Just a few reactions to the Republican debate Thursday night in Houston, and then a long chunk of transcript that will highlight the elegant simplicity of Donald Trump’s health-care thinking.
In general, the debate was crazy. Disgraceful, really. The name-calling, the constant interruption, the constant talking past the allotted time, candidates talking as if the bell ringing indicating that their time has expired is only annoying them. It only punishes any candidate who is foolish enough to play by the agreed-upon rules.
Obviously, both Sens. Marco Rubio and Ted Cruz realized that the jig was up on their past strategy of waiting for someone else to try to attack Donald Trump. Rubio especially was loaded for bear by his opposition researchers. He argued, logically and probably based on facts that would more or less check out, that Trump is a liar and a hypocrite who has been on both sides of a great many questions, and whose business practices, including hiring undocumented workers, are unsavory.
The Atlantic’s instant analysis of the debate holds that Rubio dinged Trump up in those exchanges. My gut feeling is that this is not going to move the poll numbers, but we should all admit that we don’t really understand how or why Trump is so dominant in the polls, so it’s hard to know whether anything could bring him down.
The pollsters also tell us that the ever-growing legions of Trump supporters are remarkably loyal, which makes it even less likely that Rubio can peel them away, but we’ll see. The last round of pre-Super Tuesday polls suggested Trump was well ahead in most of the Super Tuesday states, including Florida, which is the second biggest prize and happens to be Rubio’s home state. If Trump beats Rubio in Florida, I don’t see much hope for Rubio. Cruz does appear, at the moment, to have a lead in his home state, Texas.
But if Rubio is going down, he decided to go down swinging. He taunted Trump, describing the Trumpian shtick thus: “I see him repeat himself every night. He says five things: Everyone’s dumb. He’s gonna make America great again. We’re going to win, win, win. He’s winning in the polls. And the lines around the states.”
Trump’s limited repertoire
This is only a slight exaggeration. Every candidate must repeat himself a lot, but Trump has a remarkably limited repertoire and much of it is staggeringly light on policy. The last part of Rubio’s bit above, the reference to “the lines around the states,” led to my favorite portion of the debate.
Trump doesn’t have a health care plan. Go to the issues section of his campaign. Really, go there, you won’t believe what you see. A typical campaign website has position papers. Trump has none. The link to “Issues” takes you to a pretty frightening page of short embedded videos of Trump himself summarizing his positions at a level of detail that you should find insulting.
But he doesn’t even have one of those on health care.
In addition to “Issues,” the site’s homepage has a pulldown menu called “Positions.” I don’t get the difference, but who cares? “Positions” are actual written-out position statements, not videos, but only on five issues, none of which are remotely related to health care (nor many other major issues).
So for Trump’s health-care thinking, we have to rely on what he says in debates and speeches and, I suppose, tweets, some of which have been controversial. When asked Thursday night under Rubio’s prodding to describe his plan for health care, he said, as he always does, that he wants to repeal the Affordable Care Act and replace it with something “much better.” Then he says (and this is a direct quote from the debate transcript): “I want to keep pre-existing conditions. I think we need it. I think it’s a modern age. And I think we have to have it.”
This is gibberish, especially the explanation that “I think it’s a modern age,” which may have some meaning but I can’t imagine what. But, in full context, it’s at least clear that the much better plan that he would propose to replace Obamacare would include the Obamacare feature that requires an insurer to cover any pre-existing conditions that the insured might have, and can’t charge them extra for it.
But when it’s time to describe other elements of the “much better” plan with which Trump would replace Obamacare, he generally mentions only one thing, which he describes, as he did Thursday night, as “getting rid of the lines around each state.”
That weird and confusing phrasing — about “getting rid of the lines around the states,” which Rubio mocked — as best as anyone can tell means that Trump wants national health insurers to be able to offer standardized plans all over the country, instead of having to meet the particular standards and requirements imposed by individual states. Different states require different things of health insurers, which prevents national firms from offering plans in all states.
Trump believes, and he’s not the only one, that “getting rid of the lines around the states” would enable more insurers to offer insurance in more states, which would lead to more competition, driving prices down, and more choices for customers. Trump has been saying this for many weeks. The idea has been around for years. Views differ on whether it would do more good or harm. But it’s really the only thing Trump mentions when he is pushed to describe his plan to replace Obamacare with something much better.
Dying on the streets
Rubio was pressing him, mockingly, to lay out his whole plan. In addition to “getting rid of the lines” and requiring insurers to cover pre-existing conditions, Trump says that he “wouldn’t allow people to die on the streets” for lack of health care. Sometimes he says “sidewalks,” or both. He often does a shtick about how the other presumably heartless Republican candidates would let people die on streets. When he does that he gets a great ovation from his crowds, who agree with him that a great nation like ours should not have dying on streets.
But I’ve never heard him describe what health care he proposed to include in his plan to keep people from dying on the streets. Thursday night, he was asked, and it turns out there is no plan.
With Rubio pressing in and badgering Trump from the sidelines — the same way Rubio was badgered a few weeks ago by Chris Christie and the way Trump often badgers other candidates — and with CNN’s Dana Bash following up, Trump said his three things: Repeal Obamacare and replace it with something much better, get rid of the lines around the states, and don’t let people die in streets. I always assumed that there was more to his plan, but I never came across the details. And, during the exchange Thursday night, it came out that there is no more. Here’s that chunk of the transcript so you can decide for yourself if I’m missing something. (I’ve done a tiny bit of editing for flow.)
BASH: Mr. Trump, Senator Rubio just said that you support the individual mandate. Would you respond?
