Sub-sections under Health Care:
• Insurance coverage
• Medicare & Medicaid
• Patient Rights
• Other issues under Health Care

Claim that drugmakers spend more on ads than R&D isn’t true

In fact, the industry spent between $5.8 billion and $8.3 billion on promotion and $21 billion on research and development in 1998. There has been a 20-fold increase in TV drug advertising over the past six years.

Physicians, not HMO should make medical decisions

GORE: I don’t feel good about that, and I think we ought to have a Patients’ Bill of Rights to take the medical decisions away from the HMOs and give them back to the doctors and the nurses. Doctors are giving prescriptions, they’re recommending treatments and then their recommendations are being overruled by HMOs and insurance companies. That is unacceptable.

BUSH: I brought Republicans & Democrats together to do just that in the state of Texas.

Drug companies spend more on ads than on research

BUSH: Step one is to reform the Medicare system. I want to call upon Republicans and Democrats to take care of a senior prescription drug program. I think it’s important to have what’s called Immediate Helping Hand, which is direct money to states so seniors don’t have to chose between food and medicine.

GORE: I have never been afraid to take on the big drug companies. They are now spending more money on advertising than they are on research. They’re trying to artificially extend the monopoly so they can keep charging high prices. I want to streamline the approval of generic drugs so that we bring the price down. I proposed a prescription drug benefit under Medicare. You pick your own doctor and the doctor chooses the prescription and nobody can overrule your doctor. You go to your own pharmacy and Medicare pays half. If you’re poor, they pay all of it. If you have extraordinarily high costs, then they pay all over $4,000 out of pocket.

Opposes Medical Savings Accounts; they segment out the sick

A: I am opposed to Republican proposals to broaden medical savings accounts. These proposals have the potential to segment healthy populations from the sick in the insurance market and therefore leave sicker populations with higher health care costs. We already have some demonstrations on MSAs today and should wait and see what kind of impact they have.

Claims Bush puts Texas oil interests before healthy children

BUSH: We spent $4.7 billion a year on the uninsured in Texas. The percentage of uninsured in Texas has gone down, while the percentage of uninsured in America has gone up. Our CHIPS program got a late start because our government meets only four months out of every two years. It may come as a shock for somebody who’s been in Washington for so long, but limited government can work. In ‘99, we signed up over 110,000 children to the CHIPS program. For comparable states our size, we’re signing them up fast as any other state.

GORE: I’m no expert on Texas procedures, but friends there tell me that the governor opposed a measure put forward by Democrats in the legislature to expand the number of children that would be covered. And instead directed the money toward a tax cut, a significant part of which went to wealthy interests. He declared the need for a new tax cut for the oil companies in Texas an emergency need.

Claims of Bush’s choices & benefits are underestimated

ANALYSIS: This is TRUE if the couple’s annual drug bill does not exceed $6,000. If it did, under Bush’s plan, the government would pay the rest.

GORE: And after 4 to 5 years, they would be forced to go into an HMO or to an insurance company.

ANALYSIS: This is NOT TRUE. They would not be forced into an HMO or private plan-they could choose to remain in Medicare.

Stronger penalties for HMOs who drop seniors

Foster competition in drug research; companies misspend R&D

Curb excess pharmaceutical profits made at consumer expense

$30B over 10 years to help families with elder care

Against assisted suicide; but leave it to the states

Last month, Gore was asked in an interview whether he supported Oregon’s law. Gore said on April 20, “I think that states should have the discretion to explore this new set of issues involving what role doctors should play when a patient is in extremis at the end of life. There are so many different situations. I think that states ought to deal with that on their own.”

Get generic drugs to market quickly & cheaply

Let FDA regulate cigarettes; fight teenage smoking

Focus on prevention to limit costs

No discriminating based on genetic information

Remove stigma & treat mental illness like physical illness

Step by step, fill in the gaps in health care

GORE: I think that we should move step by step toward universal health coverage. But I am not in favor of government doing it all. We’ve spent 65 years now on the development of a hybrid system--partly private, partly public--and 85% of our people have health insurance, 15% don’t. That adds up to 44 million people; that is a national outrage. We have got to get health coverage for those who do not have it. And we have got to fill in the gaps in coverage by finally bringing parity for the treatment of mental illness because that’s been left out. We’ve got to deal with long-term care. I will make a commitment to bring health care coverage of high quality that is affordable to every single child in America within four years. And then, we’ll fill other gaps by covering the parents of those children when the family is poor or up to two and a half times the poverty rate.

Wants some form of non-government universal health care

BUSH: For working folks that want health care, that can’t afford it, a couple of things: I’ve put money in my budget to expand community health centers all around the country. These are places where people can get primary care. Secondly, you get a $2,000 rebate from the government if you’re a family making $30,000 or less - it scales down as it gets higher - that you can use to purchase health care in the private market. Allow business associations to write association plans across jurisdictional lines so that small businesses have got the capacity of national pooling to drive the cost of insurance down.

GORE: I’d like to see some form of universal health care, but I’m not for a government-run system. We should start by greatly expanding the so-called child health insurance, or CHIP program, to give health insurance to every single child in this country.

