On Monday, December 8, 2003, President Bush signed into law a Medicare prescription drug benefits package designed to help American seniors pay for their medications. This month, the Kerry campaign released a TV ad attacking President Bush’s Medicare record stating, “The very next day George Bush imposes the biggest Medicare premium increase in history while prescription drug costs still skyrocket.” There are several problems with this ad, namely that fact that 1) Kerry skipped the December 8 vote and 2) Kerry voted to support the increase in Medicare premiums that he now criticizes. The Kerry campaign offers no specifics on controlling health care costs, but the Bush administration does.

If the cost of Medicare is so important to Senator Kerry, then why did he avoid voting on one of the largest changes to this health program in history? Eileen McNamara of the Boston Globe has an interesting take on Kerry’s absence:

There is something to Kerry's process-oriented, Beltway view of politics. Senators routinely skip votes when the leadership concludes they would not affect the outcome. Even Kennedy excused Kerry's absence. "John Kerry was there when the vote mattered," he said. "We nearly stopped this misguided bill in its tracks, and John was there fighting hard against it." But most voters do not live inside the Beltway. When they read that this is a "historic" vote, they might wonder why a senator and presidential candidate would choose not to record his opposition.

If the cost of Medicare is so important to Senator Kerry, then why did he vote for a formula which mandated the 17% Medicare premium increase which he now attacks? According to the Washington Post:

But the ad overstates the case by saying that "George Bush imposes" the increase in Medicare premiums. By law, the premiums are set by the Department of Health and Human Services without any White House involvement, based on a formula that in this case largely reflected rising health costs and increased benefits.

Note: Kerry supported the medicare formula when he voted for the Balanced Budget Act Of 1997 (PL 105-33, Sec. 4571, 8/5/97).

Just how will Senator Kerry fix America’s health insurance woes? His website makes lots of promises, but is low on specifics. He claims he will:

- Cut Your Premiums
- Cover All Americans With Quality Care
- Cut the Cost of Prescription Drugs
- Cut Waste And Inefficiency

The Kerry website provides absolutely no details on how the Senator would “cut family premiums by up to $1,000,” or “extend coverage to 95 percent of Americans,” or “harness[es] American ingenuity to cut waste, save billions.” The only specific plan on the website claims that Kerry/Edwards will “reduce prescription drug prices by allowing the re-importation of safe prescription drugs from Canada … and ending artificial barriers to generic drug competition.” This statement is true – that is, if “President” Kerry would have to guts to stand up to the drug lobby. As the senator is the “most liberal member of Senate,” his solutions will most likely involve big spending and big government.

I am thoroughly disappointed with President Bush’s prescription benefit package. It is indeed a $300-500 billion “handout” to the big drug companies. I am surprised that a conservative president would engage in protectionism, shielding American drug manufactures from the forces of free trade. But I differ with Bush on far fewer issues than I do with Kerry. The good senator can’t seem to hold a consistent stance on any issue, let alone health care (see also here).

On the other hand, President Bush has laid out a practical agenda for controlling health care costs. During his acceptance speech at the Republican Convention, he laid out specifics:

In a new term, we must allow small firms to join together to purchase insurance at the discounts available to big companies.

We will offer a tax credit to encourage small businesses and their employees to set up health savings accounts and provide direct help for low-income Americans to purchase them. These accounts give workers the security of insurance against major illness, the opportunity to save tax-free for routine health expenses, and the freedom of knowing you can take your account with you whenever you change jobs.

We will provide low-income Americans with better access to health care. In a new term, I will ensure every poor county in America has a community or rural health center.

BUSH: As I have traveled our country, I've met too many good doctors, especially OB/GYNs, who are being forced out of practice because of the high cost of lawsuits.

To make health care more affordable and accessible, we must pass medical liability reform now.

And in all we do to improve health care in America, we will make sure that health decisions are made by doctors and patients, not by bureaucrats in Washington, D.C.

Allowing small businesses to pool their insurance buying power is probably the most creative proposal I’ve heard. This is simple supply and demand economics. Consortiums of businesses will be able to bring much greater numbers of workers to insurance companies. Insurance companies will be able to provide lower premiums because of the high quantities of policies written. When large numbers of people buy policies, overall risk is spread out and lowered.

President Bush is absolutely right identifying frivolous lawsuits as contributing to skyrocketing health insurance premiums. Notice that Kerry’s running mate, John Edwards, has been silent on this issue. He keeps playing up the fact that his father was a textile mill worker. But Edwards hasn’t spent much time mentioning that his personal net worth is estimated at between $20 million to $50 million. He made most of this loot as a lawyer by suing people and companies. In other words, Edwards has helped to increase insurance and other costs for the common man. In fact, he has opposed legislation that would’ve tried to put limits on the sue-happy trial lawyers. When companies are sued, how do you think they cover the costs of litigation and settlements? They pass these costs on to the consumer by increasing the prices of their products and services. Litigation is one of the reasons health insurance premiums keep increasing every year. With Edwards by his side, do you really think Kerry will tackle tort reform?

Letting doctors and patients make health decisions will most likely reduce costs. Yes, there are plenty of crazy people out there, but by and large American physicians and patients can make good decisions one-on-one in the examination room. Having an army of government and/or insurance company bureaucrats pushing papers for every health decision costs a lot of money.

Only one of Bush’s points bothers me: “I will ensure every poor county in America has a community or rural health center.” He doesn’t explain how this can be done. Leave it to government, and their initial solution would be spending lots of money. Perhaps a program that gives monetary incentives (student loan forgiveness) to medical school graduates if they agree to spend 2-3 years in a rural practice?

Kerry’s latest Medicare ad belies his usual flip-flopping on issues, his disingenuousness, and his desperation. The opinion poll bump that President Bush received after the Republican convention, and which he now maintains, has got the Kerry campaign worried. Americans are listening. They do want facts. They do want consistency. Unfortunately for Mr. Kerry, he can offer none of the above.