HEALTH CARE: PAYING FOR REFORM

October 22, 1992

Both Gov. Bill Clinton and President Bush have plans to expand access to health care for the poor, the uninsured, and the underinsured. Health-care spending is already more than $800 billion a year - 13 percent of the American economy - and growing. Neither candidate has been very specific about how to pay for his program. Ross Perot has not even outlined goals for health-care reform. BUSH

His plan for expanding access to health care would grant tax credits of up to $3,750 a year for poor families to spend as health-insurance vouchers. More affluent families would get tax deductions up to the same amount, which could cut their actual tax bill by about $1,000. The White House estimates the cost to the US Treasury of this plan at about $20 billion a year. Outside economists estimate a higher cost, and Governor Clinton's advisers peg it at $36 billion.

Under the existing system, however, state and federal governments pay about $27 billion a year to hospitals for caring for the uninsured, according to the White House. The Bush plan

proposes to divert that money - and other savings and efficiencies - into the tax credits that would finance better and cheaper care for some people. CLINTON

Most of the cost of his plan will be borne by businesses, which will be required to insure their employees. Some new costs will be a responsibility of the government, however.

To start, Clinton promises a tax credit to businesses that "need help" to cover premium costs. The government will sponsor purchasing groups to buy private insurance for people without employers or for employers unable to find competitive insurance policies.

The Clinton campaign has not specified exactly how businesses would pay for the publicly sponsored policies. The Bush campaign has argued that it would require a payroll tax of at least 7 percent.

The unemployed would pay according to their income. Clinton has not specified how that cost would be covered. Like the Bush plan, the Clinton plan counts on savings from efficiencies and use of preventative care. PEROT

No specific plans outlined to pay for any reform proposals.