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Back
in the Spotlight
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Democratic
presidential candidates focus on health care |
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By Chris Schreiber Healthcare reform is back on the political landscape as Democratic presidential candidates Bill Bradley and Vice President Al Gore make it a key issue of their campaigns. Members of both parties, including President Clinton himself, had shied away from the issue since the resounding failure of Clinton’s sweeping proposals for healthcare reform during his first term. Critics said his proposals were too costly and too radical, and most of the proposals were so roundly defeated that pundits said they led to the “Republican Revolution” that swept into Congress in 1994. This year, however, neither Gore nor Bradley has backed away from the healthcare debate. Although their Republican counterparts have yet to speak out on the issue, the two have addressed some important healthcare issues, including the future of Medicare and Medicaid, the nation’s 44.3 million uninsured, HMO reform, and the Patients’ Bill of Rights. In fact, both have used healthcare reform—specifically the uninsured—as the issue that defines their “vision of where the country should go,” as Bradley said in the pair’s first debate, in New Hampshire Oct. 27. |
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Bradley’s proposal
Running as a dark horse, Bradley, the former New Jersey senator, Rhodes scholar, and professional basketball player, has put Gore on the defensive by appealing to his party’s traditional ideologues on the left. His most talked-about plan would provide health insurance for all children and would insure 95 percent of those now without health insurance. Bradley estimates that the three-tiered, 10-year plan would cost between $500 billion and $650 billion, funded by the expected budget surplus. He argues that streamlining administrative costs by shifting paper forms to the Internet can mean significant savings. His plan also calls for establishing government-subsidized vouchers that citizens can use to pay for private insurance, and abolishing Medicaid altogether. “That is a great deal of money, but a campaign proposal without a price tag is just another politician’s promise,” Bradley said in a Sept. 28 speech in Los Angeles. “I think of health care as a good investment—in our productivity and our growth. But I do not justify it as only an investment. I ask for it as a fulfillment of the nation’s responsibility to its people.” Too much? Many observers welcome that kind of talk, but fear that like Clinton’s plan before it, Bradley’s plan may be attempting too much. “I think the experience with health care this century is that healthcare reform has either been too big or too small,” said Karen Ignagni, president and CEO of the American Association of Health Plans, an organization of more than 1,000 health plans. “The idea is to think very big about health care, but act more conservatively.” Ignagni said that Bradley’s plan would call into service the country’s private sector healthcare providers in ways that have not yet been attempted and that no one is quite sure how much it might cost. Bradley’s “think big” proposals have drawn fire from Republicans who believe they mark a return to the “tax and spend” days of Democrats past. Even Democratic centrists, including Gore, think Bradley’s plan represents too radical a departure from the “fiscal responsibility” the party has espoused during the unprecedented economic run of the last five years.
Gore’s alternative In addition, Gore says Bradley may be underestimating the cost of his healthcare reform plan. “When people have the time to analyze what he is actually proposing, they are in for a real surprise,” Gore said last month. He estimates the Bradley plan will cost closer to $1.2 trillion and said in their debate that if it were enacted, it would “shred the social safety net.” Gore has countered Bradley’s plan with a more moderate approach, funded by tax credits for employers and parents to encourage them to provide health insurance. Veering off the successful economic path the country is on is unnecessary, Gore said. “I put out a healthcare plan that reaches coverage for almost 90 percent of the American people,” Gore said at last week’s debate. “It gives coverage to 100 percent of all children. The cost is $146 billion over 10 years, and a prescription drug benefit is provided under Medicare for $118 billion over 10 years.” Gore has also attacked Bradley for his plan to abolish Medicaid by offering coverage to qualified people under the Federal Employees Health Benefit plan. Gore wants continued reform of the health plan for the poor and has promised to use 15 to 20 percent of the budget surplus to save Medicare. Gore and Bradley agree on other hot-button issues, though they continue to disagree on funding methods. They support Clinton’s proposal to extend Medicare to include a prescription drug benefit, and both would fund the provision using the budget surplus. In addition, both candidates have been vocal in their support of HMO reform, including the Patients’ Bill of Rights, which would allow enrollees to sue their health plans. “I am encouraged that [health care] is back on the political map again,” said Ron Pollack, executive director of Families USA, a national organization for healthcare consumers. “Nothing is as sweeping as the 1993 Clinton plan, but it’s a step back in the right direction. And while [Gore and Bradley] are different in mechanics, they have very similar goals in mind.”
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