Does Trump have a plan to reform healthcare in America?

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0:31Because Schwab knows that when it comes to your finances, choice matters. No matter your goals, investing style, life stage or experience, Schwab has everything you need, all in one place, so you can invest your way. Visit schwab.com to learn more. Has Donald Trump just said the quiet part out loud? Has he told us what he really thinks about Europe? I think they're weak, but I also think that they want to be so politically correct. I think they don't know what to do. Europe doesn't know what to do. So that was Donald Trump talking to Politico about what he sees as the dangers of European immigration policy.

1:12And he went on to call some of those countries weak and decaying. We want to unpack what else he had to say and what all of this means for America's relationships with its traditional allies. What could it mean for NATO? What does it mean for all of us? Welcome to America.

1:29americast americast from bbc news when donald trump calls they say yes sir right away sir happy to lick your boot sir we are the sickest country in the world oh dear are you worried that billionaires are going to go hungry of course the president supports peaceful protest what a stupid question are you still talking about jeffrey epstein

1:54Hello, it's Sarah here. And today I'm actually at home in Georgetown in Washington. And it's Anthony. I'm also at home, not your home, my home, across the river in Arlington, Virginia. Yeah, not that far away. Now, Anthony, on Monday we were talking about the new national security paper that has been published by the White House, which has pretty coruscating criticism for all of European countries in it. Well, now Donald Trump has given an interview to Politico. And so we've heard from his own lips that kind of criticism as well. And I mean, he is being very, very harsh about European leaders.

2:28Yeah, he didn't pull any punches. Trump was talking to Politico's Dasha Burns. It was an interview recorded Monday night. It covered a lot of ground, not just on US security strategy and Europe, but also on health care reform and the economy. We'll get to all of that later in this podcast. But the relevant part was the talk about Europe. Politico had named Donald Trump the most influential person shaping Europe. This is a list that they have been coming out with for decades. But this was the first time an American has been named at the top of that list. And Donald Trump had lured Donald Trump into sitting down for a pretty lengthy interview.

3:08That's really interesting, isn't it? That it was because he was being awarded this status on their published list that he agreed to do an interview with a publication which he doesn't really like that much. And it did make me think immediately, we've got to just come up with some kind of AmeriCast peace prize like FIFA did or most influential person in the universe AmeriCast award. And then we'll get to run the podcast. I think that's a great strategy. We're going to have to put our heads together and come up with a ghoulish trophy we can give him as well. We should concentrate on what he did have to say to Politico once they had scored this interview, because he also made it very clear that on the list of European countries and European leaders that he was criticizing so harshly, the UK is included.

3:48And you can tell that when you listen to some of the interview. How much should European leaders prepare for your administration to push to reshape the continent's politics? Well, Europe is a different place. What do you mean by that? And if it keeps going the way it's going, Europe will not be, in my opinion, many of those countries will not be viable countries any longer. Their immigration policy is a disaster. If you take a look at Paris, it's a much different place. I loved Paris. It's a much different place than it was. If you take a look at London, you have a mayor named Khan. He's a horrible mayor.

4:23He's an incompetent mayor, but he's a horrible, vicious, disgusting mayor. I think he's not a terrible job. London's a different place. I love London. I love London. And I hate to see it happen. You know, my roots are in Europe, as you know. Right. And I hate to see that happen. This is one of the great places in the world. And they're allowing people just to come in and unchecked, unvetted. So how involved are you going to get? I mean, could we see you getting involved in European elections, for example? I want to run the United States. I don't want to run Europe. I'm involved in Europe very much.

4:58Might you endorse candidates? NATO calls me daddy. I mean, I have a lot to say about it. Look, I raised GDP from 2 % to 5%. The 2 % they weren't paying and the 5 % they are paying. You know, sir, it's sometimes hard to tell when you say these things. Do you intend to send kind of a message of tough love to our allies to push them to make reforms? Or do you think that many of them are just weak and you don't really want to be allies with them? I think they're weak, but I also think that they want to be so politically correct. I think they don't know what to do. Europe doesn't know what to do. I have no vision for Europe.

