About The Gazette Search Back Issues Contact Us    
The newspaper of The Johns Hopkins University September 20, 2004 | Vol. 34 No. 4
BSPH Hosts Health Care Debate

For Kerry, Christopher Jennings

Bush, Kerry proxies lay out the candidates' plans

By Rod Graham
School of Public Health

Close to 400 students, faculty and staff packed Sommer Hall and crowded around television sets at the Bloomberg School of Public Health on Sept. 13 to hear representatives of George Bush and John Kerry face off in a debate titled "Access to Public Health Care: The Presidential Positions."

The American system currently gobbles up 14 percent of the gross domestic product, whereas Germany, for instance, which has one of the next most expensive plans, spends just 9 percent of its GDP for health care — and manages to insure 100 percent of its population.

Exposing how the two candidates' visions of how to shore up America's health care system contrast sharply were Bush proxy Gail Wilensky, a senior fellow with Project HOPE, and Kerry representative Christopher Jennings, president of Jennings Policy Strategies.

Alfred Sommer, dean of the Bloomberg School, moderated the debate and allotted time for three sessions of questions, one from members of the audience and two from an expert panel, which was seated on stage between the speakers.

Panel members were Jonathan Weiner, professor, Health Policy and Management, and deputy director, Health Services R&D Center; Michael Gibbons, assistant professor, Health Policy and Management, and associate director of the Johns Hopkins Urban Health Institute; Alex Dominguez, science and health reporter for the Associated Press; and Jonathan Bor, medical reporter for The Baltimore Sun.

For Bush, Gail Wilensky

Wilensky stressed that Bush was for individual empowerment through health savings accounts; Jennings spoke of Kerry's desire to bolster the existing system and to bring more people into it.

In their opening salvos, the two speakers mapped out their candidates' disagreements. Wilensky said that Kerry's much costlier plan — with a price tag of $1.5 trillion over 10 years vs. Bush's $128 billion — would expand the price of health care but do nothing to reduce the bottom line. Bush's plan, she said, would not only bring in 7 million uninsured (as compared to Kerry's bid to include 28 million additional recipients), but it would also make patients more cost-conscious by emphasizing high-deductible policies that would exempt insurance companies from paying for routine preventive care.

Jennings countered by saying that Bush's plan neither increases the number of people eligible for coverage nor makes health insurance more affordable. He cited independent sources that contend that during George Bush's watch health care premiums have increased by a factor of three to four times increases in wages, drug prices have ballooned at three times the rate of inflation, 5 million more people are now uninsured, the Children's Health Insurance Program has actually lost members, and Medicare is now on schedule to become insolvent 13 years earlier than previously indicated.

Debate highlights:

Who should be covered? Wilensky said Bush has no problem with providing insurance to all Americans below the poverty line and would allow potential Medicare beneficiaries to choose a plan on their own. Kerry would extend coverage to those with incomes 200 percent to 300 percent above the poverty line and would automatically enroll all those eligible.

Curbing Malpractice Suits. Bush would curb malpractice suits against physicians, thus reducing insurance premiums by 2 percent, a savings of $32 billion. Kerry would put into place a better system for reporting and rooting out physician errors and would nip frivolous lawsuits in the bud by not allowing any lawyer to try malpractice cases who has had three or more thrown out.

Mental Health Parity. Mental health premiums carry higher co-payments than traditional types of health insurance, and a bill to bring these two expenses more in line with each other has died in Congress. Wilensky said that Bush has been supportive of the general idea of mental health parity and she presumed that in the next four years Bush would focus more on this issue. According to Jennings, Bush made an explicit commitment over one year ago to support mental health parity but to date has done nothing to see that this measure is passed.

Importing Cheaper Drugs from Canada. Wilensky cautioned that if drugs are bought over the Internet, patients will not know if their dosages are correct, if they've been stored properly or even if the manufacturer is correctly identified. Furthermore, she said that the notion that Canada could supply the entire United States with drugs is ridiculous; demand, she said, would quickly drive up prices. Jennings said Kerry would beef up FDA oversight so that the safety of imported drugs could be guaranteed.

Preventive Health Care. Bush believes that while preventive care will save money, chronic care is a much bigger problem. Kerry, Jennings said, wants to head off the deaths that obviously can be prevented. "Congress won't regulate tobacco," he said, "but Kerry-Edwards will fix that, along with other bipartisan agreements that are now being blocked."

Summing up. "To govern is to choose," Jennings said. "If we want to build on quicksand, we can. George Bush has decided to extend his tax cuts and make them permanent. John Kerry will roll back those cuts to Clinton-era levels and use that money to make a reasonable investment in health care."

"George Bush," Wilensky said, "wants to empower individuals to satisfy their health care needs by allowing them to shop around for the right insurance company. George Bush would also take steps to discourage the medical malpractice suits that now foster defensive — and thus expensive — medical practice. The fact that health care issues were not solved during the prosperous 1990s indicates these problems will not go away without some belt tightening."

To see and hear the debate, go to the webcast at


The Gazette | The Johns Hopkins University | Suite 540 | 901 S. Bond St. | Baltimore, MD 21231 | 443-287-9900 |