Policy Points: Bush vs. Kerry (continued)
Drug policy
Kerry and Bush also differ regarding
allowing reimportation of drugs from Canada or Mexico:
Kerry supports allowing such imports as a way of saving
costs; Bush opposes imports, arguing that the quality of drugs
could not be assured. Kerry would have the Medicare program
negotiate prices more vigorously with drug companies, whereas
Bush favors negotiation of drug prices through multiple private
sector pharmacy benefit managers. Kerry says that Bush’s
policy “rewarded industry profits rather than
America’s seniors.”
Tort reform
The candidates differ on tort reform. Bush
wants a nationwide cap of $250,000 on non-economic damages.
Non-economic damages include pain and suffering and diminished
enjoyment of life resulting from negligent acts. Bush believes
that placing limits on the amount of money that can be paid out
for medical malpractice claims will lower the cost and increase
the availability of malpractice insurance, thus making health
care more available. Kerry says placing a cap on non-economic
damages “denies justice to those who suffer
life-shattering injuries.” Both candidates, however,
support not allowing punitive damages in medical malpractice
actions unless the conduct is egregious.
Areas of agreement
In addition to agreeing to limit punitive
damages in medical malpractice actions, John Kerry and George
W. Bush also agree in at least four other areas of health
policy:
• Passage
of a Patients’ Bill of Rights—Protections in the Bill of Rights would include:
easier access to specialists, particularly obstetricians
and gynecologists; rights to appeal denial of coverage; and
broader rights to sue HMOs.
• More
use of electronic record-keeping—Increased use of electronic billing and patient
record-keeping would reduce administrative costs. Both
candidates also support having secure electronic health records
that could be accessed and updated by health-care providers.
• More
community health centers—Additional
funding would increase the number of community health centers
serving rural and inner-city areas.
• More
funding for medical research—Both
candidates support increased funding for medical research,
although Kerry supports broader use of stem cell research than
Bush.
Incremental reforms
Both Bush and Kerry favor incremental
reforms of the health-care system. They would add funding to
selected programs they deem important and would adopt new rules
they believe will make the system better. Bush’s approach
is more modest, both in terms of the amount of government money
he is willing to spend on health care and in the number of
uninsured people for whom he would expand coverage. Kerry is
willing to spend a great deal more money and his proposals
would cover more Americans who currently do not have insurance.
Bush’s plan
generally favors reforms coming through the private sector.
Under Kerry’s plan, the federal government would exert
more control as well as provide more funding.
Broader reforms of the
American health-care system, including coverage for all
Americans without health insurance, are not part of either
George W. Bush’s or John Kerry’s campaign
proposals. If such changes are to occur, it may require a
higher level of crisis than we have now, or a greater level of
prosperity. g
Jeff
Atkinson teaches courses in
health-care law and policy at DePaul
University College of Law in
Chicago, where he graduated summa cum laude. He writes on
legal, medical, and ethical issues.
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