Cover 12 million uninsured at a 10-year cost of $157 billion

Gore has a more articulate, wide-ranging strategy on health, besides a more aggressive attitude to drug companies and HMOs. He proposes to:
• Cover 12 million uninsured at a 10-year cost of $157 billion
• proposes to extend health insurance to the uninsured by expanding the State-Children’s Insurance Program (S-CHIP) to include both more children and also their parents.
• wants to change the Medicare rules to let Americans buy into the program with the help of a 25% tax credit, ten years earlier than they can now. Estimates for costs and coverage are 12 million more Americans insured, at a cost of $157 billion over ten years.
• proposes providing a subsidized prescription drug benefit to all enrolled in Medicare, administered through the existing Medicare system. Estimated costs: $253 billion over ten years.
• supports a patients’ bill of rights which extends broad rights such as guaranteed access to specialists and the ability to sue negligent health plans.

Move toward universal health coverage, step by step

All children should have health care by 2004

Expand Children’s Health Insurance Program for working poor

$146B over 10 years to insure 90% of adults & 100% of kids

Medicare Rx plan: you choose, Medicare pays

BUSH: I’ve got a plan on Medicare that’s a two-stage plan that says we’re going to have immediate help for seniors in what I call “Immediate Helping Hand,” a $48 billion program. [Then,] seniors are going to have not only a Medicare plan where the poor seniors will have their prescriptions paid for, but there will be a variety of options. My plan not only trusts seniors with options, my plan sets aside $3.4 trillion for Medicare over the next 10 years.

Put Medicare in lockbox so seniors can afford prescriptions

BUSH: I cannot let this go, the “We’re going to scare you in the voting booth.” Under my plan, the man gets immediate help with prescription drugs. It’s called “Immediate Helping Hand.”

GORE: If you make more than $25,000 a year, you don’t get a penny of help under the Bush prescription drug proposal for at least four to five years.

Protect Medicare’s funds with “lockbox”

Gore’s “Crossroads” plan for Protecting Medicare:
• Takes the entire Medicare surplus ($360 billion over ten years) and places it in a lockbox;
• Ensures that Medicare payroll taxes only go for Medicare and paying down the federal debt;
• Uses the interest savings from debt reduction to keep Medicare solvent until at least 2030.

Modernize Medicare with choice, efficiency, competition

Gore’s “Crossroads” plan for Modernizing Medicare:
• Letting seniors make choices about their health coverage;
• Making sure seniors can choose their own doctor;
• Increasing price competition;
• Cracking down on fraud;
• Introducing new management techniques;
• Protecting choice by increasing penalties for HMOs that cherry pick [choosing healthy patients over riskier patients]

Too many seniors have to choose between drugs and rent

Senior prescription drug benefit with $4,000 cap

Gore’s “Crossroads” Prescription drug plan:
• Ensures all beneficiaries access to a voluntary prescription drug benefit;
• Ensures that all beneficiaries have their choice of doctor and pharmacy;
• Covers half the costs of all prescriptions up to $5,000 a year;
• Provides catastrophic protection to ensure that no beneficiary pays more than $4,000 annually on prescriptions;
• Ensures that the lowest income beneficiaries pay no premiums.

Allow 55-65 year olds to buy into Medicare

Free preventive cancer screenings for Medicare beneficiaries

$253B for Medicare prescriptions & subsidized premiums

1997 Medicare cuts went too far-put back $339B

Health Care Trust Fund to expand coverage

$300B over 15 years to keep Medicare solvent

Patient Rights: power to doctors; right of appeal

Supports Dingell-Norwell Patient Bill of Rights

Q: Do you two agree on that?

GORE: Absolutely not. The Dingell-Norwood bill is the bipartisan bill that is now pending in the Congress. The HMOs & the insurance companies support the other bill that’s pending, the one that Republican majority has put forward. [The Dingell-Norwood bill] is being blocked by the Republican leadership in the Congress. I specifically would like to know whether Gov. Bush will support the Dingell-Norwood bill, which is the main one pending.

BUSH: I talked about the principles and the issues that I think are important in a patients’ bill of rights. Now, there’s this kind of Washington, D.C., focus, well, it’s in this committee or it’s got this sponsor. If I’m the president, we’re going to have emergency room care [and the rest of] what I’ve done in Texas. And that’s the kind of leadership style I’ll bring to Washington.

Encourage competition, ensure choice, stop abuses

Private medical information should not be bought and sold

Enforce HMO coverage of women’s cancer treatment

Patients have right to more access, protection, recourse

Gore supports the bipartisan Norwood-Dingell bill, which includes:
• Protections for all Americans in health plans;
• protections from financial sanctions for patients accessing emergency room care;
• access to health care specialists and clinical trials;
• access to a fair and timely appeals process to address health plan grievances; and
• enforcement mechanisms that ensure recourse for patients who have been harmed as a result of a health plan’s decision.

25% tax credit for health insurance; HMO appeals

On HMOs:Supports right of patients to “independent appeal” when denied treatment, guaranteed coverage of emergency room treatment, and “redress” for actions of the HMO, & other protections.

Patient rights: emergency coverage & performance disclosure

Patients and doctors should decide who gets what care