American College of Physicians: Internal Medicine — Doctors for Adults ®


Health reform takes a back seat in party platforms

From the September 1996 ACP Observer, copyright 1996 by the American College of Physicians.

The presidential election season is in full swing, and health care issues are a much lower priority in party platforms compared with four years ago. Although platforms aren't what they used to be—the principal way of expressing a party's philosophy—they "can provide some indication of where the party is headed," as political analyst Jack W. Germond noted recently in the Baltimore Sun. Here's a summary of each party's platform:

The Democratic Party platform devotes more space to past efforts and accomplishments than to future initiatives. The platform reminds voters of Democratic initiatives to expand the Women, Infants, and Children's (WIC) program that provides prenatal and early childhood nutrition; to immunize more children; to shorten the approval process for drug approval; to increase research on women's health issues and AIDS; to hold the line against Republican-sponsored "mean-spirited" cuts in Medicare and Medicaid; to extend the life of the Medicare Trust Fund; to give states flexibility to expand Medicaid coverage; and to crack down on health care fraud and abuse.

Future goals are far less lofty than the 1992 platform's devotion to comprehensive health care reform. This time, Democrats support "steps to ensure that Americans have access to quality, affordable health care;" helping people pay premiums, if necessary, between jobs; expanding coverage of home care, hospice and community-based services; and cracking down on illegal tobacco sales to children. Democrats vow to "protect and strengthen" Medicare and Medicaid.

The Republican Party platform spells out an approach to "improving America's health care," which the party defines as "allowing health care providers to respond to consumer demand through consumer choice."

The Republican Party health care plank, like the Democrats', also focuses on accomplishments, particularly reforms passed this summer as part of the Kassebaum-Kennedy health insurance portability bill (see "How the new insurance legislation can benefit patients and doctors"). It also proposes expanding use of tax-free medical savings accounts (MSAs)—Medicare and Medicaid recipients would be included; reforming malpractice laws; permitting families with incomes up to twice the poverty level to buy into Medicaid; and changing IRS rules to make more health insurance policies tax deductible. The party's position, as well, is that the government should "avoid mandatory coverages that make consumers pay for more insurance than they need."

On the issue of Medicare, the platform "reaffirms [Republicans'] determination to protect Medicare," ensuring "a significant annual expansion in Medicare" and allowing "unprecedented patient choice in Medicare, so that older Americans can select health care arrangements that work best for them, including provider-sponsored organizations." Medicaid, meanwhile, should be turned over to state management, the platform states, with state officials given the authority to weed out substandard providers and to eliminate excess costs.

Information for this article was compiled by Kathleen Haddad and Deborah Gesensway.

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