The country described by the Democrats running for president is mired in child poverty, riven with economic unfairness and broken in its approach to health care, crime and guns. The country presented by President Donald Trump is roaring and ascendant — and, hey, how about those moderating prescription drug prices?
The reality, of course, is more complex than this tale of two nations.
After three turns on the debate stage by the Democratic candidates, it's become clear that for the most part they hew to actual statistics and other fundamentals more closely than does Trump, who routinely says false things and repeats them as if willing them into being.
U.S. & World
That's not to say the Democrats are beacons of accuracy. Some will use older statistics when newer ones don't suit their argument or give a selective reading of history when that fits the story they want to tell. Sometimes what they don't say speaks loudly, as when they won't acknowledge the cost of their plans or the likely tax hit on average people.
All of that was seen in the past week of political rhetoric. A look:
TRUMP: "Democrats want to confiscate guns from law-abiding Americans so they're totally defenseless when somebody walks into their house with a gun." — remarks Thursday to House Republicans in Baltimore.
THE FACTS: That's a vast overstatement. No Democratic candidates have proposed stripping all guns from Americans. One of the top 10 candidates, former Texas Rep. Beto O'Rourke, has proposed confiscating assault-type weapons such as the AK-47 through a mandatory buyback program.
JOE BIDEN, on the treatment of migrants in his time as Barack Obama's vice president: "We didn't lock people up in cages." — Democratic presidential debate Thursday.
THE FACTS: Yes they did.
The "cages" — chain-link enclosures inside border facilities where migrants have been temporarily housed, separated by sex and age — were built and used by the Obama administration. The Trump administration has been using the same facilities.
Democrats routinely accuse Trump of using cages for migrant children without acknowledging the same enclosures were employed when Biden was vice president.
BERNIE SANDERS: "Every study done shows that 'Medicare for All' is the most cost-effective approach to providing health care to every man, woman and child in this country." — Democratic debate.
THE FACTS: No, not every study.
The nonpartisan Congressional Budget Office said in a report earlier this year that total spending under a single-payer system, such as the one proposed by Sanders, "might be higher or lower than under the current system depending on the key features of the new system."
Those features involve details about payment rates for hospitals and doctors, which are not fully spelled out by Sanders, as well as the estimated cost of generous benefits that include long-term care services and no copays and deductibles for comprehensive medical care.
A report this year by the Rand think tank estimated that Medicare for All would modestly raise national health spending, the opposite of what the Vermont senator intends.
Rand modeled a hypothetical scenario in which a plan similar to legislation by the Vermont senator had taken effect this year. It found that total U.S. health care spending would be about $3.9 trillion under Medicare for All in 2019, compared with about $3.8 trillion under the status quo.
Part of the reason is that Medicare for All would offer generous benefits with no copays and deductibles, except limited cost-sharing for certain medications. Virtually free comprehensive medical care would lead to big increases in the demand for services.
TRUMP: "Our ambitious campaign to reduce the price of prescription drugs has produced the largest decline in drug prices in more than 51 years." — remarks at North Carolina rally Monday night.
THE FACTS: He's exaggerating his influence on drug prices, which haven't fallen for brand-name drugs, the area that worries consumers the most.
Most of his administration's "ambitious campaign" to reduce drug prices has yet to be completed. Major regulations are in the works and legislation has yet to be passed by Congress. A rule requiring drugmakers to disclose prices in TV ads has been blocked for now by the courts.
Harsh criticism of the industry — from Trump and lawmakers of both parties in Congress — may be having some effect, however.
The Commerce Department's inflation index for prescription drug prices has declined in seven of the past eight months, which is highly unusual. That index includes lower-cost generic drugs, which account for 90% of prescriptions filled in the U.S. Prices for generics have been declining under pressure from big drug distributors.
For brand-name drugs, though, a recent analysis by The Associated Press shows that on average prices are still going up, but at a slower pace. The cost of brand-name drugs is what's most concerning to consumers, with insured patients facing steep copays for some medications.
