What Harris and Trump Say About Healthcare

Plus, should someone fearing job loss pay off their mortgage? 

Ric Edelman: It's Tuesday, October 15th. I hope you had a wonderful Columbus Day weekend. I'm continuing to get lots of comments and e-mails from you in response to the series we've been holding all this month on the presidential election. Thank you for the e-mails and continue to send them. I read every one and I'm very interested in your thoughts.

I will share with you a lot of the new comments that I have obtained. I'll do that tomorrow. So, send me your thoughts between now and then and I'll incorporate them in my show tomorrow as best I can.

Today we're going to talk about health care on our list of 34 topics, involving the presidential election.

But before we get to that, I've got a question on mortgages from Tim.

Tim: “I have been listening for a few months and really enjoy the show. I'm 50 years old and still owe $70,000 on my home. I have about $500,000 in my 401k and about $250,000 in savings and investments. I'm very concerned I will lose my job in my early 50s and have to live on much less of an income. Thus, I'm saving like crazy right now. I'm wondering if I should pay off my mortgage. I have a 4 percent interest rate.”

Ric Edelman: No, Tim. I don't see any particular reason why you should pay off your mortgage. You only owe $70,000, which suggests to me that you've been living in your home for a really long time. Because I doubt your house is worth only $70,000. I think your house is worth hundreds of thousands, perhaps even more, and that you've been diligently paying off the mortgage over time for the past couple of decades. You only now have a $70,000 balance, which means the bulk of your monthly payment today is most likely principal, not interest.

You see what most people don't realize, when you get a 30-year mortgage and you have a mortgage payment, that payment consists of a combination of principal and interest. What most people don't realize is that the mortgage company front loads the interest. In other words, on the very first payment you make on that 30-year mortgage, you know, that's 360 payments you're going to make, right?  30 years, 12 months in a year, 360 payments.

The very first payment is almost entirely interest. 90-some percent of that. payment. Your last payment is almost entirely principal. So you are paying mostly interest in the early years of the mortgage, and you're paying mostly principal in the final years of the mortgage.

Meaning, at this stage of your mortgage history, you're not paying very much in interest. You've already paid it, which means all you're doing is giving your own cash to the mortgage company to reduce the mortgage balance. There's not really a big point to doing this. You're not saving yourself on the interest expense.

All you're doing is taking the money you have which is liquid and available to you and giving it to the mortgage lender where the money becomes illiquid and unavailable to you. Considering that you've got $500,000 in your 401(k) and another $250,000 in savings and investments and a house worth hundreds of thousands of dollars or more.

I don't really see a concern here for you to pay off your mortgage, especially, and this is counterintuitive, especially since you're worried you're going to lose your job. See, very often when people say to me, I'm afraid I'm going to lose my job. Therefore, I don't want to have debts with I am unemployed. I won't have any income. I won't be able to pay my debts.

No, it's the exact opposite. Instead of getting rid of the mortgage, so that you don't have the debt if you're out of work, you want to keep the mortgage, which means you are able to keep your money. You don't want to give the mortgage company $70,000 in cash. If you lose your job, you're going to need the $70,000 to pay your bills, to buy food, and to pay for insurance and repairs and maintenance on the house and support your lifestyle, medical expenses, or what have you.

If you give that money away to the mortgage company, you'll have a house fully paid for, but you can't use that to buy food. All you'd end up doing is getting a brand-new mortgage, starting that mortgage clock all over again. And if that's the case, why pay off the mortgage right now? It makes no sense. So, I get your concern that you're afraid you may lose your job and you're going to have to live on less of an income, But that means you're going to need as much of your savings as you currently have to be able to generate investment income to replace your earned income from your job.

Talk to a financial advisor I'm giving you an education not advice, but if it were me, I would definitely not pay off the mortgage on that house

You can send me your question as well, just send it to AskRic@TheTruthAYF.com. The link is in the show notes.

Let's now go tackle today's topic of healthcare. Of our 34 topics in our 19 podcasts here in the month of October, healthcare is a very, very big conversation.

Lots of subjects within the broad umbrella of healthcare, the Affordable Care Act, also called Obamacare, the overall cost of healthcare, prescription drugs, Medicaid, Medicare, LGBTQ health, public health, mental health, the opioid crisis, long term care, and immigrant health. Let's tackle all of these. One by one.

