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This election is focusing on the wrong health issues

Miranda Yaver, PhD
Policy
October 19, 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 and the now infamous revelation of the 2005 tape in which Mr. Trump boasted about being able to grope women without consent on account of his celebrity status.  The purported justification with respect to the focus on candidate health 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’ health care plans. (Side note: Libertarian candidate Gary Johnson does not even list health care 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 health care 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, noting President Clinton’s recent criticism of Obamacare, noting Secretary Clinton’s desire to expand it, and Mr. Trump’s desire to repeal it. Governor Pence did not, in his discussion of Obamacare, discuss with any substance the alternative that he and Mr. Trump propose. 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 percent, and the delivery of much-needed primary care and behavioral health care 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. This is particularly striking giving that health care accounts for 17.5 percent of the United States GDP.

It was not until the second presidential debate — admittedly one in which the chatter was much more focused on the Trump tape and the challenges it presents for his campaign and party — that a single question was asked on the subject of health care and how the candidates would address the challenges that some are facing of higher costs and, in some cases, less coverage. This provided the first opportunity for the candidates to provide their talking points on health care over the course of approximately seven minutes, with Secretary Clinton discussing her desire to keep what works within the Affordable Care Act but curb costs and make it easier for small businesses to afford to provide health insurance, and Mr. Trump articulating a desire to repeal the ACA and allow for the selling of health insurance across state lines (though some argue that that would not actually curb costs). Within these settings, we unfortunately still have had no discussion of prescription drugs, the pricing of which have been in the news with EpiPens most notably.

Two days after the debate, Mr. Trump returned the conversation to Secretary Clinton’s health in a new ad.

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 health care plans is a disgrace.

Miranda Yaver is a political scientist. She can be reached on Twitter @mirandayaver.

Image credit: Shutterstock.com

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This election is focusing on the wrong health issues
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