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Published on Thursday, April 20, 2000 in the St Paul Pioneer Press
Good Health Not Another Free Market Commodity
by Farai Chideya
 
If ``compassionate conservatism'' were a Broadway show, last week would have been its grand revival, lights ablaze to welcome star George W. Bush back from his long hiatus in South Carolina and the Bible Belt.

After wielding the power of the religious right to finish off John McCain, Dubya has spun a 180 for the general election: gathering with a few gay Republicans (after refusing to meet with a larger gay group) and going head-to-head with Vice President Al Gore on such traditional Democratic issues as education and health insurance.

But Bush's recent policy proposal for tax credits that would help low-income individuals buy health insurance underscores the flaws behind the ``compassionate conservative'' approach to poverty issues.

In conservative orthodoxy, if you're going to deal with a wussy Dem issue like health care at all, you'd better deal with it in a ``free market'' manner, such as offering tax credits rather than relying on ``big government'' approaches. God knows, the government has its problems -- but anyone who has been watching the Nasdaq knows the stock market has its own. Dubya's health-care proposal betrays a naivete about the pitfalls of a free-market approach that could end up hurting some of the families he aims to help.

``Every low-income, working family in America must have access to basic health insurance -- for themselves and for their children,'' Bush said in Cleveland last week. ``In my administration, low-income Americans will have access to high-quality health care.''

That's certainly not true in the state he governs. Texas ranks 49th among the states in the number of citizens, and children, who have health insurance. About 25 percent of Texans are uninsured, and some 1.4 million of the nearly 11 million American children nationwide without health insurance live in Texas.

Dubya's new plan won't do much for the uninsured in America at large, either. It allots $35 billion in tax credits to help 18 million Americans buy private coverage. Families earning less than $30,000 a year would get a $2,000 credit; individuals earning less than $15,000 a year would get half that.

But what would these credits buy? Bush says $2,000 will cover 90 percent of health insurance costs. But in 1998, the Kaiser Commission on Medicaid and the Uninsured surveyed insurance costs nationwide and found that employers paid an average of $4,092 for a family policy. Costs are higher for individuals under any nongroup plan, and it's hard to imagine that many families would be able to cough up the extra $2,000-plus they'd need for coverage.

In fact, Bush's own advisors say his health plan would only help about 4 million uninsured Americans get coverage. The rest of the money would go to families who are struggling to pay for health coverage they already have.

Today, 44 million Americans lack health insurance. Even in the best Bush scenario, 40 million Americans would remain without health coverage.

Gore's proposal -- yes, a big government proposal, and still incomplete at that -- would insure 11 million to 15 million Americans by expanding the federal Children's Health Insurance Program and providing a tax credit for uninsured adults who purchase their own policies. It also would carry a far heftier price tag: $146 billion over 10 years. The price tag on Bush's plan is $40 million to $45 million.

Most disturbing about the Bush plan is the prospect that the free-market approach will provide opportunities for hucksters who just want to make a quick buck off the poor. As Lorraine Woellert writes in the current Business Week, ``In 1993, a House investigation found that a $500 tax credit for individual health insurance -- the brainchild of former Sen. Lloyd M. Bentsen Jr., D-Texas -- had drawn few takers yet had spawned hundreds of scam artists touting cheap policies that failed to deliver on their promises. As a result, Congress repealed the program.''

The free-market approach to America's massive health-care problem keeps appealing to us, Democrats and Republicans alike, for two reasons. It's easy to understand and it's relatively cheap. But, unfortunately, it's not enough. During a decade of unprecedented prosperity, the number of nonelderly Americans without insurance has increased by millions, putting our public hospitals and clinics under more strain than ever. Our inability to even attempt a broader solution means the health-care crisis will spiral further out of control. And the Bush tax-credit plan will be but a Band-Aid over a gaping, growing wound.

Chideya is a New York journalist. Distributed by the Los Angeles Times Syndicate.

2000 PioneerPlanet / St. Paul (Minnesota) Pioneer Press

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