Jewish World Review Nov. 16, 1999 /7 Kislev, 5760
Where is Bush on health care fight?
THE FURIOUS FIGHT between Democratic presidential candidates Al Gore and Bill Bradley over health care raises the question: Where is GOP front-runner George W. Bush?
The answer is that Bush advisers are working on proposals to help the uninsured, patients' rights, Medicare and medical research, but we aren't likely to see them until next year.
One adviser said Bush's schedule was too clogged -- with his major foreign policy speech next week and his economic/tax plan coming in December -- to permit an early foray into health policy.
There are risks both to waiting and to going early. Polls show that health issues have leapt to the top of the national agenda. By waiting, Bush looks to be out of the action. Moreover, some Bush political advisers think the Texas governor's record on health care is so weak that he has to unveil some proposals soon to show he cares about the issue.
About one-quarter of all Texans lack health insurance, one of the highest rates in the nation, and Bush has done little about it. He even resisted expanding the Children's Health Insurance Program until Democrats forced him to do so.
Against those arguments for speaking out soon, one health adviser says Bush ought to wait because his plans for the uninsured and Medicare certainly will be compared unfavorably to Gore's and Bradley's, which promise to cover more people and provide richer benefits.
One alternate strategy is for Bush to unveil part of his program this year -- calling for doubling the medical research budget over five years, which he's said to favor -- and leave the rest for next year.
Neither Bradley nor Gore has come out for doubling research, so Bush could beat them at least on that score. What's more, Bush would be endorsing a goal the Republican Congress has already begun achieving.
Gore and Bradley are at war over plans for the uninsured and Medicare that will cost somewhere between $30 billion and $100 billion a year, depending on who's estimating.
Bush's plans are likely to cost less, although Bush aides claim they will be better designed and contain far more market-based reform than the Democrats are proposing.
For the nation's 44 million uninsured citizens, Bradley has proposed giving tax credits to allow low-income people to buy into the Federal Employees Health Benefit Program. He says this will guarantee insurance to 95 percent of the population at a cost of $55 billion a year.
Gore asserts Bradley's plan will cost too much -- $100 billion, he says -- and instead Gore wants to guarantee coverage to the nation's 11 million uninsured children at a cost estimated at $30 billion a year.
Bush aides say their man's focus is likely to be on 17 million employed persons who lack health insurance, although how much help he will give them -- and how -- is still under debate.
At one of two half-day health policy sessions he's held, according to one adviser, Bush said that "a person who gets up in the morning and goes to work ought to have the same access to health insurance whether they work at the corner gas station or Dow Chemical. Why should you have a tax code that helps one and hurts the other?"
Existing tax laws give a deduction to companies that cover their employees, but none to individuals who buy their own insurance. Bush has not decided, though, that tax credits for individuals are the way to go.
A means-tested tax break like Bradley's, say Bush aides, would discourage workers from earning more money. So Bush is considering a new idea to provide block grants to states that encourage insurance companies to offer lower-cost policies to the uninsured.
Both Gore and Bradley likely will criticize Bush -- as Bradley criticizes Gore -- for being too "incremental." Bush aides say that both Gore's and Bradley's plans are too government-dominated and inefficient.
Bush aides say he will offer health reform "in morsels big enough for the American public to chew," rather than overhauls such as those proposed by President Clinton in 1994, which the public rejected.
On Medicare, Bush favors the approach taken by the co-chairmen of the Bipartisan Medicare Commission -- Sen. John Breaux, D-La., and Rep. Bill Thomas, R-Calif. -- to help seniors buy private health insurance and provide a prescription drug benefit for those with low incomes. Bradley and Gore both want to provide drug benefits for all seniors, though Bradley's method is more generous.
Meantime, on patients' rights, Bradley and Gore both favor the House-passed Norwood-Dingell bill that allows patients to sue their health plan when services are denied.
Bush signed a bill in Texas that is like the Republican alternative sponsored by Reps. Tom Coburn, R-Okla., and John Shadegg, R-Ariz., that allows suits only after administrative review and limits damage awards.
Bush's approach to health care seems in keeping with his overall theme of "compassionate conservatism." It deals with all the issues Democrats are raising -- from the uninsured through patients' rights -- but less expensively and through private-market mechanisms.
The Bush approach probably will work in a general election campaign, but he can't wait too long before starting to sell
JWR contributor Morton Kondracke is executive editor of Roll Call, the newspaper of Capitol Hill. Send your comments to him by clicking here.
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