First, the Affordable Care Act, Obamacare. Donald Trump, when he was president, tried to repeal it back in 2017. He failed. Congress wouldn't let him. He says he will try again if elected, but he hasn't said what he'll replace it with. Kamala Harris, on the other hand, fully supports the Affordable Care Act, and in fact, she wants to expand it.

How about the overall costs of health care? As president, Donald Trump signed a law protecting patients from unexpected medical bills. He also issued an executive order on price transparency, and his administration challenged anti-competitive behavior. In this year's campaign, he's promising to lower health insurance premiums, but he hasn't offered any details on how he plans to do so.

Kamala Harris says she wants to cancel Americans medical debt. That is a massive number, and some people have likened this to student loan debt. That is just another government giveaway of people incurring debt and the government wiping it away. Look at the implication on the companies that have incurred expenses associated with providing that cash. She wants to cancel Americans medical debt. That's a very big number.

She has also proposed, until the medical debt is waived, she wants to remove the medical debt from your credit report, so that the presence of medical debt doesn't hurt your ability to get a mortgage, or buy a car, or obtain a credit card.

Let's move on to drugs. Donald Trump, as president, cut insulin costs to $35 a month. He also allowed states to import prescription drugs from Canada to save money. He also passed a law eliminating Medicare (Part D) price increases, but Congress delayed that law to 2032. And he tried to set drug prices to match those of other countries, but the courts shot it down.

Kamala Harris, meanwhile, as Vice President, cast the tie breaking vote in the Senate for the Inflation Reduction Act. That law requires Medicare to negotiate prices for some drugs, it caps out of pocket drug spending, and it keeps insulin at the $35 a month that Donald Trump created. It also increases financial assistance for low-income patients. But that law that Donald Trump signed to eliminate Medicare (Part D) price increases?  The Harris-Biden administration delayed it, like I said, to 2032.

And how about Medicaid? When Donald Trump was president, he tried to reduce Medicaid spending by a trillion dollars over 10 years. Harris wants to do the exact opposite. She wants to expand Medicaid.

And Medicare? Trump has promised to quote, always protect Medicare and patients with preexisting conditions. As president, he signed legislation that expanded treatment for substance abuse disorders and other mental health conditions. He also allowed Medicare Advantage plans to offer additional benefits for people who are chronically ill. And he increased Medicare premiums for higher income households.

Kamala Harris wants to further increase Medicare taxes on high earners even more. And during the primaries, she advocated Medicare for All, which would have eliminated the ability for you to buy private health insurance. She now says she will not pursue that idea.

And how about LGBTQ? Donald Trump restricted their rights and access to healthcare. His administration wrote rules allowing healthcare professionals to deny services to people if those services that those folks wanted violated the healthcare professional's conscience or religious views. The Harris-Biden administration reversed Donald Trump's rule and Kamala Harris has promised to pass a law that would prohibit healthcare professionals from discriminating against people who are LGBTQ. She also supports lawsuits to overturn state laws that stop children from getting gender affirming treatment. Harris also supports paying for prison inmates to have gender transition surgery.

On the topic of guns, Donald Trump banned bump stocks, but the Supreme Court struck that law down. He also reversed Obama regulations that blocked people on mental disability from buying guns. Trump has said that if more people carried guns, we'd have less gun violence.

Kamala Harris is on the other side of the spectrum. She wants more gun regulation. red flag laws, universal background checks, and a ban on assault weapons and high-capacity magazines.

Now let's talk about public health. Donald Trump created Operation Warp Speed during COVID. That led to the fastest vaccine development in history, which saved millions of lives. But at the same time, he downplayed COVID-19 as a health threat, and he criticized the government's advice regarding school reopening’s, testing, and masking. He touted unproven therapies such as hydroxide chloroquine, ultraviolet light, and injections of disinfectant. He ultimately proposed budget cuts to the CDC, and he says he will probably disband the White House Office of Pandemic Preparedness and Response Policy, which the Biden-Harris administration created with Congress last year.

Harris, on the other side, she says she'll rely on science and evidence-based guidance, and she wants to significantly increase the public health budget each year.

Mental health? Donald Trump wants the country to return to institutionalizing those who are severely mentally ill. Vice President Harris, on the other hand, talks about maternal mental health. She wants to expand mental health and substance use treatment, including for children and underserved populations. And the Biden-Harris administration had created a national strategy for suicide prevention for high-risk groups, such as LGBTQ, veterans and new moms.

