President Bush charged in a pair of television ads yesterday that John F. Kerry's health care plan would lead to "rationing," "less access," "fewer choices" and "long waits." But his campaign acknowledged that these were references to the existing Medicaid program, whose eligibility would be expanded under the Massachusetts senator's proposal.
The ads also charge, as Bush has on the campaign trail, that his challenger's plan is "a big government takeover." But there is no takeover -- the Kerry plan builds on the existing system of private health insurance, primarily through tax credits and incentives.
Fact sheets provided by the Bush campaign offered little evidence for these and other accusations beyond excerpts from such conservative forums as the Wall Street Journal editorial page and the Weekly Standard.
One ad says the Kerry plan "includes the IRS, Treasury Department, and several massive new government agencies." The other says that "Washington bureaucrats, not your doctor, make final decisions on your health."
Senate Majority Leader Bill Frist (R-Tenn.), a former heart surgeon made available by the Bush campaign, said federal officials would inevitably be involved with treatments costing more than $30,000 because the federal government would reimburse up to 75 percent of those high-cost cases. As a doctor, "I would not be dealing with the patient," he said. But in a speech in July, Frist proposed a catastrophic reinsurance program similar to Kerry's.
Frist said the Kerry plan "aggravates" what he views as rationing and other problems in Medicaid by adding an estimated 22 million beneficiaries to the 40 million already on the rolls. By this standard, the administration is presiding over health care rationing, as well.
Kerry senior adviser Tad Devine called the ads "utterly false and completely dishonest." Kerry health adviser Chris Jennings said most of the newly covered people would enroll not in Medicaid but in the state Children's Health Insurance Program, whose age limits would be expanded. In all cases, he said, enrollment would be voluntary, as would decisions by businesses and insurance firms to participate in the catastrophic program. No government agencies would be created, Jennings said.
The ads say Kerry's proposal would cost $1.5 trillion, based on a 10-year estimate by the right-leaning American Enterprise Institute. Kerry puts the price tag at $653 billion but counts on about $300 billion in projected savings that may not materialize.
Kerry responded hours later with his own health care ad, saying that "for the last four years, one man has stood between America and lower-cost prescription drugs: George Bush." Kerry says in the ad that he will fight to legalize drug imports from Canada and to allow Medicare to make bulk purchases. Critics have raised safety questions about imported drugs and say large-scale Medicare buying could effectively amount to price controls.
Health care is not the only battlefield. In an ad released Sunday, the president cites Kerry's comments to the New York Times Magazine: "We have to get back to the place where terrorists are a nuisance like gambling and prostitution . . . we're never going to end them." The commercial says: "Terrorism . . . a nuisance? . . . How can Kerry protect us when he doesn't understand the threat?"
But Kerry did not call terrorism a nuisance. He said "it's something that you continue to fight" and that his goal is to reduce it to a nuisance level.
The ad also quotes Kerry as saying that "defeating terrorism was really more about law enforcement and intelligence than a strong military operation." While Kerry has used that formulation, he said in a January debate that the war "will continue" to be military in nature "for a long time. And we will need the best-trained and the most well-equipped and the most capable military."
Kerry has responded to other Bush attacks with a spot that says: "Here's the truth about taxes. After nearly four years under George Bush, the middle class is paying the bigger share of America's tax burden, and the wealthiest are paying less. It's wrong."
A Congressional Budget Office study found that while the richest Americans have seen their part of the tax burden drop since 2001, the share of tax payments by those earning $50,000 to $75,000 increased. But in saying that "we need to cut taxes on the middle class, not raise them," the Kerry ad ignores that Bush has cut taxes for middle-class families -- by 9.3 percent, for example, for those averaging $50,000 in income. Kerry's "cut" would simply extend the Bush reductions, although he would add new breaks for health care and college.
Staff writer Ceci Connolly contributed to this report.