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Gore the Ox

By William Saletan
Posted Friday, Oct. 29, 1999, at 3:30 AM ET

Ever since Al Gore woke up and opened fire on Bill Bradley, Gore has vacillated between two lines of attack. One is that Bradley is a big-spending liberal. The other is that Bradley is a closet Republican who voted for President Reagan's budget cuts and promoted school vouchers. In Wednesday night's debate, Gore finally demonstrated how he plans to unite these two indictments. He will tell voters that Bradley's big spending threatens middle-class entitlements.

Gore's message reflects a cynical lesson of the past six years: Defense wins. In 1993 and 1994, Gore and President Clinton pursued a bold liberal idea: mandating universal health insurance. Conservatives thwarted them and captured Congress by convincing voters that the plan threatened existing health benefits, particularly the right of patients to choose their doctors. In 1995 and 1996, Newt Gingrich and Bob Dole pursued a bold conservative idea: reducing the size of government to liberate the economy and to let taxpayers keep more of their money. Clinton and Gore thwarted them and defeated Dole by convincing voters that Republican budget cuts threatened Medicare. To cynics, the lesson of these wars is that most voters don't care about liberal or conservative principles. What they care about is losing the benefits they have.

Bradley has proposed to extend health insurance to 95 percent of Americans through subsidies and tax credits. Ten minutes into Wednesday's debate, a librarian asked him how much the plan would cost and how he would pay for it. Bradley said it would cost "between $50 billion and $65 billion a year" and would be funded either "from the surplus" or "through the enormous savings that we can get through the application of technology to the medical system," such as "moving things from paper to Internet."


When Gore got his next chance to speak—in response to a different question—he turned back to the cost issue. He said his own health insurance plan, which would ostensibly cover "90 percent of the American people" and "100 percent of all children," would cost "$146 billion over 10 years," plus "a prescription drug benefit … under Medicare for $118 billion over 10 years." Citing an analysis by Emory University, Gore said Bradley's plan "costs $1.2 trillion. That is more than the entire surplus over the next 10 years. We have to look ahead and save some of that surplus for Medicare. If we wipe out Medicaid and wipe out the chance to save Medicare" by funding Bradley's health insurance plan, we would "shred the social safety net" and "give two-thirds of the money to those who already have health insurance."

The next questioner asked about campaign reform, but Gore refused to let go of the health-care dispute. "Medicare cannot be an afterthought," said Gore. "The only way to fix Medicare fairly is to set aside 15 to 16 percent of the surplus to do it now. Otherwise, you're putting Medicare at risk. Sen. Bradley said in an interview that he would speak to this issue later on, but if you spend the entire surplus on the first campaign proposal, then that does not leave money that should be allocated for Medicare." A few minutes later, Gore steered a question about education back to the Bradley health plan. "If the entire surplus is spent, then there is no money left over for new initiatives on education," he argued.

From one perspective, Gore's attack is conservative. Liberals habitually champion new programs and entitlements without explaining what they would cost. Conservatives habitually expose and exaggerate the cost of these programs, which they translate into tax increases. On health care, Bradley is championing an entitlement, while Gore is exposing—and, according to Bradley, exaggerating—its cost.

From another perspective, Gore's attack is liberal. Conservatives habitually champion smaller government and tax cuts without explaining which programs would be reduced and which beneficiaries would suffer. Liberals habitually expose and exaggerate the suffering caused by these reductions. Gore isn't suggesting that Bradley's health insurance plan will force a tax increase. He's suggesting that in order to fund that plan, Bradley will have to cut other programs, particularly Medicare and education.

The advantage of this critique is that because it is conservative as well as liberal, Gore can use it in the Democratic primary and then build on it in the general election. In the primary, he can tell liberal voters that Bradley's health insurance plan would suck up all the oxygen in the budget, thereby suffocating the left's favorite programs. If Gore were to complain that Bradley's plan required a tax increase, liberals would shrug and vote for Bradley. By confronting them with budget cuts instead of tax increases—claiming that Bradley would "shred the social safety net" and stifle "new initiatives on education" in order to "give two-thirds of the money to those who already have health insurance"—Gore gives them pause.

