Bush draws backing for health-clinic proposal

ST. LOUIS - Gov. George W. Bush visited an inner-city health clinic Wednesday promising $4.3 billion to expand medical care in poor and remote areas.<br><br>One health-care advocate said the proposal to

Thursday, April 13th 2000, 12:00 am

By: News On 6

ST. LOUIS - Gov. George W. Bush visited an inner-city health clinic Wednesday promising $4.3 billion to expand medical care in poor and remote areas.

One health-care advocate said the proposal to build 1,200 new clinics around the country outdoes a similar plan that Democrat Bill Bradley pushed before leaving the presidential race.

Others cautioned that the plan, while worthwhile, doesn't address the shortage of doctors and nurses willing to work at the 3,000 existing facilities.

"Our society resolved long ago to provide a safety net for those in the most desperate circumstances - a safety net that includes income support, housing assistance and health services," Mr. Bush said after a tour of Grace Hill Family Health Clinic, which served 29,000 patients last year, nearly a third of them homeless. "My administration will work every day to extend the blessings of prosperity to all the people of our country."

Since conservatives rescued him from rival John McCain's onslaught in the GOP primaries, Mr. Bush has recast himself as the man of the middle, emphasizing programs that fit under the "compassionate conservative" flag that weds fiscal restraint to concern for the needy. In recent weeks, he has focused on education, environment and home ownership - traditionally seen as Democratic strong suits - at inner-city sites such as Grace Hill.

The theme of the current blitz is "opportunity." The opening salvo came Tuesday at a Cleveland charity, where Mr. Bush offered a $39.6 billion plan to help 18 million low-income Americans buy health insurance over five years.

As Mr. Bush pressed health care for a second day in Missouri, Vice President Al Gore continued to belittle his record back home. During a speech in Washington, Mr. Gore accused Mr. Bush of "political malpractice" in Texas, where a quarter of the population lacks insurance. Asked about the clinic expansion plan, Gore spokesman Doug Hattaway added, "How can anyone believe Bush's promises when he didn't lift a finger to improve health care in Texas?"

The core of the plan Mr. Bush unveiled Wednesday is $3.6 billion to build 1,200 community and migrant health centers across the country. An additional $500 million would be set aside for grants so that communities could establish pilot programs that address problems such as diabetes, AIDS awareness and mental illness.

The federal government now provides about $1 billion a year to fund clinics in inner-city neighborhoods and rural areas, serving 11 million patients. Care is provided regardless of ability to pay, and 4.4 million of the patients are uninsured. The clientele is mostly low-income children, Medicaid recipients, rural residents and the homeless.

Mr. Bush estimated that adding 1,200 clinics would double the number of people served, saying, "The most difficult places to build a quality health facility are the very areas where the need is greatest."

A bipartisan effort in Congress would double clinic funding to $2 billion over five years. Mr. Bradley, defeated by Mr. Gore for the Democratic nomination, wanted the funds earmarked immediately.

Daniel Hawkins Jr., vice president for federal and state affairs at the National Association of Community Health Centers, a trade group based in Washington, D.C., attended Mr. Bush's speech and graded his proposal an "A-plus-plus."

"This trumps anything," he said. "It is a bold and innovative and creative plan to get significant amounts of care out there at relatively low cost."

But pediatrician Robert Edmonds, medical director at Grace Hill and former president of the Missouri Academy of Pediatrics, said turnover is so high in many clinics that he's hard-pressed to see where all the doctors will come from.

"You have to be prepared to be overworked, underpaid and isolated," he said. "The details have to be worked out."