BUSH/GORE: Plans Differ from 1992 Proposals
The issue of the uninsured has "flared anew" in the presidential campaign, sparking "fierce exchange" between Vice President Al Gore and Texas Gov. George W. Bush (R), but neither of the candidates' plans is "on the scale proposed by their 1992 counterparts," the New York Times reports. For example, Bush's plan of using tax credits to pay for health insurance is "dwarfed" by his father's 1992 proposal, while Gore's "popular" proposal to expand CHIP "falls well short" of President Clinton's goal of universal health care. Some health officials say that the contrast between the 1992 proposals and their scaled-down 2000 counterparts is "particularly striking" given the country's 1992-1993 budget deficits of nearly $300 billion. Health policy experts speculate that the booming economy and the budget surplus have caused public attention to shift away from the uninsured, although the number of Americans lacking health insurance rose throughout the country's economic expansion and only began to decline last year, for the first time in 12 years. In addition, the dilemma of the uninsured has been "eclipsed" by prescription drugs for the elderly, in part because it seems to be an "easier ... and cheaper" problem to solve. "The elderly are a powerful vote. And not only do seniors vote more, but their ability to organize, to hold forums, has garnered their cause a great deal more attention than the uninsured," Harvard health care expert Robert Blendon said.
Some experts say that smaller, step-by-step goals for health care reform are more "politically realistic" than promises of sweeping reconfigurations. Ron Pollack, head of the consumer advocacy group Families USA, said, "I personally do not believe we're going to get universal coverage in one piece of legislation." The Times reports that Clinton's failed 1993 attempts at universal health insurance, combined with former Sen. Bill Bradley's (D-N.J.) unsuccessful effort at resurrecting the issue in his presidential campaign this year, have led politicians to tout more incremental plans. Bush's proposed tax credits of up to $2,000 to help families earning $30,000 a year buy private insurance have drawn criticism for being "too small." Dr. Judith Feder, dean of policy studies at Georgetown University, likened Bush's plan to "giving a 10- foot rope to people in a 30-foot hole." Gore's plan, which would expand CHIP to cover low-income parents and all children with families earning up to $42,000 a year, has earned support from advocacy groups. Gore's plan would also give a tax credit to uninsured parents with higher incomes to buy into the program. "If I had to pick two increments, I'd pick getting the job done for kids and providing meaningful coverage for low-income parents," Pollack said. Other health care officials recommended a combination of the two candidates' plans, and speculated on the "possibility of a real compromise" between the two proposals following the election. Stuart Butler, a health expert at the Heritage Foundation, said that he envisioned conservatives accepting some expansion of children's coverage and liberals accepting greater use of tax credits for "more moderate income people." Dr. Drew Altman, president of the Kaiser Family Foundation, urged the two parties to "stop fighting over ideological differences" and use the country's current prosperity to enact change. Altman said, "If we're not able to deal with this issue [of the uninsured] now, when will we ever be able to deal with it?" (Toner, New York Times, 10/15).