by Thomas Meek
LONDON, Nov 9 (APM) - Republican Donald Trump defied expectations to take victory in the U.S. presidential election late on Tuesday, in a result that will likely have a major impact on healthcare in the country.
Trump's triumph over Democrat Hillary Clinton, who was strong favourite to become the first female president of the U.S., was confirmed with his victory in Wisconsin, which put him over the 270 out of 538 electoral college votes needed to win the White House. His win already looked likely earlier on, as he took key states such as Florida, Ohio and North Carolina.
In a speech in New York to announce the success after an extremely divisive campaign, he said: "I just received a call from secretary Clinton. She congratulated us on our victory."
"Hillary has worked very long and very hard over a long period of time, and we owe her a major debt of gratitude for her service to our country."
He added: "It is time for us to come together as one united people."
Although the Trump campaign focused on immigration and Islamism as its key issues, it is expected that the Republican administration under his leadership will impact healthcare in the U.S. after he takes office next year.
At the top of the agenda is repealing the Affordable Care Act, also known as Obamacare, which was introduced by current president Barack Obama in 2010 to expand coverage of state health insurance programme Medicaid to millions of low-income Americans.
A post on Trump's website says that U.S. citizens have "had to suffer under the incredible economic burden" of the act, commenting that it has resulted in runaway costs, greater rationing of care, higher premiums, less competition and fewer choices.
"On day one of the Trump administration, we will ask Congress to immediately deliver a full repeal of Obamacare," says the post, which puts repealing Obamacare as one of seven key goals in healthcare.
Instead, the Trump regime will favour following free market principles to create sound public policy that it says "will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans".
Another healthcare pledge on Trump's website that will impact pharma companies more directly is the removal of barriers to entry into free markets for drug manufacturers. This would open up the U.S. market to imported drugs from overseas, giving more options to consumers.
"Congress will need the courage to step away from the special interests and do what is right for America," says the post. "Though the pharmaceutical industry is in the private sector, drug companies provide a public service."
At the start of the year, Trump also called for national social insurance programme Medicare to be able to negotiate with pharmaceutical companies to lower drug prices. This is a policy long backed by Democrats, including Bernie Sanders, who was a competitor to Hillary Clinton for the Democratic presidential nomination.
Trump told a crowd in Farmington, New Hampshire, in January that this could save Medicare billions of dollars a year, before criticising the industry for not allowing the practice.
"We don't do it. Why? Because of the drug companies," he said.
Trump has also weighed into the wider drug pricing debate, calling out Martin Shkreli as a "spoiled brat" after he was widely criticised in the media for hiking up the price of a life-saving drug used by patients with HIV and Aids during his time in charge of Turing Pharmaceuticals.
In a press conference in September 2015 at the University of South Caroline Koger Centre, he said: "This young guy raised the price to a level that's absolutely ridiculous, and he looks like a spoiled brat to me… I thought it was a disgusting thing, what he did. I thought it was a disgrace."
Other healthcare proposals among the seven listed on Trump's website include allowing the sale of health insurance across state lines; allowing individuals to fully deduct health insurance premium payments from their tax returns under the current tax system; and allowing individuals to use tax-free health savings accounts.
The campaign also calls for price transparency from all healthcare providers, especially doctors and healthcare organisations like clinics and hospitals, and to turn Medicaid funding into a block grant to states.
The post says that the economic burden of providing healthcare will be eased through other policies as well, including Trump's plans to curb immigration, with healthcare for illegal immigrants said to cost $11 billion annually.
"If we were to simply enforce the current immigration laws and restrict the unbridled granting of visas to this country, we could relieve healthcare cost pressures on state and local governments."
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