On Who Will Whip Whom

Carter and Kennedy duel over competing health plans

The Congressmen could hardly believe their ears. Joining a small group of legislators attending a White House dinner, the President was asked the inevitable question about Ted Kennedy and made an altogether unexpected reply. "Excuse me, what did you say?" asked a startled William Brodhead of Michigan. "I don't think the President wants to repeat what he said," interjected a worried Toby Moffett of Connecticut. "Yes I do," said a cocky Jimmy Carter--and then stated again, loud and clear, "If Kennedy runs, I'll whip his ass."

Rather mild by Nixon-tape standards, perhaps, but coming from the "born-again" Christian from Plains, Ga., the remark touched off a furor that newspapers and TV stations had a hard time deciding how to handle (see PRESS). Far from being embarrassed, White House aides were proud of the boss's feistiness. Indeed, they encouraged Congressmen to confirm Carter's words. Kennedy roared with laughter when he heard about Carter's crack, and later joked, "I always knew the White House would stand behind me, but I didn't realize how close they would be." Funny enough, but Kennedy also said: "If I were to run, which I don't intend to, I would hope to win."

The dustup had its serious side: the increasingly acerbic Carter-Kennedy rivalry is coloring important national issues. Last week's example was the key question of how the nation can extend adequate health care to every American at something resembling an affordable cost.

Kennedy has long tried to make the issue his own by advocating a comprehensive program giving medical insurance to everyone, regardless of age, income or state of health. Carter last week struck back by describing the less comprehensive but still sweeping bill that the Administration will send to Congress shortly. Main features:

>No family with at least one member employed would have to pay more than $2,500 a year in total medical expenses. Employers would have to provide a standard package of medical-insurance benefits for workers and their families, and pay at least 75% of the cost. Employees would pay the rest, but federal subsidies of $1.6 billion would hold down premiums for both workers and bosses.

>The Federal Government would pick up all basic health costs for everyone whose income falls below a certain figure--roughly $4,200 for a family of four--and the costs of prenatal care for all mothers. The Government would pay for all care for infants in the first year of life, regardless of family income.

>Medicare for the aged and Medicaid assistance for the poor would be merged into a single, more generous "Healthcare" program; for example, no elderly person now on Medicare would have to pay more than $1,250 a year for treatment.

>Doctors' fees to Healthcare patients would be fixed by the Government. Physicians could charge other patients what they pleased, but the Administration hopes that wide publicity given to the maximum Healthcare charges would curb their other bills.

In addition to its other coverage, the Administration estimates that the plan, which would go into effect in 1983, would protect 80 million Americans who have no insurance against devastating medical costs. Price for the total package: $24.3 billion a year at first--$18.2 billion to the Government, $6.1 billion to employers.

Carter was making news, but Kennedy's shadow loomed over the occasion. The President's aides estimated that the Senator's comprehensive plan would cost a staggering $63.8 billion a year to the Government and employers, just for openers. It makes more sense, said Carter, to make a start with a less sweeping plan. HEW Secretary Joseph Califano observed that there was no more chance of getting a program like Kennedy's through Congress "than putting an elephant through a keyhole."*

Later Kennedy held a jampacked press conference to brand the President's proposal as inadequate, inflationary and dangerous. His own plan, the Senator noted, would fix doctor and hospital charges for everybody, the President's only for Healthcare patients. Thundered Kennedy: "This step is a regressive one, inconsistent with the goal of a truly single-class health care system. By failing to set a national budget, by failing to control doctors' fees in the private sector, by perpetuating two separate and unequal systems of care, the President's plan may well become the straw that breaks the back of the American health care system."

His own plan, Kennedy said, would cost Americans "only" $35.7 billion a year net; he arrived at that figure by subtracting from the federal and employer tab of $63.8 billion the sum of $28.1 billion which he claims the nation would save in medical bills. On the same basis, Carter's plan would save $6 billion, reducing its net cost to $18.3 billion. The Senator claimed that the eventual cost of the fuller scheme that the President promised to work for would be $60 billion a year.

The debate might seem like shadowboxing. Congressional leaders agree that neither Carter's nor Kennedy's plan has an elephant's chance of slipping through a Congress that is pinching pennies and looking forward nervously to the 1980 elections. At minimum, however, the Carter-Kennedy battle will keep the issue alive until the primaries begin. And if Kennedy does decide to square off against Carter, the health plan that sounds better to Democratic voters may have a say in deciding who whips whom.

* Kennedy promptly sent Califano an assemblage of a small, fuzzy pink elephant easily slipping through a keyhole in white posterboard paper. The scrawled note at the bottom: "Joe, it looks to me like it fits. Ted. June 1979."

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