WASHINGTON – President Bush touted his proposals to rein in health care costs on Tuesday, portraying his election-year approach as a means to create jobs amid the Democratic clamor over disappearing jobs.
Bush also used a town-hall appearance with small business owners to put a human face on his tax cuts for the wealthiest — the area of tax policy where he differs with Democratic rival John Kerry.
In his "conversation on health care," Bush did not mention the estimated 43 million Americans who have no health coverage. He focused on business owners who struggle to provide health insurance to their workers, framing the health insurance issue primarily as one that affects unemployment.
"What we're interested in is a market working so people can hire people, that's what we want," Bush said. "That's the public policy ramification of good health care insurance."
The president surrounded himself with five small business owners, the latest in a series of "conversations" choreographed by the White House to provide a person-on-the-street echo for Bush's policies. Tuesday's event was hosted by the U.S. Chamber of Commerce (search), a group traditionally friendly to Republicans.
Each of the five described the difficulties in providing health coverage to workers, and then praised various ideas Bush has promoted for lowering the costs of health care.
"I have been a big advocate of the associated health plans," said Patty Orzano, the owner of a Seven-Eleven franchise in Massapequa, N.Y. "I implore you, Mr. President, to bang heads of those people in the Senate" to approve the plans, which allow small businesses to band together and negotiate better health-insurance rates.
Association health plans are a cornerstone of Bush's health agenda. A fierce battle in the Republican-controlled Congress has prevented lawmakers from sending Bush a bill. Many states and national insurance companies oppose them.
Sandy Calohan, the president of Carolina Paper & Builders Inc. (search), of Charlotte, N.C., said health savings accounts had sliced her monthly health premiums in half.
Bush argues that health savings accounts (search) are a good way for people to control their health care costs. The accounts, approved as part of last year's Medicare bill and offered by a growing number of insurance companies, allow people to save tax-free to pay for their routine health care needs.
Critics, including Kerry, say they primarily benefit healthy, wealthy Americans while doing little to expand coverage.
Calohan and several others in Bush's "conversation on health care" said health savings accounts had helped them keep workers on the insurance rolls.
When Bush asked Calohan whether her firm planned to hire any new workers this year, she said she hoped so.
"Me too," Bush said, alluding to unemployment — an issue on which his campaign for re-election could hinge.
More than 2 million jobs have been lost since Bush took office in January 2001.
Bush also wants to expand the number of community health centers in America, facilities that can treat people less expensively than emergency rooms; and cap at $250,000 noneconomic damages on medical liability awards (search).
After each of his five participants spoke, Bush went out of his way to note that their firms are organized as partnerships or businesses that generally don't pay corporate taxes. Income flows through the business to the partners or shareholders, who report it as individual income.
Bush has tried to portray Kerry as determined to raise taxes. Both men want to make permanent several tax cuts due to expire at the end of this year. But Kerry would roll back tax cuts for Americans who earn more than $200,000 a year.