What Clinton and Trump are ignoring

By now we’ve heard all the sound bites a million times. Seen the tweets. The talking points. Hillary Clinton’s a “liar,” Donald Trump’s a “fraud.” Email servers. Nuclear codes. Immigration. Gold Star families. “Mexican” judges. She won’t release her speeches because it might be embarrassing. He won’t release his tax returns for the same reason.

The broad theme that both of these nominees is trying to drive home is one of character — namely that the other one doesn’t have an ounce of it.

Is this it? That’s all we get? Ninety-eight more days of sleaze and dirt? It’s too bad, because there are tons of critically important issues — things that will truly affect lives over the next four years — that need more discussion. Here are a few of many that come to mind:

Drought, water — and jobs

Take water for granted? Big mistake. Much of the country has been hit for years now by shortages. In our two biggest states — California and Texas — home to some 67 million people, jobs have been lost and economic growth stunted. Clinton has said practically nothing about this, other than to blame leaky “water systems (that were) built before our time.” To her it’s an infrastructure issue, not an unreasonable point given the hundreds of water mains that break daily in this country. For his part, Trump, in California, claims “there is no drought,” blaming bureaucrats and environmental regulations for the state’s water woes.

Entitlements, the deficit and debt

Fact: over the next eight years, 75% of the federal budget is projected to go to entitlements (Medicare, Medicaid, Social Security) and interest on the federal debt. These spending programs are on autopilot; the money’s going out the door no matter who wins. And with 10,000 baby boomers retiring every day (a trend that will continue for years to come) entitlement spending will soar. The deficit — down 70% since 2009 — is projected to go right back up, topping $1 trillion by 2025 unless something is done.

Despite this coming gusher of red ink, neither Trump nor Clinton propose monkeying around with entitlements. Trump says cutting the budget elsewhere will rein in costs. Yet all he’s really proposed so far is eliminating the Department of Education (including Pell grants for low-income students), and the Environmental Protection Agency. That’s about $86 billion.

Trump also complains about foreign aid — but doesn’t seem to know it’s less than a penny of every federal dollar spent. What about the ever-popular “waste, fraud and abuse?” Even one of Washington’s top budget hawks, California Republican Darrell Issa, says this is about 7 cents of every federal dollar. Trump’s plans are like trying to soak up the ocean with a sponge. Why aren’t reporters pressing him on this?

Clinton, too, needs to answer more questions. She’s proposing $1.6 trillion in budget savings over the next decade — but $1.8 trillion in new spending. The nonpartisan Committee for a Responsible Budget credits her for detailing how she’d pay for her ideas but says she “fails to address our national debt,” which will continue to soar. Bottom line: If you think we’re up to our necks in debt now, it looks like it’ll get worse — no matter who’s in the White House.

Drug shortages

For all the candidate talk about the important issues of terrorism and violence on the streets of America, there has been practically nothing said about preventing another killer: big nationwide shortages of drugs that hospitals rely on to save lives every day. In 2010, the U.S. Government Accountability Office reported new or ongoing shortages of 328 drugs. Last year it reported 427.

“There’s no doubt that patients are suffering because of this market failure,” says Dr. Erin Fox, director of drug information at the University of Utah who has been tracking drug data since 2001. “When a patient needs a drug that’s in short supply, alternative medicines are sometimes prescribed — but because these alternative drugs aren’t as well-known, they can be applied improperly, or in the wrong dosage. Even when the proper drug can be obtained, delays in patients not being treated on time can also cause harm.”

All of this makes it hard to quantify the number of deaths directly attributable to shortages, Fox says — but adds there’s no doubt that there have been fatalities.

On the front lines — in hospitals, where doctors and nurses are working to save lives, here’s what it’s like. In a recent article in The New York Times, Dr. Yoram Unguru of the Children’s Hospital at Sinai in Baltimore was quoted as saying: There are “two kids in front of you, you only have enough for one. How do you choose?”

What’s going on? Business practices at pharmaceutical companies, manufacturing problems and government delays in approving new drugs are three reasons. Want to save lives? Mrs. Clinton and Mr. Trump? Pay attention to this.

China: Connecting the dots

We all know Trump wants to hike trade tariffs with China. The wisdom of that has been endlessly hashed over by others, so here’s a different question: How does Trump think he’s going to be tough with China — and then expect its leaders to lift a finger on other critical issues such as cybersecurity, North Korea and Iran?

Trump sees China through the prism of just one issue: trade. Fact is, every issue with Beijing must be considered within the broader context of all the others; Trump has never been subject to intense questioning about how he’d manage the true complexity of what is the world’s most important bilateral relationship. Clinton, the former secretary of state, gets much higher marks here.

Finally, here’s one that particularly bugs me. Over the past two decades, political civility has nose-dived in this country — only to take an even sharper turn for the worse this year.

Do these candidates — particularly Trump — realize the long-term damage being inflicted on our democracy and reputation abroad and the poor example being set for our next generation of leaders? I don’t have the sense that this has ever crossed his mind — and it is something Clinton could address more consistently. That’s too bad — for all of us.

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