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Jewish World Review April 17, 2001 / 24 Nissan 5761

Morton Kondracke

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Consumer Reports

Congress Should Boost Bush
Budget For Health Programs -- PRESIDENT Bush may go down in history as an education president and a tax cut president, but he won't make it as a health care president without pressure from Congress.

Bush's new budget contains some worthy health initiatives, but it's woefully unambitious and underfunded in two major areas: aiding the uninsured and providing a prescription drug benefit for Medicare recipients.

One way in which Bush has shown vision is with his proposed 13.5 percent, one-year increase for the Agency for Healthcare Research and Quality, which is on its way to giving health care providers, consumers and policymakers accurate data on treatment outcomes, costs and provider performance.

Bush also deserves credit for a patients' rights proposal that offers an independent review of HMO coverage decisions and a right to sue, but caps legal damages to keep insurance rates affordable.

Moreover, he has proposed a $2.7 billion increase for the National Institutes of Health - although the Senate saw fit to raise that number by $700 million in order to stay on track to double the medical research budget by 2003.

However, Bush's health budget, like his proposals for energy funding, transportation and non-medical research, demonstrates the effect of trying to hold down spending to make room for his $1.6 trillion, 10-year tax cut.

Originally, Bush's Office of Management and Budget called for slashing support for pediatric teaching hospitals from $235 million last year to just $40 million. Health and Human Services Secretary Tommy Thompson fought for and won $200 million, but that still represents a cut.

Much more dangerously from a political standpoint, Bush's budget calls for a mere $156 billion over 10 years for a prescription drug benefit and reform of the Medicare system. Last Friday the Senate voted to establish a "reserve fund" of $300 billion for prescription drugs.

Democrats also attacked Bush on the grounds that he plans to pay for the drug benefit out of Medicare surpluses - rather than by reducing the tax cut - which would hasten the time when the Medicare system goes bankrupt.

Bush argues that his forthcoming reform plan for Medicare, creating incentives for seniors to enter managed-care plans, would extend its solvency. The President also intends to reshape the overstressed Health Care Finance Administration, which runs Medicare.

Still, no expert believes that the amount he budgeted for Medicare is anything close to adequate. Rather, it is thought that the figure was mandated to make room for his top priority, the $1.6 trillion tax cut.

For the nation's 42.5 million uninsured, Bush is proposing a one-year increase of

$124 million for community health centers to provide primary care and preventive services for about 11 million people, about 4.4 million of whom are uninsured.

For the long run, however, Bush is calling for tax credits worth only $71.5 billion over 10 years, which would help fewer than 5 million people - and only those whose employers do not provide insurance.

During the budget debate, the Senate approved another $7 billion, but it has the opportunity to pass a bipartisan proposal - admittedly expensive - that would cut the ranks of the uninsured in half.

Originally put forward last year by the "New Democrat" Progressive Policy Institute, the $400 billion plan has been introduced by Sens. Jim Jeffords (R-Vt.) and John Breaux (D-La.), with Sens. Bill Frist (R-Tenn.), Olympia Snowe (R-Maine), Tom Carper (D-Del.) and Blanche Lincoln (D-Ark.) as co-sponsors.

Unlike Bush's proposal, the Jeffords-Breaux measure would provide tax credits to help lower-income workers participate in employer-provided health plans, thereby encouraging the employers not to drop coverage.

As first described by columnist Matthew Miller, the concept behind the proposal is a amalgam of the traditional liberal idea of eventual universal health coverage and conservatives' refusal to put the government in charge of health care.

Bush, the New Democrats and the Jeffords-Breaux group all accept the idea of tax credits as the vehicle for expanding coverage. In fact, one of Bush's new White House health advisers, Mark McClellan, formerly of Stanford University, helped draft the Progressive Policy Institute proposal.

That plan also calls for the creation of voluntary purchasing groups to bargain with insurance companies, state oversight of the plan and retention of existing "safety-net" programs, such as Medicaid and the Children's Health Insurance Program.

An ABC News poll released this week reveals that by 52 to 42 percent, adults prefer providing health care coverage to the uninsured to receiving an income tax cut.

That indicates that Congress would be on safe ground shifting Bush's priorities - and that he'd benefit by this action. In fact, the Senate began that procedure by shaving his tax cut by $400 billion and applying the money in part to health care. The House should go along.

JWR contributor Morton Kondracke is executive editor of Roll Call, the newspaper of Capitol Hill. Send your comments by clicking here.


