There has been much discussion in the media about Trump's promise to repeal the Affordable Care Act, which will result in over 20 million people losing health insurance coverage. The implications of a Trump presidency for health care go much further than this. Here is a summary of the probable outcomes.
The Affordable Care Act (ACA) not only provides subsidized coverage for 20 million Americans who will no longer be able to afford health insurance. The ACA also requires health insurers to cover people regardless of whether they have pre-existing conditions. Before the ACA, if someone without insurance who had a chronic illness tried to get insurance, they were unable to get coverage. People who lost job based insurance, including those who lost their jobs due to illness rendering them unable to work, were unable to get insurance coverage. Though Trump has recently given lip service to keeping this popular provision of the ACA, he tends to be very big business friendly and insurers don't like covering sick people, because it eats into their profits. So, expect this safeguard to disappear.
Medicare as we know it is in grave danger. Republicans for many years have been advocating to turn Medicare into a voucher system. This means that Medicare beneficiaries, both the elderly and disabled, will, instead of getting guaranteed coverage under a federally controlled system, with a reasonable premium, will be given a voucher for a specific amount of money which they can then use to shop for private health insurance. There is no guarantee that the amount of the voucher will cover the cost of health insurance. Insurers will be able to charge what they please. The elderly and disabled are expensive to insure and most have pre-existing conditions so there is no guarantee under this system that (1) they will be able to afford health insurance and (2) they will be able to buy it at any price. Trump, because of his history of favoring the interests of big business over the interests of the average person, is unlikely to these efforts. His transition team appointments already look ominous on this issue. See economist Paul Krugman's column for more about this: www.nytimes.com
Medical Marijuana laws, which have been gaining in popularity over the years, have been state initiatives. Marijuana in any form remains illegal under federal law. Medical marijuana is very unpopular with pharmaceutical companies because many patients prefer it to pharmaceuticals. Medical marijuana is actually much safer and more effective than prescription drugs for many common medical conditions, including chronic pain, anxiety and seizure disorders, hence its growing popularity among consumers. Until a few years ago, when it was stopped by the Obama administration, the federal Drug Enforcement Agency (DEA) actively tried to interfere with implementation of state legalization efforts. One favorite tactic was armed raids of medical marijuana dispensaries, seizure of supplies and arrest of proprietors. Landlords who rented to these businesses were also threatened with property seizure and arrest. Although Trump gave lip service early in his campaign to support for medical marijuana, his advisors have publicly expressed opposition. Expect a big business-friendly Trump administration to return to DEA suppression of state efforts. Jeff Sessions, Trump's pick for Attorney General, is virulently anti-marijuana. See more about this here: www.leafly.com
Access to nutritional supplements and herbal medicine will probably be restricted. The pharmaceutical industry-friendly FDA and many Republican congressmen have been trying for years to label high dose vitamins and herbal supplements as medicines. As increasing numbers of Americans have turned to more natural methods of maintaining health and treating disease, the competition to pharmaceuticals has grown. If supplements are classified as medicine, they must go through an extremely expensive drug approval process that is unaffordable for sellers of natural substances that cannot be patented. These types of limitations on access to natural supplements have already succeeded in the European Union, where many natural products have become illegal and unavailable. Under a Trump presidency, this is very likely to happen here.
We still have a chance to prevent a Trump presidency that poses such a huge hazard to our health. On December 19, the electors will meet to choose our president. Under the electoral college system, each state, based on which presidential candidate won the most votes in their state, appoints electors who actually cast the votes that determine the presidency. Trump did not win the popular vote--Hillary Clinton did. A petition has been started asking the electors to honor the popular vote and cast their votes for Clinton. The petition currently has about 4.5 million signatures. You can sign and share the petition here: www.Change.org.
We need a president that will expand access to health care, including alternative treatments. We all need to do what we can to have a new administration that will do that, not one that favors corporate profits over patients' needs.
Cindy Perlin is the author of The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free.