How They Would Handle Health Care

Here’s a look at where the major presidential candidates (Bill Bradley, Al Gore, George W. Bush and John McCain) stand on health care reform. Among the issues being debated is how to deal with an estimated 43 million Americans who have no health insurance. In California, the number of uninsured is estimated at 7 million. Nationwide, about one child in 10 does not have health insurance.

BILL BRADLEY (D)

“All Americans deserve the helping hands to a productive life, whether they are the hands of family members or the hands of that extended family of all Americans helping each other. You can call that extended family government if you like, but government is, after all, just the people.”

* Require parents to insure all children at birth. He would abolish Medicaid, making the federal government, not the states, responsible for the health care of America’s poorest residents.

* Federal government would pay the full premium for health care plans selected by parents of children in households with annual incomes below $32,800 for a family of four. Partial premium subsidies would be provided for children in households with incomes up to $49,200.

* Allow all Americans to participate in the Federal Employees Health Benefits Program, the same insurance program provided for members of Congress and 9 million federal workers.

* Fully subsidize insurance for all adults in poverty (a family of four making less than $16,400) and all current Medicaid participants.

* Exclude insurance premium payments from taxable income.

* Those who use the proposed Medicare prescription benefit would pay a $500 deductible, a $25 monthly premium and 25% of the costs of the drugs, which would be generic whenever possible. There would be no cap on prescription spending.

Estimated cost: Up to $65 billion a year, to be paid from non-Social Security budget surplus.

AL GORE (D)

“Taken together, these steps will make health care affordable for millions of Americans who can’t afford it today. They will move us toward the day when every American has access to affordable, quality coverage.”

* Expand an existing federal-state program that helps provide health insurance and offer it to children whose parents make about $41,000 to support a family of four, up from the current income target of about $33,000 for a family of four.

* Allow the uninsured parents of children who qualify for the Children’s Health Insurance Program or for Medicaid to buy insurance at reduced rates, thus lessening the numbers of uninsured working parents.

* Enable Americans ages 55 to 64 to buy into Medicare, expanding access for one of the fastest-growing segments of the uninsured population.

* Expand coverage and create prescription drug benefit under Medicare.

* Allow a 25% refundable tax credit for premiums for the self-employed.

* Allow small businesses to deduct 25% of health insurance costs.

Estimated cost: More than $250 billion over 10 years.

GEORGE W. BUSH (R)

“Medicare is a plan that is inefficient, it is a plan that is antiquated, and what our government must do is empower our seniors to make choices for themselves.”

* Supports expanded medical savings accounts.

* Would consider charging wealthier Medicare recipients more for coverage.

* Strengthen tax incentives to small businesses that provide health care to employees.

* Supports a law to give all Americans the right to sue their managed health care providers, if the measure is modeled on a 1997 law in Texas. That legislation, which Bush allowed to become law without signing it, establishes an independent panel to hear patients’ claims that their health care plans wrongly refused treatment.

Estimated cost: Not available.

JOHN McCAIN (R)

“Too many Americans go to sleep at night desperately fearing illness or injury to themselves or a family member because they are without health insurance to pay the bills. Eleven million children go to sleep without health care coverage. My friends, we are a better country and a better people than that.”

* Supports expanding prescription drug assistance for seniors by establishing a program to provide a significant block grant to any state willing to share the cost.

* Would fund regional pilot programs to provide seniors, regardless of income, with assistance for catastrophic drug expenditures.

* Offers consumers a limited right to sue HMOs for medical malpractice.

* Supports providing $2 billion to improve the health of veterans “who have risked their lives in defense of ours.” * Supports expanded medical savings accounts.

* Offers tax deductions for health insurance for the self-employed.

Estimated cost: $4.3 billion in the first year and about $7.6 billion annually by the fifth year.

GLOSSARY

Federal Employees Benefit Program: The insurance program provided for members of Congress and 9 million federal workers, retirees and their dependents.

Medicaid: The nation’s major public financing program for providing health and long-term care coverage to low-income people. In 1997, an estimated 40.6 million people were enrolled in Medicaid. Eligibility is determined through several criteria, including income.

Medical Savings Account: Accounts that allow employees/employers to create cash accounts for employees to spend on routine medical care.

Medicare: A federal program that provides virtually universal coverage for all elderly and many disabled Americans. Nearly everyone aged 65 and older is covered based on their eligibility for Social Security benefits. In 1999, 39 million citizens received benefits under the Medicare system.

Prescription Benefit: A Clinton administration proposal calls for adding a prescription drug benefit to Medicare. With drug prices soaring 15% a year, well ahead of inflation, the idea of Medicare covering not only inpatient care but essential drugs outside the hospital has been steadily gaining popularity.

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Sources: Staff reports, Associated Press and candidates’ campaigns.