Heal thyself

Tired and uninspired, Bush unveils his Medicare reform plan, but his campaign still looks ill.

Published September 6, 2000 6:00PM (EDT)

In an effort to catch up with Vice President Al Gore in the polls and deliver on the promises of his own political spots, Gov. George W. Bush campaigned in the swing state of Pennsylvania Tuesday to unveil his prescription drug plan for seniors.

Just weeks ago, the idea that Bush would be following Gore's lead on such an issue -- one demonstrably off-message for the GOP nominee -- seemed unlikely, to say the least. But, with his wife Laura, running mate Dick Cheney and Pennsylvania Gov. Tom Ridge as seemingly calming presences, Bush tried Tuesday to reassert himself as the candidate of bipartisan reform after a rough spell on the campaign trail.

It's been a bad couple of weeks for the GOP nominee, who has shown himself to be alternately irritable, crude, listless and fumble-mouthed. Attacked for approving a sneering TV ad skewering Vice President Al Gore last week, he insisted condescendingly that he hadn't violated his pledge to "change the tone" in Washington from a politics that is "ugly and mean" with the controversial spot.

Then he sidetracked his campaign with his refusal to accept the three presidential debates laid out by the bipartisan Commission on Presidential Debates, instead agreeing to two network chat show invitations -- one with Larry King on CNN, the other with NBC's Tim Russert on "Meet the Press" -- forums that would be shorter and have smaller audiences than the CPD-proposed events

CNN's "Larry King Live," while popular, only draws an average of 1 million or so viewers, while NBC's "Meet the Press" with Tim Russert has an audience of about 3.6 million. Even if both shows got a big bump by hosting the two major candidates, they'd draw only a fraction of the audience expected for the debate commission's proposed three-network, prime-time debates. The 1992 Bush-Clinton debates were on every major network, not just one, and averaged 90 million viewers per debate.

The controversy, which bubbled out of control over the weekend, certainly made it seem as though Bush is running from exposure. (That said, it's also worth noting that Gore did in fact accept with no conditions both King and Russert's invitations to debate, though he's now claiming that Bush must accept the CPD debates before he'll entertain any other offers.)

Bush capped off Labor Day weekend by calling the New York Times' Adam Clymer "a major league asshole," a remark that was intended for the ears of running mate Dick Cheney, but was inadvertently picked up by a vigilant microphone and widely broadcast.

Bush's appearance at the Gross Towers retirement community in Bethlehem, not far from Allentown, didn't exactly restore his campaign to its midsummer health.

In a state of seeming exhaustion, he unveiled his $198 billion drug-benefit proposal -- which carries the clunky title "MediCARxES" -- with a lackluster performance. The plan includes $110 billion for Medicare modernization, the restoration of $40 billion in Medicare funding that the GOP Congress fought to have cut (though Bush blamed it on the Clinton administration), plus something he called "An Immediate Helping Hand" -- a four-year, $48 billion grant to states for immediate relief until Medicare reform is enacted.

But toward the end of his low-key address, Bush made a telling stumble.

"The measure I am proposing today: immediate prescription drug help for all seniors -- for seniors -- will be my second bill introduced to Congress," he said, quickly amending his remarks to eliminate the "all" from the pledge.

And rightly so. In fact, the plan will provide free prescription drugs only for seniors living at less than 135 percent of the poverty level -- individuals making less than $11,300, and couples making less than $15,200. It also includes a sliding scale subsidy for those with incomes between 135 and 175 percent of the poverty level -- those making less than $14,600, or $19,700 for couples -- and will cover 25 percent of the cost of drugs for everyone above that income level.

Unlike Gore's larger prescription drug plan, Bush's plan would do little for a senior with an annual budget of, say, $14,605.

As the Gore campaign was quick to point out in a fact sheet waiting for reporters at the hotel where we were shuttled to write our stories, more than half of the seniors without drug coverage have incomes that exceed 150 percent of the poverty level. His plan, therefore, would only pay for 25 percent of the drug costs for an elderly couple making $19,705 a year.

So while Bush's ad on the topic pledges to provide prescription drugs for every senior who needs them, he was judging that "need" somewhat sparingly. That's a judgment made necessary by the $1.3 trillion tax cut he's proposed, 60 percent of which is earmarked for the nation's richest 10 percent, in addition to $1.3 trillion in additional spending programs such as $200 billion in Social Security transition costs and $350 billion in various congressional tax cuts Bush has endorsed.

