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Published on Thursday, April 13, 2000 in the New York Times
GW Bush: Clueless In Texas
by Bob Herbert
Last week he was an environmentalist. Now he's a health care reformer. Who knows what rewriting of reality is yet to come?

George W. Bush's first speech on health care was delivered in Cleveland on Tuesday.

"We will promote individual choice," he said. "We will rely on private insurance. But make no mistake: In my administration, low-income Americans will have access to high-quality health care."

That very morning The Times was out with a page-one article by Adam Clymer that began as follows:

"Texas has had one of the nation's worst public health records for decades. More than a quarter of its residents have no health insurance. The Mexican border is a hotbed of contagion. The state ranks near the top in the nation in rates of AIDS, diabetes, tuberculosis and teenage pregnancy, and near the bottom in immunizations, mammograms and access to physicians.

"But since George W. Bush became governor in 1995, he has not made health a priority, his aides acknowledge. He has never made a speech on the subject, his press office says. His administration opposed a patients' bill of rights in 1995 before grudgingly accepting one in 1997, and fought unsuccessfully to limit access to the new federal Children's Health Insurance Program in 1999."

The rest of Mr. Clymer's article was just as devastating. Governor Bush may be lip-synching the language of reform as he seeks to impress independent and Democratic voters, but the reality in Texas is tragic. According to a report by the state comptroller's office in 1998, "Health conditions in the Texas-Mexico border are among the worst in the U.S., so distressful that reports on health conditions suggest a remote country in need of medical missionaries, not a part of Texas."

Texas has been notoriously backward when it comes to health care. But if George W. Bush was at all concerned about that, he didn't let on. His choice for state health commissioner, Dr. William R. Archer III, would likely make a real health care reformer ill. Example: Texas may be at the bottom of the national heap in terms of health insurance coverage, but that's no big deal to Dr. Archer.

Mr. Clymer wrote: "Almost alone among health experts in Texas, Dr. Archer minimizes the importance of the low rate of health insurance, a protection that two-fifths of the state's poor children lack. In an interview, he said he thought that while 'eventually we have to insure everybody,' he believed the uninsured were still getting care."

Well, sure. Some do. They get sick and show up at hospital emergency rooms. Of course, some wait too long.

Dr. Archer's easy acceptance of this wretched method of delivering health care mirrors that of Governor Bush. Referring to a hypothetical uninsured mother of two, the governor said in a television interview last month: "She's got accessibility, in my state at least, to health care in emergency rooms and clinics."

He admitted that wasn't the "most affordable" or "the smartest way to run a health system." But it was, you know, access.

Answering a question about health care on a Fox News program in January, the governor said: "You go to emergency rooms in my state. . . . They're full of people. They're full of people. There's access."

Mr. Bush said affordable insurance was his health care goal, his "mission," but he saw the crowded emergency rooms in Texas as proof that his constituents already had access to health care.

This is not good. The governor appears to be clueless about health care, both unaware and unconcerned.

In February, during a campaign appearance in Florida, Mr. Bush was questioned by a woman who wanted to know what he might do about the fact that her health insurance did not fully cover the needs of her son, who had a chronic, life-threatening illness.

According to The Times's Frank Bruni, Mr. Bush seemed "stumped" by the query. "He sang the praises of medical savings accounts," wrote Mr. Bruni, "then acknowledged that it was too late for the woman to start one and that he really had no specific remedy for her."

Mr. Bush told the woman: "I'm sorry. I wish I could wave a wand."

Copyright 2000 The New York Times Company


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