Clinton, Dole Steer Clear Of Issues That Matter For Fear Of Backlash Clinton Remembers Health Care Fiasco; Gop Hurt On Medicare

When it comes to the big issues of campaign ‘96, it is what Bill Clinton and Bob Dole do not say that may matter most.

They both love to talk issues - but safe issues, their issues. Like tax cuts. Anybody want a tax cut? Clinton and Dole both push tax cuts. They both are big on children, the family and the American dream, too.

But here are some things you don’t hear either major candidate for president saying much about:

The Medicare trust fund that insures health care for the elderly will go broke in five years unless the next president and Congress fix it.

Some 40 million Americans have no health insurance, and the health-care safety net they turn to in emergencies is under growing strain.

Political campaigns are awash in contributions from special-interest groups, fueling widespread public cynicism that politics is corrupt.

Benefit checks to retirees will begin draining Social Security trust funds in 16 years unless that system is reformed, and experts agree that the sooner a fix is made, the less disruptive to Social Security it will be.

Clinton and Dole are both fully aware of these problems. They both know that whoever is elected president Nov. 5 almost certainly will have to deal with them. And they both have official “positions” on these questions, which effectively boil down to “elect me now and I’ll get to it later.”

But neither man is using his campaign to educate the voters about these problems. Neither is outlining proposed solutions and seeking a mandate from the people to pursue them.

“Neither candidate wants to face the American public with the reality of what will be needed in the next decade,” said economist Robert Reischauer, former director of the Congressional Budget Office. “It’s not the road to the White House.”

To be sure, maverick candidate Ross Perot highlights several of these issues - especially the need to reform campaign finance, Medicare and Social Security. He is loud on decrying these problems but quieter on specific reforms. But thus far, his candidacy has not forced Clinton or Dole to pay more attention to the problems.

“We have a very dispiriting public dialogue,” comments James S. Fishkin, a professor of government at the University of Texas. “Issues like Social Security are going to confront the country after the election, but nobody wants to talk about it because look at what happened to the Republicans on Medicare.”

Last year the GOP Congress proposed to cure Medicare’s looming financial shortfall by cutting the growth of its projected costs; Medicare expenditures still would have risen over time, but more slowly than under current law.

President Clinton led Democrats in denouncing the GOP plan as a savage attack on Medicare. That helped put them back on top of the polls, but it leaves Medicare still facing a crisis.

“You might argue that the Republicans stuck their necks out on Medicare and took a beating for it, and that Clinton stuck his neck out on health-care reform (in 1993-94) and took a beating,” Fishkin said. “They both attempted to exercise leadership and found out how hard it is.”

Chastened by defeat, now both Clinton and Dole play it safe.

“I don’t think they are addressing the issues that count because they are afraid of a backlash,” said Connie Slaten, 48, a bank employee from Hastings, Minn. “People are running on the issues that will get them elected, instead of the things that will help them do a good job of governing.”

The problem, Fishkin said, is the way modern presidential campaigns have evolved, and “it doesn’t matter who the candidate is.” The primary system, television, big money, campaign consultants, the media and other forces combine to push candidates away from open, honest debate on complex questions for fear of getting blasted in hyperbolic attack ads.

But ducking the big questions during campaigns often makes it harder to resolve them later, because public opinion has not been prepared.

“We learned in ‘94 that if you try to get reform of a complicated system without being informed of what the public is willing to accept, there’s going to be a big problem,” said Stephen Zuckerman, director of the Urban Institute Health Policy Center, referring to Clinton’s failed health-reform plan.

What follows are capsule reviews of several big challenges that will face the next president:

Medicare

The $179 billion-a-year health-care program for 33 million elderly and 4 million disabled people is in serious trouble. Its hospital trust fund is projected to go broke early in 2001.

The basic dilemma: The program’s costs keep growing faster than its income from wage taxes.

Dole backs a GOP Congress proposal to trim about $170 billion from projected Medicare expenses over six years. Clinton proposes about $100 billion in similar trims. But neither plan would buy more than a few more years of solvency for Medicare.

According to the Congressional Budget Office, a long-term fix for Medicare would require an overhaul. Beneficiaries would get a voucher or credit for buying into a private insurance plan. Most people would go into managed-care plans. Out-of-pocket costs would increase for many.

Social Security

Like Medicare, Social Security’s problem is that the system’s income from wage taxes isn’t keeping pace with the growth in benefits.

But Social Security doesn’t become critical until 2012, when the youngest of 78 million baby boomers begin to retire. That’s the first year payroll tax revenues won’t cover benefits. For now, Social Security still runs a surplus.

The delay makes it easy for politicians to put off action. Neither Clinton nor Dole has said much about Social Security, other than general pledges of support for the program.

The case for dealing with Social Security sooner rather than later rests on fairness. Retirement planning is a multiyear process; any changes in the rules should be made well in advance. Also, acting now would allow a more even distribution of sacrifices among generations. Putting off action lets current beneficiaries off the hook.

Health insurance

Clinton’s ambitious 1993-94 plan to provide health insurance for all Americans was a political disaster. He was tarred as a big-government liberal, an attack line that helped Republicans take control of Congress for the first time in 40 years.

No wonder no politician backs such a plan this year.

Meanwhile, 40 million Americans remain without health insurance and “the problem could be getting worse,” said Zuckerman of the Urban Institute.

Private insurers working through managed-care plans are squeezing payments to doctors and hospitals. That restrains health-care providers’ ability to subsidize the uninsured with medical services that they have paid for, until now, with higher fees to the insured.

Clinton recently said he would appoint a commission to study how managed-care insurance plans are affecting the quality of health care, but for now he proposes nothing. Dole offers no plan for people lacking health insurance.

Campaign finance

By some estimates, candidates for federal office will spend up to $600 million on campaigns this year. Most of the money comes from special interests hoping to buy at least a hearing, if not a favor, from the government.

Polls show most people believe this corrupts American democracy.

Clinton and Dole both have called occasionally for an independent commission to recommend campaignfinance reforms, but none exists, and neither man has worked hard to create one. Instead both rake in all the money they can get, like most other candidates in both parties.

“It’s a tough issue for them because both campaigns are up to their eyeballs in the money-and-politics muck,” said Ellen Miller, director of the Center for Responsive Politics.