Former president Bill Clinton yesterday assailed his successor's domestic priorities, saying the Bush administration's eagerness for tax cuts is rendering the government unable to address fundamental shortcomings in the nation's health care system, including the 41 million people who are uninsured.
In his first major speech on health policy -- a signature issue of his presidency -- since he left the White House two years ago this week, Clinton said that President Bush has promoted tax reductions for the wealthy while depriving states, small businesses and working families of money to expand health coverage.
"You are having a conversation about air if you don't have any money," Clinton told an audience of liberal health care activists. He criticized the main device the administration has proposed to increase coverage -- tax credits for people to buy insurance policies on their own -- saying that such credits would not give enough financial help.
Clinton was one of two influential Democrats who sought yesterday to draw attention to health care problems, less than a week before Bush is to lay out his agenda for the year in his State of the Union address.
"The health care system in the country is in a real crisis," Sen. John Breaux (D-La.) told the U.S. Conference of Mayors. He pointed out that the price of insurance coverage is rising far more quickly than overall inflation, more Americans are becoming uninsured, and fewer small business are offering workers coverage.
The prescription Breaux outlined went considerably beyond Clinton's advice. The senator advanced a new proposal for making sure that everyone in the country has basic health insurance, saying that such a system would be akin to laws that require drivers to carry auto insurance.
Under Breaux's proposal, people with incomes of 150 percent of the federal poverty level or less would not have to pay for insurance, while the government would give partial subsidies to incomes up to 250 percent of the poverty level. The government would create a method to try to ensure that employers do not drop any coverage they already provide, and states would be encouraged to form purchasing pools so individuals could obtain insurance at a reasonable price.
Breaux acknowledged that his proposal faces difficult prospects. "Is it going to pass this year? The answer is no. But let the debate begin."
In their remarks, Breaux and Clinton each noted that the United States spends more on health care than other nations while access to that care remains uneven.
The changes Clinton recommended are more gradual than the comprehensive revision of the health care system that he proposed in 1993, and that Congress rejected the following year. Yesterday, he called for the government to shore up Medicaid, the public insurance program for the poor, particularly because many states are facing historic financial strains.
He revived an idea he promoted toward the end of his presidency: allowing some parents to obtain coverage through the Children's Health Insurance Program that Clinton helped to create. And he said the medical malpractice system could use improvement, although he said its problems are not as severe as Bush contends.
Clinton was harshest in his depiction of the $1.3 trillion tax cut that Bush pushed through Congress in 2001 and the additional $670 billion in cuts the president is proposing this year. Noting that the 2001 tax cuts have contributed to the resumption of federal deficits, he said, "The first thing you ought to do when you find yourself in a hole is quit digging. They are looking for a bigger shovel."
Alluding to his increased wealth since leaving public office, Clinton said: "In times like these, states usually get a little extra help from Washington. Instead, they are going to give the money to me."
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