Health Policy Issues in the June 27th, 2024, Presidential Debate

Universal Health Monitor (UHC) on LinkedIn, Year 1, Number 1, June 18th, 2024

Andre C. Medici

Introduction

In the CNN debate held on June 27, 2024, President Joe Biden and former President Donald Trump discussed a range of American domestic and foreign issues. The debate had many substantive discussions, however, most people paid more attention to the discursive performance than to the substantive performance of both candidates and, apparently, in the question of discursive performance Donald Trump appeared to the majority as better.

The Democratic Party's reaction to President Joe Biden's performance in the debate has been one of significant concern. Several factors contribute to a certain state of panic among the democrats. First, Biden's performance was seen by some as lackluster, raising concerns about his ability to effectively counter Donald Trump in the general election. Democrats worry that his age and potential for verbal slip-ups could be exploited by the opposition, amplifying existing voter concerns about his fitness for office.

Second, Biden was not able to context and respond properly to several false or misleading claims presented by Trump. The former president falsely asserted that the 2020 election was stolen from him, despite numerous audits and court rulings confirming the legitimacy of the results. Trump inaccurately claimed his administration's handling of the pandemic was exemplary, ignoring significant failures and the high death toll. Trump exaggerated the economic performance under his administration, not acknowledging the pre-pandemic economic trends and recovery issues.

Despite the role of Vice-President Kamala Harris on dismissing all criticism on Biden’s performance from the Democratic Party members in a interview to CNN journalist Anderson Cooper, just after the debate, the party members and supporters are still worried. Biden has been trailing Trump in several key polls, which has heightened anxiety within the Democratic Party. The debate was viewed as an opportunity for Biden to close the gap, but mixed reviews of his performance have left many unsure if he achieved that goal. The close race and Biden’s poor approval ratings, particularly concerning the economy and his age, add to the urgency of finding a viable strategy to improve his standing.

While Biden is the presumptive Democratic nominee, there is growing speculation about his viability heading into the Democratic National Convention in the next August 19-22 in Chicago. Some Democrats fear that if his performance in the debate does not significantly improve his poll numbers, there might be calls to replace him with another candidate, though this would be unprecedented and risky.

Despite these concerns, Biden still has opportunities to solidify his position, including in the upcoming Democratic National Convention and another scheduled debate in September. However, the reaction within the party indicates a deep-seated worry about the challenges ahead and the critical nature of Biden’s campaign performance in the coming months.

Our goal in this article is not to analyze the entire political debate, but simply to discuss Biden and Trump's approach to some relevant health policy issues, including Medicare, Medicaid, the opioid crisis, children's health care, and sustainability of healthcare related to migration issues.

Affordable Care Act (ACA), Medicare, and Medicaid:

Joe Biden emphasized his administration’s success in expanding ACA coverage, highlighting record enrollments. He advocated for making the enhanced subsidies under the Inflation Reduction Act (IRA) permanent to keep insurance premiums low. He also discussed efforts to strengthen Medicare, including capping insulin costs at $35 per month and expanding drug price negotiations. He also proposed closing the Medicaid coverage gap and maintaining coverage for Medicaid expansion enrollees. Biden highlighted measures to reduce prescription drug costs, such as requiring rebates from drug companies if prices rise faster than inflation, and extending these rebates to commercial drug sales.

While Biden emphasized expanding the ACA and protecting Medicare and Medicaid, critics pointed out that he did not provide detailed plans on how these expansions would be funded or implemented in the long term. This left some viewers uncertain about the feasibility of his proposals. Biden often found himself on the defensive, especially when Trump criticized the ACA and accused the Biden administration of mismanaging Medicare and Medicaid funds. Biden's responses were seen as reactive rather than proactive, which did not instill confidence in his leadership on these issues.

Donald Trump reiterated his intent to replace the ACA with a more efficient system, though details remain vague. He criticized the ACA for its high costs and inefficiencies. Trump committed to protecting Medicare and Social Security, focusing on reducing waste and fraud rather than cutting benefits directly. He also mentioned promoting state flexibility and potentially introducing work requirements for Medicaid. He emphasized his administration’s past efforts to lower drug prices, including a cap on insulin costs for some Medicare beneficiaries, and expressed his commitment to further reduce prices.

