Commentary. Thorpe estimates the Bush proposal will initially cover an additional 2.4 million uninsured Americans, but this number will decrease to 2.1 million by 2014 due to the decreasing value of the refundable tax credits. He projects the total cost at $90.5 billion over the 10 years.7 The Table compares the Bush and Kerry health insurance proposals.
TABLE
Comparing costs assumed in the Bush and Kerry proposals for reforming health insurance
| Bush | Kerry* | |
|---|---|---|
| Federal cost of plan (billions) | ||
| 2005–2010 | $45.7 | 176.3 |
| 2005–2014 | $90.5 | $653.1 |
| Newly insured (millions) | ||
| 2008* | 2.4 | 26.7 |
| 2014* | 2.1 | 26.7 |
| Note: About 70% of the newly insured would claim the credit in the Bush plan expressed in 2003 figures. | ||
| *Net cost of plan including estimated federal savings. | ||
| Source: AAFP website: www.aafp.org/x22202.xml. | ||
Malpractice reform
President Bush made malpractice reform a priority issue in the current Congressional session. The key provision in his proposals is a $250,000 cap on non-economic damages, a position strongly supported by most national medical organizations (eg, AMA, AAFP). In the current Congress, a bill including this provision has passed the House but has failed to gather sufficient support for approval in the Senate.
Senator Kerry reflects the prevailing Democrat view opposing a cap on non-economic damages. Instead, he proposes prohibiting individuals from filing a suit unless a qualified specialist determines a reasonable claim exists and requiring mandatory sanctions for frivolous lawsuits.
Prescription drug costs
The Medicare prescription drug bill was reviewed in a recent issue of the JOURNAL OF FAMILY PRACTICE. Since the passage of that legislation, many Democrats continue to argue that not enough was done to provide recipients with affordable drug prices. A recent survey of Medicare recipients by the Kaiser Family Foundation showed 47% had unfavorable views of the law and 26% had favorable views, but a majority wanted Congress to fix the law, not repeal it. The survey found extensive support for allowing importation of drugs from Canada and allowing the government to negotiate the price of drugs with pharmaceutical companies.9
Senator Kerry has made these 2 proposals a prominent part of his campaign.
President Bush has resisted allowing importation of drugs from Canada on the basis of safe-ty concerns and has opposed having the government directly involved in negotiating Medicare drug prices saying that competition among private plans would lead to similar savings. As of September 2004, a handful of states had set up websites to allow residents to access information about buying medicines from Canada. The FDA has said this amounted to allowing importation of pharmaceuticals from other countries and was not allowed, but it had not moved to stop the activity.
Stem cell research
President Bush limited government funding of stem-cell research to those cell lines that were created before August 9, 2001. Research has continued in other countries and somewhat in this country through private funding, but many US medical organizations and scientists have argued that we are gradually losing ground in this field to foreign scientists.10
Senator Kerry has made the expansion of government funding of stem cell research a prominent part of his health care platform.
Correspondence
Eric Henley, MD, MPH, 1601 Parkview Avenue, Rockford, IL 61107. E-mail: ehenley@uic.edu.