Bush's Healthcare Plan

A CORE issue in healthcare, this political year as always, is choice. Whatever Washington does, it should enhance people's ability to choose the care they want.

The healthcare debate will focus on relatively narrow issues: the addition of a prescription drug benefit to Medicare and passage of a patient's bill of rights.

Many older Americans, whose clout at the polls is renowned, are rallying for the new Medicare benefit. President Bush proposes spending $190 billion over 10 years to pay for prescriptions for low-income elderly. Many in Congress want at least $300 billion (see story page 2).

Indeed, with rising prices for pharmaceuticals, it's hard to see where the spending spiral would end. How deeply can government afford to involve itself before it starts dictating what can be paid for and what can't?

Currently, health maintenance organizations and health insurers try to hold down costs by controlling access to certain types of care. Patient's bill of rights legislation - passed last year by both houses of Congress, but stuck in conference - would restrict such cost-cutting and give people the right to sue health plans. It would also raise healthcare costs.

What can get lost in the political dust-up over these issues is the human dimension. As health costs ratchet upward, many elderly on fixed incomes and many poor families have legitimate worries about receiving the kind of care they believe they need.

Politicians should keep in mind that government doesn't have the ability to guarantee all citizens all the care they need or want. At best, it can address specific gaps in the system, being careful to preserve an individual's choice.