GORE VS. BRADLEY ON HEALTH

	November 25,1999
	Health Unit correspondent Susan Dentzer reports on the health care challenge between Democratic presidential candidates Bill Bradley and Vice President Al Gore.

SUSAN DENTZER: Among the top issues drawing the attention of the two Democratic candidates for president is the plight of those without health insurance. AL GORE: Let me be clear, we cannot rest until every single American has affordable health coverage. BILL BRADLEY: Here we are at time of unprecedented prosperity in this country. If we can't at this time reduce the number of children in poverty in America and increase the number of Americans with health insurance, when are we going to do it? SUSAN DENTZER: Last year, an estimated 44.3 million Americans were uninsured. One quarter, or about 11 million, were children. About one in four of the uninsured were poor, but many of the rest were in families with low to moderate income. By and large, these families are headed by workers in small to medium-sized firms. Increasingly, these companies and their workers find the cost of health insurance prohibitive. Consultant John Sheils follows health spending trends. JOHN SHEILS, Health Care Consultant: For the past two decades, we've seen the number of uninsured increase by about a million persons every year. And much of that, we believe, is due to price. SUSAN DENTZER: Gore and Bradley have proposed two different approaches to the problem. Gore wants to target groups in households that lack health insurance and expand existing programs to get them covered. Think of his plan as an airplane flying over a town to air drop relief on individual homes of the uninsured. In contrast, Bradley wants to devise whole new systems for covering millions of Americans, including by subsidizing many who already have health insurance. Think of his plan as an airplane flying over a town and dropping relief on almost everybody. AL GORE: Experience has taught us that there is a way to keep what is right, while fixing what is wrong with American health care. SUSAN DENTZER: Drawing on lessons learned from 1994, when the Clinton administration's proposed health reforms collapsed, Gore proposes to build on what is already working, rather than invent whole new systems of coverage. He'd start with uninsured kids. Through a combination of federal carrots and sticks, states would be nudged into expanding the children's health insurance program, or CHIP. That's a joint federal-state program for low-income kids that Gore would also make available for adults. AL GORE: I will propose to expand our current children's health initiative, so that families earning up to $41,000 per year-- that's 25) percent of poverty -- will be eligible for the benefits it provides. SUSAN DENTZER: For workers whose employers don't offer coverage, Gore would also provide a tax credit to help pay for insurance equal to 25 percent of the premium. Gore estimates that his plan would cover between ten million and fifteen million uninsured Americans. The cost? By Gore's calculation, $264 billion over ten years. That includes adding a new prescription drug benefit to Medicare. For his part, Bradley is thinking bigger. BILL BRADLEY: It's a big problem; it deserves a big solution. I've offered that, and I think he's been much more incremental in nature. SUSAN DENTZER: First, Bradley would do away with two existing health insurance programs, Medicaid and CHIP. Instead, people now covered under those programs would use the federal employee health benefits plan. That system lets nine million federal workers and their dependents choose coverage from a range of private health plans. Bradley would mandate that parents buy coverage for their children through this system or through an employer. BILL BRADLEY: Enrollment would be the responsibility of the parent. Just as brand-new parents would sign a birth certificate before leaving the hospital, those parents must also enroll their new child in a health care plan. SUSAN DENTZER: Bradley would fully subsidize those purchases for kids in poor families, and partly subsidize them for families with incomes up to about $50,000 a year. Then he'd make billions of dollars more in subsidies available to help provide coverage to low- and moderate- income adults. Bradley says his plan would cover 30 million of the uninsured. Including his own proposal to add a generous drug benefit to Medicare, he estimates the cost at $1 trillion over ten years.