TRUMP: I just want to say, I agree with that 100 percent, except pre-existing conditions, I would absolutely get rid of Obamacare. We’re going to have something much better, but pre-existing conditions, when I’m referring to that, and I was referring to that very strongly on the show with Anderson Cooper, I want to keep pre-existing conditions. I think we need it. I think it’s a modern age. And I think we have to have it. (APPLAUSE)
BASH: OK, so let’s talk about pre-existing conditions. What the insurance companies say is that the only way that they can cover people [who have pre-existing conditions and would be more expensive to cover] is to have a mandate requiring everybody purchase health insurance. Are they wrong?
TRUMP: I think they’re wrong 100 percent. What we need — look, the insurance companies take care of the politicians. The insurance companies get what they want. We should have gotten rid of the lines around each state so we can have real competition. We thought that was gone, we thought those lines were going to be gone, so something happened at the last moment where Obamacare got approved, and all of that was thrown out the window.
The reason is some of the people in the audience are insurance people and insurance lobbyists and special interests. They got — I’m not going to point to these gentlemen, of course, they’re part of the problem, other than Ben [Carson], in all fairness. And, actually, the governor [John Kasich], too. Let’s just talk about these two, OK? Because I don’t think the governor had too much to do with this.
But, we should have gotten rid of the borders, we should have gotten rid of the lines around the states so there’s great competition. The insurance companies are making a fortune on every single thing they do. I’m self-funding my campaign. I’m the only one in either party self-funding my campaign. I’m going to do what’s right. We have to get rid of the lines around the states so that there’s serious, serious competition. And you’re going to see — excuse me. You’re going to see pre-existing conditions and everything else be part of it, but the price will be down, and the insurance companies can pay. Right now they’re making a fortune. (APPLAUSE)
BASH: But just to be specific here, what you’re saying is getting rid of the barriers between states, that is going to solve the problem…
TRUMP: That’s going to solve the problem. And the insurance companies are going to say that they want to keep it. They want to say — they say whatever they have to say to keep it the way it is. I know the insurance companies, they’re friends of mine. The top guys, they’re friends of mine. I shouldn’t tell you guys, you’ll say it’s terrible, I have a conflict of interest. They’re friends of mine, there’s some right in the audience. One of them was just waving to me, he was laughing and smiling. He’s not laughing so much anymore. Hi.
Look, the insurance companies are making an absolute fortune. Yes, they will keep pre-existing conditions, and that would be a great thing. Get rid of Obamacare, we’ll come up with new plans. But we should keep pre-existing conditions.
RUBIO: Dana, I was mentioned in his response, so if I may about the insurance companies…
BASH: Go ahead.
RUBIO: You may not be aware of this, Donald, because you don’t follow this stuff very closely, but here’s what happened. When they passed Obamacare they put a bailout fund in Obamacare. All these lobbyists you keep talking about, they put a bailout fund in the law that would allow public money to be used, taxpayer money, to bail out companies when they lost money. And we led the effort and wiped out that bailout fund. The insurance companies are not in favor of me, they hate that. They’re suing right now to get that bailout money put back in.
Here’s what you didn’t hear in that answer, and this is important, guys, this is an important thing. What is your plan? I understand the lines around the state, whatever that means. This is not a game where you draw maps…
TRUMP:…And you don’t know what it means?
RUBIO: What is your plan, Mr. Trump? What is your plan on health care?
TRUMP: You don’t know. The biggest problem…
RUBIO: …What’s your plan?
TRUMP: … You know, I watched him melt down two weeks ago with Chris Christie. I got to tell you, the biggest problem he’s got is he really doesn’t know about the lines. The biggest thing we’ve got, and the reason we’ve got no competition, is because we have lines around the state, and you have essentially….
RUBIO: …You already mentioned that [inaudible] plan. I know what that is, but what else is part of your plan?…
TRUMP: …You don’t know much…
RUBIO: …So, you’re only thing is to get rid of the lines around the states. What else is part of your health-care plan?…
TRUMP: …The lines around the states…
RUBIO: …That’s your only plan…
TRUMP … Excuse me. Excuse me.
RUBIO: … His plan. That was the plan?…
TRUMP:…You get rid of the lines, it brings in competition. So, instead of having one insurance company taking care of New York or Texas, you’ll have many. They’ll compete, and it’ll be a beautiful thing.
RUBIO: Alright…So that’s the only part of the plan? Just the lines?
TRUMP: The nice part of the plan — you’ll have many different plans. You’ll have competition, you’ll have so many different plans.
RUBIO: Now he’s repeating himself.
TRUMP: No, no, no. I watched him repeat himself five times four weeks ago…
RUBIO:… I just watched you repeat yourself five times five seconds ago…
TRUMP: I watched him meltdown on the stage like that, I’ve never seen it in anybody…
BASH:…Let’s stay focused on the subject…
TRUMP:…I thought he came out of the swimming pool…
RUBIO:…I see him repeat himself every night, he says five things: Everyone’s dumb, he’s gonna make America great again…We’re going to win, win win. He’s winning in the polls…And the lines around the state. (APPLAUSE)
BASH: Senator Rubio, you will have time to respond if you would just let Mr. Trump respond to what you’ve just posed to him…
RUBIO: … Yeah, he’s going to give us his plan now, right? OK…
BASH [to Trump]:…If you could talk a little bit more about your plan. I know you talked about…Can you be a little specific?…
TRUMP: … We’re going to have many different plans because… competition…
RUBIO: … He’s done it again.
TRUMP: There is going to be competition among all of the states, and the insurance companies. They’re going to have many, many different plans.
BASH: Is there anything else you would like to add to that…
TRUMP: No, there’s nothing to add. What is to add?
BASH: Thank you. Thank you both.
Here’s the New York Times’ instant transcript and a Times’ instant fact-check of claims made in the debate.