Trump criticized the ACA and spoke about the need for a better system but failed to present a detailed alternative plan. His proposals lacked specifics, making it difficult for viewers to understand how he would achieve his goals without significant disruptions to the current system. Trump’s promises to protect Medicare and Social Security while also cutting waste and fraud seemed contradictory to some viewers. This inconsistency undermined his credibility on these issues.

Opioid Crisis:

Joe Biden highlighted a comprehensive strategy to combat the opioid crisis, including expanding access to life-saving medications, reducing stigma, and ensuring more flexible treatment options, such as take-home doses of methadone and telehealth services for opioid use disorder treatment. Regarding future plans, Biden proposed additional funding for opioid treatment programs and emphasized partnerships with community organizations to distribute naloxone and provide overdose prevention training.

Biden’s approach to the opioid crisis included discussing the administration's regulatory changes and funding increases for treatment programs. However, his explanations were sometimes too technical and failed to emotionally connect with the audience or convey a clear vision for tackling the crisis comprehensively.

Despite highlighting regulatory updates and funding increases, Biden did not effectively counter Trump’s claims of insufficient progress, leading to perceptions that his administration's efforts have not significantly improved the opioid situation.

Donald Trump ?pointed to his administration’s increase in funding to combat the opioid crisis, support for community prevention programs, and efforts to crack down on the supply of illicit drugs. He highlighted securing commitments from international partners, such as China, to reduce fentanyl trafficking. For the next presidential mandate, Trump reiterated his commitment to continue these efforts, emphasizing the importance of securing the border and enhancing law enforcement measures against drug traffickers.

Trump focused heavily on law enforcement measures to combat the opioid crisis, such as border security and cracking down on drug traffickers. Critics argued that he did not give enough attention to treatment and prevention, which are crucial for a comprehensive approach to the crisis. Trump’s strategy of blaming previous administrations for the opioid crisis did not sit well with some viewers, who felt he should have taken more responsibility for the current state of affairs and provided clearer plans for future actions

Children's Healthcare:

Joe Biden proposed policies to ensure continuous healthcare coverage for children from birth until age six and reduce administrative burdens on families by requiring Medicaid paperwork submission only once every three years. He also highlighted the need for increased funding for women’s health research and initiatives to improve children’s health outcomes through better insurance coverage. While Biden did mention efforts to ensure continuous coverage for children, he missed opportunities to provide a compelling narrative or specific new initiatives that would capture the audience’s attention and demonstrate a strong commitment to children’s healthcare beyond what is already in place.

Donald Trump did not provide specific new proposals on children’s healthcare during the debate, focusing more on general healthcare reforms and cost reductions. Trump did not offer new initiatives or detailed plans for improving children's healthcare, relying instead on broad statements about reducing costs and improving the system. This was seen as a missed opportunity to address a critical issue in depth.

Migration and Healthcare Sustainability:

Joe Biden discussed policies aimed at expanding access to healthcare for vulnerable populations, including migrants. He emphasized the importance of sustainability in healthcare by improving efficiency and reducing costs through better policy frameworks and support for comprehensive healthcare coverage. Biden’s responses on migration and healthcare sustainability were seen as vague. He did not clearly articulate how his administration plans to balance the healthcare needs of migrants with the sustainability of the healthcare system, leaving a gap in his argument that Trump exploited

Donald Trump’s discussion on migration related to healthcare focused on controlling costs and ensuring that immigration policies do not strain the healthcare system. He reiterated the need for stringent immigration controls to prevent additional pressures on healthcare resources. Trump’s focus on strict immigration controls and their impact on the healthcare system came across as overly harsh to some viewers. His failure to address the humanitarian aspects of migration and provide a balanced approach was seen as a significant flaw. Trump did not present a clear plan for ensuring the sustainability of the healthcare system in the context of migration. His emphasis on border security overshadowed the need for policies that integrate healthcare sustainability with humane migration practices.

Conclusions

Overall, the debate highlighted stark differences in the healthcare approaches of Biden and Trump, with Biden advocating for expanded coverage and cost reduction through existing frameworks, while Trump emphasized cost control, deregulation, and border security as key components of his healthcare strategy.

However, both candidates had notable failures in addressing these critical issues, with Biden struggling to provide clear and engaging responses and Trump failing to present detailed and?cost reduction through existing frameworks, while emphasizing cost control, deregulation, and border security as key components of his healthcare strategy.