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Health Care: Dr. Feelgood And Dr. Status Quo Read The Voters Pulse


Washington Outlook

HEALTH CARE: DR. FEELGOOD AND DR. STATUS QUO READ THE VOTERS PULSE

Reading opinion polls on health care is like gazing at clouds: With imagination, you can see just about anything. So its no wonder that President Bush, who favors minimal federal intervention in the health system, and challenger Bill Clinton, who wants radical surgery, both think they've latched onto a winning issue. But with voters confused about health care options, the candidates are carefully test-marketing their reform ideas.

The differences in the two approaches are stark. Bush would provide new tax breaks to help families buy insurance and would rely on market forces to control costs. Clinton wants to require employers to make benefits available to workers. And to hold down costs, he would set a yearly cap on national health care spending and require states to negotiate fees with doctors and hospitals.

Each candidate has cause to think he has chosen the popular course. A joint survey by Democratic and Republican pollsters found that 60% of the public favors a government-run health care system. However, in response to another question, the same percentage voiced support for a private insurance system. Elsewhere, 67% felt the current setup needs significant changes; then 71% expressed satisfaction with the status quo.

LONG LINES. Until recently, it looked as if the Bush campaign planned to steer clear of the issue, fearing that the Democrats would always out-promise them. Indeed, Democrats quickly put the White House on the defensive, blasting Bush's February proposal for its failure to provide universal coverage and for doing too little to control costs.

Most polls showed the public leans toward Clinton's prescription. But Bush campaign chairmanand sometime pollsterRobert M. Teeter saw an opening. Focus groups he conducted found that voters wanted relief from soaring costs. But they worried that reform could bring long lines, inferior health care, and a restricted choice of doctors. So on Aug. 2, Bush attacked. In a Clinton Administration, he declared, "the government will run health care in this country, and our health care system will combine the efficiency of the House Post Office with the compassion of the KGB."

In the heat of a campaign, it may not matter much that Bush is attacking proposals that Clinton hasn't made. For example, the President claims the Clinton plan includes a 7% payroll tax, but the Arkansas Democrat hasn't offered a financing mechanism yet. The goal is to paint Clinton simultaneously as an advocate of socialized medicine and as a tax-and-spend Dr. Feelgood. Democratic reform plans, says White House health care specialist Gail R. Wilensky, mean "a new government mandate, new government taxes on small business. And that's the worst thing we can do in order to promote economic growth."

NOISE. Clinton isn't taking this lying down. He has blasted Bush for doing "next to nothing to provide health insurance to every American and nothing to control health care costs." The Democratic nominee plans to keep the issue at the top of his agenda. GOP attack dogs, says top Clinton aide Mickey Kantor, "want to throw the discussion back at us because they don't have a plan of their own. We are more than delighted to have this debate." Clinton aides will fill in some details, but Bush's barrage makes it unlikely that hell say how he would finance expanded coverage.

Such political exigencies mean that the health care debate will mainly produce noise. "I had hoped that the issue would crystallize," says Drew E. Altman, president of the Henry J. Kaiser Family Foundation, which funds health-policy research. "But it will be a sea of sound bites with no reality." With voters deeply divided by the issue, there's little reason to expect better.Susan B. Garland with Douglas Harbrecht Edited by Stephen H. Wildstrom


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