Sick of the health care debate?

Neither Bradley nor Gore is telling the whole truth about what it will take to reform the system.


Jake Tapper
December 21, 1999 6:00PM (UTC)

Former Sen. Bill Bradley and his advisors act as if they can't believe the aggressive tactics and misleading accusations coming from Vice President Al Gore lately. Bradley seems stunned that Gore would sink to the depths of ... (cue thunderclap) a politician.

True, some of the rhetorical arrows in Gore's new quiver are somewhat questionable. He slams Bradley for refusing to rule out tax increases, despite the fact that he fundamentally holds the same position. His campaign hires a guy to dress up as a chicken and run out onto the court of Madison Square Garden during the climax of Bradley's basketball fund-raiser. He gathers seniors and the disabled 'round the campfire to tell them that Bradley wants to end their Medicaid -- while failing to add that Bradley does plan to replace Medicaid with another program.

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"It's classic Al Gore," Republican Sen. John McCain assessed last
week. "Attack, attack, attack."

And it's working. Gore's pummelling is clearly getting to the remote
Bradley, rattling him, dislodging him from his talking points and
diminishing his debate performances. Additionally, Gore's charges are
clearly being heard out in the hinterlands where
Bradley's momentum has slowed. In New Hampshire, for instance, where
Bradley was once several points ahead of the vice president,
according to polls, the two are now neck and neck.

Some of Gore's campaign charges are of questionable fairness and
accuracy. Kathleen Hall Jamieson, dean of the Annenberg School of
Communication, goes so far as to call a few of them "false," telling
NBC's Lisa Myers last Friday that Gore has made "clear, documentable
distortion(s) of Bradley's position."

But amidst the obnoxious and occasionally misleading charges, Gore is
asking some questions about Bradley's health care proposal that are
completely fair.

"I don't believe that candidates should come out with plans as
detailed as the health care proposal Bradley came out with," said
Robert Reischauer, a senior fellow at the Brookings Institute. "When
you put forward a whole bunch of specifics, they just end up killing
you."

Take Gore's dispute with Bradley over Medicare funding, for instance.
Gore has proposed funneling 15 percent of the budget surplus
into the Medicare trust fund and has hammered Bradley for not making
a similar proposal.

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Gore put this question directly to Bradley at the Dec. 17
debate
in Nashua, N.H., hosted by ABC's "Nightline."

"Since you do not set aside any of the [budget] surplus to strengthen
Medicare," Gore asked, "and since everybody knows the population of
Medicare recipients is going to double over the next 30 years, and
since there's a shortage in some parts of Medicare now, what other
proposals are you going to make to strengthen Medicare?"

Bradley, noting that Medicare is "solid until 2017 in this country,"
said that Medicare funding would be helped by better disease
management, major breakthroughs in drugs and the fact that "there is
a great probability that people who enter Medicare 10, 15 years from now
will be healthier because they have been exercising, not smoking."

Seizing on this last observation, on Monday in Des Moines, Iowa, the
Gore campaign sent a caravan of senior citizens to stand outside
Bradley events doing jumping jacks. "The Bradley plan for Medicare:
No additional funding and more exercise," read a Gore 2000 press
release.

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But, looking past the old folks doing jumping jacks, what about the
Gore campaign's charges that he plans to address the coming
bankruptcy of Medicare, and Bradley does not?

The truth is that "neither one of the candidates really addresses the
real problem," said Reischauer.

Payments to hospitals, nursing homes and hospices will soon exceed
the money in the Medicare trust fund. "We need to restructure the
entire program along the lines of the proposals by President Clinton,
or Sen. [John] Breaux, [D-La.], and Rep. [Bill] Thomas, [R-Calif.]," Reischauer said, "combined with some form of a
competitive kind of system."

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Seen through the prism of what actually needs to be accomplished,
Reischauer continued, neither candidate's Medicare solution is close to
sufficient.

"Having healthier people is not the answer to Medicare's problem,
though what Bradley said can be true and can result in some small
amount of savings -- but not enough to solve the problem." On the
other hand, "All Gore is doing is taking some bucks and putting them
into the trust fund, which isn't changing in any way the underlying
revenue problem, or addressing Medicare spending." Gore's plan to
funnel 15 percent of the budget surplus into the Medicare trust fund
only "puts off the day of reckoning a few years."

Another charge that Gore repeats constantly is that Bradley's 10-year, $650
billion health care proposal means less money for the health
insurance of poor Americans. Remember this exchange on Sunday's "Meet
the Press"?

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"There are 75 million Americans today who get Medicare and Medicaid,"
Gore said. "They are all left out under Sen. Bradley's plan
because he eliminates Medicaid and replaces it with little
$150-a-month vouchers, which also limits the access -- "

"That's wrong," Bradley said. "That's not correct."

"There are seven million disabled Americans who rely on Medicaid,
many of them to get out of bed each morning ... half of the people with
AIDS and two-thirds of all the seniors in nursing homes rely on
Medicaid," Gore said. "He eliminates it, and he doesn't save a penny
for Medicare ... 95 percent of all the health insurance plans
that are part of the Federal Employee Benefit Plan have premiums that
are far in excess of $150 a month."

Despite Bradley's protests, Reischauer agreed that Gore is pretty much on target.

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"Medicaid is a very generous benefit package," he explained. "It's more
generous than any insurance you or I have probably ever had. So what
Bradley is saying is that he is going to 'mainstream' those people
and put them in a policy that's less generous. One with co-pays and
deductibles, one that probably will not cover dental and vision, or
early and periodic screening for children."

On the other hand, by mainstreaming Medicaid recipients into more
modest programs, Bradley is able to provide health care for millions
more Americans. Gore's plan "clearly wouldn't cover nearly as many
people," Reischauer said. And "Bradley has much more generous
prescription drug benefits for Medicare recipients than the president
and Gore do. That's the major reason why some outside analysts say
that Bradley's plan might cost more than he says he thinks it will
cost."

Bradley might be relying too much on states picking up the slack
where he would cut off Medicaid's generous coverage, "hoping that
states will maintain those generous benefits for the really needy,"
Reischauer said. "But left to their own devices, I don't think
they [the states] will."

On the other hand, during the Dec. 17 debate, Gore implied that
Bradley's health care proposal would be "a big mistake that might put
[the economy] at risk." But according to Reischauer, the plan, if
enacted, wouldn't "make a dime's worth of difference from the
standpoint of the economy."

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"It's a crazy thing to have the two Democratic candidates fighting
over this," Reischauer said. "The point is the Democrats are
interested in doing something about the uninsured. They're going
about it in different ways, but they have the same common
objective. Bradley's plan is very ambitious. And Gore's plan is
incremental, by and large.

"In a way, their proposals complement one another. Gore's plan to
provide health care coverage for children and low-income adults would
be something you could implement the first year of your presidency.
But for the long haul, you should think about more fundamental
restructuring of the sort that Bradley is putting forward.

"This is an issue that was very divisive in 1994 and 1995, and [it's
not helpful for the Democrats] to have them squabbling over how to go
about achieving their common objective. Both of them are giving
Republicans lots and lots of quotes that will be used in the general
election no matter which one of them wins."


Jake Tapper

Jake Tapper is the senior White House correspondent for ABC News.

MORE FROM Jake Tapper

Related Topics ------------------------------------------

Al Gore Healthcare Reform

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