Miranda Yaver, PhD
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FOCUSING ON THE WRONG HEALTH ISSUES

10/6/2016

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​For all the media’s (and candidates’) attention to candidate health over the course of this presidential campaign, we seem to be spending precious little time in the presidential debates discussing the candidates’ actual health plans.
 
Those on the left have “diagnosed” Mr. Trump as unhinged and mentally unstable, calling attention to a narcissistic personality consistent with a DSM diagnosis, though in violation of the “Goldwater Rule.” They have further raised the unusual way in which Mr. Trump’s medical records were released, with language better characterized as flamboyant rather than scientific or precise, and a discussion of his health history on the television show of the widely debunked Dr. Oz.
 
Mr. Trump and those on the right have mocked Secretary Clinton’s health, replaying a collapse amid an episode of pneumonia. Pharmaceutical executive Martin Shkreli further went on Twitter to postulate that Secretary Clinton had what he viewed to be Parkinson’s disease, despite any medical records to support the “diagnosis.”
 
All told, the health of the candidates and public insistence on revelation of medical records was dominating much coverage prior to the more recent discussion of the importance of revelation of candidates’ tax returns.  The purported justification is that the American electorate deserves to know whether a person is physically fit for the demanding job of president, though presidential candidates’ publication of medical records has been a rather inconsistent practice over time, and past presidents’ deaths in office were not always attributable to medical conditions (e.g., assassination). More often than not, the emphasis appears to be for the purpose of media, gossip, and distraction.
 
That an American presidential campaign would be dominated at least in part by media sensationalism is hardly a surprise.  What is more distressing is that we have thus far spent more time discussing candidate health – which does not appear to have a bearing on the ability to effectively hold the office of President of the United States (think FDR) – than we have spent in the presidential and vice presidential debates on the candidates’ healthcare plans. (Side note: Libertarian candidate Gary Johnson does not even list healthcare on his website’s “Issues” section).
 
The first presidential debate between Mr. Trump and President Clinton did not include a single discussion of either candidate’s healthcare plans, whether with respect to access to care or reducing the cost of too-often-exorbitant prescription drug prices. With a record-breaking viewership of 84 million viewers, this was a missed opportunity for both candidates to discuss the merits of their plans on this key issue.
 
In the days that followed, Mr. Trump spoke at a rally in Altoona, Pennsylvania in which he not only encouraged his supporters to intimidate voters – an action that would have garnered the top headline any other election – but also mocked Secretary Clinton’s stumble, to the cheers of his supporters. Mayor Giuliani was interviewed and continued his long history of unfounded assertions of an illness that Secretary Clinton might be keeping secret. 
 
During the vice presidential debate, the Affordable Care Act got mentioned by Governor Pence in his discussion of the concerns he had regarding the national debt:  “But a trillion dollars in tax increases, more regulation, more of the same war on coal, and more of Obamacare that now even former President Bill Clinton calls Obamacare a crazy plan. But Hillary Clinton and Tim Kaine want to build on Obamacare. They want to expand it into a single-payer program. And for all the world, Hillary Clinton just thinks Obamacare is a good start. Look, Donald Trump and I have a plan to get this economy moving again just the way that it worked in the 1980s, just the way it worked in the 1960s, and that is by lowering taxes across the board for working families, small businesses and family farms, ending the war on coal that is hurting jobs and hurting this economy even here in Virginia, repealing Obamacare lock, stock, and barrel, and repealing all of the executive orders that Barack Obama has signed that are stifling economic growth in this economy.”
 
There are three points here worth emphasizing.
 
1. In two debates – one presidential, one vice presidential – no one has actually asked any of the candidates about healthcare, despite the fact that healthcare accounts for 17.5% of the United States GDP.
 
2. Governor Pence did not, in his discussion of Obamacare, discuss with any substance the alternative that he and Mr. Trump propose.
 
3. Senator Kaine did not use Governor Pence’s comments as an opportunity to pivot the conversation toward the progress that the Affordable Care Act has created – namely, 20 million more people with health insurance and a historic low uninsured rate of 8.6%, and the delivery of much-needed primary care and behavioral healthcare through Medicaid expansion in 31 states and the District of Columbia (which Governor Pence should know given that his state of Indiana accepted those government funds).
 
84 million watched the 90-minute presidential debate. 37 million watched the 95-minute vice presidential debate. In none of those 185 minutes did we learn – apart from the Trump/Pence ticket’s pledge to repeal the Affordable Care Act – anything about the candidate’s positions on this issue affecting every American, rich or poor, young or old, Democrat or Republican.
 
That the personal health of the presidential candidates is making top headlines is silly, though not altogether inconsistent with the antics that have characterized this highly unusual election cycle. That their personal health is garnering greater attention during these forums than their own healthcare plans is a disgrace. 
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    Author

    Miranda Yaver is a political scientist, health policy researcher, and comedian in Los Angeles. She received her PhD in Political Science at Columbia University in 2015. She has taught courses on American politics, public policy, law, and quantitative methodology at Washington University in St. Louis, Yale University, Columbia University, and Tufts University.

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