• More Blogs
• Observations »
• Bering in Mind »
• Cross-check »
• Extinction Countdown »
• Solar at Home »
• Expeditions »
• Guest Blog »
• Anecdotes from the Archive »

SEATTLE -- If the U.S. wants real health care reform, it needs to make sure everyone is covered. The way to pay for that coverage? Limiting the tax-exempt status of health insurance premiums, Sen. Ron Wyden (D-Ore.) said yesterday at the annual meeting of the Association of Health Care Journalists.

Wyden's Healthy Americans Act -- co-sponsored with Republican Robert Bennett of Utah -- would require all Americans except those covered by Medicare or in the military to buy a health insurance policy. (The Wall Street Journal's Gerald Seib has an excellent summary of the bill here; you can see Wyden discuss the plan here and read the full text here.)

Here are the basics: The government would pay the costs for those at or below the poverty line, and that subsidy would decrease as a family's income increased. Employers would still be welcome to provide coverage, but if they didn't, each employee would get a check for the amount that coverage his or her coverage would cost. But as the WSJ's Seib points out, employers "would pay a fee -- a tax, really -- for each employee to help fund those federal subsidies to help families buy their policies."

How those numbers work out, and just what percentage of this insurance "rebate" check would be taxable for the employees who got them, remains to be seen, particularly as Congressional committee members mark up the bill and make changes. But Wyden is convinced that whatever health care reform costs, it will pay for itself. And the Congressional Budget Office (CBO) agrees with him -- to a point. They'll "score" some of the cost savings he's claiming for his bill, but not others, particularly those directed at prevention -- eg lowering cholesterol and blood pressure. Overall, however, the CBO says the proposal will in fact pay for itself.

For his part, Wyden is optimistic that the time is right for real health care reform. The history of health care in the U.S. is "a story of unrequited love for health care reformers," Wyden said. But despite the fact that the last major reform effort -- the Clinton plan in 1993 -- was a complete failure, he said there are reasons for hope.

Chief among them? The fact that health care is consuming such a large percentage of the GDP creates pressure to bring down costs, especially during the economic meltdown. "Fixing health care and fixing the economy are not only not mutually exclusive, they go hand in hand," he said.

The U.S. spends enough on health care -- $2.5 trillion per year -- he says, but it spends it in the wrong places. The CBO says current health care spending could pay for one doctor for every seven U.S. families, Wyden notes. But many remain uninsured, while others get care they may not need or is too expensive. "We can't fix the economy without fixing health care," Wyden said. "The middle class can't get ahead because their wages are gobbled up by health care."

Wyden also says the time is right because "there has never been the opportunity for bipartisanship that there is today." He notes that the Wyden-Bennett measure is the first time in history so many Senators from both sides of aisle have signed onto a bill.

Health care reform is not Wyden's first foray into medical issues. In 2005, Wyden threatened a Senate filibuster over the Terri Schiavo case, because he was concerned about the integrity of Oregon's death with dignity law.

Bonus: Fun facts about Wyden: His wife owns The Strand bookstore in New York. The couple introduced former CBO director Peter Orzsag (now White House budget director) to his current girlfriend (thanks, @jcohntnr).

photo of Sen. Wyden copyright Scientific American

5 Comments

1. 1. seeqer 08:03 AM 4/19/09

   I'm as concerned about health care as the next guy. I do believe that we should have some kind of national health care. This guy's plan seems plausible at first glance. However, I have a question. In what universe is this a science story and not a political story?

   Reply | Report Abuse | Link to this

2. 2. Prototerm 09:36 AM 4/19/09

   So, let me get this straight. Wyden's plan to fix the health care system isn't to reduce the cost of it (the real problem), but to force the millions of people who cannot afford coverage to buy it anyway. Because, make no mistake, it isn't just the people below the poverty line who find health insurance out of reach. Many of the people who are struggling with this issue are in the Middle Class!
   Hey, if this is such a good idea, why not pass a law requiring everyone in the country to own at least one GM car as a way to solve *that* problem as well?
   
   No, Health Care reform has to begin with reducing cost, not some lame shell game that merely moves that cost from one pocket to another. For a starter, find a way to fix the whole medical malpractice issue, to reduce a doctor's insurance costs. But, gee, that would impact both the insurance industry (malpractice insurance premiums) and (if lawsuits were reduced as well) lawyers' fees. Can't have *that* happen, now can we? It's better to maintain the status quo, using sleight-of-hand to make people *think* things have changed.

   Reply | Report Abuse | Link to this

3. 3. rukidn 08:28 PM 4/19/09

   I'm still hoping that we won't accept mandatory insurance in place of universal healthcare. Where is the incentive for providers or Insurance companies to reduce cost, if the government is going to force everyone to
   buy the product?? The article made one good point, for only 3 billion dollars we could hire enough doctors to have one for every seven people in the country. So then, how much to build and staff the clinics to put them in? Do we really need a bunch of rules on income and paper work to fill out to see who the government will cover. I can see that costing as much to process as if we just said walk in and we'll treat you. How much could hospitals reduce what they charge if they knew they would get something for everything they did? (ie. The government simply paid for the staff and supplies) I don't like this idea!

   Reply | Report Abuse | Link to this

4. 4. wfitz1964 03:27 PM 4/20/09

   Insurance mandes have been done in Mass. Health insurance prieums are still around the same cost. I think there needs to be private plans as well as a public plan. The public plan would put pressure on public insurance plans. Right now there is no form of open compition in public insurance you either get insurance from your employer or you attemp to purchase insurance from open market. If your health in good you can get coverage if not you are discriminated agaist as having a pre-esiting condition and any coverage you can get is very limited.
   I also feel there has to be cost control in health care indusrty and private insurance. This will not be popular with anyone but it will reduce costs. I feel he is right that there has to coverage for every one and it should be manitory. My wory is if you simply handed some one a check and say buy insurance would any one realy do it ? Most would but some would not . I don't think that is such a good idea. What should be health credits that you can purchase thru a government run clearing house that offers public and private plans that have set deductable and procedures and all plans must offer a core set of service covered. This would improve things. This is basicaly like medicare which has part A part b part c , d and son one part A & cover hospital doctor but the rest like part is is private plans that cover meds and other items not part of a public plan. This would allow private insurace to esit with out the need for underwriting . It would make health insure a no fault and not have to have a need for risk mangement and aviodece like the private plans of today.

   Reply | Report Abuse | Link to this

5. 5. HIDQ64 07:13 PM 4/20/09

   Better health care brought to us by the same people that did not recognize the financial breakdown till 15 months ago! Now they have financial and medical smarts after change in presidential office. May GOD have mercy on our wonderful nation!!

   Reply | Report Abuse | Link to this