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He’s taking the government out.

"To reduce the number of individuals needing access to programs like Medicaid and Children’s Health Insurance Program" - from Trump's plan.

That's not taking government out, that's just shrinking it somewhat. There shouldn't be a Federal Medicaid plan, period. Any such government health care for the poor and needy should be at the state and local level, as it was pre-LBJ. Return it along with the tax base paying for it. As a fourth generation physician, whose family started providing medical care in the McKinley era, I recall my ancestors being insulted by claims physicians hadn't provided good care to the poor prior to Medicaid. And there REALLY shouldn't be CHIP, which by definition is healthcare welfare for the non-poor, just not wealthy. We did fine before Bill and Hillary added that entitlement.

And although some of his points are good, needed, relatively standard GOP healthcare reform boilerplate: allowing health insurance to be sold across state lines (I wish someone would explicitly mention that's an appropriate use of the Interstate Commerce clause), HSAs and other tax code improvements Mr. Trump still managed to slip a new 'mandate' into his plan, "Require price transparency from all healthcare providers." The government shouldn't be 'requiring' that. Let the market regulate how much and what manner of 'price transparency' is provided. Trump saying 'require' and his repeated comments that he likes this or that aspect of socialized medicine, when I've despised for fifty years, at best earns a "trust but verify" from me.

A government requirement tends to be a one size fit all (poorly) solution. Administrative requirements promulgated by government and its insurance company cronies is making it very difficult for solo practitioners to survive compared to larger groups of physicians. But although larger groups make sense in some circumstances, they don't in all. My great-grandfather was a GP in a rural Iowa county seat. There wasn't, and still isn't there, the mass or density of population to support large groups of primary physicians, much less groups of specialists. I grew up in what passes for urban areas in Iowa with my father being one of only two solo practitioners in his specialty in town. Although economic growth eventually allowed more solo colleagues, Dad remained solo until I joined him. Solo practices were the norm in my field in Iowa and still are common. If only larger groups remain viable, access to timely care in non-urban areas will suffer.

Complaints over any lack of price transparency shouldn't be directed at the physicians, they should be directed at the government and the insurance companies that greatly increased billing complexity. When I joined Dad he gave me a one page typed sheet listing all of his prices as of a few years prior. But insurance mandates had force him to adopt the CPT coding system (instituted to buy off the AMA, which used to be a force for freedom) and soon its logic required a database program to maintain my price lists with hundreds of codes and multiple fee schedules for different payers. Its a royal pain to maintain as part of my government expanded job description. I'd love to return to Dad's one page price list, but the third parties won't pay me from it. A patient paying directly for his own medical care knows what value he's receiving just as he does eating out, buying clothes, etc. But a third party middleman doesn't know what they're paying for unless giving detailed information. They weren't there. Remove the third party payers for the vast number of routine medical encounters that should be relatively inexpensive and remove a vast amount of medically useless administrative costs. And having been personally cheated out of thousands of dollars for legit provided care by blatantly lying Medicare administrative incompetence in the past I have a very different take on 'Medicare fraud' than the politicians who brag they'll reduce it.