ABOUT 30 years ago, when a proposal called Medicare was being developed, a corporate spokesman named Ronald Reagan coined the phrase "socialized medicine" in an attempt to discredit the plan. Ever since, American health-care reform has been held hostage to that argument. He didn't stop Medicare, which became a vital part of the safety net for America's elderly. But the old scare tactic still stalks the debate.
When George Bush finally issued a health-care proposal last month, he conceded the central point of health-care reform - that it is a right of all Americans, not a privilege for the well-heeled or safely employed. But he couldn't resist invoking the echo of that tired argument.
Time passed him by. Americans from every walk of life today, executives and line workers alike, agree. The debate about health care is no longer about "socialized medicine" versus the illusion of a perfect free-market system. The debate today is about how well a plan meets a pressing national need. It's about controlling our skyrocketing medical bills and providing quality, affordable health care to all.
Judged by that standard, the president's plan is woefully inadequate. It is not a serious effort.
Over the last few months I have asked Americans across the nation what they want from a health-care system. I heard the same response over and over. Americans want affordable, quality care that's there when it's needed. They want reliability. They want peace of mind. They don't want a system that makes them wonder if their child's illness will make the family uninsurable, if the loss of a job takes with it health coverage, or if an illness or accident will devastate them with unexpected bills.
American health costs today aren't affordable. A dozen years ago, Americans spent $2,600 per family per year on health care. In 1991, they spent $6,500 per family per year. The Bush administration projects it could reach $14,000 by the end of the decade.
The national health bill is staggering. Last year, America spent $738 billion on health care. This year, it's estimated we'll spend over $817 billion.
We're spending more than any other developed country and getting less affordable care, less preventive care, less access to care, and less coverage. If any other economic sector devoured as many resources, produced as uneven an outcome, and threatened as great an inflation rate, it would be in for immediate overhaul.
For three years, President Bush ignored these obvious problems. He said health-care reform could wait. Now, under election-year pressure, he's changed his tune. He has come forward with a proposal. But his plan fails the test of real reform. It doesn't control costs and doesn't give all Americans access to care.
The president would give middle-income families earning from $23,000 to $50,000 a year a health-care tax deduction worth a maximum of $563. That's less than one-tenth of the $6,500 average annual cost of health care for a family of four. That's his plan for middle-income families.
The president suggests that for low-income people, the money to pay for health care could come out of Medicare, which provides health care to the elderly. In essence, this pits senior citizens against the uninsured. That's both insensitive and irresponsible. The elderly need quality care, and long-term care.
The president says costs can be reined in with medical liability reform and increased reliance on managed care. Few experts share that belief. Liability insurance doesn't by itself drive health costs. Managed care can't by itself control health-cost inflation.
Bush says he's against regulating the health-insurance system, but says his plan will stop the denial of insurance to those with preexisting medical conditions. But denial of health insurance occurs not just from outright refusal to insure at any cost, it also occurs because people are priced out by sky-high premiums. How does he plan to stop this without regulating insurance coverage, assigning people to risk pools, or setting premium rates? The answer is he can't. So the argument about regulation is as
phony as the argument about socialized medicine.
The president's plan won't control rising health-insurance costs or ensure that all Americans can obtain affordable coverage. Instead, it exacerbates the current system's failings, only throwing more dollars at the problem. It's hard to avoid the conclusion that the Bush proposal is political, not practical.
The American people deserve better. Along with other Senate Democrats, I have introduced HealthAmerica, a plan for systemic and comprehensive health-care reform. It's an approach that builds on our tradition of free choice of doctors and employer-based insurance, but plugs the gaps in that system.
Most importantly, this approach meets the test of real health-care reform. It controls runaway health-care costs and gives all Americans access to quality, affordable care. Our plan is designed to buy more health care at the same cost.
HealthAmerica will assure every American basic health coverage, either through employer-provided insurance or a federal-state insurance program. It will establish an independent agency, the Federal Health Expenditure Board, to set overall national health spending targets. Within those targets, purchasers and providers of health care will negotiate to set payment rates to providers.
Our plan will ensure coverage of preexisting conditions and place limits on annual increases in premium costs. And it will reduce the paperwork costs of the duplicative insurance system in place today.
HealthAmerica will ensure peace of mind for American families by eliminating the financial fear of care. That's the central issue. Parents should know that if their child becomes ill, the cost of care won't be an added stress. Spouses shouldn't have to worry that a heart condition or a tumor will spell financial disaster. Today, too many families aren't certain if their insurance will cover all the care they might need, or if a serious illness or pink slip makes them uninsurable.
For all the money we as a nation spend on health care, we're getting the worst of bargains. We have a system that distorts economic choices and efficiencies at virtually every turn. It fails to provide Americans with the care they need, the peace of mind they want, at a cost they can afford.
The president's plan will maintain the status quo, and just throw more money at it. Democrats prefer change. HealthAmerica does so. It's the better way to go.