Dean Offers Rival Health Care Proposal
WASHINGTON — Former Vermont Gov. Howard Dean on Tuesday unveiled a health care plan that he said would cover as many of the uninsured -- at a fraction of the cost -- as a sweeping proposal by Rep. Richard A. Gephardt of Missouri, a rival for the Democratic presidential nomination in 2004.
While Gephardt's plan is centered on a large new federal subsidy to help private employers insure workers, Dean aims to increase access to health care primarily by expanding existing public programs that provide coverage for the uninsured.
Dean said his plan, like Gephardt's, would extend coverage to about 30 million of the 41 million Americans the Census Bureau reports lack health insurance. But Dean projects he could insure those people for $88.3 billion a year -- a substantial sum, but only about a third of the $247 billion annually that Gephardt's plan would cost by 2007.
In a speech at New York's Columbia University, Dean previewed his line of argument with Gephardt by portraying his own plan as both ambitious and fiscally realistic. Gephardt responded by charging that the Dean plan would only "nibble around the edges" of the nation's health care problems.
The exchange -- following several pointed volleys over health care between Gephardt and the other candidates during a recent debate in South Carolina -- underscores the central role that the issue is assuming in the intensifying Democratic race. The temperature could rise further on Thursday, when Sen. John F. Kerry of Massachusetts is scheduled to release his own plan for expanding access to health care -- one also expected to rely largely on expanding public programs.
Like most Democratic proposals since the collapse of President Clinton's massive national health care initiative in 1994, Dean's plan attempts to cover the uninsured without disrupting existing arrangements for the 85% of Americans with insurance.
"It's a good gap-filling strategy that says let's minimize disruption and maximize the way we build on existing structures to try to bring more people into the coverage net," said Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured, an independent policy institute.
In an interview after his speech, Dean said he would pay for his plan by eliminating much of the 2001 tax cut law pushed by President Bush, including a reduction in the top rate for taxpayers earning more than $300,000 annually. He would also trim a promised cut in the estate tax under that law. Those provisions alone wouldn't nearly cover the cost of Dean's plan, but he said he has not decided which additional tax cuts he would seek to rescind.
