Analysis: Where Do [the Presidential Candidates] Stand?

Published April 1, 2003

Health care issues–especially access to affordable health insurance–will likely play a larger role in the 2004 Presidential race than in 2000, particularly if proposals from former Vermont Governor Howard Dean and Missouri Congressman Richard Gephardt are taken seriously. Addressing the uninsured could be a centerpiece of the Democratic strategy for recapturing the White House.

Kenneth Thorpe, a former Clinton administration official and an Emory University professor, recently told the Los Angeles Times, “To me, what’s exciting is that the universal coverage debate is back on the national agenda. That in itself is huge.”

The Los Angeles Times also reported universal coverage plans are a response to increasing health insurance costs and narrowing access to care–factors that inspired former President Clinton’s doomed crusade for universal coverage. To avoid the backlash Clinton’s plans received, new Democratic proposals are accompanied by claims they will be administratively simple, preserve consumer choice, and won’t disrupt the existing health system.

In his fiscal year 2004 budget blueprint, President Bush proposed spending $89 billion over 10 years to give Americans tax credits to purchase health insurance. Eligible families with two or more children and annual incomes below $25,000 could receive up to $3,000 in credits to cover as much as 90 percent of the costs of purchasing health insurance.

Stuart Butler, director of domestic policy studies for The Heritage Foundation, told the Los Angeles Times, “The irony is that you’ve got liberals saying we’ve got to let employers, even if they are lousy employers, make all the decisions for you and your family, and here are the conservatives saying, ‘Let’s let ordinary people decide what’s best for themselves.'”

Former U.S. Senator, Illinois

Braun has not yet addressed health care as an issue for her campaign, nor was it a key issue during her Senate term.

Indeed, Braun’s closest encounter with health care policy may be the investigation launched against her for Medicaid fraud. The Chicago Tribune reported in September 1992 that Braun was investigated for taking a $28,750 check from her mother so Medicaid would continue paying for her mother’s nursing home care. The Illinois Department of Public Aid investigated the matter while Braun was serving as Recorder of Deeds for Cook County, Illinois. Braun eventually re-paid $15,239.

The Chicago Tribune has called her public service a “squandered” and “failed” opportunity to represent Illinois. “She has given Illinois citizens a stream of reasons to question her judgment.” She has been plagued by scandal, including misappropriation of an inheritance, allowing sexual harassment of workers, and misuse of campaign funds. The Internal Revenue Service twice sought to investigate her finances, but the Clinton Justice Department denied both requests.

Braun’s voting record is solidly liberal, including her vote for the largest tax increase in U.S. history; a vote to increase taxes on senior citizens’ Social Security benefits; and numerous “yea” votes for federal budgets balanced using the Social Security surplus.

Former Governor, Vermont

The centerpiece of Dean’s Presidential platform is universal health care. He is on record as saying he would repeal most of President George W. Bush’s tax cut in order to fund a national health insurance program.

According to David S. Broder, writing in the July 12, 2002 edition of The Washington Post, “Dean not only advocates universal health insurance but also tells audiences that Vermont already has moved in that direction. How to pay for this? Simple, says Dean. Roll back virtually all of President Bush’s tax cut of 2001.”

C. David Kotok, writing in the October 9 Omaha World-Herald, notes, “In his appearances, Howard Dean champions universal health care patched together with a government-supported program to guarantee health insurance for the young, prescription benefits for the elderly, and insurance support for small-business employees. ‘This is not a big government plan,’ Dean said. ‘Insurance companies should like this plan.'”

Dean’s proposal, which does not yet have a cost estimate, would extend Medicaid to all U.S. residents under age 23 and offer subsidies to small employers to encourage them to offer their employees health insurance.

In the December 18 issue of the Rutland (Vermont) Herald, John McClaughry, president of the Ethan Allen Institute, accused Dean of balancing the state budget on the backs of citizens by “robbing other state funds, increasing local share property taxes, and levying an unlegislated tax on health insurance paid by individuals, small businesses, and self-insured companies.”

U.S. Senator, North Carolina

According to the May 8, 2002 edition of CNN’s Inside Politics, “After Edwards’ lackluster performance on NBC’s Meet The Press, many Democrats felt he may not be ready for prime time.” According to Marc Rotterman, writing in the December 8 issue of the Raleigh News and Observer, “Edwards has become a captive of the trial lawyers and the left-wing special interests in Washington. He has lost touch with the average American.”

Wall Street Journal editors note more than four of every five dollars raised by Edwards for his PAC, New American Optimists, has come from personal injury trial lawyers. They say Edwards caters to that special interest group by fighting tort reform in Congress and facilitating the initiation of lucrative lawsuits in the private sector.

