The GOP Congress' tin ear

July 16, 1999|By Jack W. Germond and Jules Witcover

WASHINGTON -- The central question in national politics today is why congressional Republicans insist on shooting themselves in the foot repeatedly.

With the GOP controlling both houses of Congress and with the likely Republican presidential nominee, Gov. George W. Bush of Texas, riding high in the opinion polls, one would think the GOP would be riding high.

Moreover, they are dealing with a lame-duck president whose personal standing with both the public and his own party has plunged after a year of scandal.

But in the debate over managed care and patients' rights, the Republicans are once again showing their special genius for projecting an image as the party whose first commitment is to corporate America. In this case, it is an image of Republicans defending health insurance companies at the expense of patients.

Polls show that Americans are not happy about their experience with managed care. Everyone has a horror story. So the market is there for a "patients' bill of rights," as both parties are calling their legislative efforts.

Given this context, it is difficult to understand why the Republicans in the Senate have chosen to be so adamant on some of the Democratic initiatives, especially those involving care of women.

With only three defections, the Republicans blocked proposals that would allow women to choose obstetrician-gynecologists as their primary care physicians and would give physicians rather than the HMOs or insurance companies final authority on patient care. The latter was aimed at allowing physicians to extend the hospital stay of women who undergo mastectomy.

These remedies already are provided in some states, and they are not needed in every managed care situation by any means. But the Republicans are clearly inviting a backlash from women by arguing, for example, that they support a grievance procedure patients can use when their physicians are overruled. What they don't point out is that the patients would have to pay for an appeal and might confront an appeals panel dominated by the insurance companies.

Ironically, this GOP stance comes at a time when polls show there's no longer a "gender gap" of women favoring Democrats in the likely presidential race of Texas Gov. George W. Bush and Vice President Al Gore.

For Republican leaders in Congress, the answer to everything seems to be their plan for some $850 billion in tax cuts over 10 years. By contrast, President Clinton is proposing only $250 million in tax cuts and a healthy contribution to shoring up the popular Medicare program.

But the Republicans are vulnerable on the tax issue in two ways. First, as the Democrats are already pointing out, most of the benefits would be realized by taxpayers earning more than $100,000 a year. There would be no cut in the payroll taxes that are the principal burden for most taxpayers.

Beyond that, however, the Democrats are already making their case that the Republicans want to reduce taxes at the expense of the long-term health of the Social Security and Medicare programs. The argument may not be entirely legitimate, but many voters already are prepared to believe it.

It is unreasonable, of course, to depict Republicans as uncaring about the health of their constituents. But they can't seem to avoid making themselves appear that way.

Jack W. Germond and Jules Witcover write from the Washington Bureau.

Pub Date: 7/16/99

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