Vice President Al Gore called for tapping the growing budget surplus to quickly create a new Medicare prescription-drug benefit and to restore some payments to health providers that were cut in the White House's 1997 balanced-budget deal with Congress.

On the second day of a cross-country "prosperity tour" to claim some credit for the booming economy as he runs for president, Mr. Gore began explaining how record federal revenues may be used to pay for a key part of his domestic agenda, expanding health care. Rural and teaching hospitals, home health agencies, and nursing homes - all of which had government medical payments cut under the balanced-budget deal - all should get more money in the future from the rising surplus, he said.

Mr. Gore didn't detail the extent of these so-called givebacks to health providers; aides said he'd wait until the new budget estimates are completed and released this summer. The cuts themselves were to have totaled $105 billion over five years, but many health-care officials say they were much higher.

The rising tide of black ink also would enable him to implement his proposed prescription-drug benefit in 2002, instead of 2006 as earlier contemplated, and to avoid charging an additional premium for the catastrophic benefit intended to cover all of a beneficiary's out-of-pocket costs beyond $4,000. Without mentioning George W. Bush, who holds a slight lead in the polls, Mr. Gore derided the GOP's approach to prescription-drug benefits during congressional debates as "a placebo".

In response to a skeptical audience member at a rehabilitation hospital here, Mr. Gore defended his plan for a "lock box" to safeguard surging Medicare revenues, citing "legal requirements " that the money be used only for Medicare, and his plan to pay off all the government's publically held debt by 2012. Mr. Gore also proposes to create a new "Health Care Trust Fund" to protect initiatives he has proposed to extended health coverage to children, working parents, small business owners, and the self-employed.

House Republican leaders are planning to endorse the Medicare lock-box concept as early as today. The idea is politically popular, but Republicans are loath to give credit to the vice president. "We've been talking about this for months", said Rep. Bill Thomas of California, the GOP's point man on Medicare and prescription drugs.

Republicans privately admit they botched the issue by not offering it first. As a result, they are scrambling to one-up Mr. Gore by demanding that $40 billion of general revenue surplus be "locked-up" for a new prescription-drug benefit.

Although Mr. Gore is advanced in his medical care views compared to some congressional Republicans, Mr. Bush, by contrast, seems to be advancing more rapidly in his understanding of the medical care crisis in America today.

Mr. Gore does not offer to restore funds taken away from the Medicare Trust Fund since 1997, funds that were originally obtained from the Medicare payroll tax, and that have been used by the Clinton Treasury Department to pay off wealthy owners of government bonds while leaving Medicare unfunded for future care. Mr. Gore merely proposes to not continue to take more of such funds.

Mr. Gore says he wants to "expand health care", and certainly over 40 million Americans have no coverage at all at present, but 160 million "covered" Americans also need "improved health care", including better funding for treatment programs as well as for screening and prevention programs.

Mr. Gore hopes to begin his prescription-drug program in 2002, rather than 2006, but assistance in obtaining neccessary prescribed drugs is needed NOW (in 2000), not 2001, 2002, 2006, or whenever.

Patients whose necessary medicine costs more than $4,000 per year, should have all their medicine costs met by Medicare, and certainly without an additional premium, since such patients will already be responsible for the first $4,000 of the cost of their needed medicines. In fact, medicines needed by Medicare patients should NOT cost Medicare patients ANY additional premiums AT ALL.

An audience has a right to be skeptical concerning Mr. Gore's plans for a "lockbox" on The Medicare Trust Fund, in view of the still-current raids on The Medicare Trust Fund and The Social Security Trust Fund by the Clinton Treasury Department.

Mr. Gore's plans to pay off the National Debt are merely plans to pay off wealthy bond owners, and will in reality deny neccessary current funding for medical programs needed by the American people.

Mr. Gore's plans for "new trusts" in Education, Health Care, and the Environment are ominous in view of the reckless plunder of the existing Medicare Trust Fund and Social Security Trust Fund.

Admittedly, most congressional Republicans are still clueless in these matters, but Mr. Bush seems to be awakening to these real issues for America, and it is Mr. Bush that Mr. Gore will have to vanquish or be cast aside. Mr. Gore has certainly no need to defend the Clinton Treasury Department.

1. "Social Security Trust Fund Used to Reduce National Debt".

2. "Bush and Gore on the Future of Social Security and Medicare".

3. "Gore's Plans for Medicare and Social Security Trust Funds".

4. Wall Street Journal on the Social Security Trust Fund.

clinicalfreedom: "the ability of the patient and the physician to do all that is medically necessary without interference".