5:35All I want to see is a strong Europe. Look, I have a vision for the United States, America first. It's make America great again. I do explain to Europe because I think, you know, I'm supposed to be a very smart person. I have eyes. I have ears. I have knowledge. I have vast knowledge. I see what's happening. I get reports that you will never see. And I think it's horrible what's happening to Europe. I think it's endangering Europe as we know it. So that's Donald Trump making very clear his views on how European countries are in particular running immigration policy. But of course, that national security paper also criticised and what they said was censoring free speech and trying to suppress political opposition, particularly on the right wing.

6:21Anthony, to what extent do you think Donald Trump is putting Europe on notice that if they don't change, their relationship with America is going to change? Or is this just him expressing his view about what he would do if he was in European leaders' positions, but it's up to them how they actually carry on? Well, with Donald Trump, you're never quite sure. I mean, in that same interview, he went on to say that he liked the crew that was in charge of Europe at this point, and that some of them were very good friends, some of them he doesn't like, but some of them he's friendly with. But if you pair what he said there with what's in this national security document, I think you do see a picture of the United States that is charting a path that's a different direction from Europe.

7:04They're warning Europe, if you don't become more like Donald Trump's America, if you don't change your immigration policies, If you don't spend more on your defense, if you don't preserve your cultural heritage. And in that document, as we discussed on Monday, it was to talk about the danger of Europe becoming majority non-European. And if Europe doesn't do that, then the United States will either one look to try to pry off some of the European countries that are more friendly to the United States, countries like Italy and Hungary and Poland. They were named explicitly in the unreleased document, national security document that we've heard reports about, but also then just go without Europe.

7:46There was also in that classified version of the document that wasn't publicly released. There was a proposal to form what's called a core five of world leaders. And that core five that would meet in the same way that the G7 meets is the United States, Russia, China, India and Japan. And Sarah, guess who's not on that five? Wow, that's really, really interesting because that's not the same five of the UN Security Council, or as you say, in the G7, or whom you would traditionally expect to be partnering with the United States. If that's in the classified section, Anthony, how come you've read it?

8:21Well, these are reports. It was circulated. Some media outlets have looked at it, have analysed it. It hasn't been publicly released yet, but it was a longer version before this shorter, unclassified version was released. Tell you what's really interesting. There are three British cabinet ministers visiting Washington this week, all on separate trips, just coincidence that they happen to be here. But of course, there was some nervousness when over the weekend, they read the national security paper being so very, very critical of European policy. And they knew that meant the UK as well. They didn't know what kind of reception they were going to get when they came to meetings with the White House and other senior Trump administration officials.

8:59Well, I spoke to one of them yesterday who told me you wouldn't know anything had changed at all, that they're being very warmly received. There are friendly talks and negotiations going on, that they're getting really good access to very senior administration officials. And that any fears they had that there might be some kind of chilling effect from all of this criticism of European countries, is that you wouldn't have noticed any difference whatsoever when you're dealing with the administration on specific things. If you've got one thing you've come to talk to them about, then they'll engage with you as though the UK still was America's best friend.

9:32And this makes no difference. But of course, it could have a wider difference when it comes to, say, foreign policy or even dealing with the US over Ukraine. And this national security document, it's a year plan. And it is the first one released at the start of the second presidential term. And then it kind of does set the framework, the goals that this administration has. And maybe we're not there yet. But, you know, if you chart a course in a different direction, you may start in the same place. And then after four years, you will see a United States and a Europe that are in two very different places.