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03/27/01: Ex-Clinton Adviser Thinks Bush Needs More Upbeat 'Vision'
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03/06/01: Bush and Congress should prepare for lean years
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02/26/01: Bush should talk about long-term budget challenges
02/22/01: AARP's agenda at odds with Bush priorities
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02/14/01: McCain won't run against Bush again, just differ on issues
02/12/01: Is Joe Lieberman tilting left toward 2004?
02/07/01: The controversy starts: Bush orders HHS study of fetal, stem cell issues
02/05/01: Dems move toward bush on taxes, but ...
02/01/01: Bush should be open with press
01/30/01: Bush Should go for broke early on education
01/23/01: Clinton ain't going away, folks
01/19/01: Bush should try for legacy as 'Great Reconciler'
01/16/01: Left-Center Rift Re-emerges For Democratic Leaders
01/12/01: Clinton doing Bush no favors in Mideast
01/09/01: Bush and Democrats can deal
12/14/00: Will Daschle make it his business to get along with President Bush?
12/08/00: GOP is in danger of ruining record on medical research
11/27/00: Some fascinating stories about how and why people voted
11/22/00: GOP Survived health bullets, but one is left
11/20/00: Can next president and Hill deal?
11/15/00: With nation split, leaders must reach across party divide
11/07/00: The Envelope, Please:Bush Beats Gore, GOP Holds Hill
11/03/00: Parties appeal to two 'gospels'
11/01/00: Lurking in the shadows
10/26/00: What's Gore's Social Security plan?
10/18/00: While Bush, Gore debate surplus, Congress spends it
10/16/00: Two debates leave lots of questions
10/03/00: What questions should be debated?
09/28/00: Gore and Bush should prepare to lead
09/19/00: Bush let values issue slip away
08/25/00: Gore hands center to Bush
08/22/00: AlGore, look to future, not to Bubba
08/08/00: 2000 race could leave high road for low
08/03/00: Convention must point Bush to center
08/01/00: GOP Readies 'Debt Lockbox' As 2000 Strategy
07/27/00: Cheney adds heft to GOP ticket
07/25/00: Foreign, Defense Policy Deserves Full 2000 Debate
07/20/00: Truman Show: Gore Replays 1948, But Bush Isn't Dewey
07/18/00: Bush Must Fight Gore's Drug Plan As 'Bad Medicine'
07/13/00: Mexico's Election Supports U.S. Action On NAFTA, Bailout
07/10/00: Abortion is good for something --- just ask AlGore
07/06/00: Meet Steve Ricchetti, Bubba's secret weapon
06/30/00: AlGore is down, but is he out?
06/27/00: Social programs caught in election-year game of one-up
06/22/00: Congress Is Near Flunking a Test On School Reform
06/16/00: Doting on the grandparents
06/13/00: On Stem Cells, Bush Has Wrong Pro-Life Stance
06/08/00: Has Gore Caught Bush?
05/26/00: PNTR Vote Could Tell Which Party Fits 'New Economy'
05/23/00: The secret to winning the election: Economic programs
05/18/00: Gore should regroup
05/16/00: McCain's Support Is Tepid, But Lets Bush Focus on Gore
05/11/00: Voters need wonk training
05/09/00: Bush Could Score With Charge That Gore's Too Partisan
04/28/00: Reno's force aids Clinton, not Elian
04/25/00: Should Clinton be indicted?
04/24/00: Can Gore win on Bush tax cuts?
04/18/00: Levin's 'bridge' key to China trade?
04/11/00: Congress, U.S. Voters Still Aren't Ready For Campaign Reform
04/06/00: Bush, Gore Silent As Popular Culture Gets Ever Coarser
03/30/00: Is 2000 Like 1948, 1976 or 1960? Or Is This Unparalleled?
03/28/00: Will Bush, Gore Go for a Better Way To Pick Nominees?
03/23/00: Medicare cutbacks bleed hospitals
03/20/00: Chances Improve That China Trade Will Pass Congress
03/16/00: Lieberman as veep would help Gore
03/14/00: Can Bush, McCain Unite to Beat Gore?
03/09/00: Can GOP Forge Unity After Nasty McCain-Bush Race?
03/07/00: What accounts for McCain's excesses?
03/02/00: 'Debate' Proved Gore Is This Year's Best Gut-Fighter
02/29/00: Surprises! The 2000 GOP race is full of it
02/25/00: Voters want centrist in White House
02/23/00: Gore would hit McCain's record
02/15/00: Will negativity hurt McCain in S.C.?
02/10/00: How hard should Bush hit McCain?
02/08/00: Bush must retool his entire campaign
01/27/00: Could Gore beat Bush as Truman beat Dewey?
01/20/00: Big New Surplus Estimates Could Alter 2000 Politics
12/21/99: Bush improves, everyone panders
12/16/99: Prospects improve for campaign reform
12/14/99: Riots raise free trade as 2000 issue
12/10/99: Gore won GOP 'debate' in N.H.
12/07/99: Election pits Bush cuts vs. Medicare boost
12/03/99: Can race be a constructive issue in 2000?
11/19/99: White House race may be best in decades
11/16/99: Where is Bush on health care fight?
11/11/99: Will TV stop profiteering from politics?
11/09/99: Is GOP isolationist, or just partisan?
11/04/99: Gore, Bradley Run Opposite Races On Style, Substance
11/01/99: GOP, Clinton could reach deal swiftly
10/27/99: Bush to fight 'culture wars' -- positively
10/21/99: Porter, Mack: heroes on medical research
10/19/99: Gore scores among party big shots, but polls go South
10/14/99: Bush critiques could help GOP Congress
10/12/99: Congress can save health care from ruin
10/07/99: Will gun-control cause the GOP to shoot itself in the foot?
10/05/99: Gore moves: Desperate but necessary
10/01/99: Fox, Armstrong make case for NIH
09/28/99: Dems' race brightens Bush's chances
09/23/99: East Timor deflates `Clinton Doctrine'
09/21/99: Buchanan v. Bush? Yeah right
09/17/99: Candidates turn attention to poverty
09/15/99: Bush's education problem
09/09/99: Budget makes 2000 an `issues' election
09/07/99:Airport rage increases, with good reason
09/02/99: U.S. future up for grabs in 2000
08/31/99: U.S. Capitol needs visitor's center -- soon
08/24/99: Will 2000 be the year of the foreign crisis?
08/19/99: Neither party has upper hand for '99
08/17/99: Ford gets freedom medal one month early
08/12/99: There's time to catch Bush, say Gore aides
08/10/99: Rudy, Hillary try much-needed makeovers
08/09/99: GOP must launch new probe of Chinagate
08/02/99: Pols blow fiscal smoke on budget surplus
08/02/99: One campaign reform should pass: disclosure
07/27/99: Gore leads Bush in policy proposals

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