“We’re not going to let people die on the streets,” said the GOP nominee, embracing a standard line of Democratic demagoguery whenever Republicans talk about reforming federal health-care spending. And not for the first time either.

How, and whether, this squares with his own proposal to send block grants to the states to run Medicaid programs, God only knows. Does he mean we should expand the block grants? Or is he giving up on the block-grant idea, fearing that it wouldn’t suit his national-savior “America’s daddy” image to have the actual life-saving elements of his job farmed out to state governments?

OZ: So what do we do with the folks who fall through the cracks?

TRUMP: We have to go and help them through the Medicaid system. We have to help them publicly. We’re going to have to do it. Nobody wants to see people — and it’s totally unfair — a lot of people said oh, gee that’s not the thing to say. I said, well you know what? If I can’t say that, I’m not running for office. There are people who say everybody should have a great, wonderful, private plan, and if you can’t afford that, and there is a percentage, a fairly large percentage that can’t afford it, then those people don’t get taken care of. That’s wrong. We’re going to take care of that through the Medicaid system. We’re going to take care of those people. We have no choice. We’re not going to let people die on the streets. But we will have competition that will be so strong for people’s business – Now, one thing you have to do is get rid of the monopolies. Because every state has a line wrapped around it. You know, they’d rather have the insurance companies and the various companies — they’d rather have one state where they’re by themselves than be able to bid all over the United States. You understand that. We have to get rid of the lines. We have to have competition. And we will have, you will have plans that you don’t even know about right now. They’ll get better and better and better, and they’ll get cheaper and cheaper, and it’ll be a beautiful thing to see. But right now Obamacare is not affordable by the country and it’s not affordable by people.

He still wants to repeal ObamaCare but ObamaCare itself involved a huge Medicaid expansion. Does Trump want to keep that part of the law in place? Are Paul Ryan and anti-entitlement House Republicans prepared to go along? His campaign says he’s not supporting a further expansion but that’s not clear from his answer above. Equally strangely, his campaign website today briefly published a fact sheet on proposed reforms to the EPA that would remove regulations on farmers that empower the “FDA Food Police.” Among the regulations targeted will be those related to food production hygiene. If he’s making a big-government pitch to the left in the name of public health, why would he complicate it by making a deregulatory pitch to the right that’ll be flogged for potentially putting America’s food supply at risk? If he’s all in on the idea of a paternal Trump-led federal government taking charge in safeguarding the people’s health, hygiene standards in producing food is an odd place to draw the line.

It’s silly to grouse about this, though. After last night’s Rush Limbaugh post, a few Trumpers pinged me on Twitter to tell me that I simply haven’t grasped yet that policy isn’t important in this election. They gave me the Coulter line — the one and only issue of real consequence is immigration, because if Clinton is allowed to set millions of illegals on the path to citizenship, it’ll transform the country permanently into a Democratic majority and any conservative policy gains will be erased anyway. These people are going to be sorely disappointed when President Trump isn’t nearly the anti-amnesty warrior in office as he is now, but never mind that. Just understand this: If immigration is the only important issue then it means Trump can and should be permitted to cave on anything else. There’s no way to hold him accountable for tacking left because he can always turn around and say “but amnesty!” That logic is especially dangerous in this area, since it’s easy to see how a “we’re not going to let people die on the streets” justification for the feds running poor people’s health care might expand organically to them running everyone’s health care. That’s single-payer or, as the left prefers, “Medicare for all.” Trump seems to like that idea. By the time he’s out of office, American governance may be so left-wing that Democrats will no longer need to import voters from Mexico to affect the transformational liberal change that Coulter et al. claim to fear so much.

Anyway, I look forward to hearing tomorrow how this is a political “home run” on the Rush Limbaugh Show.