And speaking of substance abuse, let's talk about the opioid crisis. As President, Donald Trump declared that the opioid crisis was a public health emergency, and he signed the SUPPORT Act into law. He's now proposing a bigger law and order response to the crisis, including more restrictive border policies, more federal law enforcement involvement in local drug investigations, and the death penalty for drug smugglers and drug dealers. He supports faith-based substance abuse treatment and job placement, but in the meantime, he wants homeless people with mental health and substance abuse problems to be relocated to locations that he says he would staff with health care workers.

The Biden-Harris administration has used Medicaid to cover treatment for addiction.

Let's talk about long-term care (LTC). Donald Trump wants to improve at-home care services by increasing the number of home health aides, and to ease the financial burden of unpaid family caregivers by giving them tax credits. Kamala Harris says she wants Medicare to pay for long-term care, just like Medicaid does. She also wants the states to recoup the costs that Medicaid incurs paying for long-term care by going after the home and the estates of people after they die.

And finally, immigrant health. Donald Trump, as president, issued a proclamation suspending the entry of immigrants into the U. S. unless they provided proof of health insurance.

The Biden Harris administration issued regulations, by contrast, that is estimated to give 100,000 DACA recipients coverage.

So, there you have it, their positions, both Trump and Harris, on topics within the health care conversation. The Affordable Care Act, healthcare costs, prescription drugs, Medicaid, Medicare, LGBTQ, public health, mental health, the opioid crisis, long-term care, and immigrant health.

The reason it's important to go through their positions on this is that it helps give us a sense of what we like about all of that, and what we don't like, in an effort to determine who do we  support. That is the whole point of this conversation that I'm having with you this entire month of October.

I'm undecided. There are a number of other Americans equally undecided as me. We need to delve into these topics one-by-one to help us figure out which candidate we like better, or frankly, hate least. So let me share with you my views of their positions on all of these health care topics.

First, The Affordable Care Act.  I am not an expert on this topic. I'm a financial advisor, not a healthcare expert. The support and opposition to the Obamacare legislation seems to me to be party-based. Democrats love it and Republicans hate it. So, all I can say is that Trump says it's bad and he wants to repeal it. But he hasn't said why it's bad, or what he'll replace it with.

Harris, for her part, says she wants to expand it, but she hasn't said why, or how, or how much it'll cost. So, to me, it's just a political ping pong game they're playing, and both of them lose on this issue. Neither wins my support.

Overall health care costs? Well, if you take away Congress, if the president was a king or a queen and could do anything they wanted, I think Harris would focus exclusively on the patients themselves. And that means she'd spend recklessly. Based on his performance in his four years in office, I think Trump in his next term would work, or at least would be open to what Congress wants to improve health care, but he would clearly pay attention to costs. He'd be more realistic, more mature about it. And frankly, mature is not a word I would ordinarily use when talking about Donald Trump. So I have to give cost control to him.

I mean, just for illustration, Kamala Harris wants to remove medical debt from credit reports. Look, I get that she wants to cancel the debt itself. You know, like I've said many times, you can choose whether to go to college. And if you incur a lot of debt to go to college, that's your own fault. That's your own mistake. It's your own bad decision making. And I'm totally opposed to Kamala Harris's views matched by Joe Biden to waive all of the student loan debt, which simply shifts the burden of that unpaid bill onto the taxpayer. I just have no support of that at all.

But Medical debt is very different from college debt. You can choose to go to college, but nobody chooses to get sick. I mean, yeah, we could argue that some people's behaviors lead them into bad health situations. I mean, if you smoke cigarettes and you end up with lung cancer, you could argue that's your own fault. But let's face it, most of us who get sick, it isn't our fault. We're really going to chastise a family because they have a five-year-old who got cancer?

I don't think anybody would do that. So, I don't have as much of a problem waiving medical debt for some people, depending on their incomes and assets and a whole lot of other details. That's one thing about the debt itself. But if you have the medical debt, we do have to tell lenders about it. Can you imagine if we don't? If you're, right now, under the law, you have a lot of medical debt, fairly or unfairly, you are obligated to pay it back. This is a debt obligation you have, just like your car payment, and your mortgage payment, and student loan payments, and credit card payments.

Can you imagine, if now, when you file a loan application, to buy a car or to rent an apartment or obtain a mortgage or incur any other debt of any other kind, you no longer would have to tell the lender that you owe tens of thousands or hundreds of thousands of dollars in medical debt? Can you imagine the impact on this? It means that creditors would give you a loan under false pretenses. They're giving you a loan because of your assertions of your ability to repay the loan. If your ability to repay that loan isn't what it appears to be because a lot of your income is earmarked toward existing medical debt, that's just completely unfair to the creditor who is otherwise willing to give you credit.

