Pivotal Elections

As we move into the final few days of this very long election campaign, I think back to my days of both working in and reporting on presidential campaigns.

My most memorable moment was in the last days of the 1980 race between then President Jimmy Carter and Republican nominee Ronald Reagan.

The U.S. hostages were still being held in Iran, the country was stuck in an economic malaise, and the Soviet empire was on the rise. That, too, was an enormously consequential election.

I was assigned by my editors from the San Diego Union to cover the Carter campaign. The traveling press corps was virtually living on the plane, traveling almost around the clock.

In the last few days, Reagan was gaining traction in advancing his positive message of hope and economic renewal– with a specific proposal of a 30 percent across-the-board cut in income tax rates.

Reagan’s message clearly was hitting home, as Carter and his advisors must have been seeing in their overnight polling.

Early one morning the weekend before the election, Carter came down the stairs of Air Force One to give a speech that was virtually a rant. I need to go to the Carter library to find the transcript, but his speech is burned into my mind and went something like this:

“The Republicans are supposed to be the party that focuses on keeping a careful watch on federal spending and that raises taxes to keep the budget in check,” Carter said. “What is going on here with a Republican now calling for tax cuts? They are not playing by the rules!” He couldn’t believe that Ronald Reagan was turning the tables on the traditional roles of the two parties in Washington – i.e., Republicans tax and Democrats spend.

Carter was furious. But his advisers calmed him down, and he changed his message in his speeches the rest of the day, basically reverting to his typical campaign themes.

I knew that I had not only the story of the day, but perhaps the story of the decade. If Reagan won, the rules of politics would be changed for good in Washington.

I wrote the story and sent it to my editors that night. (That was the day when we had just one news cycle a day, amazing as it may seem.) “Where did you get this?” they asked. “That’s not the story that The New York Times is writing.”

“Then The New York Times is missing the story,” I told them. I refused to budge and so did they. I said that my story was the one I was reporting. If they wanted another story, they should run what the Times reporter wrote. Which they did.

That was the beginning of the end of my journalism career. When I realized that I couldn’t write what I saw and what I knew was news because it wasn’t politically correct, it was time to move into another career, which I did. It’s hard to explain how lonely it was then to be a journalist seeing the world through the prism of free markets and economic growth.

I have lost my notes and that article I wrote in early November of 1980, but the memory of that day is forever embedded in my mind. It truly was a pivotal moment in American politics. And the rest, of course, is history.

The current election also is very consequential, with two very different visions of the future, especially in health care.

The president wants to cultivate an ownership society with new subsidies and new options for people to buy private health insurance. Sen. Kerry would add millions more Americans to the rolls of government-run entitlement programs and underpin job-based coverage.

Tying health insurance to the workplace is out of step with the economy. Using billions of dollars in taxpayer money to patch together a system that was adequate, at best, for the last century looks to the past.

But allowing more individual ownership of health insurance looks to the future of a mobile, flexible workforce and allows competition to expand choices and lower costs.

The health care plans of the two candidates offer a clear choice. Be sure your voice is heard on November 2.

Grace-Marie Turner


  • Health Savings Accounts in the news
  • Health care policies could be a bonanza for Iowa
  • High prices
  • Blame Congress
  • Kerry win: Bad medicine for health care
  • New survey finds Medicare critics scaring millions away from prescription drug benefits


It’s open enrollment season again, and many workers are making decisions about their health insurance for next year. Below you will find links to four pieces that explain how Health Savings Accounts (HSAs) work and why they can be beneficial.

The Washington Post ran two detailed articles on Tuesday that gave federal workers an overview of the new HSA option they will have next year.

USA Today featured a basically favorable editorial this week saying, “While HSAs are no cure-all for the crisis in health care, they could make consumers more cost-conscious and reduce premiums, making insurance more affordable for the 45 million people who lack coverage.”

And finally, Robert Helms of the American Enterprise Institute describes the benefits of consumer involvement and HSAs in the New Jersey Star Ledger. “There is a simple logic behind HSAs that is supported by volumes of empirical research–consumers will be more careful in spending their own money than they would be spending someone else’s money,” writes Helms. “They will begin to demand more information about the comparative costs and quality of the providers and treatments–the kind of information that is extremely difficult to get in the present market. Rather than focusing solely on lower costs, consumers will seek the best value for their money.”

Washington Post articles: www.washingtonpost.com/wp-dyn/articles/A62492-2004Oct25.html, www.washingtonpost.com/wp-dyn/articles/A62631-2004Oct25.html

USA Today editorial: www.usatoday.com/news/opinion/2004-10-25-health-coverage_x.htm

Helms in the Star Ledger: www.aei.org/news/filter.all,newsID.21441/news_detail.asp


Authors: Newt Gingrich and Vince Haley

Source: Des Moines Register, 10/25/04

Newt Gingrich and Vince Haley of the Center for Health Transformation write that President Bush’s proposal for a national health insurance market “will make Iowa the biggest winner of any state in terms of generating jobs and growing the Iowa economy.” A Zogby poll conducted for the Council for Affordable Health Insurance last month found that 72% of those polled supported allowing someone living in one state to purchase health insurance from another state if the insurance is state-regulated and approved. According to a report by eHealthInsurance, average health insurance premiums for single policies are the lowest in Iowa among the 43 states included in their study. “By making it possible for residents in states with high insurance costs such as New York, New Jersey and Minnesota to buy health policies in Iowa, the state will attract an enormous amount of new insurance business because it has among the lowest average health-insurance costs for individual policies,” write Gingrich and Haley.

