EATTLE - Rounding out a coast-to-coast duel over health care and education, Vice President Al Gore yesterday pledged to expand patients' rights and Governor George W. Bush of Texas promised to bring greater local control of education.
The issues were largely overshadowed by news of a Republican attack ad, and by anticipation of the Labor Day holiday, which is widely considered a benchmark date in the campaign. Still, both candidates stuck to their designated roles, allowing surrogates to dish out the harshest attacks.
Gore, completing a week of health-care events with a day devoted to a patients' bill of rights, accepted the endorsement of the American Nurses Association here, and promised to fight for a plan now stalled in the Republican-controlled Congress.
''There's an emergency in America all right, and it's the lack of a strong, enforceable patients' bill of rights,'' Gore said. Promising to give doctors power to make all medical decisions - rather than leaving them up to cost-conscious health maintenance organizations - Gore said the insurance employee has no ''right to play God.''
The Gore campaign also unveiled an ad about health care, deriding health insurance managers as ''some bean-counter behind a computer terminal'' who should not be able to deny patients certain treatment because it costs the HMO too much.
Under the Gore plan, patients who belong to both state-regulated and federally regulated HMOs would have the right to sue the company if the HMO made a harmful decision. The Democratic proposal would also guarantee patients access to emergency room protections, clinical trials, and an independent review of their claims if they are rejected by HMOs.
Bush has said he supports a patients' bill of rights, and signed one into law in Texas three years ago. But the Gore campaign said Bush supports a weak Republican version of the bill, which would not allow patients who are covered by state-regulated HMOs to sue the companies. That would leave 135 million Americans without the right to bring suit.
Bush spokesman Dan Bartlett said the Gore campaign had mischaracterized the Texas governor's position, insisting Bush would support a plan that covers everyone equally.
A patients' bill of rights - different versions of which passed both houses of US Congress this year - has become a key issue in dozens of local races, where Democrats are using health care to demonstrate their differences from Republicans. Some officials hope to address the issue when Congress reconvenes next week, but a reconciliation appears unlikely.
During his health-care push this week, Gore also outlined his plan to include prescription drug coverage in Medicare, his proposal to shore up the Medicare system, and a plan to expand the Children's Health Insurance Program.
During the midday appearance, Gore delivered an unusual blend of salty and erudite remarks, at one point urging the crowd to ''reject the appeal of ironic detachment.'' That followed on the heels of an equally unpopulist remark by his press secretary, Chris Lehane, who called the Republican attack ad ''callow'' and alluded to Jay Gatsby, the empty protagonist of the F. Scott Fitzgerald novel.
Halfway across the country, Bush visited his 100th school this campaign, telling a raucous crowd he will make education his top priority as president and seek to improve it with more local control, greater accountability, and fresh emphasis on reading and character building.
''Education isn't a partisan issue; it's an issue that requires strong leadership,'' the Republican presidential contender told a cheering crowd of 3,000 in a high school gymnasium in suburban Toledo, Ohio.
For the past two weeks, as American students have headed back to school, Bush has highlighted and built upon the education agenda he outlined shortly after launching his candidacy in June 1999.
All told, the proposals total about $15 billion in spending over five years, far less than the $115 billion, 10-year plan outlined by Gore.
The Gore plan calls for the hiring of more teachers, tax incentives to raise teachers' salaries and a battery of repairs to fix crumbling schools. The centerpiece of the Gore education platform is a measure to ensure children full access to preschool.
The Democrats criticized Bush's plan as well as the 100th-school event, noting the count includes the governor's Feb. 2 visit to Bob Jones University, a South Carolina school that Bush was later embarrassed to learn banned interracial dating. The school has since changed the policy.
Bush conceded the event had a contrived air, saying when asked to explain the significance of the 100th visit, ''It's a nice round number.''
Education has long been considered a Democratic issue, especially after Republicans threatened to close down the federal Department of Education, but Bush sought in his remarks to make Republican inroads. In part, he did so by highlighting the poor, minority schools he visited across the country.
''Whether the school was a public school or not, inner city or suburban, new or old, all good schools have something in common: first, people around the school - teachers, superintendents, and principals - who believe that every child can learn,'' Bush said. ''My education plan trusts local folks, empowers teachers, works with schools to meet basic education, to build upon the character of students and focus on making sure that not one single child gets left behind.''
Kornblut reported from Seattle; Glen Johnson of the Globe Staff contributed to this report from Ohio.
