George W. Bush

Candidate response not received.

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John Kerry

Health Care
What will you do to enable more Americans to obtain and keep health insurance coverage so they can get the care they need?

My plan expands health care coverage to 96 percent coverage. It makes a new deal with the states: the Federal government will pay the entire cost for children on Medicaid and assure that all eligible children are automatically signed up, if states will pay their share to expand their children's health programs to higher income families and expand coverage to parents and single adults. This would not only provide coverage to millions of Americans but would help states get some much needed financial relief so they don't need to cut back on those with coverage today.

I would also allow Americans to access to same plan Members of Congress get today. Most Americans have too few choices for health care or unaffordable premiums. This plan will allow people to choose their own doctor and the plan that works best for them, and it provides tax credits to small businesses and those who are 55 to 65 who have trouble buying coverage. I would also provide a 75 percent subsidy for those who are unemployed so that can keep their current health care coverage through COBRA if eligible or buy into the Members of Congress plan if they are not.

I believe that we can cut costs to make health care more affordable and extend coverage to the millions who don't have it today.

Do you support providing employers with immediate relief for health care costs that threaten retiree coverage and put U.S. firms at a competitive disadvantage with overseas companies?

Yes. My health care plan provides relief for both large and small businesses.

Simply having employers absorb rising health care costs is putting U.S. manufacturers at an impossible competitive disadvantage with overseas producers. Between $650 and $830 of the cost of each car produced by the Big Three automakers goes toward health care costs.

That is why I have introduced a reinsurance plan that will help workers in big companies save up to $1000 a year in health care costs. In 2001, only 4/10 of one percent of private insurance claims were for individuals with health expenses in excess of $50,000. However, these claims accounted for nearly 20 percent of medical expenses for private insurers. My proposal for a new 'premium rebate' pool will help keep heath care more affordable for all employers and employees by helping out with certain high cost health cases. Under this plan companies and insurers that guarantee a pass-through of the savings to their workers through reduced premiums and offer all their employees health care, would be reimbursed for 75 percent of catastrophic costs above $50,000. To be eligible for this 'premium rebate' pool, employers and their insurers would have to: (1) provide affordable health coverage to all of their workers; (2) demonstrate they will pass-through savings of up to $1,000 to workers; and (3) encourage disease management to improve and hold down the cost of care.

What steps will you take to control rising health care costs?

In addition to my plan to cut spiraling health care premiums by up to $1,000 a year described above, I have a number of other strategies to cut health care costs. For example, my plan would: require transparency rules for pharmaceutical benefit managers to clearly show what savings they are receiving from the industry and from bulk purchasing; close loopholes that delay getting quality generic alternatives to the market; focus on reducing medical errors that harm patients and cost money and provide incentives for insurers, providers and employers who implement quality measures to reduce errors; support employers and plans that offer disease management programs that improve health care and save dollars. These are just a few aspects of my plan. I think we need to focus intensely on controlling health care costs because they are making our companies less competitive and leaving workers with more costs.

How will you ensure that prescription drugs are available and affordable for working families and retirees?

My plan will cut the greed and excess across the health care system that contributes to rising costs in prescription drugs. For example, most Americans get their prescription drugs through wholesale drug buyers that get billions in financial incentives because of their market clout. My plan says if these companies want to do business with the government, they need to disclose the financial incentives they receive. It also ends loopholes that prevent affordable prescription drugs from coming on the market, which will make health care more affordable for everyone.

We also need to pass a real prescription drug benefit that rewards employers who are offering retiree health benefits rather than undermining them. One of the most significant flaws in the prescription drug benefit currently before Congress is that it does not do that and therefore would cause millions of employers to drop benefits. I will work for a prescription drug benefit that is affordable accessible and meaningful and that makes it easier for employers to offer retiree benefits.

Do you support or oppose measures to privatize or partially privatize the Medicare program?

I oppose measures that will privatize the Medicare program. I don't understand why the current President proposed a plan that would push seniors into HMOs or why Republicans are advocating a prescription drug benefit that is run totally by the private sector. We created Medicare in the first place because the private sector was not working to cover seniors and I oppose efforts to privatize Medicare.

How would you improve patient safety and reduce avoidable medical errors?

Many employers and purchasers are working to make these changes. To implement widespread change in the health care system, we need a national commitment. I have proposed a "Quality Bonus" program that will provide financial incentives to help providers and purchasers to improve quality, reward health care organizations and physicians that invest in modern information systems, provide economic incentives to computerize prescribing systems, and to make errors transparent - not to punish people, but to find ways to prevent the reoccurrence of these errors.

I also support the medical errors legislation before Congress that encourages reporting and dissemination of information. Finally, I think there needs to be a special emphasis on prescription drug errors that account for more than one in ten hospitalizations. We need to take steps to assure patients have better understanding of medications and are able to communicate with a health professional to assure they are complying with the medication.

What would you do to improve nurse staffing ratios in our health care facilities?

Nurses perform heroic work in our medical system. The wide-spread nursing shortage reflects the combination of challenging work and difficult working conditions that characterize the nursing profession. I co-authored the Nurse Reinvestment Act to encourage more nurses to enter the workforce today and improve training, education, and retention for those who are there today. I also support efforts to improve working conditions for nurses and, in turn, the quality of care they are able to provide patients. I have sponsored legislation to prohibit mandatory overtime which is not only unfair to nurses but undermines safety. Finally, I strong support labor law reforms to assure that nurses have the right to organize. I worked to help nurses in Brockton Massachusetts settle a strike and I understand that too often working conditions do not improve without the right to organize.