This is abhorrent. Harris is dead wrong about this, and it's just another example of how clueless she is about how the economy works. Healthcare is a damn big part of the economy, and we can't act like we have a blank check. So I have to say, strictly, limitedly, narrowly on the topic of healthcare costs, Trump wins on that narrow topic.

Now, what about drugs? Trump cut insulin costs. He lets states go to Canada. I haven't seen the Biden Harris administration do much of anything on this issue, so Trump gets a check mark on this one too.

Medicaid? When he was president, Trump tried to reduce spending by a trillion dollars over 10 years. Harris, on the other hand, wants to expand Medicaid. I don't see how either of them is particularly superior to the other. Trump trying to cut costs to such a massive degree, I think ignores the genuine plight of low-income households dealing with healthcare costs. Kamala, on the other hand, who wants to just write checks willy-nilly without regard to how will we ever pay for it, is equally bad. So I don't support either one of them on this.

Medicare? The only thing Kamala Harris has talked about here is increasing taxes on rich people. I've seen nothing innovative, and as I've said on prior podcasts in this series, throwing money at problems doesn't solve them. And the worst part is that she promoted Medicare for All. And that's as extremist, far left liberal policy as I have seen. So on this topic, Harris loses me.

How about LGBTQ? There's a clear difference between Trump and Harris here. I much prefer Kamala Harris's views. But she goes way overboard by saying that we ought to be paying for gender-transition surgery for convicted criminals who are in prison. That doesn't seem to make a whole lot of sense to me. She's also supportive of the whole conversation of gender transition for young school children. I don't agree with that either. It's like so many times that I find myself liking Kamala Harris, I see her going off the deep end, and I find myself saying, wowa, why does she have to keep talking like that?

It's like every time Trump opens his mouth about the 2020 election and people eating cats and Lord knows what. Why does he have to keep doing that? Anyway, it's all why I'm still undecided. Sorry, I digress.

Let's keep going. Public health. Donald Trump found himself facing COVID. Nobody saw this coming. Under his administration, we got the COVID vaccine faster than any in history. But then he went nuts on his crazy claims about it. Harris says she'll rely on science. So she wins on this topic for me.

Mental health? For thousands of years, we either killed people with mental illness, or we locked them up. As we got more civilized over the past few decades, we removed people from those institutions. But does anybody really think that this new approach is really working? People who used to live in facilities are now living on the streets, with the attendant decline in our cities. More crime, more fear. These folks aren't getting any mental health services, and I don't think shutting down the institutions has really saved us any money or reduced any deaths.

So, I think Trump might be on to something. The key will be entirely in how we implement this idea, and I'm really not sure how much I trust the government's ability to pull it off. I worry about the people who might be institutionalized, beginning with whether or not they will be institutionalized against their will. Who will be the deciders of who gets committed.

I like Kamala Harris's attention on maternal mental health, but really, how big a deal is that? Beyond what's already available? Is this really where her focus ought to be? Again, it's like she's acting like a queen with an unlimited budget and unlimited resources.

So, on mental health, the issue's a draw for me. I'm not motivated or compelled to support either one of them on this issue.

The opioid crisis? They both call it a public health emergency. They both want to provide treatment. But only Trump has said that he wants to solve this by stopping the entry of the drugs at the border. So he wins on that one.

Long term care? Well, this is without a doubt a massively huge issue. I've been talking with you about long-term care costs for decades. The incredible expense associated with this that wipes out the life savings of the middle class and causes people to fall from middle class to poverty levels where they become eligible for Medicaid. This is a huge problem. And frankly, all I see both of them saying is that we have a big problem. We need to provide money to help people pay these costs. And all they're doing is throwing money at the issue.

None of them are really addressing the core, which is how do we help improve the quality of people's health to reduce the likelihood they will need long-term care services? So neither one of them gets my support on the topic of long-term care.

And our final topic, immigrant health. Kamala Harris says that she would spend hundreds of billions of dollars giving immigrants health care coverage. I would love to do that too. I would love to give health care coverage to everybody who's already currently living in Mexico, Central America, and South America. And while we're at it, let's throw in Africa and Asia and Europe as well.

