Thursday, May 01, 2003

Opinion

Kaiser Daily Health Policy Report
Rounds Up Reaction to Gephardt Universal Coverage Plan

      Several opinion pieces have been published in recent days addressing presidential candidate Rep. Dick Gephardt's (D-Mo.) near-universal health insurance coverage plan. Under the proposal, Gephardt would expand access to coverage by roughly doubling the federal subsidy to businesses to pay for insurance premiums to 60% and require employers to provide coverage; expand Medicare to allow individuals ages 55 to 64 to pay to enroll in the program; provide federal subsidies to help the unemployed purchase health coverage through COBRA; expand the CHIP program to cover parents of eligible children; and provide $172 billion to state and local governments over the next three years to reimburse them for the cost of health insurance for their employees. Gephardt said that the proposal would provide health insurance to 97% of the estimated 41 million U.S. residents who lack coverage and cost $214 billion in 2005 and $247 billion by 2007. To fund the plan, Gephardt would repeal tax cuts enacted by President Bush (Kaiser Daily Health Policy Report, 4/29). The following are summaries of reactions.

Columnists

• David Broder, Washington Post: Gephardt's proposal "sent echoes" across the Democratic party, Broder writes in his Post column. According to Broder, although "[m]uch is debatable" about Gephardt's plan, it will compel every other Democratic president candidate to produce a counterplan and will push the Bush administration to address the issue of the uninsured as well. Broder concludes, "A debate that has languished in Congress for nearly a decade will be joined" (Broder, Washington Post, 4/30).
  
• E.J. Dionne, Washington Post: Gephardt has "already succeeded" in his campaign efforts because he has "drawn a clean, clear line across American politics by challenging Bush on precisely the issue that should be at the heart of the domestic debate in 2004," Dionne writes in a Post column. Although expensive, Gephardt's plan would boost the economy by increasing the share the federal government pays for employers' health care costs, freeing up capital that would "inevitably translate into new investment, higher wages or both," Dionne writes, adding that the plan offers voters a choice: "They can have Bush's tax cuts or they can have secure health coverage." Dionne concludes, "If nothing else, Gephardt has broken the spell of the Clinton Syndrome, the affliction that sees all efforts to achieve universal health insurance coverage as doomed to the same fate as ClintonCare. Gephardt will stand or fall on his health plan, but at least he'll stand for something" (Dionne, Washington Post, 4/29).
  
• Jerry Heaster, Kansas City Star: Gephardt's plan is a "ruinous idea in the service of his presidential aspirations," Heaster writes in a Star column. According to Heaster, the plan would hinder economic growth by "increasing the government's claim on wealth-creating resources" and "forcing the private sector to give back benefits already received from earlier tax relief measures." The plan would also hurt job growth by requiring employers to cover their employees "whether the company could afford this benefit or not," forcing many "marginal" small business to close, he states. Further, a "flood of new clients" entering Medicare through Gephardt's plan to offer access to the program to people between the ages of 55 and 64 would "swamp" the program and make it less efficient, according to Heaster. He concludes, "Creating a fiat benefit with such extensive negative consequences would in fact diminish the quality of health care for virtually everyone by allowing government to misallocate scarce resources" (Heaster, Kansas City Star, 4/30).
  
• James Kuhnhenn, Knight Ridder/Kansas City Star: Gephardt's plan has "set the tone" for the nine Democratic president candidates and ignited a "major debating point for the American public," Kuhnhenn writes in his Knight Ridder/Star column. Since 1994, Democrats have avoided "overhauling" the nation's health care system because of the Clinton administration's failed attempt, he states. However, with Gephardt's plan, Kuhnhenn concludes, "[K]ey Democrats and their health care allies, tired of incremental fights over patient-friendly health maintenance organizations and prescription drugs for seniors, are thinking big again" (Kuhnhenn, Knight Ridder/Kansas City Star, 4/30).
  
• Matt Miller, Philadelphia Inquirer: Gephardt's plan has "launched two great and indispensable debates": whether covering the uninsured or instituting tax cuts is the "bigger priority," and how Democrats will "achieve their goals" in the near future, columnist Miller writes. Miller concludes, "Thanks to Gephardt, these overdue debates will start earlier and on a bigger scale than most of us expected" (Miller, Philadelphia Inquirer, 4/29).
  
• Grace-Marie Turner, St. Paul Pioneer Press: Gephardt's basic concept in his coverage plan is to "assume that government knows best how to redistribute and spend citizens' money," Turner, president of the Galen Institute, writes in her Pioneer Press column. According to Turner, Gephardt's plan "is based on a Keynesian notion that government spending creates prosperity" -- that by increasing taxes on workers, money would go from taxpayers to the government to employers, who would then spend it on health coverage and wage increases. However, Turner says that reversing Bush's tax cuts would be a "disincentive for Americans to work, save and invest," and workers would be encouraged to "consume as much health care as they can to get their money's worth," further driving up health care inflation. Turner states that Gephardt's plan would hinder "consumer empowerment, market-driven efficiency and continued innovation in health care financing." Instead, providing refundable tax credits to people who are uninsured would be "more politically palpable," according to Turner. Turner concludes, "Tax credits would be a first step that could provide millions more Americans with health insurance, without the huge costs and disruption of trying to do too much all at once" (Turner, St. Paul Pioneer Press, 4/30).

Editorials

• Albany Times Union: President Bush's call for universal health care coverage in Iraq as part of a reconstruction package and Gephardt's near-universal coverage proposal have some people asking, "Why for Iraq and not the U.S.?" a Times Union editorial states. The Times Union notes that with the war in Iraq coming to an end, polls have indicated Americans are "increasingly focusing" on domestic issues, including health insurance. The Times Union concludes, "[I]f the Bush doctrine in Iraq should produce a universal program as promised, the focus on this issue can only intensify in the U.S. And this time, it's not likely to go away" (Albany Times Union, 4/29).