The problem with Bradley's big idea
By John F. Dickerson/Washington
October 4, 1999
Web posted at: 12:29 p.m. EDT (1629 GMT)
For some time Bill Bradley had been promising something big.
While other campaigns parceled out policy papers, he vowed that
his ideas would be truly profound. So last week Bradley launched
his Zeppelin--a plan that could cost taxpayers $65 billion
annually to provide health insurance for most of the 45 million
Americans currently without it. "Big problems require big
thinking," declared Bradley, dismissing Al Gore's health-care
proposal as "timid."
Health care is the obvious issue to allow Bradley to make a
splash. The number of uninsured Americans is the one social
problem that has grown worse during the Clinton Administration.
For a decade, the issue has offered both opportunity and peril to
Democratic candidates. In 1991, it elected the Democratic
underdog Harris Wofford to one of Pennsylvania's U.S. Senate
seats. One year later, Bill Clinton ran with it to the
presidency. But the failure of the complicated plan that he and
Hillary proposed contributed heavily to the Democrats' loss of
Congress in 1994. This year's Democratic presidential candidates
have learned the lessons of that debacle, not demanding anything
of employers and proposing, among other things, tax breaks rather
than government controls as a way to shrink the ranks of the
The plan that Gore unveiled in early September--more limited than
Bradley's--focuses on the elderly and children and attempts to
cover no more than a third of America's 45 million uninsured.
Behind Gore's plan is the recognition that in the
special-interest thicket that is health care, you can make
progress only by working to get coverage for one or two
constituencies at a time. By contrast, Bradley's goals are nearly
as grand as Hillary's: to impose unenforceable "mandates" on
parents to provide their children with insurance; to expand
Medicare benefits; and to offer subsidies so low-income adults
can buy coverage from private insurers or join fehpb, the
government plan that covers federal workers.
If Bradley's plan is a bold one, there's another B word it also
brings to mind: blurry. To begin with, although the former
Senator says he's still working on the fine print, most experts,
including some who advised Bradley, agree that his $65
billion-a-year cost estimate is too low. Worse, he expects to use
the projected budget surplus to pay for it all but has no
fallback plan in the event that the surplus does not materialize.
Bradley also overpromises. The subsidies he would provide to the
poor in many cases won't be enough to cover actual premium costs
if he plans to make good on offering a choice between private
insurance plans and the government-employee plan. Unless he
increases the amount, further inflating the cost of his program,
Bradley may not be able to cover as many of those low-wage
workers as he claims, those for whom having to pay even a few
hundred dollars would keep them from buying coverage.
Bradley assumes that among those not eligible for a subsidy,
millions will buy insurance because his plan would give them a
tax deduction for the amount they pay in premiums. That may be
doubtful. Even after Bradley's tax break, a family of four making
$50,000 would still have to find $4,250 a year. On other
questions, the Bradley team offers the most favorable
interpretation--for instance, hoping that the federal health plan
that now covers a relatively healthy middle-class work force will
not see its costs go up with the arrival of poorer and
potentially less healthy members.
For his part, Gore has said he too wants a change in health care,
but he doesn't want this much change. What Bradley calls timid,
Gore defines as responsible stewardship: insuring children with
programs already in place while leaving money to shore up
Medicare. So far, Gore has been as vague as Bradley on how much
his proposals will cost, but he is correct to point out that
Bradley's expensive plan, even if it could be paid for, doesn't
seem to leave much money for fixing Medicare.
At the new Gore campaign headquarters in Nashville, Tenn., where
the Vice President is moving his campaign, members of his team
will be hard at work gathering a response to Bradley's first big
policy salvo. Soon they are likely to have lots of colorful pie
charts showing how the Vice President's policies will work out.
Their efforts are a direct response to Bradley's momentum and
money: the former Senator pulled even last week with the Vice
President's once invincible fund-raising machine. The Vice
President, under assault, has also called for debates. They will
be an opportunity "to rekindle the spirit of democracy," he says.
It seems as if Al Gore is trying a little big thinking of his
Two Fixes for Health Care
THE GORE PLAN
--Expands the current Children's Health Insurance Program to
guarantee access to affordable insurance for all children by 2005
--Allocates $374 billion from the budget surplus to ensure the
solvency of Medicare
--Gives 25% tax credits to small businesses and uninsured
individuals to help purchase coverage
THE BRADLEY PLAN
--Mandates that all children have health insurance. Relies not
on enforcement but on the "goodness of the American people"
--Subsidizes full coverage to lower-income adults and children
and provides tax breaks for health-insurance premiums for all
--Provides access to the health-insurance system available to
Federal Government workers
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Cover Date: October 11, 1999