care for all proposed
By Ricardo Alonso-Zaldivar, Staff Writer
Los Angeles Times
Thursday, December 14, 2006
WASHINGTON -- A prominent Democratic senator unveiled an
ambitious proposal today to provide health insurance for all
Americans, while reining in rapid healthcare inflation that
threatens benefits for millions of workers and their
The plan by Sen. Ron Wyden (D-Ore.) comes a month after the
health insurance industry offered its own comprehensive
proposal and signals a growing willingness by politicians to
tackle a subject that has been off limits since the
mid-1990s collapse of then-President Bill Clinton's sweeping
health reform package.
Considered liberal on social issues and moderate on economic
policy, Wyden combined elements of reforms that have been
proposed by Democrats and Republicans.
His plan would guarantee coverage for all, including nearly
47 million uninsured, a Democratic objective. But it would
also limit employers' exposure to relentless cost increases
and encourage workers to shop for cost-effective insurance
plans — ideas that have Republican support.
"I think the country wants healthcare fixed," Wyden said at
a briefing for reporters earlier this week. "It's possible
to get good quality, affordable, universal private health
coverage that can never be taken away for the amount of
money that is spent today."
Wyden is a member of two Senate panels that are heavily
involved in healthcare, the Finance and Budget committees.
Americans spend more than $2 trillion a year on healthcare,
more on a per-person basis than any other country. But the
returns on that investment are uneven, with many insured
patients getting less than optimal care and millions of
workers unable to afford health coverage, which costs about
$12,000 to $13,000 a year for a family plan.
Employers have traditionally provided coverage for workers
and their families. Although most workers are still insured
through their jobs, corporate leaders are increasingly
questioning whether the system can be sustained in an era of
Wyden's plan would require employers to continue
contributing toward the cost of health coverage, but it
would get them out of the business of directly providing
insurance and limit their exposure to double-digit annual
In the first two years of the plan, employers who now
provide coverage would be required to directly pay workers
what they were spending on insurance. Thereafter, most
companies would pay the government a healthcare contribution
that resembles a payroll tax.
Using the money from their employer, individuals would be
required to purchase a private insurance policy through a
purchasing pool in their state. Benefits would be keyed to
the Blue Cross Blue Shield Standard Plan available to
federal workers. Workers would not have to pay higher
income taxes because of the employer contribution.
The uninsured would also have to buy coverage, but premiums
for the poor would be fully subsidized by the government.
Middle-class families with incomes up to $80,000 for a
family of four would be eligible for help on a sliding
Premiums from individuals and contributions from employers
would be collected by the government through the tax system
and distributed to insurers. Once enrolled, individuals
would be covered until retirement. Seniors in the Medicare
program would not have to make any changes.
An economic analysis of the plan by the Lewin Group
consulting firm found it could be paid for with a little
less than what the nation now spends on healthcare. In
theory, the plan would hold down healthcare inflation
because individuals would have to pay more out of their own
pockets for plans with lavish benefits.
Wyden's proposal — spelled out in a 166-page bill that he
plans to introduce soon — is complex and such changes are
not likely to be easily enacted. Most experts believe major
healthcare reform will only be possible if a presidential
candidate is elected with a mandate to tackle the problem.
Nonetheless, Wyden won compliments for taking on a tough
"We are very supportive of the goals Sen. Wyden has
established," said Ron Pollack, executive director of
Families USA, a liberal advocacy group that will play a key
role on health policy in the Democratic-led Congress. But
he called the plan "a first step" and "a work in progress."
At the Committee for Economic Development, an organization
of CEOs from major companies, senior economist Joseph
Minarik said Wyden's plan sounds like "a first or second
cousin" to ideas the organization is considering in
formulating its own proposal that will be announced next
"The story overall is that people are beginning to come to
the conclusion that the employer-based health insurance
system is very vulnerable," Minarik said.