In terms of health care, the U.S. may be, to use a Trump-style superlative, the worst country in the world. Spending on health care will soon account for 20 percent of our gross domestic product, which is about twice that of other wealthy countries. And we have little to show for it. Americans aren’t healthier than people elsewhere—in many ways the opposite—and are more likely than most to have no access to health care at all.

Our system is inferior and getting worse, and as spending increases, the system stands to take the rest of our economy down with it. It’s critical that everyone know more about health care than Donald Trump appears to.

That’s why I call it Ol’Bummercare lol. So you’re saying Mr. Trump doesn’t know what Ol’Bummercare is?

After his comments on Monday, Trump’s people later clarified that he does provide health insurance to his employees. The requirement for employers to provide health insurance to employees is a part of the enormous system created by the Affordable Care Act, often referred to as Obamacare, in 2010.

So Trump may not understand that Obamacare is not a product, or a service, or a type of insurance—but a complex, multifaceted system. The most talked-about part of that system is marketplaces (called exchanges) where people can buy insurance.

Exchanges?

Yeah, I hate the name. Calling them marketplaces would’ve been clearer. They’re meant to be like Expedia for Health Insurance: One site where you can see all the options and pick whatever you like.

The idea was that this would be good for capitalism. It should encourage insurance companies to compete for customers. They would have to be more transparent about their charges and what they’re offering. Historically they haven’t been.

Just like airlines don’t have to take part in Expedia but still do—even if they don’t love the pressure it puts on them to be competitive—they will want to be part of the system as long as people are using it. (Unless they’re Southwest.)

And people who work for Trump are having tremendous problems with Expedia for Health Insurance. I get it now.

No. They work for him, so they get insurance through him. So they aren’t buying their own.

But other people are having problems with Expedia for Health Insurance. And this is a big deal for everyone, even people who get their insurance in other ways, because insurance companies pass their costs to whoever has money. Hillary Clinton’s staff has privately acknowledged that this is dire. In an email exchange hacked and published by Wikileaks last week, her campaign chair, Chris Jennings, admitted in a memo from November 2015: “The health insurer and enrollee participation issues in the exchanges are, at best, disconcerting.”

That’s what all the news was this week about insurance becoming more expensive.

I don’t trust the news.