It all adds up to $2.9 trillion in new spending, the Gore folks argue, while the Congressional Budget Office assesses the on-budget surplus -- not including Social Security and Medicare -- as being more than a trillion dollars less than that: $1.75 trillion.

Casting himself as the non-Washingtonian with a decent Texas record of bringing Democrats and Republicans together -- which is somewhat true -- Bush had more than a few salient points to make about the failure of the Clinton-Gore administration to accomplish much when it comes to healthcare, and not just after the first lady's disastrous partisan approach.

Bush accused the Clinton-Gore administration of playing politics with Medicare reform, pointing to the administration's failure to act on the recommendations of a bipartisan commission appointed to deal with the issue. The commission, headed by Rep. Bill Thomas, R-Calif., and Sen. John Breaux, D-La., "outlined a bipartisan direction for fixing this program," Bush said. "But, at the last minute, the Clinton/Gore administration turned against the commission and undermined its work."

Many observers have suggested that Clinton scrapped the Breaux-Thomas Commission's recommendations as a way of shoring up his liberal base in the wake of the Lewinsky scandal.

Bush then quoted Breaux complaining: "We are not going to fix it. We are going to be looking for issues to beat each other over the head once again. That is the old way of doing it. That is old politics."

But that's the Clinton-Gore way, Bush insisted. "Instead of solving an important problem, they chose to score political points," he said.

But Bush is guilty of at least some of the old politics when it comes to Medicare, too. One of the Breaux-Thomas recommendations was the politically risky suggestion of raising the first year of Medicare eligibility from 65 to 67. Bush has hemmed and hawed on this issue, but Tuesday he stated that his "reforms will be made without increasing the eligibility age of Medicare or increasing the payroll taxes. My position is clear. There will be no age increase, no tax increase. This is my commitment to the American people."

Other specifics within the Bush plan seemed inherently contradictory -- which is the problem with them pesky specifics: They can bite 'cha when you're not looking. Bush slammed Gore's Medicare proposal as putting "us well on the way to price controls for drugs," since the federal government would be "the largest purchaser of prescription drugs in America."

But later in his speech, when describing what his "Immediate Helping Hand" proposal would do, Bush argued that it would let states have large buying pools as part of their $48 billion, 4-year plan, and thus "states will be able to negotiate significant discounts on drugs." That seemed to be exactly what he was warning against in the Gore plan.

When asked about the seeming incongruity of the remarks, Bush healthcare advisor Gail Wilensky said that the state program was short-term and just for the very poor, as opposed to forever and for everyone. When it was suggested that short-term, small government programs have a nasty habit of becoming long-term, enormous ones, Wilensky said "I won't argue that point." But she continued to point to the difference in the programs' sizes, regardless of the similarities in principle.

Thus, much of Bush's proposal remained somewhat vague, despite his attempt to sketch out specifics.

Reporters wanting to know how to describe to their readers what the Bush proposal will do and cost as compared with the Gore plan left the speech and the subsequent briefing unsatisfied.

"This is an issue where we would like you to be reasonable," Wilensky said to the press corps at the Bethlehem Holiday Inn when pressed for details. While Wilensky's genial explanations and dodges were an improvement over Bush's whiny snarl about Adam Clymer caught on tape Monday, some hostility nonetheless lingered. Much of it seemed to come from the school of reporters, many of whom detect a bit of blood in the water.

Reporters peppered Wilensky, healthcare advisor Sally Canfield and spokeswoman Karen Hughes for information about the proposal that they wouldn't or couldn't give -- like, say, how much it would cost for those above the 175 percent poverty level to join the prescription drug program he would set up.

"One size doesn't fit all," Hughes said.

Bush was clearly hoping reporters and voters would focus not on his plan's details, but on his depiction of Gore as a harsh partisan who failed to make good on his 1992 campaign's promises on healthcare.

"The Clinton-Gore administration promised," said Pennsylvania Gov. Tom Ridge at a Tuesday afternoon event at a Scranton community medical center. "They promised that they would reform Medicare. They promised they would provide prescription drug coverage ... There's been eight years of promises and eight years of talk but there's been no reform."


By Jake Tapper

Jake Tapper is the senior White House correspondent for ABC News.

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George W. Bush Healthcare Reform Pennsylvania