BY J. MICHAEL BRODIE
Want to know the biggest difference between the two leading candidates vying for the White House? Take a look at their health care plans and the price of implementing them. The proposals could not be further apart when it comes to how they would decrease the number of uninsured Americans and how they would set a federal price tag for doing so, according to Kenneth Thorpe, Ph.D., chair of the health policy and management department at Emory University, Atlanta.
"As you look at what they are proposing for health care, what you are seeing is the biggest area of difference between the candidates," said Thorpe in a recent FP Report interview. "Health care is, by far, a clear area where there are fundamental policy differences."
Thorpe has studied the federal costs of health care proposals by President George W. Bush and Sen. John Kerry, D-Mass., and how the proposals might affect the uninsured. Thorpe's analysis is available on the AAFP Web site at http://www.aafp.org/x22202.xml.
Thorpe's analysis notes that, in the administration's fiscal year 2005 budget proposal, Bush promises to reduce the price of health insurance. His plan would trim insurance premiums, for example, through encouraging the use of association health plans that enable small businesses and associations to buy insurance through large purchasing pools. It also would provide refundable tax credits for people who buy individual (not employer-sponsored) policies. Thorpe's report says Bush's plan to cover the uninsured would cost about $90 billion from 2005 to 2014 and would insure up to 2.4 million otherwise uninsured people.
Kerry's plan aims to make health insurance more affordable and expand coverage to 27 million otherwise uninsured Americans, according to Thorpe's analysis. The Kerry plan would cost taxpayers about $653 billion from 2005 to 2014. Much of the cost of the plan would come from providing tax cut initiatives to encourage small businesses, people 55 to 64 years old and workers in between jobs to buy health insurance. The plan also calls for the federal government to fund the expansion of the number of children and adults qualified for Medicaid and the State Children's Health Insurance Program.
During the interview, Thorpe said he regarded this election as critical because the road voters choose to travel will determine whether an already overburdened health care system will be further stretched or greatly eased.
"Half the battle is to make sure that what is being proposed here (by Bush and Kerry) is being discussed," said Thorpe, who hopes his work will add to the national health care debate. "These are radical policies on how to spend federal dollars."
To reach writer J. Michael Brodie, e-mail mbrodie@aafp.org.
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Copyright © 2004 by
American Academy of Family Physicians.