The following is a summary of the positions the major candidates seem to be taking on health care thus far.

The Clintonian candidate:

Al Gore:    Gore carries on his back the legacy of the failed Clinton health plan, and after the subsequent, shocking overthrow of the Democratic majority in both the House and Senate, he understands fully the political risks inherent in a big government proposal. Gore is still quite gun-shy, and his program for government expansion into health care is fairly circumspect.  His proposal is to expand the Child Health Insurance Program (CHIP) over several years, and to take a few other relatively small steps. 

Notably, his now-defeated rival in the Democratic Primary, Bill Bradley, had a much more comprehensive notion of what was needed to reform health care. Bradley is unabashedly a big government, big program kind of guy. His role models are FDR and LBJ, and he envisioned a broad reform of the health care system of a magnitude akin to Social Security or Medicare. Bradley proposed to abolish Medicaid, and enroll the poor into the insurance program that already exists for federal employees. He would give some form of tax breaks and other subsidies to help pay for the insurance, but is woefully short on details. While his plans were vague, he clearly wanted a big government program to fix the growing health care crisis. Indeed, Bradley's proposal for health care was the cornerstone of his entire campaign. 

And, Al Gore undoubtedly sees, it led him to overwhelming defeat.  If Gore plays his cards right, he will be able to take the "high road" on health care (making only modest and incremental proposals, while castigating the Gekkonians' persistent refusal to see any problem at all save insufficient free enterprise) while avoiding the apparently still-poisonous ideal of government-controlled health care.  

Comment:  The Gekkonian model is so clearly failing that, if health care becomes a major campaign issue in 2000, it should be an issue of some advantage to Gore. It is, after all, the Clintonians' turn to screw things up. (If one agrees that the major media has a  liberal bent, then one can expect that media to whip the public into a frenzy over health care this year. Those of us who think the public should pay serious attention to the health care crisis will not object to raising the issue, whatever our political inclinations.)  

In any case, Gore cannot even begin to touch the real problem facing our health care system, since to do so would require admitting that rationing is necessary. Instead, his plans call for bringing the government yet more deeply into our health care system (as Clintonians are wont to do), without addressing the fundamental, underlying problem.  Enlightened physicians ought to worry deeply about such plans, since whenever you create even more impossibly complicated and contradictory regulations, you create more opportunity for nearly every doctor to be guilty of fraud. (Then, of course, all you have to do is decide which ones to audit. See the Regulatory Speed Trap.)

The Gekkonian candidates:

Bush:  Bush's website  Bush, being Gekkonian, would rather not talk about health care. Since the Gekkonian promise of more efficiency, lower costs, better quality, and broader coverage appears to be a complete wash, and since, if the efficiencies of the marketplace seem to be failing, the obvious remaining option is for more government involvement (a la the Clintonians), it's just better not to talk about it at all. Bush (and the other Gekkonians) need to come up with something, and fast. Vague statements about more private-sector alternatives, expanding medical savings accounts, and somewhat less vague statements minimizing the significance of the growing number of uninsured (again, in an era of unprecedented prosperity), probably won't cut it for long.

Bush might profit from at least considering the stance of his main rival in the Republican nomination, John McCain. McCain at least came out in favor of some program that would produce universal health-care coverage. It would seem a good approach for any "compassionate conservative."  (McCain, however, saw campaign-finance reform as the key to all things, including health care reform - it was his Grand Unification Theory. He didn't know what the solution to the health care crisis might be, but knew that, whatever it was, it wouldn't be found as long as the Republicans are bent on protecting insurance companies, and Democrats are bent on protecting lawyers.) 

During the week of April 10, 2000, Bush finally began to flesh out the semblance of a health care policy, and the Clintonians, predictably, counterattacked.  See our report.  

Comment: One must truly feel sorry for the Gekkonians. Free enterprise is failing the health care system, and they are largely at a loss to come up with alternative ideas that don't involve big government. McCain clearly distinguished himself from the other Gekkonians in that he was more willing to talk about health care. But his complete reform of campaign finances would actually not eliminate special interests from the mix, as you can never eliminate special interests (You can only get them to change tactics.) Besides, special interests, while a huge hindrance to fixing health care, are not the root problem. 

All Gekkonians endorse medical savings accounts. DrRich likes MSAs too (he has one himself), and considers them to be one of the fundamental steps to health care reform.  Indeed, he includes MSAs in his proposed solution to the health care crisis, described in Section 8 of the Grand Universal Theory.  Nonetheless, MSAs themselves are entirely insufficient to solve the problem. In order to have any impact, they must be part of a much broader plan, and that plan must acknowledge and forthrightly deal with the need to ration. MSAs as they are currently formulated are also politically incorrect (since they disadvantage the disadvantaged).  They will not be the salvation of the Gekkonians in 2000.

If the health care crisis grows significantly in importance this year, one almost has the sense that the Gekkonians' best strategy (at least, regarding health care) would be to let the Clintonians have a turn. After the Clintonians fail to solve the health care crisis once more, maybe the Gekkonians' star would rise again. As it is, their best bet, a tact they are clearly embracing, is to try to talk about something else, and hope that health care becomes merely a background issue until after the election.

Back to main Campaign 2000 page

YourDoctorintheFamily.com Home Page