Bush’s Ill-Advised Remedies

In a phrase that promised little more controversy than a lollipop in a pediatrician’s office, President Bush in his State of the Union speech Tuesday called on Congress to make health insurance “more affordable.” But the matters Bush then sketched would only send health-care costs soaring beyond their already astronomical levels. Plans include a Medicare prescription drug benefit with virtually no cost control or anti-fraud provisions, and a $3,000-a-year health-care tax credit to a family of four that earns less than $25,000 annually, starting in 2006. It’s a stretch to call the latter “compassionate conservatism” given experts’ estimates that by 2006 the average family health policy will cost about $14,000.

In fairness, it should be noted that the Democratic presidential contenders have paid no more than perfunctory attention to soaring health-care costs. All embrace one significant, much-needed reform: legislation to let Medicare officials negotiate low prices for prescription drugs. The new Medicare benefit, at the behest of the drug industry, bars federal officials from doing this. Mostly, however, candidates have done little more than murmur, as former House Speaker Newt Gingrich did in the 1990s, that they would rein in costs through more preventive care and new “high technologies.”

The Democratic front-runners all have their health spending plans: $72 billion for John Kerry, $69 billion for Wesley Clark, $88 billion for Howard Dean and $53 billion for John Edwards. What they need, however, is to put forward plans to save money on health care.

Here’s one idea: U.S. hospitals report that every year they spend $30 billion on care for patients without insurance, an expense they pass along by charging inflated rates to employers and individuals. This sort of shifting is a major reason why health-care costs are expected to rise by 14% this year alone. Rather than detailing how they would spend taxpayer money, the Democratic candidates and the president need to offer ways to save it -- for example, by reducing the number of the uninsured streaming into hospitals. The biggest burden should fall on the president, who also in his speech asked Congress to cut taxes permanently by $300 billion a year, mostly for the affluent. Voters should insist that he explain why, say, $80 billion of that sum shouldn’t go to extending health coverage to 43 million uninsured Americans.

What was perhaps most telling about Bush’s speech was how it excoriated “a government-run health-care system [as] the wrong prescription.” Bush knows that Dennis Kucinich, the key Democrat pushing this idea, has as much chance of implementing it as the president does of winning the San Francisco vote. But Bush’s decision to attack the idea signals that he and his advisors think it may be gaining traction. That’s why Bush -- if he believes that national health care is the wrong prescription -- must go beyond platitudes and bad policies to craft concrete, cost-effective proposals that prove private health care works.