AT ISSUE: WHICH CANDIDATE PROPOSES THE BEST HEALTH CARE PLAN? : Point-Counterpoint

The Charge: President Bush initiated the debate this week, charging that Bill Clinton would “create lines at hospitals” while at the same time imposing a 7% payroll tax on middle-income Americans through his plan to phase in universal health care. The result, Bush argued, would be the loss of 700,000 jobs, and a health care system with “the efficiency of the House post office and the compassion of the KGB,” he said. As an alternative to greater direct government involvement, the President earlier this year proposed tax incentives to help those without coverage buy insurance.

The Response: Clinton’s plan to phase in universal access to health care would not require a general tax increase, his staff says. Instead, all employers would be required either to insure their employees or to buy into a public insurance plan; Clinton would initially provide some federal aid to help companies with the cost. Also, he says the burden would be minimized by extensive new cost controls on medical services and insurance reforms that would bring down the cost of coverage. All those without jobs would be covered by the public plan. Clinton says Bush’s plan fails to control costs or guarantee coverage and his proposed tax breaks are insufficient to permit the uninsured to afford insurance.

The Analysis: Both Bush and Clinton have been vague about how they would pay for their proposals to expand access to health care. Almost six months after he unveiled it, Bush has still not yet drafted legislation to implement his tax-credit idea--or specified how he would fund it, except to say that reductions in Medicare and Medicaid spending would cover the cost. Clinton’s insistence that all employers not now covering their employees provide insurance or buy into a federal plan amounts to an effective new tax on such businesses--but he argues that such companies are currently being subsidized by other employers, who pay higher health bills that reflect costs of uncompensated hospital care for uninsured Americans. Somewhat similarly to Bush, Clinton argues that the cost of extending coverage to those without jobs would be offset by insurance reform and squeezing waste out of the system.