NEW YORK ― Hours after he celebrated a vote in the House of Representatives to get rid of the Affordable Care Act, President Donald Trump praised Australia’s publicly funded, universal health care system.
The bill that Trump and congressional Republicans were celebrating Thursday afternoon dramatically scales back government assistance that helps Americans pay for health care. The 2010 law, also known as Obamacare, had expanded coverage to 20 million more Americans, and an analysis of an earlier version of the GOP bill passed Thursday estimated it would cause 24 million Americans to lose coverage.
The irony of the remark seemed lost on Trump, who made the comment during a meeting with Australian Prime Minister Malcolm Turnbull in New York City on Thursday night.
“It’s a very good bill right now. The premiums are going to come down, very substantially. The deductibles are going to come down. It’s going to be fantastic health care. Right now Obamacare is failing. We have a failing health care. I shouldn’t say this to our great gentleman and my friend from Australia, because you have better health care than we do.”
Australia has a government-run, universal insurance system in which people can buy additional private coverage to get more choices and quicker access to providers or to fill in the gaps of what the public program does not cover. Government takes a direct role in setting prices for providers and drugmakers, and in establishing an overall “global” budget for health spending each year.
In the United States, universal coverage remains an aspiration. The number of people without coverage is at its lowest level ever, thanks to an expansion of means-tested public insurance programs (Medicaid) and the tax credits that helped low-income Americans afford coverage. But 10.9 percent of the adult population remains uninsured, according to the latest data from Gallup.
The U.S. government doesn’t negotiate drug prices and doesn’t set a global budget, in part because it lacks control of enough of the health care system to do so. Not coincidentally, the U.S. ends up spending a lot more on health care. In 2013, Australia spent $4,115 on health care per capita, while the United States spent $9,086, representing 9.4 percent and 17.1 percent of GDP, respectively.
According to a 2016 telephone survey by the nonpartisan Commonwealth Fund, 14 percent of Australians reported having “cost-related barriers to health care access” over the previous year, compared with 33 percent of Americans. Also, 51 percent of Americans reported having difficulty getting access to after-hours care, while 44 percent of Australians said they did.
Sen. Bernie Sanders (I-Vt.) was quick to pounce on Trump’s comment, noting he would quote him on the floor of the Senate.
During Friday’s press briefing, White House deputy press secretary Sarah Huckabee Sanders said Trump was merely offering a compliment.
“The president was complimenting a foreign leader on the operations of their health care system and that it didn’t mean more than that,” she said. “I think he believes that they have a good health care system for Australia. Again that’s one of the biggest things that is wrong with Obamacare. It’s tried to be a one size fits all. That’s the opposite of what the plan is that we’re putting in place right now. It allows for flexibility. What works in Australia may not work in the United States, so again I think he was focused on complimenting the prime minister.”
But soon after Huckabee made the comment, Trump tweeted praise of Australia’s system again.
This article has been updated with Sarah Huckabee Sanders’ comments from Friday’s press briefing and Trump’s subsequent tweet. Jonathan Cohn contributed reporting.