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President Donald Trump and former Vice President Joe Biden offered different approaches to healthcare during their debate. Getty Images
  • Several healthcare issues were prominent in Thursday night’s debate between President Donald Trump and former Vice President Joe Biden.
  • On COVID-19, Trump emphasized that the country’s businesses and schools need to reopen soon, while Biden said the government needs to provide businesses with the materials required to reopen safely.
  • On the Affordable Care Act, Trump said the healthcare law needs to be replaced with a new plan that still guarantees coverage of preexisting conditions, while Biden said he wants to improve and expand the program that’s also known as Obamacare.

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Last night’s presidential debate was the final opportunity for President Donald Trump and former Vice President Joe Biden to take the stage together and tackle a number of key health issues at stake in this year’s election.

The event kicked off with a heated discussion around COVID-19, as each candidate shared their opposing visions for reopening the United States, bringing a vaccine to market, and how to get a handle on virus transmission.

Next up was healthcare, specifically the future of the Affordable Care Act (ACA), a law that’s provided health insurance coverage to about 20 million Americans.

Although both candidates agreed on protecting those with preexisting conditions, Trump wants to do away with the ACA, also known as Obamacare, whereas Biden wants to improve it and introduce a new plan called BidenCare.

The debate concluded with both candidates sharing their vision for protecting the environment.

Trump, whose administration has rolled back several environmental protections, prioritizes oil and gas industries.

Biden wants to introduce regulations that will clean up air and water, with the goal of creating jobs.

Here are five key health takeaways from the final presidential debate of 2020.

Trump said he supports opening the country entirely, stating, as he often has, that the “cure cannot be worse than the problem itself.”

According to Trump, the shutdowns have done irreparable damage to people’s livelihoods. The president said that with a disease that has a survival rate of about 99 percent, the country needs to learn to live with COVID-19.

Biden, on the other hand, wants to scale reopenings based on local transmission rates and provide funding and resources — such as personal protective equipment, ventilation systems, rapid testing kits, and plexiglass barriers — to small businesses so they can safely open.

Dr. Anne Liu, infectious disease physician at Stanford Health Care in California, says that in a country with 330 million people, a 99 percent survival rate still means 3 million deaths.

She says reopenings and enforcing the mitigation efforts to help reduce transmission require a nuanced approach that takes local conditions into account.

“As was predicted in the beginning and as has been demonstrated in countries where the virus was controlled without prolonged shutdown, economic recovery cannot really happen unless the epidemic is controlled,” Liu told Healthline.

Trump has been insistent that the country is “rounding the corner” with COVID-19, but data demonstrating surges across the country suggest otherwise.

For example, the United States recorded more than 71,000 new COVID-19 cases on Thursday, the highest 1-day total since July.

Biden says the country needs to wear masks, first and foremost, and quickly get businesses the support they need to operate safely.

It’s true the death rate has significantly decreased from what was reported at the start of the pandemic and that doctors now have a better understanding of how to treat the infection. But experts say we’re not out of the clear.

Infectious disease experts continue to warn that this winter could be a bleak one as coronavirus cases surge and influenza activity picks up.

Dr. Matthew Heinz, a hospitalist in Tucson, Arizona, says although we’ve learned more about COVID-19, its death rate remains much higher than the flu, and cases are currently climbing at an alarming rate.

“We are far from rounding the corner on this pandemic. We are entering the beginning of a third peak in disease activity that has the potential to be the most deadly of the pandemic so far due to the season and coinfection with other pathogens [like pneumonia and influenza],” Heinz told Healthline.

There’s no clear timeline for when a vaccine will get authorization from the Food and Drug Administration (FDA), but most health experts predict we’ll see a vaccine widely available sometime around the middle of next year.

Trump, however, insists that a vaccine will be approved in the coming weeks and potentially be available to some by the end of this year.

“Even if a vaccine were approved today, there would not be enough supply nor the necessary infrastructure to distribute to the entire population simultaneously,” Heinz said.

Frontline healthcare workers, first responders, essential workers, and high-risk groups would be vaccinated first. Then vaccines would be distributed to the rest of the general population.

With that in mind, we’ll likely still be in a “pandemic mode” until at least August 2021, Heinz says.

Trump is looking to repeal the ACA and replace it with a healthcare plan that would still protect people with preexisting conditions.

There are no other details regarding Trump’s plan. Without the ACA or a viable alternative, millions of people could lose coverage.

Biden wants to expand and improve upon the ACA, but if the healthcare law is ruled unconstitutional by the Supreme Court, he would present a plan called BidenCare that would help reduce drug prices, lower premiums, and protect preexisting conditions.

Biden also clarified that he doesn’t want to do away with private insurance plans.

“Making sure that most (all) U.S. citizens have health insurance is critically important, because the care for those uninsured is usually more complicated. They are not seen on time, do not get routine care, cannot get sufficient follow-up, and thus tend to present more sick and suffer more complications,” Dr. Naftali Kaminski, the chief of pulmonary, critical care, and sleep medicine at Yale School of Medicine in Connecticut, told Healthline.

Liu says there’s no good time for a disruption in health insurance, but now — during a pandemic in which 12 million people have lost insurance and millions are contracting the coronavirus — seems like a particularly bad time.

“It would be astoundingly irresponsible to eliminate the ACA without a viable alternative for the millions of people who depend on it,” Liu said.

The candidates also faced off regarding the environmental health of our nation.

Scientists have repeatedly warned that in about 10 years, the damage to our ecosystem caused by global warming could be irreversible.

“Climate change has already begun to affect human health in a multitude of ways, including precipitating food insecurity and water insecurity, and exacerbating respiratory diseases. It may be affecting vector-borne diseases through changes in tick and mosquito activity,” Liu said.

More than 11 million people of color live near chemical plants. Because many of these plants release toxic chemicals, higher rates of cancer and death are reported in these neighborhoods.

Children who live near mining operations, for example, have higher rates of asthma and bronchitis, according to Heinz.

“Air pollution is the biggest environmental risk for early death, responsible for numerous premature deaths each year from lung diseases as well as heart disease, stroke, and other disease,” Kaminski said.

A report from the American Thoracic Society suggests that clean air regulations could save thousands of lives, Kaminski added.

Biden sees climate change as a threat to humanity and believes we have a moral obligation to deal with it.

His plan, which he says has been endorsed by major environmental groups, will create millions of jobs, help clean the environment, and protect our health.

Biden also stated he’s not against fracking and would rejoin the Paris Agreement on climate change.

Trump doesn’t have an official plan to clean up the environment. He has already approved several environmental rollbacks — related to air pollution, water pollution, and the use of toxic substances — and took the United States out of the Paris Agreement, essentially saying he’s not willing to sacrifice jobs and oil and gas industries for the environment.

“When you remove regulations, you get more pollution, not less, which is bad for the health of Americans,” Kaminski said. “It is really extremely worrisome.”