Health care

The Kerry health-care plan hardly amounts to government-run health care.

One of the tallest tales to come out of the campaign of President George W. Bush this election year is that the health-care proposals put forward by Democratic presidential candidate Sen. John Kerry amount to a government takeover of health care. That gross exaggeration is meant to remind voters of the health-care debate in 1994, when former President Bill Clinton’s bid for universal coverage died a slow death in Congress.

But this is not 1994, and Kerry is not Clinton. Kerry’s prescription for the ailing U.S. health-care system hardly puts government in the driver’s seat. But it does offer a chance to slow the increase in health-care costs and reduce the ranks of the uninsured – two goals Bush shows no sign of taking seriously.

The health-care challenges confronting the next president are daunting. Approximately 45 million people in the United States go without health insurance – approximately one in six. Premiums continue to increase at a double-digit pace, led by the exploding costs of prescription drugs. Employers, who provide much of the insurance coverage for those younger than 65, have responded by slimming down benefits and asking employees to pay higher premiums, deductibles and co-pays. As the population ages and medical technology becomes increasingly sophisticated, those costs will soar even higher.

Solving these problems should have been a priority four years ago, when Bush took office. Unfortunately, the president has not proven himself up to the task. His campaign promise to reduce the uninsured by 5 million, a modest but worthy goal, has not been fulfilled. In fact, the number of uninsured has increased by more than 2 million under the Bush administration. His attempts to slow the growth of health-care costs have been equally ineffective.

These failures should not come as a surprise. In advancing his reform agenda, the president has nipped at the edges of a health-care system badly in need of large-scale reforms. Proposals to subsidize the purchase of insurance in the private market, revamp medical liability laws and allow small businesses to band together in “purchasing pools” will mean little to the uninsured. According to one estimate, the administration’s plan would bring insurance to only 6.7 million uninsured people.

Bush has consistently overstated the likely benefits of his proposals. He has argued that malpractice reform would slow the growth in health-care premiums, but many experts doubt that frivolous lawsuits and large jury awards account for much of today’s high premiums.

Bush’s fascination with health savings accounts and other proposals that give consumers more say over how they spend their health-care dollars is ill-suited for a system in which most people get their insurance through the government or employers. His plan to provide tax credits for the individual purchase of insurance would be more realistic if the credits covered more than a fraction of the premiums most families would pay.

The president’s only serious health-care reform – a Medicare prescription drug benefit – might do more for large pharmaceuticals than cash-strapped seniors struggling with the high costs of drugs. Bush refused to give the federal government the power to negotiate lower drug prices for its Medicare beneficiaries, a move many economists believe would help slow the growth in drug costs.

The Bush plan for health-care reform cuts a paltry figure beside a Kerry plan that would result in approximately 27 million newly insured people. Kerry’s plan is aimed at strengthening the employer-provided insurance system and expanding low-income programs such as Medicaid and the State Children’s Health Insurance Program.

That approach is hardly the “government takeover” Bush alleges at nearly every campaign stop. Kerry intends to reimburse employers for 75 percent of their highest, or “catastrophic,” medical costs. In exchange, employers would agree to cover all employees and pass the savings on to workers. The proposal is an innovative way to contain rising premiums and make health benefits more affordable for small-business owners.

Kerry would also expand Medicaid and the State Children’s Health Insurance Program to cover children and working parents well above the poverty level. That move is targeted at working families of modest incomes who often do not receive health benefits through their employers.

Kerry and Bush have put forward two very different plans to reform the U.S. health-care system. Bush has contented himself with small solutions to a big problem. Kerry has a plan that would bring insurance to millions of people by strengthening the current health-care system. That’s not “government run” health care. It’s the right thing to do in a country with the most advanced and effective health care in the world.