Bush switches from Iraq to domestic agenda


YOUNGSTOWN, Ohio - A day after trying to rally the nation behind his Iraq policy, President Bush pivoted back to his domestic agenda yesterday, traveling to this Democratic stronghold to highlight the role of community health centers in caring for the uninsured.

In a campaign-style "conversation" at Youngstown State University, Bush promoted neighborhood clinics, a centerpiece of his health care agenda, as a primary way to expand access to medical services.

He hailed the thousands of community health centers in the country as "a safety net" that provides primary care to those without insurance. "This is access to health care in a practical way," he said.

With the number of Americans lacking insurance now at more than 43 million and rising, the twin issues of health care access and soaring costs have continued to hover as top-tier social concerns in the decade since President Clinton and now-Sen. Hillary Rodham Clinton, a New York Democrat, attempted, but failed, to restructure the health care system.

Bush's appearance here signaled that he was not about to cede the issue to Democrats during the campaign.

In a background paper, the White House noted that Bush's 2005 budget proposal contains $1.8 billion for community centers, an increase of $218 million over 2004, and a 57 percent increase since Bush took office.

The National Association of Community Health Centers, a nonprofit organization that represents the clinic network, welcomed Bush's support but said more funding is needed.

In 2002 and last year, about 1,250 clinics applied for federal funds, but only 411 applications were approved, the group said. The association reported this year that 36 million Americans lack access to basic medical care. About 3,500 community health centers across the country serve up to 13 million people, most of whom live in low-income urban neighborhoods or underserved rural areas. About 40 percent have no health insurance, and many more are underinsured and cannot afford to meet the cost of their deductibles and co-payments.

Most of the clinics, which provide primary medical care and basic dental services, receive little or no federal funding.

Since his first year in the White House, Bush has made expansion of the health-center safety net the centerpiece of his health care policy. His five-year initiative calls for 645 new health centers and 555 expanded clinics by 2006.

Administration officials say this expansion, if fully funded by Congress, would extend health care availability to an additional 6 million Americans.

Another provision of Bush's health care platform would allow small businesses to band together to buy insurance for their employees as a group, thereby qualifying for lower premiums.

Bush also has called for imposing limits on awards to victims of medical malpractice, saying that such caps would deter "junk and frivolous lawsuits," as he put it here, that he said drive up medical costs.

The Los Angeles Times is a Tribune Publishing newspaper.

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