How the Primary Candidates Would Reform Healthcare

Neil Chesanow

Disclosures

May 25, 2016

In This Article

And Then There Were Three

On May 3, New York real estate tycoon Donald J. Trump trounced his chief rival, Texas Senator Ted Cruz, to win Indiana's primary, forcing Cruz to quit the race and positioning Trump to easily accumulate the 1237 delegates needed to avert a contested Republican nominating convention in Cleveland in July.[1]

Republican National Chairman Reince Priebus declared Trump the "presumptive nominee."[1] The next day, Ohio governor John Kasich, who had won only his home state, also suspended his campaign.[2]

On the Democratic side, Vermont Senator Bernie Sanders scored an upset victory—winning 52.7% of the vote among Indiana Democrats—over former Secretary of State Hillary Clinton.[3] The following week, Sanders captured the West Virginia primary. Although he vows to remain in the race until the Democratic nominating convention, to be held in Philadelphia in July, it is mathematically impossible for him to reach the number of regular delegates necessary to win the nomination using pledged delegates alone.[4]

Sanders would instead have to win over superdelegates—party leaders and elites who can back the candidate of their choice.[4] However, to date, Clinton has won 520 superdelegates to Sanders's 39, making this route to the nomination unlikely.

But by remaining in the race, Sanders could still influence the Democratic party platform, nudging it to the left in Philadelphia.[5] His unexpected success, particularly with younger Democratic primary voters, has already prompted Clinton to add a public option to her proposals for reforming the nation's healthcare system in the hope of winning their support in the general election.

What the three candidates propose to reform the nation's healthcare system is a study in contrasts. Clinton seeks to build on the successes of the Affordable Care Act (ACA); she proposes incremental change.[6] Sanders seeks to replace the ACA with single-payer, Medicare-for-all coverage.[7] Trump also proposes revolutionary change, starting with repeal of the ACA, but details on what he would replace it with have not yet been revealed.[8]

How realistic are their proposals? If enacted, what would they mean for you and your patients? Let's take a look.

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