10:08And I think, you know, you saw when we were listening to that clip, Donald Trump kind of hemmed and hawed about whether he would endorse right wing candidates in Europe. He has in the past, though, in Germany, endorsed the AFD, the right wing party there. And in that national security document, in the publicly released version of it, it said that the United States would support politicians and parties that would resist the current trajectory of Europe. So I think it's a very explicit threat that the United States is going to start meddling in European domestic affairs. And I can't imagine if the United States does that regularly.

10:49I mean, already we're seeing European leaders chafe at that idea in the same way that Americans would be very upset if Europe started endorsing and supporting candidates here. Yeah, British prime ministers have come out and supported one or other presidential candidate. I mean, albeit from one of the two mainstream parties. But yeah, I mean, views have been expressed about who they would rather see be president of the United States. There was something else in the interview, which went a bit further than the national security paper, which was when Donald Trump was talking about Ukraine. He was criticizing European countries who have been trying to intervene on Ukraine's behalf, saying they just do a lot of talking, but they never come up with any serious proposals.

11:25But he was also sounding incredibly sympathetic towards Russia and a bit hostile to President Zelensky, who I think would be very worried listening to that interview because he was saying, look, Russia has the stronger hand in negotiations and essentially they're going to win. On Sunday, your son, Donald Trump Jr., responded to a reporter's question about whether you will, quote, walk away from Ukraine. And your son said, I think he may. Is that correct? No, it's not correct, but it's not exactly wrong. We have to, you know, they have to play ball if they don't read agreements, potential agreements.

12:02You know, it's not easy with Russia because Russia has the upper hand. And they always did. They're much bigger. They're much stronger in that sense. I give Ukraine a lot of, I give the people of Ukraine and the military of Ukraine tremendous credit for the, you know, bravery and for the fighting and all of that. But, you know, at some point, size will win generally. He would say that President Zelensky basically had to start accepting some of the proposals that were being put by American negotiators and just accept that he cannot win this war and basically get on board with the American plan, which was, I think, as explicit as we've heard him be since this round of negotiations started about saying, yeah, basically he's going to side with Russia on this and Ukraine just has to accept, well, as he famously said in the Oval Office, that they just don't have any cards to play.

12:53Right. I think there's clearly Donald Trump becoming more frustrated by the lack of progress. And when he gets frustrated, he starts to blame Zelensky more than Putin. And that has been kind of the path we've seen over the past year. Every so often he does take a few swipes at Putin. But when push comes to shove, he seems to think it's Zelensky and the Ukrainians, not the Russians, that are going to have to give some ground and give physical ground, give territory in order to reach some sort of a peace. And in that national security document as well, there was only one mention of Russia. I don't know if you saw that.

13:36I mean, Russia was pretty much just kind of glossed over a lot more focus on the Western Hemisphere, on Europe, even more mention of China. I think the only mention of Russia was that some Europeans view Russia as an existential threat without without offering any even kind of judgment on whether that's true or not. It's like, well, Europeans are worried about Russia. And that was it. So I think we probably shouldn't be surprised that the Russian foreign ministry came out with a statement after that document was released saying that there was a lot of stuff to build on there. And they were kind of happy with the direction that was showing.

14:11Yeah, good week to be in Moscow, clearly, if you're listening to what Donald Trump's got to say. He was also, I thought, really interesting on some aspects of domestic policy, because he was quite forthcoming in this interview. It felt as though he was offering more detail than you often do. You often get in an interview with him when sometimes it can just all be a lot of bluster. But actually, he was kind of properly engaging with topics. And he was talking about health care, which is an ongoing battle in Congress, obviously. And I think potentially a really difficult moment for Republicans in this administration because healthcare premiums for people who use what's called Obamacare could double, triple even really quite soon because the Republicans have not voted to extend government subsidies that were bringing the prices down.

15:00How much of an issue do you think this is going to be, Anthony, when this actually happens, when people have to start paying these premiums? Is it going to turn people who voted for Donald Trump against the administration? Well, it's already turned some of the Republican politicians who have been with Donald Trump through thick and thin against him. Marjorie Taylor Greene obviously had a very dramatic break with Donald Trump. One of the things she was saying before she announced she was leaving Congress was that ending these health care subsidies was going to hurt the white rural voters who have supported Trump in the past.

