WASHINGTON — Although the presidential campaign has been dominated for months by Iraq and, more recently, the candidates' military records, few issues matter more to voters -- or more profoundly divide President Bush and Sen. John F. Kerry -- than the plight of the U.S. healthcare system.
The system's problems now are coming into sharper focus on the campaign trail. Bush and his Democratic challenger began running ads on health policy in the last week, and their differences on the topic were spotlighted by an exchange Monday between the two camps.
The issue's new prominence has been spurred by a spate of reports documenting the rising cost of healthcare -- and the dearth of adequate coverage for many.
Bush and Kerry do not simply disagree on how to deal with these troubling developments. They want to take the system in radically different directions.
Kerry would expand the existing system of employer-provided insurance and federal health programs for those who slip through the cracks. Bush, in healthcare as in other aspects of social policy, wants to rely on market-oriented alternatives to government programs.
Bush on Monday portrayed Kerry's healthcare plan as a "government takeover." Citing a new study by the American Enterprise Institute, a conservative think tank, the president also charged that the plan would cost $1.5 trillion over a decade -- more than twice the estimate by the Kerry camp.
"What would you expect from a senator from Massachusetts?" Bush told supporters in Michigan. "That's what you would expect. A government takeover of healthcare with an enormous price tag."
Kerry aides said Bush's critique was off-base because the Democrat's health plan would be built on private insurance as well as government programs. They dismissed the new cost estimate as riddled with false assumptions, and they noted that it came from a think tank with links to Vice President Dick Cheney and his family. Cheney's wife, Lynne, was a senior fellow for the institute.
In "town hall" meetings and campaign ads, Kerry has stepped up his effort to blame Bush for recent bad news about healthcare and to decry the consequences of its rising cost. "It's wrong to allow skyrocketing healthcare costs to choke off new jobs, eat up family incomes and leave millions uninsured," Kerry said last week in Iowa.