Edwards is unpopular among health care providers because he supports unlimited awards in medical malpractice suits, according to a June 24, 2001 Chicago Tribune article by Jill Zuckman. Senator Lauch Faircloth (R-North Carolina) told CNN’s Jonathan Karl in November 1998, “He is absolutely a clone of Bill Clinton.”

Edwards has not articulated a formal position on health care reform, but actions often speak louder than words. Between 1999 and 2002, according to a Congressional Quarterly vote comparison (, Edwards voted with Senator Edward Kennedy (D-Massachusetts) 90 percent of the time and Senator Hillary Clinton (D-New York) 89 percent of the time.

U.S. Representative, Missouri

Gephardt, according to an article by Dan Balz in the January 20, 2003 issue of The Washington Post, is an ineffective leader, traditional liberal Democrat, and “keeper of the liberal flame for organized labor and party activists.” But Iowa Governor Tom Vilsack (D) warns “Gephardt’s union support is not a sure thing,” and Balz quotes Iowa resident Libby Slappey as saying, “Gephardt’s not even on our radar screen.”

In announcing his Presidential campaign, Gephardt offered a sweeping plan that would require all employers to offer health insurance; give employers a tax credit that would cover as much as 65 percent of their costs to do so; allow uninsured people aged 55 and older to buy into Medicare; allow parents to enroll in CHIP programs aimed specifically at uninsured children; and offer subsidies to help unemployed people retain their former health coverage through COBRA.

The Gephardt campaign has not worked up a cost estimate for his proposal, but an aide told Health Care News he would fund it by repealing most of the 2001 Bush tax cut and by using the increased tax revenue he expects to come from businesses expanding as a result of reduced health benefits costs.

U.S. Senator, Massachusetts

According to the Roll Call Key Votes summarized by Congressional Quarterly at, Kerry voted in lockstep with Massachusetts Senator Kennedy in each of 10 years between 1985 and 2001. Over the course of his Congressional career, Kerry has sided with Kennedy 94 percent of the time when key votes were taken on Kennedy’s favorite cause: a government-run national health care plan.

Kerry has supported the Medicare Reform Act, the Patient Bill of Rights, the State Children’s Health Insurance Plan (SCHIP), the Nurse Reinvestment Act, the Women’s Health Equity Act, the Family and Medical Leave Act, and the Health Insurance Portability and Accountability Act (HIPAA).

Each of those measures imposes significant benefit and procedural mandates on health care providers and the health insurance industry. Research has shown those mandates have increased the overall cost of health care and health insurance, which in turn have led uninsurance rates to climb.

A U.S. Newswire report dated February 5, 2003 quotes Kerry as saying, “We have spent more than a decade putting patient protections into place, protections that the Bush administration is forfeiting for a bargain basement solution for small businesses desiring affordable health.

“The challenge, ” Kerry notes, “is to develop more effective pooling mechanisms that give small businesses more leverage in the health insurance market.”

If Kerry’s support for “pooling mechanisms” extends to association health care plans, he should come right out and say he supports the position President Bush has staked out. If he thinks a national health care plan is the best way to offer small businesses a “pooling mechanism,” Kerry should say that, too.

Kennedy has repeatedly balked when asked if he supports Kerry’s bid for the nomination. But on January 22, 2003, the Boston Globe reported Kennedy “not only backed his junior colleague, but expected him to win the White House.”

U.S. Senator, Connecticut

Of all the potential candidates, according to Laurence D. Cohen’s article in the November 3, 2002 issue of The Hartford Courant, Senator Lieberman “is so inventive, has been so creative, and has been so gymnastic in its many shapes and forms, that only he can even begin to explain it. Many politicians look a bit oily, a bit uncomfortable moving across and around the political spectrum, but our Joe looks as comfortable as if he’s merely changing clothes.”

When Al Gore chose him as his running mate for the 2000 election, Lieberman ranked as one of the more conservative Democrats in the Senate. But as a Vice Presidential hopeful, he ran away from his conservative record on many issues, including approaches to expanding health care access and lowering insurance premium costs.

In hundreds of media interviews, Lieberman has never articulated a clear position on health care reform. The media appears to have avoided asking him the tough health care reform questions, and Lieberman himself remains conspicuously silent on the issue.

Even his Web site ( is devoid of any statement of his health care reform philosophy. The best one gets is “he works to expand quality and affordable healthcare to all Americans and safeguard Medicare and Social Security for future generations.”

Just how President Lieberman would “expand quality and affordable healthcare” is a mystery.

Conrad F. Meier is managing editor of Health Care News.