It's unrealistic. We simply don't have the money or the resources. I just question the Kamala Harris focus here. I think that we have too many issues, [00:24:00] domestically here at home, for American citizens to be diverting too much attention to the needs of immigrants. So, if we can't afford to provide the immigrants the health care that we know they need and we ought to be providing, we then we can't allow them into the country in the first place.

That's a horrible answer to the question. I'm not really happy that I'm even saying it. Saying it makes me think how silly it is to hear it. But the bottom line is, it's a matter of resources. And a realistic evaluation of what's going on, as opposed to what our genuine, pure preference would be in an idealistic world. I have to say, I support Trump on this one.

So, if I add it all up, if I look at all of these issues, on the Affordable Care Act, it's a draw. I don't like either one of their views. On health care costs, I give that to Trump. On prescription drugs, I give that to Trump. Medicaid is a draw. Medicare goes to Trump. LGBTQ is a draw. Public health goes to Harris, mental health is a draw, the opioid crisis goes to Trump, long term care is a draw, and immigrant health goes to Trump.

So, add it all up, there are 11 topics, I score 5 for Trump, 1 for Harris, and 5 of them neither get my support. You know, this is really shocking me. I was sure. as I just thought of the very phrase healthcare, I was sure that I preferred Harris on this topic, but I don't. So, 5, 1, and 5? That. is a surprising result to me.

And I think what this is saying to me is how important it is that we look at the details of each of these topics and not just superficially at the emotional soundbite…what a given issue at first might suggest.

This is why I created the Excel spreadsheet that I've been telling you about, and I encourage you to download it, which you can do for free. The link to it's in the show notes, I list out all 34 topics, allowing you to say who you prefer Trump or Harris, and how important is the topic to you? And how high a score do you give to help reach a conclusion?

Overall, given all the varied topics, all the complexity associated with them, and a desperate effort, frankly, I am getting desperate here with only two weeks to go till the election, a desperate effort for me to quantify which of the candidates I either like better or dislike least. Check out my XLS in the link in the show notes.

Tomorrow's conversation, climate change. That's going to include the environment. Drilling, fracking, energy, nuclear energy, fossil fuels, and green energy. All that tomorrow, here on the show. See you then.

If you like what you're hearing, be sure to follow and subscribe to the show, wherever you get your podcasts, Apple, Spotify, YouTube, and remember leave a review on Apple podcasts. I read them all. Never miss an episode of The Truth About Your Future. Follow and subscribe on your favorite podcast app.

We're taking Monday off in celebration of Columbus Day. See you Tuesday. Have a great weekend.

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Ask Ric: https://www.thetayf.com/pages/ask-ric

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Links from today’s show: 

Click here for Ric's worksheet to help you evaluate the candidates

10/7 Monday Election Podcast-The 34 Election Issues and Ric’s worksheet for you: https://www.thetayf.com/blogs/this-weeks-stories/the-2024-election-the-tool-i-ve-created-to-help-me-decide-who-gets-my-vote

10/8 Tuesday Election Podcast-The Economy, Stupid!: https://www.thetayf.com/blogs/this-weeks-stories/ric-chooses-between-harris-and-trump-on-the-big-topic-the-economy-stupid

10/9 Wednesday Election Podcast-Housing and Homeownership: https://www.thetayf.com/blogs/this-weeks-stories/10-9-24-housing-and-homeownership-among-the-34-key-issues-of-election-2024

10/10 Thursday Election Podcast-Education: https://www.thetayf.com/blogs/this-weeks-stories/both-harris-and-trump-need-an-education-on-education

10/11 Friday Election Podcast-Abortion: https://www.thetayf.com/blogs/this-weeks-stories/abortion-the-most-emotional-election-issue

Kamala Harris Official Campaign Website Policy Page: https://www.kamalaharris.com/issues/

Donald Trump Official Campaign Website Policy Page: https://www.donaldjtrump.com/platform

Digital.Health: https://digital.health/

NextMed Health: Re-imagining the Future of Health and Medicine:   https://www.nextmed.health/

NextMed Health Conference December 10^th-13^th in San Diego: https://www.nextmed.health/

10/9 Webinar Replay- Crypto for RIAs: Yield, Staking, Lending and Custody. What’s beyond the ETFs? https://dacfp.com/events/crypto-for-rias-yield-staking-lending-and-custody-whats-beyond-the-etfs/

10/23 Webinar - How to Factor Longevity into Your Financial Planning: https://www.thetayf.com/pages/october-2024-webinar-how-to-factor-longevity-into-your-financial-planning

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