Based on their recent comments, perhaps President Donald Trump and some other Republicans are getting ready to embrace universal health care. 

Universal health care involves some form of the government ensuring everyone has medical coverage at little or no out-of-pocket cost, beyond what people pay in taxes. Many countries, including much of western Europe, have some form of universal health care. 

The United States does not, even though various Democrats, ranging from Harry Truman to Barack Obama, from Kamala Harris to Bernie Sanders, have embraced some form of universal health care at some point in time.

Republicans have portrayed universal health care as the bogeyman, as socialism, as the worst thing that could happen to the United States and would eventually lead to capitulation to Russia.

Yet, Trump and others seem to be warming up to the possibility.

In recent weeks, congressional Democrats have been fighting to extend enhanced subsidies for private insurance purchased on the Affordable Care Act’s marketplace exchange – a fight that was at the center of the 43-day federal government shutdown that ended last week. The federal subsidies pay a significant portion of the cost of the health insurance purchased on the exchange.

Trump recently posted on social media, as he is wont to do, that instead of providing these subsidies to big insurance companies, he would prefer to give the money for health care directly to the American people.

How would this work? He didn’t say, but that did not stop many Republicans from embracing the idea. And it does not appear many Republicans voiced concern about such a scheme.

But according to the Congressional Budget Office, as explained in an MSNBC article by Miranda Yaver, a University of Pittsburgh assistant professor of health policy and management, the health insurance companies received about $92 billion in federal ACA subsidies in 2023. During the same year, just the out-of-pocket costs – those not paid by the insurance companies – totaled $500 billion for Americans.

So, in short, if Trump diverts that $92 billion from insurance companies to individuals, there also must be a method to pay for the additional costs of health care Americans will incur.

The amount of the subsidies each individual would receive will not cover the cost of a serious illness or accident. Would the people facing major medical expenses be left to face the impossible-for-most task of paying those tens of thousands of dollars in health care costs by themselves? Or would they need some, gulp, insurance, to help pay for those additional costs?

Insurance, love it or hate it, exists to level the playing field. By having a large number of people on insurance, the costs paid by those with expensive medical needs are held down by those who have insurance but seldom or never have to use it.

So, all this begs the question: What is the answer for those, like President Trump, who don’t like subsidizing big insurance?

The obvious answer to that question is, drum roll please, universal health care coverage, often referred to as Medicaid and Medicare for all or a public option.

Universal health care could be fashioned a number of ways. People could be expected to provide, as Republicans like to say, some “skin in the game” by paying for some of the costs themselves.

It could be a program where, if you have private insurance and you like your private insurance, you can keep it just as long as it is not paid for with federal dollars.

President Trump and others have been obsessed with getting rid of the Affordable Care Act. The president seems upset that it is called Obamacare.

It is important to note that it was first labeled Obamacare by those who opposed the legislation that was passed way back in 2010. But now that polls show it is popular, Trump seems upset that it is called Obamacare.

As a matter of fact, he said that money for health care being sent directly to the American people “would be so exciting. Call it Trumpcare. Call it whatever you want.… Anything but Obamacare.”

Perhaps Democrats, many of whom always supported universal health care as the most logical way to deal with an often broken and complex American system, could achieve that goal by just agreeing to call it Trumpcare.