD – http://herplace.com

Republican presidential candidate Donald Trump recently released his health-care reform plan by summarizing the problems of Obamacare that the Association of American Physicians and Surgeons (AAPS) has been warning of since 2009:

“Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare. This legislation, passed by totally partisan votes in the House and Senate and signed into law by the most divisive and partisan president in American history, has tragically but predictably resulted in runaway costs, websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices. Obamacare has raised the economic uncertainty of every single person residing in this country. As it appears Obamacare is certain to collapse of its own weight, the damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next president and a Republican Congress lead the effort to bring much-needed free market reforms to the health-care industry. But none of these positive reforms can be accomplished without Obamacare repeal.”

Clearly Donald Trump understands the job-killing effects of Obamacare and its unsustainable costs. Thus, Step One is full repeal of Obamacare. Trump then lists several key reforms that free market proponents such as AAPS have been advocating for many years:

  • Allowing Americans to purchase health insurance across state lines. That would allow people in high-cost states such as New York, New Jersey, Massachusetts, California, and others to buy lower cost “plain vanilla” policies rather than those loaded with state-mandated benefits they don’t need or want.
  • Allowing true catastrophic medical insurance that would cover serious illness only, rather than costly prepayment for everything, whether you need it or use it or not. Passing money through a third party instead of paying directly always increases cost.
  • Strengthening individually-owned Health Savings Accounts (HSAs). Obamacare strangles HSAs, which lower costs, increase competition, and put medical decision-making in the hands of patients and their physicians rather than third parties. Obamacare, in its effort to maintain control of health decisions, reduces the amount that can be contributed and restricts uses of the money. If Trump is sincere about increasing free market options and putting control back in the hands of patients, he will eliminate restrictions and expand options. For example, he could eliminate the age-65 cut-off for tax-free HSA contributions. Many Americans now have to work well past age of 65, and health-care expenses typically rise in later life.
  • Allowing patients more freedom to purchase prescription medications from overseas to help save on the high costs in the US. As a physician, I see pitfalls to this option, but I have also seen it work exceptionally well to help patients get desperately needed medication either not covered by Obamacare plans, or so expensive as to be unattainable in the U.S. For example, one patient from my own practice needed erythromycin daily for a lung disorder. The generic medication had soared in the last few months from $15.00 to more than $280.00 for a month’s supply. The dramatic rise in U.S. cost appears related to an FDA loophole that allowed generic manufacturers of older drugs to increase price. The patient traveled overseas, to a first-world country with comparable medication quality and regulatory oversight, where he was able to purchase a year’s supply of his erythromycin for $8.00 per month.

Other features of Mr. Trump’s plan that have been the focus of AAPS and other organizations advocating for increased medical freedom:

“Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system.” The use of pre-tax dollars would effectively reduce the cost of health insurance by 15 percent to 35 percent.

“Require price transparency from all health-care providers, especially doctors and healthcare organizations like clinics and hospitals.” A free market is not possible without accurate price information, which hospitals in particular have been loath to publish so patients can make informed decisions about where to receive care.

“Block-grant Medicaid to the states…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.” While there remain many unanswered questions in the proposal released by Mr. Trump to date, his initial proposal includes the kinds of changes urgently needed to lower costs, improve access, improve competition, and put more medical freedom in the hands of patients and their health professionals. This is a very good start to undoing the damage of Obamacare.


Elizabeth Lee Vliet, M.D., is Chief Medical Officer of Med Expert Chile, SpA, an international medical consulting company based in Santiago, Chile whose mission is high quality, lower cost medical care focused on preserving medical freedom, privacy, and the Oath of Hippocrates commitment to individual patients. Dr. Vliet is a past Director of the Association of American Physicians and Surgeons (AAPS). Dr. Vliet also has an active US medical practice in Tucson AZ and Dallas TX specializing in preventive and climacteric medicine with an integrated approach to evaluation and treatment of women and men with complex medical and hormonal problems. Dr. Vliet received a NECO 2014 Ellis Island Medal of Honor and the Arizona Foundation for Women 2007 Voice of Women award for her pioneering medical and educational advocacy for overlooked hormone connections in women’s health. She received her M.D. degree and internship in Internal Medicine at Eastern Virginia Medical School, and completed specialty training at Johns Hopkins Hospital. She earned her B.S. and Master’s degrees from the College of William and Mary in Virginia. Dr. Vliet has appeared on FOX NEWS, Cavuto, Stuart Varney Show, Fox and Friends, Sean Hannity and many nationally syndicated radio shows across the country as well as numerous Healthcare Town Halls addressing the economic and medical impact of the 2010 healthcare law. Dr. Vliet is a past co-host of America’s Fabric radio show. Dr. Vliet’s health books include: It’s My Ovaries, Stupid; Screaming To Be Heard: Hormonal Connections Women Suspect– And Doctors STILL Ignore; Women, Weight and Hormones; The Savvy Woman’s Guide to Great Sex, Strength, and Stamina, and The Savvy Woman’s Guide to PCOS. Dr. Vliet’s websites are http://www.HerPlace.com, and http://www.MedExpertChile.com.

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