Why seeing a candidate’s health records and tax returns matters

By Joe Garofoli, San Francisco Chronicle

Tuesday, Sept. 13, 2016 | 2 a.m.

SAN FRANCISCO — Instead of discussing the economy and foreign policy, which affect every voter, the presidential campaigns now are talking just about each other, specifically the health of the candidates, how much they pay in taxes and how secretive they are.

It may seem an odd detour from the kitchen-table issues that voters want to hear discussed — especially now, less than two months before election day. But analysts say a candidate's transparency provides insight into how that person will behave in the White House.

"There is a fundamental democratic value that basic questions about the president are a matter of public interest, because of all the power in the presidency,'' said John Wonderlich, interim executive director of the nonpartisan Sunlight Foundation, which analyzes transparency and the intersection of money and politics.

While the Clinton campaign's secrecy about her pneumonia diagnosis become a headline after she left the 9/11 memorial service in New York early Sunday because she was "overheated,'' her campaign has been far more open than Trump's in terms of overall transparency, analysts said.

On Monday, several campaign officials said Hillary Clinton wanted to "power through'' her illness without acknowledging the diagnosis. But campaign director Jennifer Palmieri tweeted Monday: "We could have done better yesterday, but it is a fact that public knows more about HRC than any nominee in history.''

Clinton was supposed to attend a campaign fundraiser at San Francisco's Masonic Auditorium on Monday, but canceled while she recovers. Instead, she was introduced by Lt. Gov. Gavin Newsom and spoke to the audience via telephone for several minutes, saying she hoped to get back on the campaign trail soon "because there is so much work to do.''

Speaking in a strong, clear voice, Clinton said Donald Trump is "helping'' her campaign "by showing again and again how fundamentally unfit and totally unqualified he is to be president.''

While the campaigns bicker about who is more forthcoming about health issues, there's little doubt that Trump is one of the most secretive candidates in recent history.

"There's no doubt that Trump is being graded on a curve here,'' said Ken Goldstein, a professor of political science at University of San Francisco. In terms of secrecy, Trump is one of the most furtive candidates in a generation, analysts said.

Not only is the New York real estate tycoon the only presidential candidate in recent history to refuse to divulge his tax returns, he has offered scant details of his medical history. That's a concern given that, if elected, Trump, 70, would be the oldest first-term president in history. (Hillary Clinton, who will turn 69 next month, would be the third-oldest first-termer if she won, slightly younger than Ronald Reagan.)

There is no such demand that presidential candidates tell Americans anything about their health. But they often do.

During his 2008 presidential run, then 71-year-old former prisoner of war Sen. John McCain, R-Ariz., proffered more than 1,000 pages of health records testifying to his fitness. McCain's opponent, then 47-year-old Sen. Barack Obama, had his doctor submit a 276-word summary of his health. Obama's physician said there was nothing significant to report.

So far, Trump, who has flashed photos of himself eating KFC on social media, has released only a four-paragraph letter from his physician of more than three decades, Harold Bornstein, a gastro-enterologist. He told NBC News last month that he wrote the memo in "five minutes.''

"If elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency,'' Bornstein wrote.

In July 2015, Clinton's personal physician released a two-page summary of her health, including brief summaries of past health issues involving blood clots and a concussion. Dr. Lisa Bardack concluded Clinton was in "excellent physical condition'' and "fit to serve as president of the United States.''

Like details about his health history, when it comes to explaining what policies he'd pursue as president, Trump's offerings "have been scant,'' Wonderlich said. The candidate has refused to detail how he would defeat ISIS, for example, other than that he would require his advisers to present him with a plan within 30 days of taking office.

Wonderlich and Goldstein said Clinton has been much more specific in describing policies she'd pursue in office.

A central message of Trump's campaign has been that he's a tough negotiator, a businessman who knows how to cut deals. But voters have had little insight — other than Trump's own braggadocio — about the inner workings of his companies.

Because he refuses to release his tax returns, Americans don't know what conflicts of interest might exist between his personal holdings and national interests, Wonderlich said. They don't know what ties to foreign governments or corporations he has. They don't know whether he would make national decisions with an eye toward benefiting his financial portfolio.

Wonderlich said there is a public expectation that presidents will be transparent in disclosing outside sources of income and avoiding possible conflicts. That's why candidates for decades have released their tax returns and why some have placed their personal assets in blind trusts during their term of office. Clinton has released hers.

Trump has not explained what he would do with his namesake companies should he win. When pressed, Trump has said he would turn them over to his children while he serves in office.

"That's really hard to imagine that working,'' Wonderlich said. "The companies are built around his personal brand. It's hard to build a firewall when your name is on buildings in two-story-high gold lettering.''

Clinton, meanwhile, needs to figure out how to disentangle herself from her family foundation, which has raised $2 billion in 15 years from foreign entities and some of the wealthiest Americans.

While there is no evidence that Clinton altered federal policy to suit donors to the Clinton Foundation when she was secretary of state, analysts say more transparency safeguards need to be in place should she win the presidency.

"The concern is that donors to the foundation get treated differently than everyone else,'' Wonderlich said.

It's hard for many to cut the Democratic nominee much slack, given that she set up a private email server in her home for the purpose of avoiding more scrutiny.

This unforced error left some prominent Democrats frustrated with Clinton's operation.

"Antibiotics can take care of pneumonia,'' President Obama's former top campaign strategist, David Axelrod, tweeted Monday. "What's the cure for an unhealthy penchant for privacy that repeatedly creates unnecessary problems?''