15:32That is not just targeting Democratic constituencies. There are Republicans, poor Republicans, who are benefiting from the lower health insurance rates because of these subsidies. And the things that you'll hear from other Republicans who say they want to get rid of them was that these higher levels of subsidies came during the covid pandemic. They were supposed to be temporary. They weren't supposed to be permanent. So now after the pandemic's over, they're just sunsetting them away. But I guess once, you know, tens of millions of Americans get used to paying a little less for health insurance, sometimes a lot less for health insurance, to have that taken away rather dramatically.

16:10suddenly, it can really sting. And that's already being felt. There are already Americans getting their invoices, their proposals for how much they have to pay for health insurance for the coming year. Those letters have already gone out in many cases, and they're seeing exactly how bad it is. And I think there will be anger, and the anger will be directed towards the party that's in power and the party that the Americans view as blocking an extension, which at the moment is the Republicans. And help us, Anthony, help me, in fact, understand exactly what kind of people we're talking about, because a lot of Americans get health care insurance through their employer.

16:49And so they don't end up having to pay a fortune for it. Although, of course, it's terrifying if you lose your job and you lose your health care cover at the same time. Who is it who is having to directly purchase their health care? Well, people who either are unemployed or people who are working jobs where they don't get health insurance subsidized by their employers. And even people who work for employers, most Americans get their health care that way. They still have to pay some. In some jobs, you pay thousands of dollars a month to insure your whole family, even with your employer taking part of the burden of those payments.

17:27But the tens of millions of Americans who get health insurance through these government-run marketplaces that were set up with the Obamacare health insurance reforms in 2010, that were rolled out in 2011 and 2012, those are people who, for one reason or another, aren't getting health insurance from their employers. They're not old enough to get the Medicare health insurance program, government run health insurance program for the elderly. I think that kicks in at 65. They aren't so poor that they can qualify for Medicaid, which is a government subsidized, government run health insurance program for the poor.

18:06So they're caught somewhere in the middle. And that's a pretty big chunk of the American population because not everyone has jobs. You're working maybe minimum wage jobs. Maybe you're working for a job for yourself. You're doing the gig economy, that sort of thing. This is the way you get health insurance to avoid getting caught with a major medical bill with no way to pay for it. And that's what the whole Obamacare system, that's who it was targeting. But Republicans have always hated it, haven't they? It's always been a longstanding Republican promise to get rid of Obamacare. But I've never heard a sort of properly thought out plan of what to replace it with.

18:48I think even there's a vote coming up, isn't there, in Congress on Thursday this week about this. But again, it's not clear exactly what kind of health care plan they would want to replace it with. Yeah. What was the thing that Donald Trump said during his debate with Kamala? Oh, he didn't have a plan for health care reform, but he had the concepts of a plan, he said in a debate. And what we will do is we're looking at different plans. If we can come up with a plan that's going to cost our people, our population less money and be better health care than Obamacare, then I would absolutely do it.

19:19But until then, I'd run it as good as it can be run. So just a yes or no, you still do not have a plan. I have concepts of a plan. And during his first presidential term, he said that the Republicans were going to have a beautiful health care plan. It was going to come out, I think, two weeks. I mean, it was it was one of those ones where, you know, a big Republican health care plan was always just around the corner. And of course, they never have, because the challenge is how do you reduce government involvement, government spending on health insurance, but still ensure that health insurance, private health insurance companies provide the kind of support, the kind of care, the kind of coverage that will allow Americans to be able to afford health care.

