The Politics of Healthcare (Published November 5, 2000)

This was to be a column comparing the healthcare proposals from Governor Bush compared to Vice President Gore. I had gathered materials and was writing the column to help readers understand their considerable differences, separating the medical facts from the political rhetoric. Then I saw The Ad. And I changed my mind about by the balanced column and have made this an Opinion Page article.

The television ad from the Bush campaign had to do with their characterization of Gore's Medicare drug benefit proposal. It was a pure lie. I certainly understand political spin and the unalienable right to have contrary opinions. But I also know pure balderdash when I see it. And I know why they did it.

The ad purports that the Vice-President proposes to put all Medicare seniors in a “single federal HMO”. I almost fell off the Stairmaster. I suppose the Republicans used this phrase to use fear-invoking terms that imply that Vice President Gore's plan would restrict choice, institute a governmental bureaucracy and drive people into a healthcare organization both hated and feared by the majority of Americans. Gore's proposal is also none of the above.

Gore has proposed a drug benefit for ALL Medicare recipients, not just those in Medicare HMOs, as well as full premium and cost-sharing protection for low income seniors. Bush proposes a drug benefit for ONLY low-income Medicare recipients, and you MUST join either an HMO or a private insurance plan (extra cost) to get it. Gore proposes no deductible, 50% co-insurance, and full catastrophic coverage after $4000 out of pocket. Bush lets each state define the benefit, and provides catastrophic coverage only after $6000 out of pocket. Gore has budgeted $356 billion for Medicare reform and drug benefit over 10 years; Bush proposes only $158 billion over the same time.

Let's not forget our children. Gore proposes covering all children by 2005 by raising Children's Health Insurance Program (CHIP) eligibility to 250% of the federal poverty level, and allowing buy-in to CHIP or Medi-Cal for children for families up to that level. Bush has also touted CHIP, but a Texas Federal District Court found the Texas CHIP program to be unlawfully deficient, and had the largest drop (193,400) in children's Medicaid coverage from 1996 to 1999. Texas also has the 2 nd largest percentage of uninsured children in the U.S.

I could go on further with their difference in Patient's Bill of Rights, long-term care, Medicare funding, patient privacy, and if the editors gave me the whole page, I would. But suffice it to say that Vice President Gore in his 24 year career as a public servant has fought for lower drug costs, the availability of comparable generic drugs, fought the 1995-6 congressional proposal to cut $270 billion from Medicare, pushed for the enactment of CHIP, successfully promoted legislation allowing working adults with health problems to keep their health coverage when switching jobs, supported strong patient rights legislation and the toughest nursing home standards in history.

Governor Bush's supporters are the for-profit HMOs, the for-profit hospital companies, and the drug companies (not to mention the NRA); if you like what they've done for the cost and quality of healthcare, you'll love Bush's healthcare policies. If you have concerns that they may have undue influence in your, your parents, or your children's healthcare if Bush wins the White House, you should consider voting for Al Gore this November 7 th and supporting the Vice President's incremental plans to have meaningful and long-term healthcare reform.



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