The AP analysis found that in the first seven months of 2019, drugmakers raised list prices for brand-name medicines by a median, or midpoint, of 5%.
That does reflect a slowing in price increases. They were going up 9% or 10% over those months the prior four years. But it's not a decrease in actual prices. There were 37 price increases for every decrease in the first seven months of 2019. Pricing data for the AP analysis came from the health information firm Elsevier.
ELIZABETH WARREN, asked whether her health plan would mean higher middle-class taxes: "We pay for it, those at the very top, the richest individuals and the biggest corporations, are going to pay more. And middle-class families are going to pay less. That's how this is going to work. ... Look, what families have to deal with is cost, total cost."
THE FACTS: That's a dodge.
The senator from Massachusetts did not answer back-to-back questions about whether middle class taxes would go up from her version of Medicare for All.
It's a given that consumers will pay less for health care if the government picks up the bills. But Sanders is almost alone among the candidates who support Medicare for All in acknowledging that broadly higher taxes would be needed to pay for that universal coverage. He would consider, and probably not be able to avoid, a tax increase on the middle class in exchange for health care without copayments, deductibles and the like. "Yes, they will pay more in taxes but less in health care," he said in a June debate.
Some rivals, including Warren, have only spoken about taxing the wealthy and "Wall Street." Analysts say that's not going to cover the costs of government-financed universal care.
ECONOMY AND TRADE
TRUMP: "How do you impeach a President who has helped create perhaps the greatest economy in the history of our Country?" — tweet Friday.
THE FACTS: "Perhaps" is a rare bit of modesty in this frequent boast by Trump but he is still wrong in claiming the U.S. has its best economy ever.
In the late 1990s, growth topped 4% for four straight years, a level it has not reached on an annual basis under Trump. Growth reached 7.2% in 1984. The economy grew 2.9% in 2018 — the same pace it reached in 2015 under Obama — and hasn't hit historically high growth rates.
The unemployment rate is near a 50-year low of 3.7%, but the proportion of Americans with a job was higher in the 1990s. More Americans are now out of the workforce, taking care of children or relatives, or going to school, while others became discouraged about their job prospects and stopped looking. The government doesn't count people as unemployed unless they are actively searching for jobs. Wages were rising at a faster pace back then, too.
TRUMP, on China's economy. "By the way, China is having the worst year they've had now in 57 years, OK? Fifty-seven." — remarks Wednesday in meeting on e-cigarettes.
TRUMP: "They've had now the worst year in 57 years." — North Carolina rally on Monday.
THE FACTS: That's not true. China is far from the impoverished disaster of a half century ago, when it was reeling from the massive famine caused by Mao Zedong's radical economic policies and heading into the chaos of the Cultural Revolution of the 1960s.
China's economy is indeed slowing from Trump's taxes on Chinese imports, as well as its own campaign to constrain runaway debt. The International Monetary Fund expects the Chinese economy to grow 6.2% this year. That's the slowest growth for China in nearly 30 years. But it's still markedly faster than U.S. growth.
Since overhauling its economy in the late 1970s, China has lifted hundreds of millions of people out of poverty, established a growing middle class and surpassed Japan to become the world's second-biggest economy.
TRUMP: "Hundreds of billions of dollars have been and are coming into our country in the form of tariffs, and China is eating the cost." — North Carolina rally.
THE FACTS: Americans are also eating the cost.
As he escalates a trade war with China, Trump refuses to recognize that tariffs are mainly, if not entirely, paid by companies and consumers in the country that imposes them.
In a study in May, the Federal Reserve Bank of New York, with Princeton and Columbia universities, estimated that tariffs from Trump's trade dispute with China were costing $831 per U.S. household on an annual basis, before tariffs were recently escalated. Analysts also found that the burden of Trump's tariffs falls entirely on U.S. consumers and businesses that buy imported products.