20:06I mean, there's a very real conflict there that you can't get around. You have to spend money. You have to regulate in order to keep prices down. If you don't do that, then it's the private sector running. And Americans sometimes make bad choices on health insurance. They pay for ones that may be cheap, but when push comes to shove, they don't get the kind of coverage that they think they have. And they end up with huge medical bills. If you want to guarantee things like an access to health insurance, you have to have the government to mandate that. One of the things before Obamacare kicked in was that if you had a pre-existing condition, say had some sort of a medical condition and you tried to get health insurance, you could either be denied outright.

20:44An insurer would say, we're not going to cover you. You're too expensive. Or your rates could go through the roof. And that is one thing that Obamacare changed. So you scrap Obamacare, you're back to that that kind of a rough and tumble system where a lot of people went bankrupt because they got sick and they couldn't get insurance or they got sick and their insurance was canceled. and then they had no means to pay for it. Well, let's listen again to what Donald Trump himself was saying about it in this political interview with Dasha Burns, where he didn't even seem to, I didn't think, seem entirely clear about what his own proposals were, although they were similar to what you were suggesting there.

21:18Let's have a listen. What I want to do, very simple, I want to give the money to the people, not to the insurance companies. People are buying their holiday presents. They're planning... Look, don't be dramatic. No, no. Don't be dramatic. They're planning their budgets for next year, Mr. President. I know. And what I want to do is help them. So will your premiums go up? I'm giving them money. I want to give the money to the people to buy their own health care. That's a good thing, not a bad thing. The Democrats don't want to do that. They want the insurance companies to continue to make a fortune.

21:48The Democrats are owned by the insurance companies. They want the insurance companies to get this trillions of dollars. We spent trillions of dollars goes to the insurance companies. I want that money to go to the people and let the people go out and buy their own health care. It works like magic. But you know who doesn't want it? The Democrats, because they're corrupt people, because they're totally owned and bought by the insurance companies. So at this point, most likely, premiums will go up and you will find another plan? Well, your premiums could go down if you did what I want to do. That's going to take time, sir.

22:24Ready? I want to give the people better health insurance for less money. The people will get the money and they're going to buy the health insurance that they want. Yeah, sounds simple. We'll not be in order to put it into practice. And whilst we're talking about the political harm that this could potentially already be doing, you've got news, Anthony, haven't you? You have a couple more special elections that have taken place. Yeah, actually, there was one in Miami. It was a mayoral election. It was a runoff election. And a Democrat there comfortably won the Miami mayorship for the first time in 30 years.

23:01Now, Miami City, Kamala Harris barely won that last year by about a percentage point. And here the Democrat won by double digits, I think even more than 20 percent. And also Miami County last year, which is the larger county surrounding Miami, Miami-Dade, Donald Trump won that last year. So it's a sign that a Democrat, once again, focusing on affordability, on local issues, on addressing the high cost of living, the high cost of housing, was able to win in a place where Democrats haven't won. And there's another one, a special election to fill a state house, a state legislature seat in Georgia.

23:39And we've talked about Georgia in the past. It's a key battleground state, one that Republicans lost in 2020, but then Donald Trump won in 2024. A Democrat flipped a seat that was held by a Republican that Donald Trump carried last year by 12 percent. That Democrat won narrowly by about one, one and a half percent, but won that seat. Another pickup for Democrats. And I think it fits with what we're seeing nationwide, which is that during these special elections this year, Democrats have been performing roughly between 10 and 15 percent better than they did last November. So if there's a seat that Donald Trump, Republicans carried by less than 10 percent last year, this year they're losing those seats.

24:26And if that continues, that trend continues into next year's midterm congressional elections, then you could see Democrats pick up easily enough seats to take back control of the House of Representatives and maybe even put the Senate into play. So yet another warning sign that these affordability concerns, these economic concerns are taking a toll on the Republicans and that if they don't do something to address them, if Donald Trump doesn't do something to address it, they could be in for a very rough year next year. Now, Anthony, we've talked before about two really big cases that are going to come up before the Supreme Court.