Full text: desmoinesregister.com

eHealthInsurance report: images.ehealthinsurance.com/


Author: Malcolm Gladwell

Source: The New Yorker, 10/18/04

“The problem with the way we think about prescription drugs begins with a basic misunderstanding about drug prices,” writes Malcolm Gladwell, staff writer for The New Yorker, in a refreshingly insightful look at the economics of the pharmaceutical industry. Gladwell argues that “volume matters more than price” and comments that “drug expenditures are rising rapidly in the United States not so much because we’re being charged more for prescription drugs but because more people are taking more medications in more expensive combinations.” He notes that the U.S. has a different pricing system than other countries and writes, “Because there are so many companies in the United States that step in to make drugs once their patents expire, and because the price competition among those firms is so fierce, generic drugs here are among the cheapest in the world.” Gladwell also examines the role of me-too drugs and Pharmacy Benefit Managers under the new Medicare legislation. The resulting discounts “could be considerable,” writes Gladwell. He criticizes Marcia Angell’s book about the drug industry and concludes, “Angell appears to understand none of this.”

Full text: www.newyorker.com/critics/atlarge/?041025crat_atlarge


Author: Robert Goldberg, Ph.D.

Source: New York Post, 10/22/04

Senator John Kerry blames President Bush for the flu vaccine shortage, but the crisis is actually the result of price controls imposed by the Vaccines for Children Program (VFC), writes Bob Goldberg of the Manhattan Institute. Established by the Clinton administration and a Democratic Congress in 1994, the VFC “federalized much of the once-private U.S. market for vaccines.” Goldberg writes, “Faced with government-set low prices – and with development and production costs soaring thanks to frivolous lawsuits, other new regulations and the need to invest in new technology – companies have been pulling out of the vaccine business in droves.” There were 30 pediatric vaccine producers twenty years ago; today, there are only three. There were four flu vaccine makers in the U.S. in 2001; today’s there’s only one. “Until investors and vaccine makers have confidence that there is a private market for their products and they are protected from crazy lawsuits, the shortages will endure and new vaccine production will lag behind the science,” Goldberg concludes.

Full text: medicalprogresstoday.com/

More on vaccines from NCPA: www.ncpa.org/pub/ba/ba493/


Author: Scott Gottlieb

Source: Forbes, 10/22/04

Should Senator Kerry win the presidential election, “new heads of FDA and Medicare?will have the opening to implement Democratic policies that have been on the shelf for the last four years,” writes Scott Gottlieb of the American Enterprise Institute. Kerry advisers would likely call for comparative effectiveness trials and cost effective tests on the drug approval process, both of which would “make drug development longer and more costly and make it harder for new drugs to more quickly reach patients who need them.” A Kerry administration would also subject medical devices to “impossibly long and expensive” approval processes that “could slow innovation and adoption of new tests.” Gottlieb writes that CMS will also have the opportunity to control the cost of new medical products through “its ability to bring more new technologies up to Washington for review and pricing” but cautions that this could result in “slower access to them while Washington takes its time to reaching decisions, as well as more rules on who can get new drugs and medical devices.”

Full text: www.forbes.com


Source: Frontiers for Freedom, 10/27/04

A recent survey conducted by the polling company?, inc. for Frontiers of Freedom indicates that partisan criticism of the Medicare prescription drug benefit program has scared away as many as 4.6 million seniors from signing up for the drug discount card. “Among seniors who say they receive their information from politicians, more than half (51%) report that what they have learned has discouraged them from enrolling in the Medicare Drug Benefit program,” Frontiers of Freedom writes in a news release describing the poll results. “Setting aside those seniors who already have drug coverage, 23% of all seniors and 31% of seniors on Medicare say the ‘criticism of the Medicare Bill’ has discouraged them from enrolling in the Medicare Drug Discount card program.”

Full text: ff.org


Improving Health Care: A Dose of Competition

American Enterprise Institute Health Policy Discussion

Monday, November 8, 2004, 10:00 a.m. – 1:30 p.m.

Washington, D.C.

For additional details and RSVP information, go to: www.aei.org.

A Post-Election Prescription for Health Care 

Pacific Research Institute Event

Tuesday, November 9, 2004, 6:00 pm to 7:30 pm

The Huntington Hotel, San Francisco

For additional details and RSVP information, go to: www.pacificresearch.org/events/2004/04-nov09.html.

“Race,” Medicine, and Public Policy 

American Enterprise Institute Event

Friday, November 12, 2004, 9:00 a.m. – 12:00 p.m.

Washington, D.C.

For additional details and RSVP information, go to: www.aei.org.

Health Policy Matters is a weekly newsletter containing summaries of timely and informative studies and articles on free-market health reform. It features research and writings by participants in the Health Policy Consensus Group, articles of interest from the health policy world, and announcements of coming events. Health Policy Matters is published by the Galen Institute, a not-for-profit public policy organization specializing in information and education on health policy. For more information about the newsletter and our organization, please visit our website at http://www.galen.org/.

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