Democratic Presidential Candidates Criticize Record of Rival Former Vermont Gov. Howard Dean on Medicare

Presidential candidate and former Vermont Gov. Howard Dean (D) on Sunday "found himself on the defensive" about his former position on Medicare after rival candidate Rep. Dick Gephardt (D-Mo.) criticized Dean's record, the New York Times reports (Swarns/Lyman, New York Times, 9/29). In an appearance on NBC's "Meet the Press," Gephardt said that Dean "deserted Democrats" in the mid-1990s by supporting decreases in Medicare spending proposed by former House Speaker Newt Gringrich (R-Ga.), the AP/Los Angeles Times reports (Kerr, AP/Los Angeles Times, 9/28). Dean, who then was chair of the National Governors Association, supported a bill in 1995 that Gephardt said would have cut $270 billion over seven years from Medicare; Gephardt voted against the bill and former President Clinton vetoed the bill. Dean supported a 1997 measure signed by Clinton that cut $115 billion from Medicare over five years. Gephardt voted against the measure (Beaumont, Des Moines Register, 9/29). Gephardt contended that Dean "just a week ago, or two weeks ago" supported "slow[ing] down the growth of Medicare by 7% to 10%. ... And he continues to say it's a horribly run program, and that it's not a good program." In his "Meet the Press" appearance, Gephardt also discussed his proposal to provide near-universal health care coverage to U.S. residents (Russert, "Meet the Press" transcript, 9/28). Speaking later at a press conference in Washington, D.C., Gephardt said Dean is "agreeing with the Republican view of Medicare, which has always been to criticize it, to privatize it." In addition, presidential candidate Sen. John Kerry (D-Mass.) on Sunday sent an e-mail to reporters saying that Dean is "working on the wrong side" on "issues such as Medicare and prescription drugs" (New York Times, 9/29). A video excerpt of Gephardt's criticism of Dean's Medicare stance on "Meet the Press" is available online in RealPlayer. The full transcript of the program is also available online.

In an appearance on CBS' "Face the Nation" on Sunday, Dean said, "I am not going to be compared to Newt Gingrich by my rivals. I did support slowing the growth of Medicare, and that was a good thing. It worked out well, Bill Clinton signed the bill and Medicare is still solvent because of it. And the folks in Washington didn't do one thing about it." When asked to address Gephardt's contention that he took the same position on Medicare as Gingrich, Dean said, "The person I supported was Bill Clinton. Bill Clinton signed a bill, which was very much like what I was proposing, which reduced the growth of Medicare so it could be sustainable for seniors well into the future" (Schieffer, "Face the Nation," CBS, 9/28). The New York Times reports that Dean has acknowledged calling Medicare "one of the worst federal programs ever" (New York Times, 9/29). However, Dean's campaign issued a statement saying that Gephardt's criticism was "desperate and baseless" and that Dean understands "perhaps better than any Democrat in the race the importance of the Medicare program" (AP/Los Angeles Times, 9/28). A video excerpt of Dean's comments on "Face the Nation" is available online in RealPlayer. In addition, Dean on Monday will discuss health care issues on NPR's "Talk of the Nation" (Neary, "Talk of the Nation," NPR, 9/29). The full segment will be available online in RealPlayer after 6 p.m. ET.

The debate over Medicare policy "culminated in a confrontation in Iowa" later Sunday between Dean and Gephardt supporters, according to the New York Times. While Dean was speaking at a long-term care senior center in Dubuque, Iowa, Gephardt supporters arrived and distributed literature about Dean's support of Gringrich's Medicare plan (New York Times, 9/29). Dean said the political attack was "Washington nonsense from candidates ... who are basically desperate and don't want change." Dean appeared in Iowa to introduce a plan for long-term care for the elderly (Des Moines Register, 9/29). After speaking on "Meet the Press" Sunday, Gephardt traveled to Manchester, N.H., and promoted his health care plan in an approximately 30-minute speech to a group of about 75 people, the Manchester Union Leader reports. Gephardt said his proposal "is the only plan that's universal and comprehensive ... it's the only plan that helps everybody" (Kepple, Manchester Union Leader, 9/29).

The plan Dean unveiled on Sunday in Iowa would expand long-term care for U.S. residents ages 65 and older. Under the proposal, states would receive grants at "matching rates more favorable than Medicaid" to provide training for family members who provide in-home care to elderly people, the New York Times reports. It also would require that long-term care workers undergo criminal background checks, and it would create a national registry of long-term care workers that would include a history of patient abuse complaints (New York Times, 9/29). Dean did not disclose a cost for the plan, but said the proposal is "modest" and would not be a "broad new spending program," the AP/Arkansas Democrat-Gazette reports (AP/Arkansas Democrat-Gazette, 9/28). In an interview Sunday with the Associated Press, Dean said that if elected, he would be willing to make spending cuts in domestic programs in order to balance the federal budget. However, he added that he would increase spending for health coverage, special education and urban improvement projects. Gephardt later criticized Dean for not specifically mentioning Medicaid as a program to be protected from budget cuts (Pickler, AP/Salt Lake Tribune, 9/28).