Donald Trump’s Gold-Plated Health Care

Shortly after returning to the White House last night, Donald Trump tweeted out a triumphant video in which he urges Americans not to let the coronavirus “dominate your life,” because “we have the best medicines in the world.”

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That was true of Trump’s stay at Walter Reed National Military Medical Center, during which doctors threw the kitchen sink of COVID-19 medicines at him while he relaxed, knowing his bills would be covered. Of course, keeping presidents healthy, and restoring them to good health when they’re sick, is in America’s national interest. But Trump’s comments on his experience might give people the false impression that most Americans would get the same quality of care he has received, which is simply not true. For the average person hospitalized for the virus, specialized treatment for COVID-19 would be less immediately accessible, less comprehensive, and much more expensive.

The president’s everyday health care is already very luxurious. He receives free care from the White House Medical Unit—a robust team that staffs an on-site, miniature urgent-care facility inside the White House and sometimes travels with the president. U.S. Naval Commander Sean Conley is the head of this unit and serves as the president’s physician. Conley is in the unusual position of reporting to his patient, the commander in chief, and risks being fired if he makes a false move.

Here, Trump stands in stark contrast to most people, who don’t have doctors at their beck and call: A third of U.S. adults have said in surveys that they do not fill a prescription, see a doctor when sick, or get recommended care because of the cost of health care.

For more advanced medical care, Trump goes to a military hospital such as Walter Reed, where his suite includes offices, conference rooms, and a private living space. To get to and from the hospital, Trump has access to a helicopter and Secret Service staffers. For everyday people, ambulance fees are the largest source of unexpected medical bills.

From the very start at Walter Reed, the president’s COVID-19 treatment surpassed what most people would receive. Fewer than 10 compassionate-use requests have been granted for Regeneron’s experimental antibody cocktail, which the president took Friday, according to the company spokesperson Alexandra Bowie. The president was, presumably, one of those 10 people. “He would never have gotten access to the monoclonal antibodies if he weren’t the president,” says Rose McDermott, an international-relations professor at Brown University who has studied presidential illness.

Presidents also receive faster access to better specialists, in part because few can refuse such an important patient. (As Rob Darling, the White House physician for Bill Clinton, told the Los Angeles Times, “If the president comes to us this morning with a mole on his cheek, a dermatologist will be seeing him today.”) This might not always be a good thing, since VIPs like the president are sometimes overtreated by their starstruck doctors. Regardless, too much quick access to specialists is not a problem most Americans have: 51 percent struggle to find care in the evenings and on weekends without going to an emergency room, according to the Commonwealth Fund.

At one point, the president was allowed to leave Walter Reed before he was discharged to take a joyride and wave to his supporters. Though few contagious people would ask to do this, it’s unlikely that a hospital would let them if they tried. “They would never, ever let anybody else do that,” McDermott says. (A spokesperson for Walter Reed told me, “Our COVID-19 treatment plans are uniquely tailored based on the presentation of each individual patient, and these treatments also adhere to the most updated national societal guidelines.”)

For Trump’s four-day stay at Walter Reed, the hospital will bill the president’s health insurance, the White House spokesperson Judd Deere told me. Though Barack Obama bought his own health insurance through the Affordable Care Act’s health-insurance exchange, it is not clear which insurance plan Trump has. Deere said that “the president received the same health-insurance options that are available to all federal employees.” He may have been referring to the Federal Employees Health Benefits Program, for which the government pays the majority of the premiums. (Here, too, the president differs from some of his countrymen, 8.5 percent of whom are uninsured—more than were uninsured when Trump took office.)

For the average American, a hospital stay for COVID-19 would rack up quite a bill. Remdesivir, one of the antiviral drugs Trump took, costs insurers $3,120. For someone insured by a large employer, being hospitalized for COVID-19-related pneumonia could cost more than $1,300 out of pocket, according to an analysis from the Kaiser Family Foundation, and someone insured by a small business might pay even more. Without insurance, the bill would be more like $73,000. People the president’s age would likely be on Medicare, which would charge them $1,408 for their COVID-19 treatment, not including any extended stays or rehab, according to the Kaiser Family Foundation analysis.

If a nonmilitary American had been rushed to a military hospital such as Walter Reed, they might be faced with an even larger and more relentless medical bill. Civilians currently owe about $198 million to military hospitals for medical treatments, as I reported in January, and unlike nonprofit hospitals, the facilities are required to take “aggressive action” to settle outstanding debts.

Even as Trump was receiving treatment at Walter Reed, his administration was continuing to fight in court to overturn the Affordable Care Act, the 2010 law that dramatically reformed health insurance in this country, prohibiting discrimination against people with preexisting conditions and eliminating lifetime limits on insurance benefits. Trump has repeatedly promised to come up with a replacement health-care plan for the country “very soon,” but has failed to do so. If the ACA were deemed unconstitutional, someone like Trump, who has had COVID-19, could be discriminated against for having a preexisting condition.