A report last month by JPMorgan Chase estimated that tariffs would cost the average American household $1,000 per year if tariffs on an additional $300 billion of U.S. imports from China proceed in September and December. Trump has since bumped up the scheduled levies even higher, probably adding to the U.S. burden.
BERNIE SANDERS: "We have the highest child poverty rate of almost any country on Earth." — Democratic debate.
THE FACTS: This oft-repeated line by the Vermont senator is an exaggeration.
There are nearly 200 countries in the world, many with people living in extreme poverty that most Americans would struggle to fathom. Poverty is also a relative measure in which someone who is poor in one nation might look rather prosperous in another.
But the Organization for Economic Co-operation and Development updated its child poverty report in 2018. The United States had an above average level of child poverty, but it was not at the bottom of the 42 nations listed in the report. The United States still fared better than Russia, Chile, Spain, India, Turkey, Israel, Costa Rica, Brazil, South Africa and China.
TRUMP: "We passed the largest package of tax cuts and reforms in American history." — North Carolina rally.
THE FACTS: His tax cuts are nowhere close to the biggest in U.S. history.
It's a $1.5 trillion tax cut over 10 years. As a share of the total economy, a tax cut of that size ranks 12th, according to the Committee for a Responsible Federal Budget. President Ronald Reagan's 1981 cut is the biggest, followed by the 1945 rollback of taxes that financed World War II.
Post-Reagan tax cuts also stand among the historically significant: President George W. Bush's cuts in the early 2000s and Obama's renewal of them a decade later.
TRUMP: "More Americans are working today than ever before in the history of our country." — North Carolina rally.
THE FACTS: Yes but that's driven by population growth. A more relevant measure is the proportion of Americans with jobs, and that is still below record highs.
According to Labor Department data, 60.9% of people in the United States 16 years and older were working in August. That's below the all-time high of 64.7% in April 2000.
TRUMP: "We passed something they wanted to do for half a century: We passed VA Choice." — North Carolina rally.
THE FACTS: It was Obama who won passage of the Veterans Choice program, which gives veterans the option to see private doctors outside the VA medical system at government expense. Congress approved the program in 2014, and Obama signed it into law. Trump expanded it.
BETO O'ROURKE, former U.S. representative from Texas, on last month's mass shooting in El Paso: "Everything that I've learned about resilience, I've learned from my hometown of El Paso, Texas, in the face of this act of terror, that was directed at our community, in large part by the president of United States. It killed 22 people, and injured many more, we were not defeated by that. Nor were we defined by that." — Democratic debate.
THE FACTS: Nobody has claimed that Trump "directed" the shooting. Earlier in the debate, O'Rourke had said the shooter was "inspired to kill by our president." It is hard to know for sure what led the gunman to open fire inside a Walmart in El Paso, killing 22 people. The suspect posted a manifesto online before the shooting that echoed Trump's comments on immigration. Yet the suspect said his own views "predate Trump and his campaign for president."
The screed spoke of what the suspect called a "Hispanic invasion of Texas," railed against immigrants and warned of an imminent attack. Nearly all of the victims had Latino last names.
The suspect purchased the gun legally, according to El Paso's police chief.
KAMALA HARRIS, on Trump: "The only reason he has not been indicted is because there was a memo in the Department of Justice that says a sitting president cannot be charged with a crime." — Democratic debate.
THE FACTS: We don't know that it's the only reason. Former special counsel Robert Mueller didn't go that far in his report on Russian intervention in the 2016 election and obstruction of justice.
Harris, a California senator, is referring to a Justice Department legal opinion that says sitting presidents are immune from indictment. Mueller has said his investigators were restrained by that rule, but he also said that they never reached a determination as to whether the president committed a crime.
In Mueller's congressional testimony in July, he said his team never started the process of evaluating whether to charge Trump.
Associated Press writers Josh Boak, Christopher Rugaber, Colleen Long, Michael Balsamo, Ricardo Alonso-Zaldivar, Mary Clare Jalonick and Amanda Seitz contributed to this report.