Where They Stand: Health Care

The Democratic presidential candidate would create a voluntary program in which businesses would offer health coverage for their employees in exchange for having the federal government pick up most of the tab for catastrophic cases. He would also give tax credits to small businesses to help them insure workers.

In an effort to cover more Americans, Kerry would also offer incentives to the states to expand programs for low-income families and children.

The Kerry plan would likely reduce the premiums many Americans pay for health insurance. But because it would cover more people, it would cost at least four times as much as the Bush plan — $650 billion over 10 years, by the campaign's own estimate.

The Bush campaign estimates the president's health care plan would cost about $158 billion over 10 years.

"The Kerry proposal does not cut costs overall. In fact, in truth it would have to increase it because it covers more people who will then use health care they didn't use before," says Princeton's Reinhardt.

Critics say Kerry's ideas merely redistribute the cost of health care in America.

"The Kerry plan isn't actually going to save health care costs. For a lot of people, it is going to reduce what they pay for health insurance premiums, but the cost didn't go away. The costs are just turned into higher taxes," said Antos.

Lowering the Cost of Prescription Drugs

As for prescription drugs, Bush takes credit for signing a bill to lower prescription drug prices for seniors under Medicare. Most of the changes in that bill take effect in 2006.

Many Democrats said the bill did not go far enough in providing relief, but independent analysts say it will help seniors — particularly those with lower incomes or catastrophic prescription drug costs.

Kerry offers his own ideas about lowering the price of prescriptions. The Massachusetts senator would allow the federal government to negotiate prices with drug manufacturers on behalf of Medicare patients. He proposes to allow re-importation of prescription drugs from other countries, such as Canada. And he promises to speed generic drugs to the market.

Analysts say Kerry's proposals would likely make a difference in drug prices if they became law.

However, passing any new health care or prescription drug policy through Congress is a difficult prospect.

Both Kerry's and Bush's plans are modest compared with what President Clinton tried to do when he entered office. And with good reason.

"No one wants to repeat, to take the risk that President Clinton took in putting forward a comprehensive overhaul of the health care system that became a big target for opponents. It scared the American people, and so both candidates are proposing small or incremental approaches," said Altman.

"To reinvent health care in this country is impossible," said Reinhardt. "You can fix it, fiddle with it, but you can't change it."

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