Two weeks ago I posted my top question for both Presidential candidates so I decided to expand on that question and post my second question.

If we have a recession in your first term, what will you as President do differently with economic policies than was done in 2008?

The reason for this question is that the economy is weak and the chance for a recession is increasing.

•  Deutsche Bank and JP Morgan said in June that the chance of a recession in the next twelve months is between 36% and 60%.
• The 1% GDP growth for the first two quarters of 2016 is sufficiently weak that a slight miss can easily drive the GDP negative and unemployment up.
• Health Services Grew Almost 12 Times Faster Than Non-Health GDP.  Since 2015 the increase in health care spending has resulted in flat retail sales. This health care driven economy is different than the consumer driven economy we have experience with. The health care driven economy has very narrow benefits to the overall economy compared to the consumer driven economy. Based on the GDP numbers over the last year and a half, it looks like we can have either a health care driven economy or a consumer driven economy but not both.
• I think after 8 years of zero interest rates the wealth given to the banks did not trickle down to the American people.

The crucial distinction between a recession in 2008 and 2017 is that there are few if any policy options left.

• With interest rates between 0% or 0.25% there is almost no benefit from lowering rates.
• Weakening the dollar to increase exports is a risky policy, too. It could cause capital flight and increased interest rates.
• It has been a Chinese goal to replace the dollar with the SDR as the reserve currency. To achieve that objective China will trade in a portion of its dollar debt for SDR based debt. This will probably cause increased interest rates.
• Can the Federal Reserve continue to expand its balance sheet in a rising interest rate environment without international repercussions?
• Can we learn anything about potential policies addressing a 2017 recession from Mr. Trump’s casino problems in Atlantic City?

My second question is what will you as President do differently concerning health care policies than was done in the Affordable Care Act?

The reason for this question is that if the ACA cannot continue in its present form so how do we address a sustainable reform?

• The health exchanges of the Affordable Care Act are probably in a death spiral.
• President Obama, Mr. Gruber, and other Affordable Care Act supporters have a trust problem with the middle class. The lies they told the middle class about the Affordable Care Act may be forgiven but they are not forgotten. Lying has consequences.
• We have two separate health care problems, a spending problem on high cost chronic care customers and an insurance problem with the healthy customers.
• The big idea for the Affordable Care Act was to dump high cost chronic care patients on the smallest health insurance market. A smarter idea would be move to high cost chronic care patients to either Medicaid or Medicare and let the health exchange work like a free market for healthy customers. If society has a moral obligation to provide affordable health care to high cost patients than it makes sense to spread these costs across a much broader base. Making a small group of healthy customers pay society’s cost for the high cost patients is the recipe for a death spiral.
• We have an extremely complex way of subsidizing health insurance.. The Affordable Care Act prepays health insurance subsidies to insurance companies for low income people and uses the IRS to check compliance. If we are concerned about making a more efficient health care system than a simple re-design would avoid the money spent by the IRS on compliance.
• As a person who started work in 1976 I have always had the option of affordable health insurance. As a recently as 2011 health insurance cost me $311 a month. By 2016 my grandfathered plan had increased 76% over my 2011 premium of $311 to $547. This increase is much greater than the increase in inflation and is an extravagant increase for a person who has not filed an insurance in over 16 years. The situation in the exchanges is unfortunately much worse. The lowest cost 2016 bronze plan would cost me $1,025 a month. This is 87% higher than my 2016 grandfathered plan and far higher than the 8.05% the IRS had declared as affordable.  Despite being the perfect insurance customer I can no longer find affordable health insurance. In 2017 I will go without health insurance.
• According to a study from the Mercatus Center the states that expanded Medicaid under the Affordable Care Act have seen enrollment higher than expected and the cost of individual enrollees has been more expensive than projected.