eorge W. Bush, like most Americans, believes health care should be more than a luxury available only to those who can afford it. But he is unwilling to devise a plan to make sure that just about every American is covered by health insurance.
Instead, Bush proposes tax credits, up to $2,000 per family, so that working people could buy it on their own. ''We will not nationalize our health system,'' he said. ''We will promote individual choice. We will rely on private insurance. But make no mistake: In my administration low-income Americans will have access to high-quality health care.''
His plan is less sweeping than that of former Democratic candidate Bill Bradley, which would have spent about $38 billion to $48 billion more a year, covered all children, and provided greater incentives for adults to get insurance. It is also less sweeping than Al Gore's plan, which would cover more children, offer a federal-state plan to insure parents, and provide a drug benefit for the elderly.
Bush, moreover, supports Medical Savings Accounts, a concept that encourages healthy people to buy high-deductible policies instead of conventional insurance. If the healthy opt out of the regular system, the cost of comprehensive policies will rise.
The Bush plan is similar to both Democrats' in that it avoids a role for government on the scale sought by Bill Clinton in 1994. There is no attempt to control costs throughout the system, no regional insurance-buying cooperatives, and none of the bureaucracy that was essential to covering the vast majority of Americans while controlling costs.
The subsidies that Bush proposes are better than nothing, though $2,000 is far too low when family policies can cost $4,000 and up. The subsidy could be increased by Congress to provide affordable insurance for millions of people.
Millions more will remain outside the health insurance system as long as ''individual choice'' determines coverage. Bush, soon to be the Republican presidential nominee, has yet to face up to the quandary of American health care: Improved access does not guarantee that everyone in the country will get the health insurance they need at an affordable cost.
