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For Bradley, health care is at the core of his campaign, and not just because his irregular heartbeat is a reminder of his own need for regular checkups. It provides him with the opportunity to lay out a massive government enterprise, one of the "big and bold ideas" that define his image of himself as a true Democrat--truer at least than the small-stepping Gore, who wants to start reform by insuring a portion of the uninsured first, then expand the pool of those covered over five years. At every campaign stop, Bradley compares himself to Franklin Roosevelt and Lyndon Johnson, Presidents who built spacious national institutions, Social Security and Medicare, with one mighty effort. "Lyndon Johnson didn't say, 'Let's give Medicare to 20% of the elderly this year and 30% next year,'" he says.
This is the kind of talk that makes Gore wince, and not just because the big gesture is not part of his nature. Having suffered collateral damage from the collapse of the Clintons' health-care initiative six years ago, he knows something about the art of the possible. He does not believe Bradley's expensive plan can make its way through any Congress likely to emerge from the next election. And Bradley's fuzzy numbers mobilize Gore's wonkish side. For weeks he has scored heavily against Bradley in New Hampshire and Iowa by shaking his head mournfully over the most controversial part of Bradley's plan--to abolish Medicaid and then provide each former recipient with as little as $150 a month to buy insurance in the open market.
In Ottumwa, Iowa, last week, Bradley was asked about Gore's claim that the $150-a-month figure would not be enough to buy new coverage anywhere. Bradley's answer was, "The number is not the point. The point is, Do you have a goal, and do you have a plan that can get us there?" Don Kirchner, 53, a burly, bearded man with two gold hoops in his left ear, is a former mental-health worker on disability, and he wasn't buying it. "Anyone running for President who says, 'Don't worry about the numbers, trust me'--I'm sorry, I'm still skeptical."
As if to second that idea, Bill Clinton's plan last week, in its focus on enlarging existing programs, endorsed the Gore approach. A prelude to his final State of the Union address this week, the President's health-care proposal was, in size and detail, a project of the kind that lame ducks love to launch as proof that they're not dead ducks. The biggest health-care initiative since Medicare was enacted in 1965, its main elements are a $3,000 tax credit for people facing such long-term expenses as nursing-home care and a $76 billion proposal to insure 4 million parents of the children who receive health coverage under Medicaid and CHIP.
Bradley, however, has his own argument with CHIP, the central engine of Gore's plan to cover children. It manages to enroll only about 10% of the eligible children in each state. In his plan Gore would expand CHIP's eligibility standard, but he offers nothing about how to go about actually gathering in more of the eligible kids. And while Gore claims that extending coverage to children is merely the first step in a larger campaign for universal coverage, Bradley likes to make clear that Gore's 10-year budget proposal contains not a penny for taking that second step.