It’s a Dems’ Game, but Bush has to Play It.

Nothing foments conservative blood quite like the concept of universal health care. According to the left this is because of the cold reptilian nature of their vital fluids, the same reason they oppose all the left’s programs of “social-consciousness.” Yet, the real motive is that conservatives and libertarians alone understand the ineptitude of government paternalism, and to have it threaten an industry as important as medicine scares the bejeezus out of them. And they know the stakes are high, while it’s easy to offer the people government services, it’s virtually impossible to take them away. Thus, there is no second chance on health care reform.

The 2004 democratic primaries are starting to impress upon the public consciousness and the one thing that is certain about the coming race is that Health Care is on the agenda in a big way. In 2000 we were subjected to empty and ignorant promises about prescription drug benefits (remember Gore, his mother and his dog). Neither candidate discussed WHY drugs cost so much, i.e. the draconian requirements of the FDA, but merely pledged to pay for them in one way or another. Quite predictably that ‘throw money at it’ approach looks to dominate again in 2004.

So prerequisite is a health program to the democratic presidential nomination that most all the candidates have already announced their plans and we’re still five months away from the first votes. Gephardt had his plan out several months ago in fact, making him the early bird that probably won’t catch the worm. Why? His program is the most expensive and the most ambitious of the viable candidates. (I say viable candidates because there is always the stargazing Kucinich, who stands no chance at mainstream support for his government-run single payer plan that would be financed by a 7% tax on employers.) The Gephardt fiasco would cost around $212 billion dollars and require employers to provide health-care to all employees, with up to 60% of the cost subsidized via tax credits. Gephardt, along with Dean, would reverse ALL of Bush’s tax cuts in order to afford his program. It doesn’t seem to be of much concern that a shrinking economy would only create a downward spiral of government spending on health care. Rising unemployment under the Gephardt dream would simultaneously create increasing claims for Medicare benefits (which Gephardt would provide) and decreasing tax revenue to pay for those benefits. But this spiral is nothing new I suppose.

Next among the big-spenders is the precipitous Howard Dean. Dean’s plan is likely to get respect because Dean is a doctor, but policy wise it doesn’t seem to part much from Gephardt’s spend-spend approach. Dean would allow all Americans to buy in to the same coverage federal employees receive and expand Medicaid and/or CHIP to insure everyone under the age of 25 with an income of less than three times the poverty level. This move no doubt panders at least a little to the 18-25 year old voting bloc, notably the weakest in the electorate, but probably the most susceptible to the Dean’s seduction. Dean’s plan would cost about $88 billion.

Edwards, just recently announced his plan and it is the cheapest and most conservative of the bunch, placing the burden of mandatory insurance for children on the parents but providing tax credits to help pay for it. He would also, like Dean, allow lower income families to buy in to state health insurance. His plan would cost a measly $53 Billion, but would probably still require tax hikes.

The most rational plan (rational for a Democrat anyway) is probably John Kerry’s. Kerry wouldn’t repeal all of Bush’s tax breaks, he would, of course repeal those cuts that benefit the wealthy. He would also close unspecified corporate loopholes. We shouldn’t hold this against him, he is a democrat after all … and a rich one at that. Kerry’s $72 million program would reimburse employer cost up to 50%, as well as pick the tab on state’s expanding Medicaid to cover 20 million uninsured children. Remarkably though, Kerry at least addresses the issues of cost reductions. He would create a catastrophe fund, similar to terrorist insurance, that would help pay for insurance claims exceeding $50,000 (only about 0.4% of all claims). Kerry also recognizes the inefficiency of the medical bureaucracy pointing out that “While banks have cut their costs to less than a penny per transaction using computers and technology, a single transaction in health care can cost as much as twelve to twenty-five dollars.” Yet, mere recognition of this problem does little to solve it and so far recognition is all Kerry seems to have.

Given the electorate’s interest in the issue (polls usually show health care as the number one domestic issue after the economy), Bush cannot appear to champion the status quo. He will have to come up with some viable alternative to these warm, fuzzy, “compassionate” financial disasters. One way to do this is to become visibly passionate by the exponentially rising costs of health care and to develop a multi-pronged attack on the crisis from a cost-reduction angle. A catchy name like “Health of the Nation” or “A Nation of Choice” would allow him to maximize his still strong rapport with the American people, while promoting a plan that, above all, must have substance. Bush might also want to co-opt the Catastrophe fund idea and provide a few more restrictions on its use. This would surely anger some conservatives, but the mainstream would love it. A catastrophe fund would certainly be an added government service but it would be easier to repeal once the “Health Care Crisis” abates, thus making it a fairly safe compromise (unlike Bush’s behemoth prescription drug benefit). Bush has to be aggressive and creative on the health care issue. Anything less will risk the health and the freedom of future generations.

Posted by Mike Van Winkle at August 3, 2003 9:40 PM