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Seen through the prism of what actually needs to be accomplished, Reischauer continued, neither candidate's Medicare solution is close to sufficient.

"Having healthier people is not the answer to Medicare's problem, though what Bradley said can be true and can result in some small amount of savings -- but not enough to solve the problem." On the other hand, "All Gore is doing is taking some bucks and putting them into the trust fund, which isn't changing in any way the underlying revenue problem, or addressing Medicare spending." Gore's plan to funnel 15 percent of the budget surplus into the Medicare trust fund only "puts off the day of reckoning a few years."

Another charge that Gore repeats constantly is that Bradley's 10-year, $650 billion health care proposal means less money for the health insurance of poor Americans. Remember this exchange on Sunday's "Meet the Press"?

"There are 75 million Americans today who get Medicare and Medicaid," Gore said. "They are all left out under Sen. Bradley's plan because he eliminates Medicaid and replaces it with little $150-a-month vouchers, which also limits the access -- "

"That's wrong," Bradley said. "That's not correct."

"There are seven million disabled Americans who rely on Medicaid, many of them to get out of bed each morning ... half of the people with AIDS and two-thirds of all the seniors in nursing homes rely on Medicaid," Gore said. "He eliminates it, and he doesn't save a penny for Medicare ... 95 percent of all the health insurance plans that are part of the Federal Employee Benefit Plan have premiums that are far in excess of $150 a month."

Despite Bradley's protests, Reischauer agreed that Gore is pretty much on target.

"Medicaid is a very generous benefit package," he explained. "It's more generous than any insurance you or I have probably ever had. So what Bradley is saying is that he is going to 'mainstream' those people and put them in a policy that's less generous. One with co-pays and deductibles, one that probably will not cover dental and vision, or early and periodic screening for children."

On the other hand, by mainstreaming Medicaid recipients into more modest programs, Bradley is able to provide health care for millions more Americans. Gore's plan "clearly wouldn't cover nearly as many people," Reischauer said. And "Bradley has much more generous prescription drug benefits for Medicare recipients than the president and Gore do. That's the major reason why some outside analysts say that Bradley's plan might cost more than he says he thinks it will cost."

Bradley might be relying too much on states picking up the slack where he would cut off Medicaid's generous coverage, "hoping that states will maintain those generous benefits for the really needy," Reischauer said. "But left to their own devices, I don't think they [the states] will."

On the other hand, during the Dec. 17 debate, Gore implied that Bradley's health care proposal would be "a big mistake that might put [the economy] at risk." But according to Reischauer, the plan, if enacted, wouldn't "make a dime's worth of difference from the standpoint of the economy."

"It's a crazy thing to have the two Democratic candidates fighting over this," Reischauer said. "The point is the Democrats are interested in doing something about the uninsured. They're going about it in different ways, but they have the same common objective. Bradley's plan is very ambitious. And Gore's plan is incremental, by and large.

"In a way, their proposals complement one another. Gore's plan to provide health care coverage for children and low-income adults would be something you could implement the first year of your presidency. But for the long haul, you should think about more fundamental restructuring of the sort that Bradley is putting forward.

"This is an issue that was very divisive in 1994 and 1995, and [it's not helpful for the Democrats] to have them squabbling over how to go about achieving their common objective. Both of them are giving Republicans lots and lots of quotes that will be used in the general election no matter which one of them wins."
salon.com | Dec. 21, 1999

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