Rivals Trade Attacks on Healthcare Programs

President Bush charged Tuesday that Democrat John F. Kerry was backing a “big-government takeover” of healthcare that would force rationing of medical services and push doctors out of decision-making roles -- claims that some independent analysts called highly misleading.

The Bush offensive, in two television commercials, was reinforced in campaign speeches by the president in Arizona and Colorado. It came two days after Bush released another controversial advertisement that some campaign observers said had quoted the Democratic nominee’s foreign policy views out of context.

The Massachusetts senator fired back with a television ad that said Bush had blocked lower prescription drug prices. That ad, too, omitted a salient fact: that Bush last year signed into law the first prescription drug benefit under the Medicare insurance program.

The heated exchange on healthcare came as the candidates prepared to debate tonight on domestic issues at Arizona State University in Tempe.

Along with jobs, healthcare has become a central domestic issue of the election. About 45 million Americans lack insurance, more than when Bush took office in 2001, and many people who do have coverage face fast-rising premiums.

“It’s clear in this campaign there’s a difference of opinion,” Bush said at a rally in Paradise Valley, Ariz. “He [Kerry] said the other day, the government doesn’t have anything to do with his plan. When he said that I could barely contain myself.

“Of course the government has something to do with his plan -- it’s the cornerstone of his plan. It’s the crux of his healthcare policy, to expand the federal government.”

But some nonpartisan analysts said Kerry’s plan would not involve the creation of new federal agencies or the preemption of patient-physician decision-making by federal authorities, as the Bush ads claim.

“You would have to search long and hard to find anything in Kerry’s plan that resembles a government takeover of healthcare,” said Diane Rowland, executive vice president of the Kaiser Family Foundation, a nonprofit research group. “It’s nothing akin to the government being in your medicine cabinet.”

The Bush ads use a complex, somewhat confusing government flow chart to depict Kerry’s plan as an expansion of the federal bureaucracy akin to President Clinton’s failed healthcare initiative a decade ago. The ads repeatedly describe Kerry as allied with liberals, an effort to stamp him as out of the mainstream.

“John Kerry and liberals in Congress have a healthcare plan for you,” one of the Bush ads says. “A big-government takeover. $1.5 trillion. Rationing. Less access. Fewer choices. Long waits. And Washington bureaucrats, not your doctor, make final decisions on your health....

“John Kerry and liberals in Congress. Big-government-run healthcare.”

The second Bush ad claims that Kerry’s plan involves “massive new government agencies.”

The Kerry campaign describes its proposal very differently. It says Kerry would spend $653 billion over 10 years to help an estimated 27 million people who now lack health insurance obtain it. The Democrat plans to do so by expanding Medicaid and other existing government programs, as well as by offering subsidies to private employers.

To back up its assessment, the Bush campaign cited a study of Kerry’s health plan by the American Enterprise Institute, a Washington-based conservative think tank where Vice President Dick Cheney was once a trustee and where his wife has been a scholar.

The campaign also cited analyses by a proponent of tax-free medical savings accounts, a prominent Republican health initiative, and by a private consulting firm based in Virginia called the Lewin Group.

But an officer of the Lewin Group said Tuesday that the Bush advertising claims appeared to be misleading. When read an ad script over the telephone, Lewin Group vice president John Sheils said: “I don’t see any truth in it anywhere. I don’t think the statement is quite true.”

Ken Thorpe, a former Clinton administration health official who now teaches at Emory University in Atlanta, said Bush’s claims presented “a silly caricature” of Kerry’s healthcare proposals.

“They’re just all wrong,” Thorpe said. “The federal government has absolutely no decision-making role anywhere in this plan.”

John C. Goodman of the Dallas-based National Center for Policy Analysis, whose work was cited by Bush, disagreed and said that under the Kerry plan, “the government will be involved in a big way, and people will not like all the consequences.”

Goodman was an advisor to the Bush campaign in 2000 but said he was not affiliated with it this year.

The Bush campaign deployed Senate Majority Leader Bill Frist (R-Tenn.) to defend the ads. Frist, a physician and leading architect of the 2003 Medicare law, belittled Kerry’s proposal to expand Medicaid.

“Just ask any physician or any hospital what happens when a patient is treated in Medicaid,” Frist said. “Prices are strictly controlled, ultimately there is rationing, all of which together destroys innovation and research and development.”

In Kerry’s ad, the Democrat says: “For the last four years, one man has stood between America and lower-cost prescription drugs: George Bush. As president, I’ll fight to allow Americans to import lower-cost prescription drugs from Canada. And I’ll make it legal for Medicare to make bulk purchases, guaranteeing a better price for Americans.”

The ad does not mention that Bush signed the Medicare drug-benefit law, which is expected to take full effect starting in 2006. But Kerry was arguing implicitly that the law itself fell short.

Bush indicated in his debate with Kerry last Friday that he was open to the idea of importing drugs from Canada, though his administration has so far blocked such efforts. The president, however, has not embraced Kerry’s proposal to use government’s bargaining power to negotiate lower prices.

Kerry, who spent Tuesday in Santa Fe, N.M., gave no public speeches. But an advisor, Tad Devine, told reporters: “We welcome this engagement. They want a debate on healthcare, and we will take it on.”

The Bush and Kerry ads, posted on campaign websites, are expected to air this week in contested states.

Times staff writers Edwin Chen in Colorado and Michael Finnegan in New Mexico contributed to this report.