PRESIDENTIAL DEBATE: Bush, Gore Tackle Health Questions

      Squaring off last night for the third and final presidential debate, Texas Gov. George W. Bush (R) and Vice President Al Gore addressed a flurry of health care issues and sparred over who would "fight" for Americans if elected in November. The debate, held at Washington University in St. Louis, featured a "town hall" format where audience members asked the candidates questions directly. Tackling the opening question about managed care reform, Gore said, "I think we ought to have a patients' bill of rights to take the medical decisions away from the HMOs and give them back to doctors and nurses. ... I support ... the Dingell-Norwood bill, a bipartisan bill," adding, "[T]he governor does not." Bush rejected the charge and chronicled Texas' patients' bill of rights, which includes a provision that allows patients to sue HMOs. Pressing Bush on the issue, Gore noted that Bush backs patients' rights legislation sponsored by the "Republican majority" that "[t]he HMOs and the insurance companies support," not the House-passed Norwood-Dingell bill. Bush answered the question about the differences between his position and Gore's by concluding, "[T]he difference is that I can get it done."

Rx Drugs, Anyone?
      When asked "Are either of you concerned with finding some feasible way to lower the price of pharmaceutical drugs ... instead of just finding more money to pay for them?" Bush responded, "I think step one to make sure prescription drugs [are] more affordable for seniors ... is to reform the Medicare system [and] have prescription drugs as an integral part of Medicare once and for all," adding, "I want to call on Republicans and Democrats to forget all the arguing and finger- pointing and come together and take care of our senior prescription drug program." Bush also expressed support for the recently House-passed prescription drug reimportation bill but noted his opposition to price controls. Attacking Bush's proposals, Gore stated, "[H]ere we go again. Now look, if you want someone who will spin a lot of words describing a whole convoluted process and then end up supporting legislation that is supported by the big drug companies, this is your man." Gore said that he has "never been afraid to take on the big drug companies" and charged that the companies today are spending more money on advertising and promotion than they do on research and development. He also said the companies are "trying to artificially extend the monopoly patent protection so they can keep charging these very high prices." Outlining his plans to add a prescription drug benefit to Medicare and "streamline the approval of competing generic drugs," Gore concluded, "If you want someone who will fight for you and who will fight for the middle class families and working men and women, who are sick and tired of having their parents and grandparents pay higher prices for prescription drugs than anybody else, then I want to fight for you."

Universal Health Folly
      Addressing a question regarding national health coverage, Gore said that he favors moving "step by step toward universal health coverage" but not "government doing it all." He also touted his proposals to allow Americans ages 55-65 to buy into Medicare and to insure "every single child in America" in four years. He added, "85% of our people have health insurance, 15% don't. That adds up to 44 million people; that is a national outrage." Tackling the same issue, Bush said, "I'm absolutely opposed to a national health care plan. I don't want the federal government making decisions for consumers or for providers." He also criticized efforts by the Clinton-Gore administration to pass a universal health care proposal in 1993. "They tried to have a national health care plan, and fortunately it failed. I trust people; I don't trust the federal government," he said. Addressing his own proposals, Bush highlighted the need for a health "safety net," including increased community health clinics, a $2,000 tax credit for working families to purchase insurance and eased restraints on small businesses that will allow them to provide health coverage to employees (Debate transcript, Washington Post, 10/18). The Washington Post offers full debate coverage, including a complete transcript, video excerpts and analysis of the candidates' "claims and charges" by "debate referee" Charles Babington.