If you want to know why the Bush campaign is foundering, you don’t need to look any farther than last week’s battle (week of September 4th, 2000) over prescription drugs.
Proving that the era of big government is far from over, Al Gore has proposed a $253 billion expansion of Medicare to create a gigantic new welfare entitlement for the elderly: government-subsidized prescription drugs. Last Tuesday (September 5th, 2000), in a bold opposing move, Bush unveiled a proposal that would do, well, essentially the same thing.
The only major difference is that Bush’s plan would spend less money than Gore’s. In short, Bush is embracing the disastrous old political stance known as “me too.” And the result is predictable: If expanding Medicare is such a good idea, voters are concluding, then why not go with the candidate who’s serious about it?
But Bush isn’t just hurting his campaign — he’s hurting all of us by failing to take a stand against a growing government takeover of our health care.
In 1994, Republicans in Congress did take a stand by voting down Bill Clinton’s attempt to socialize medicine. They stood up in favor of free markets and private medical care, and they were rewarded with a sweeping election victory. Bush needs to assert the same kind of leadership today — because Gore’s prescription drug plan is every bit as bad as Clinton’s plan.
Gore’s proposal would make the government into the major buyer of prescription drugs. And what happens then? Exactly what has happened with Medicare: the government’s costs soar, and politicians react by imposing price controls on doctors, hospitals — and now drug companies. And under price controls, the incentive to provide quality care disappears.
In a government-run system, for example, expect to see your doctor pressured not to prescribe expensive drugs that are “unnecessary” — as judged, not by a doctor, but by a government bureaucrat. We can expect this, because that has become the norm under Medicare. Here’s how one observer sums up the effect of government-run medicine: “[U]nder the present system, the hospital not only has to cut services drastically — it is to its interest to conceal this fact from the patient.” Was that said about the ruthless cost-cutting policies of HMOs today? No, that was said, 15 years ago, about the perverse incentives created by Medicare price controls. It could be a description of what will happen to prescription drugs tomorrow.
Even worse, consider the effect of price controls on the development of new drugs. Gore is already condemning the pharmaceutical industry for making “excessive” profits, and in one speech, he even lashed out at a manufacturer, incredibly, for the crime of spending too much money on advertising. The implication is clear. Once government becomes the largest buyer of prescription drugs, Al Gore — or some other politician like him — will dictate what profits drug companies can make and where they can spend their money.
Ask yourself how the industry can keep developing life-saving new drugs under this kind of stultifying bureaucratic control. Will investors risk the average $500 million necessary to bring a new drug to market, when their profits are limited by government fiat? Will scientists devote themselves to the average 15 years of research and clinical trials necessary to win FDA approval, when their rewards are dictated by the state? Would you work under these conditions? Then don’t expect others to do so.
This is the direction that Al Gore is taking us. And who’s going to stop him? Not George W. Bush.
The real solution to the problems created by Medicare is the same as the solution to the insolvency of Social Security: privatization. Bush could, and should, make the case for replacing Medicare with a system of personal savings and private medical insurance. That would provide the American people with a clear alternative to Gore — and it would establish Bush as a real leader willing to take a bold, principled stand.
As it is, Bush’s fellow Republicans are urging him to get more aggressive and to assert his own agenda. The problem is that “me too” is Bush’s agenda. The Democrats have set up a prescription drug takeover as their test of a candidate’s “compassion.” Rather than challenge that premise, Bush accepts it and merely offers us a scaled-down, “conservative” version of the same idea.
If this is the real meaning of “compassionate conservatism,” the American people deserve better.