In the general election, Gore can hold the same ground against the Republican nominee. He can tell moderate voters that the GOP's "risky tax scheme" (translation: tax cuts) would eat up the surplus and force deep cuts in—remember this?—"Medicare, Medicaid, education, and the environment." And now that the government is in sufficiently good shape to stop borrowing from Social Security, Gore can tell voters that he would protect that trust fund, whereas the Republican tax cuts would force the government to "raid" it again. Gore also gets the benefit of triangulation. When the Republican nominee portrays Gore as an arrogant Washington politician who won't give back the tax money you overpaid the government, Gore can remind voters that he defended "fiscal responsibility" against Bradley's reckless spending as well as the GOP's reckless tax cuts.

Gore's accuracy can certainly be disputed. Bradley has already accused him of exaggerating the cost of Bradley's health-care plan. Likewise, Republicans can accuse Gore of overestimating the cost of their tax cut and underestimating the projected budget surplus. And reporters can question Gore's inference that any candidate who fails to reserve 15 percent of the surplus for Medicare is putting the program "at risk" and "wiping out" the chance to "save" it.

But as a political strategy, Gore's position has an unbeaten record. Hillary Clinton messed with health insurance and went down in flames. Newt Gingrich messed with Medicare and went down in flames. Democrats offered more spending and lost the House. Republicans offered tax cuts and nearly lost it back. The only thing still standing is the entitlements middle-class voters feared they might lose to visionaries on the right or the left. For six years, Bill Clinton has stayed alive by clinging to those entitlements. Al Gore could do worse.

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William Saletan is Slate's national correspondent and author of Bearing Right: How Conservatives Won the Abortion War.
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The readers respond:


This article is one of the best explanations I have read in a long time about how Americans want to have their cake and eat it too. It's great to cut the budget, as long as it comes out of somebody else's pocket. While this is in large part simple human nature, much of the blame has to go on the folks who decided it was politically expedient to call these "Entitlement" programs. Although I have heard this name defended by claims that in "government-speak" the word had a different meaning, it was clearly intended to make Americans believe they are ENTITLED to these funds, i.e.; it is their RIGHT to receive them. And it's downright un-American to take away someone's rights!

(To reply, click here.)


It seems to me that this debate misses the point completely. The health care system of the USA does not need more money: It already spends about 30% more per head than any other country, including European nations with a much more comprehensive health insurance. The U.S. system is grossly and scandalously inefficient, and more money isn't the answer. What it needs is reform to make sure that more of the money goes to patients, instead of to lawyers, executives and stockholders. American politicians should learn to look over the border. There are better ways to do things.

(To reply, click here.)


I just want to post my support for Mutatis. I moved to Holland in February, and got health care here last month. I now pay $70 a month for insurance, and that's because I'm a freelancer; if I worked for a company I would pay a third that amount. In the U.S. I was paying $225 a month, and counting myself lucky to be part of a group plan, rather than out on my own. I can pick any doctor I want, I'm fully covered in any EU country and 75% covered on trips to the U.S., and prescription medicines are paid for. And this is on a PRIVATE plan; Holland doesn't have national health insurance. That's why it now has what it considers a scandalously high number of people with no health insurance--I think it's about 4%, or fewer than Bradley's plan would leave uncovered. What America needs to do is kick the freaking insurance agents out of the loop.

(To reply, click here.)


I have news for you. It isn't the insurance agents. they make about 20% commission on first year premiums, and 3% in subsequent years. $45 per month on your first year premium and $6.75 after that. It's the fact that a doctor charges $250 in the hospital to stick his head in your room and say "Hi!" And the fact that drug prices are 3 to 4 times higher for the same stuff here as in other countries. And don't even get me started on malpractice attorneys!

(To reply, click here.)



(10/29)

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